Short Answer

In North Carolina, urgent medical decisions are first made by any valid health care agent named in a health care power of attorney. If there is no agent or guardian, the law allows a spouse to act as the default medical decision-maker. In a true emergency, doctors may treat without consent. If there is disagreement or a hospital requires court authority, you can ask the Clerk to appoint an interim guardian quickly. Dismissing the case without prejudice lets you refile later.

Understanding the Problem

In North Carolina, you want to know whether you can make urgent medical decisions for your spouse while a guardianship case is paused. You filed a petition, the Clerk sent a voluntary dismissal notice (with or without prejudice), and you still must serve an adult child and a court-appointed guardian ad litem. Your spouse is in the hospital on a ventilator, and you need to decide about care now.

Apply the Law

North Carolina law prioritizes an existing health care power of attorney. If none exists and no guardian is in place, the law sets a default “surrogate” list that typically places a spouse near the top. In emergencies, physicians can proceed without consent to prevent serious harm. When court authority is needed or there is a dispute, you may file a verified motion for an interim guardian of the person; the Clerk must set the hearing as soon as possible, and no later than 15 days after service. An interim appointment lasts up to 45 days and may be extended once for good cause. If you voluntarily dismiss your pending petition without prejudice, you can start a new guardianship later; after an interim-guardian hearing occurs, dismissal requires court permission.

Key Requirements

• Existing health care agent controls: A valid health care power of attorney governs unless a court later suspends the agent’s authority.
• Default surrogate if no agent/guardian: If your spouse lacks capacity and no agent or guardian exists, North Carolina law authorizes a spouse to consent as a statutory surrogate.
• Emergency care without consent: Providers may treat without consent when delay risks serious harm.
• Interim guardian for urgent disputes: File a verified interim-guardian motion when immediate court authority is needed; hearing is expedited, and any order is time-limited.
• Voluntary dismissal options: Without prejudice ends the case now but preserves your ability to refile; with prejudice generally bars refiling. Special limits apply after an interim-guardian hearing.

What the Statutes Say

• North Carolina Gen. Stat. § 90-21.13 (Health care consent for incapacitated adults) – Sets the surrogate consent hierarchy when a patient lacks capacity.
• North Carolina Gen. Stat. § 90-21.14 (Emergency treatment without consent) – Allows treatment when delay threatens serious harm.
• North Carolina Gen. Stat. § 35A-1114 (Interim guardian) – Provides expedited process, standards, timeframe, and 45-day limit (extendable once).
• North Carolina Gen. Stat. § 32A-22 (Health care power of attorney; relation to guardianship) – Health care agent’s authority continues unless a court suspends it for good cause.

Analysis

Apply the Rule to the Facts: If your spouse signed a health care power of attorney, that agent decides, and the hospital should follow it unless a court later suspends the agent’s authority. If there is no agent or guardian, as the spouse you generally qualify as the statutory surrogate and can consent for treatment. If the adult child disagrees or the hospital wants a court order, file an interim-guardian motion so the Clerk can set a prompt hearing and grant limited medical decision-making authority. If you dismiss the case without prejudice now, you can refile a new petition later.

Process & Timing

1. Who files: You (the petitioner). Where: Clerk of Superior Court, Special Proceedings, in the county where your spouse resides or is present. What: If court authority is needed, file AOC-SP-200 (check the interim-guardian box and include a verified interim motion) and AOC-SP-201 (Notice of Hearing). When: The Clerk must set the interim-guardian hearing as soon as possible and, in any event, within 15 days after service.
2. Serve the respondent (your spouse) per the rules; serve the guardian ad litem; and give notice to the adult child and other next of kin as directed by the Clerk. Many counties schedule interim hearings within days once service is complete.
3. If granted, the interim guardian’s order (often on AOC-SP-900M) will specify limited medical powers and lasts up to 45 days, with a possible one-time 45-day extension for good cause. Separately, if you choose to dismiss, a dismissal without prejudice ends the current case but allows you to refile later as a new petition.

Exceptions & Pitfalls

• If a valid health care agent is named, that person—not the spouse—makes decisions unless a court suspends the agent’s authority.
• Ex parte emergency orders before any incompetency finding are limited; interim-guardian procedure is the usual route for urgent court authority.
• Choose your dismissal option carefully: with prejudice generally prevents refiling; without prejudice preserves the ability to start over. After an interim-guardian hearing, dismissal requires court permission.
• Service and notice matter: failure to properly serve the respondent, guardian ad litem, or required next of kin can delay emergency relief.

Talk to a Guardianship Attorney

If you’re facing urgent medical decisions during a paused guardianship case, 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.