What are my rights if someone with a medical power of attorney sends EMS to my home without my consent? – North Carolina

Short Answer

In North Carolina, a competent adult controls medical decisions and may refuse evaluation or transport, even if a health care agent exists. A health care power of attorney typically becomes effective only when a physician determines the patient lacks capacity, and an agent cannot override a capable patient’s wishes. Emergency medical providers may treat without consent only in true emergencies. If misuse occurs, a capable patient can revoke the health care power of attorney and notify providers.

Understanding the Problem

This question asks whether, under North Carolina estate planning and health care directive rules, a health care agent can involve emergency medical services (EMS) at a private residence against the wishes of the adult present. The focus is: North Carolina; a health care agent’s authority; EMS contact and treatment; and the trigger for that authority. The core concern is whether a competent adult can decline EMS involvement when a medical power of attorney exists.

Apply the Law

Under North Carolina law, adults generally have the right to make their own medical decisions. A health care power of attorney authorizes an agent to act only when the patient cannot make or communicate informed choices, typically after an attending physician documents incapacity. When the patient is capable, the patient’s decisions control. In emergencies where delay risks serious harm, providers may treat without prior consent. Disputes about capacity or misuse can be taken to the Clerk of Superior Court, and a capable patient may revoke a health care power of attorney at any time by clear communication and notifying the attending physician.

Key Requirements

• Capacity Controls: A capable adult may refuse EMS evaluation or transport; the agent cannot overrule a capable patient.
• Trigger for Agent’s Authority: The health care agent’s authority typically begins when an attending physician determines the patient lacks capacity to make or communicate health care decisions.
• Emergency Exception: EMS and providers may give necessary treatment without consent only if delaying care risks death or serious harm.
• Scope Limits: A health care agent speaks for the patient’s medical decisions, not for property rights; the agency does not grant power over another person’s home.
• Revocation Option: While capable, the patient may revoke the health care power of attorney and should promptly notify the attending physician and any providers.
• Forum for Disputes: If capacity is disputed or immediate protection is needed, relief can be sought in the Clerk of Superior Court, including temporary measures in urgent cases.

What the Statutes Say

• N.C. Gen. Stat. § 32A-20 (When a health care power of attorney becomes effective) – Agent acts when an attending physician determines the principal lacks capacity; the principal’s decisions control when capable.
• N.C. Gen. Stat. § 32A-23 (Revocation of health care power of attorney) – A capable principal may revoke at any time by any clear means; effectiveness follows notice to the attending physician.
• N.C. Gen. Stat. § 90-21.13 (Informed consent) – Treatment generally requires consent; emergency care may proceed without consent if delay endangers life or serious health.
• N.C. Gen. Stat. § 35A-1119 (Interim or emergency guardianship) – Court may appoint an interim guardian in urgent situations to prevent harm, subject to prompt review.

Analysis

Apply the Rule to the Facts: A relative is recovering from surgeries while living in another’s home, and the relative’s sibling is the health care agent. If the recovering relative is capable, the agent cannot override their refusal of EMS evaluation or transport. EMS may still check welfare but must honor a competent refusal absent an emergency. If post-surgical medications or symptoms impair capacity, the agent’s authority may temporarily activate after an attending physician documents incapacity; emergency care may proceed if delay risks serious harm.

Process & Timing

1. Who files: The patient (if capable) to revoke a health care power of attorney. Where: No filing is required to revoke; deliver written revocation to the attending physician and providers. What: A signed revocation identifying the prior document; request the chart be updated and copies removed. When: Effective once the attending physician is notified; deliver promptly.
2. If capacity is disputed or urgent harm is alleged: An interested person may file a petition with the Clerk of Superior Court in the county for guardianship relief, including interim measures in emergencies. Timeframes are expedited for interim requests but can vary by county.
3. Provider coordination: Give copies of any revocation or updated directive to the primary care office, hospital, and, if relevant, share instructions with local EMS or the care team. Expect providers to update records and honor the current directive once notified.

Exceptions & Pitfalls

• Emergencies: If delaying care risks death or serious harm, EMS may treat without prior consent; this does not permanently expand an agent’s authority.
• Capacity swings: Post-surgical medications or complications can temporarily impair capacity; the agent’s power may activate and then suspend as capacity returns. Ensure the attending physician documents capacity status.
• Revocation notice gaps: Revocation is only effective for providers who receive notice. Send the revocation to the attending physician and any facility or practice that relied on the prior document.
• Scope overreach: A health care agent’s authority covers the patient’s medical decisions, not control over third-party property or household access. Absent emergency or court order, an agent cannot compel entry into someone else’s home.
• Escalation path: If the situation involves ongoing risk or contested capacity, seek relief with the Clerk of Superior Court; interim guardianship may be available in urgent cases.

Talk to a Estate Planning Attorney

If you’re dealing with unwanted EMS calls tied to a health care power of attorney and need to clarify who can decide, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at 919-341-7055.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.