In South Carolina a living will is formally a Declaration of a Desire for a Natural Death under the Death with Dignity Act, S.C. Code § 44-77-10 et seq. It directs that life-sustaining procedures be withheld or withdrawn if you have a terminal condition or are permanently unconscious, and it lets you say whether you want artificial nutrition and hydration in those situations. To be valid it must substantially follow the statutory form in § 44-77-50 and be dated and signed in the presence of a notary and two qualified witnesses (§ 44-77-40). It speaks only when you cannot; until then, you decide, and you can revoke it at any time.
What a living will does, and what it does not
The declaration covers one narrow situation: you have a terminal condition, or you are permanently unconscious, and you cannot make your own decisions. In that situation it tells your physicians not to use procedures that would only prolong the dying process. It does not cover a routine surgery, a treatable illness or a temporary coma, and it never withholds comfort care: medication and procedures to keep you comfortable continue regardless of your other choices.
It is also not a do-not-resuscitate order, and it is not a health care power of attorney. The health care power of attorney names a person to make every other medical decision and to enforce the living will if a facility hesitates. The two documents are designed to be signed together.
What the declaration can say
- Whether life-sustaining procedures such as mechanical ventilation, dialysis and cardiopulmonary resuscitation should be withheld or withdrawn once your condition is certified
- Whether artificial nutrition and hydration (feeding tubes and IV fluids) should be provided; you may answer differently for a terminal condition and for permanent unconsciousness, and the form requires a specific choice
- That comfort care and pain relief continue
- Your wishes about organ and tissue donation, which we usually also place in the health care power of attorney
Signing it so it counts
S.C. Code § 44-77-40 is strict, and a declaration that misses a requirement can be set aside at the moment it is needed. The declaration must be dated and signed by you in the presence of a notary (or another officer authorized to administer oaths) and two witnesses, one of whom may be the notary. Each witness must affirm that they:
- are not related to you by blood, marriage or adoption
- are not entitled to any portion of your estate, under your will or by intestacy, and have no claim against it
- are not directly financially responsible for your medical care
- are not your attending physician or the physician’s employee
- are not, if there is more than one such witness, employees of the health facility where you are a patient
If you sign while you are a patient in a hospital or a resident of a nursing care facility, one of the witnesses must be an ombudsman designated by the State Ombudsman in the Office of the Governor. That rule exists to protect patients, and it is why we strongly prefer to sign these documents at our office, while you are well, rather than at a bedside.
When physicians follow it
The declaration becomes operative only after your attending physician determines that you are in a terminal condition or permanently unconscious, with the concurrence of a second physician who has examined you, and only while you are unable to make decisions. A declaration has no effect during a pregnancy. Until those conditions are met, your physicians treat you normally and take direction from you or your health care agent.
Revoking it
You may revoke the declaration at any time and in any manner that shows your intent: destroying it, signing a written revocation, or simply telling your physician. A revocation is effective once it is communicated to the attending physician. A later declaration replaces an earlier one.
Living will, health care POA, DNR and POST
| Document | Who signs it | What it does |
|---|---|---|
| Living will (Declaration of a Desire for a Natural Death) | You, before a notary and two witnesses | States your own wishes about life-sustaining treatment in a terminal condition or permanent unconsciousness |
| Health care power of attorney | You, before two witnesses | Names a person to make every other medical decision and to carry out your living will |
| Do-not-resuscitate (DNR) order | Your physician | A medical order not to attempt CPR; emergency responders follow it |
| POST form (Physician Orders for Scope of Treatment) | Your physician, with you | Portable medical orders for a seriously ill patient, honored across care settings |
Where to keep it
Give copies to your health care agent, your physicians and the hospital system you use, whether that is Summerville Medical Center, Trident, Roper St. Francis or MUSC, so it is in your chart before a crisis. Keep the original with your other estate documents and tell your agent where it is. Review it after a serious diagnosis, a move from another state, or a change in the people you have named.
Speak for yourself before you can’t.
A living will and health care power of attorney take one short meeting, and they are included in every estate plan we prepare.
Questions people ask
Is a living will the same as a DNR?
No. A do-not-resuscitate order is a physician’s order about CPR in an emergency; a living will is your own statement about life-sustaining treatment in a terminal condition or permanent unconsciousness. Many people have both.
Does a living will need to be notarized in South Carolina?
Yes. The declaration must be signed in the presence of an officer authorized to administer oaths, such as a notary, and two witnesses who meet the statute’s requirements. The notary may serve as one of the witnesses.
Will paramedics follow my living will?
Emergency responders follow physician orders, such as a DNR or POST form, not a living will. The living will guides hospital decisions once your condition is assessed and certified.
Can my family override my living will?
Not legally. A valid declaration controls, and your health care agent’s job is to see that it is followed. In practice hospitals listen to families, which is why naming a strong agent and telling your family what you decided matters as much as the paper.
Does a living will from another state work in South Carolina?
Often it is honored, but South Carolina’s witness and notary rules are specific and a facility may hesitate. New residents should sign a South Carolina declaration; it takes minutes.
Related pages
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Signing and recording rules, what an agent can and cannot do, and the health care power of attorney.
Learn moreLast will and testament
Who inherits, who is in charge, and who raises the kids—decided by you, not the statute.
Learn morePlan reviews & trust amendments
Second opinions on existing plans; amendments and restatements of trusts.
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