Default Health-Care Surrogate Priority in North Carolina
At a glance
| When the default route opens | Comatose or otherwise unable to make or communicate health-care decisions (§ 90-21.13(c)). |
|---|---|
| Care or setting covered | Consent to medical treatment; the grant is framed by treatment, not a named facility (§ 90-21.13(c)). |
| Guardian or appointed agent | Guardian of person or general guardian first, subject to a valid health-care agent's granted authority; appointed agents follow (§ 90-21.13(c)(1)–(3)). |
| Family and partner order | Spouse; combined adult parents and children; adult siblings (§ 90-21.13(c)(4)–(6)). |
| Friend or other nonfamily person | Established relationship, good faith, and ability to reliably convey patient's wishes (§ 90-21.13(c)(7)). |
| Decision within one class | Majority of reasonably available adult parents and children together; then majority of reasonably available adult siblings (§ 90-21.13(c)(5)–(6)). |
| Who is available and eligible | Parents, children, and siblings must be at least 18 and reasonably available; friend must meet relationship and good-faith criteria (§ 90-21.13(c)(5)–(7)). |
| Decisions limited or excluded | Other listed statutes control on conflict; withholding life-prolonging measures without a declaration has added medical findings and concurrence requirements (§§ 90-21.13(e), 90-322(a)–(b)). |
| No surrogate or disputed authority | If no listed person is reasonably available, attending physician may treat with second-physician confirmation, except when delay would endanger life or seriously worsen condition (§ 90-21.13(c1)). |
Requirements one by one
When the default route opens
Section 90-21.13(c) authorizes another person to consent for a patient who is comatose or otherwise lacks capacity to make or communicate health-care decisions. The grant addresses medical treatment and does not name a required facility setting.
Guardian or appointed agent
The list starts with a guardian of the person or general guardian with authority over the person, but preserves a valid health-care agent's granted powers unless the clerk has suspended them. Other appointed agents follow to the extent of their granted authority. Only then does § 90-21.13(c)(4) reach the spouse.
Family and partner order
After the spouse, § 90-21.13(c)(5) puts adult parents and children into one combined group: a majority of those reasonably available may consent. A majority of reasonably available adult siblings follows under subsection (c)(6).
Friend or other nonfamily person
The final listed person under § 90-21.13(c)(7) need not have a named family relationship, but must have an established relationship, act in good faith for the patient, and reliably convey the patient's wishes.
Decisions limited or excluded
Section 90-21.13(e) makes several special provisions controlling in a conflict. For withholding or discontinuing life-prolonging measures when there is no declaration, § 90-322(a) requires a high-certainty finding that capacity will not return, one of its specified medical conditions, written confirmation by a second physician, and a life-prolonging measure. Under § 90-322(b), the attending physician directs and supervises withdrawal with the listed person's concurrence; if none is reasonably available, the physician has a separate discretionary route.
No surrogate or disputed authority
If no person in § 90-21.13(c) is reasonably available, subsection (c1) allows the attending physician to treat without surrogate consent after another physician confirms the patient's condition and treatment necessity. That second confirmation is excused when waiting would endanger life or seriously worsen the patient's condition. The section supplies this no-available-person route without a general rule for resolving a disagreement among available people.
What trips people up
Parents and children vote together under § 90-21.13(c)(5); they are not separate successive classes. The same section gives siblings their own later majority rule. The § 90-322 path for life-prolonging measures has medical prerequisites beyond ordinary treatment consent.
Common questions
Can one adult child consent when another adult child is available? Section 90-21.13(c)(5) requires a majority of reasonably available adult parents and children combined; the answer depends on that group's membership and votes.
Can a trusted person act without being family? Yes, if that person meets all three criteria in § 90-21.13(c)(7) and the earlier listed classes do not supply the decision maker.
Does the attending physician always need a second physician? The no-available-person treatment route in § 90-21.13(c1) normally requires confirmation, but excuses it if delay would endanger life or seriously worsen the condition.
Statutes and sources
- N.C. Gen. Stat. §§ 90-21.13 and 90-322. Verbatim official text, source links, and access dates appear in the source fields above.
Source links
Every statute quoted above, linked, with the date we checked it.
What does North Carolina law mean for your facts?
You just read the general rule. Ask your own question and see which parts of current North Carolina law apply to your situation, with citations you can check.
Opens in Ezel Pro.
- Starts from the statutes this survey is built on
- Cites every source it relies on, so you can verify it
- Chat, drafting and research in one workspace