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How do I create an advance healthcare directive in South Carolina?

Federal & State Law Editorial TeamLast reviewed: 2026-05-18

1. Types Recognized

South Carolina recognizes: (a) Declaration of a Desire for a Natural Death / Living Will (S.C. Code §§ 44-77-10 to 44-77-160 — Death With Dignity Act), (b) Health Care Power of Attorney (S.C. Code §§ 62-5-501 to 62-5-505 — under SC Probate Code), (c) POST (Physician Orders for Scope of Treatment) under DHEC guidelines, and (d) DNR.

2. Statutory Form

S.C. Code § 44-77-50 provides the Declaration of a Desire for a Natural Death form. S.C. Code § 62-5-504 provides the Health Care Power of Attorney form. Substantial compliance is required.

3. Execution Formalities

LIVING WILL: 18+ and of sound mind. Signed before TWO adult witnesses AND notarized (S.C. Code § 44-77-40). Witnesses cannot be: related by blood/marriage, entitled to estate, attending physician/employee, person directly financially responsible for care, or beneficiary of life insurance. HCPOA: § 62-5-504 requires two adult witnesses meeting similar restrictions plus optional notarization.

4. Healthcare Agent Authority

Under S.C. Code § 62-5-504, the agent may make any healthcare decision the principal could make, but to authorize WITHHOLDING ARTIFICIAL NUTRITION OR HYDRATION the principal must EXPRESSLY initial that authority in the statutory form. Authority effective when attending physician determines incapacity.

5. Pregnancy Clauses

S.C. Code § 44-77-70: a Declaration is INEFFECTIVE during pregnancy. The HCPOA statutory form requires a separate pregnancy election. Provisions remain in force post-Dobbs.

6. Reciprocity

S.C. Code § 44-77-100 and § 62-5-505 honor directives validly executed in another state.

7. POST

South Carolina POST (administered by DHEC) is a physician-signed bright-pink order portable across care settings, used for seriously ill patients.

8. Revocation

Under S.C. Code § 44-77-80 and § 62-5-504(F), the directive is revocable at any time, regardless of mental state, by: physical destruction, written revocation, oral expression of intent, or execution of a new directive.

9. Default Surrogate

S.C. Code § 44-66-30 (Adult Health Care Consent Act) provides surrogate priority for incapacitated patients without an HCPOA: guardian > spouse > adult child > parent > adult sibling > grandparent/adult grandchild > other relative > anyone with authority to act.

This is legal information, not legal advice.

When to Talk to a Lawyer
  • Two documents needed (living will + HCPOA) with different formalities
  • Express ANH authorization required — initial-by-initial in statutory form
  • Pregnancy exclusion under § 44-77-70 affecting directive
Related Statutes & Laws
  • S.C. Code §§ 44-77-10 to 44-77-160 (Death With Dignity Act)
  • S.C. Code §§ 62-5-501 to 62-5-505 (HCPOA)
  • S.C. Code § 44-66-30 (surrogate priority)

This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.