How to Create a Living Will in South Carolina

To create a living will in South Carolina, you fill out the state’s statutory Declaration of a Desire for a Natural Death, make your choices about life-sustaining treatment and tube feeding, and sign the document before two qualified witnesses and a notary public. The form comes from the South Carolina Death with Dignity Act, and your declaration must be substantially in the statutory form to be valid.¹

Who Can Create One

You must be at least 18 years old and of sound mind. That is the entire eligibility test. You do not need a terminal diagnosis, a lawyer, or any pre-existing medical condition to sign one; a living will is a document you prepare in advance so that it is already in place if the day comes when it applies.

The declaration itself only takes effect when two physicians, one of whom is your attending physician, personally examine you and certify in writing that you either have a terminal condition or are permanently unconscious. Until that happens, the document sits in your records and changes nothing about your care.²

Get the Statutory Form

South Carolina requires that your declaration be substantially in the form set out in Section 44-77-50 of the Code. The form is available through the South Carolina Department on Aging. Downloading a generic living will from somewhere else is risky; use the state form so you know every required element is in place.¹

A lawyer is not required. An estate planning attorney will typically draft and oversee execution for a few hundred dollars, and if you have questions about the witness rules or want end-of-life documents handled together, that cost is often worth it. If you are comfortable reading the form yourself, you can complete it on your own.

Make Your Choices on the Form

The form asks you to initial one statement from each of four paired options. The first pair covers what you want if your condition is terminal. The second pair covers what you want if you are permanently unconscious. Each pair asks the same question: should nutrition and hydration be provided through tubes, or not?

You can answer differently for each scenario. Some people want tube feeding continued if they are permanently unconscious but discontinued if they are terminally ill, or the reverse. Think through both situations before you sit down to initial anything. If you leave the nutrition and hydration section blank, the law defaults to providing nutrition and hydration necessary for your comfort and pain relief.²

The form also lets you name a designee. This is an optional person who has authority to revoke the declaration on your behalf if you become unable to revoke it yourself. Naming one gives you a safety valve if your situation or your wishes change after you can no longer speak for yourself.

One point to understand before signing: a living will under this Act only addresses life-sustaining procedures when you are terminal or permanently unconscious. Comfort care and pain medication are never affected by what the document says.²

Choose Two Witnesses Who Qualify

South Carolina is strict about who can serve as a witness. Each of your two witnesses must affirm, to the best of their knowledge, that they meet every one of the following conditions:

Not related to you by blood, marriage, or adoption. The statute specifically excludes your spouse, your ancestors, descendants of your parents, and spouses of any of those people.
Not entitled to any part of your estate under your will, as an intestate heir, or as a life insurance beneficiary.
Not holding any existing claim against your estate at the time of signing.
Not directly financially responsible for paying your medical care.
Not your attending physician, and not an employee of that physician.
No more than one witness may be an employee of the healthcare facility where you are a patient.

A useful detail: the notary public can also count as one of your two witnesses. In practice, that means you only need to bring one other qualified person to the signing.³

Sign in Front of the Witnesses and Notary

You, both witnesses, and the notary must all be physically present at the same time. The notary verifies identities and administers an oath to the witnesses, who then sign an affidavit confirming they meet the eligibility requirements and that you appeared to be of sound mind and signed voluntarily. The notary then notarizes the document. If anyone required is missing from the room during signing, the declaration may not be valid.³

Share Copies So the Document Will Actually Be Followed

A living will only works if your doctors know it exists. South Carolina does not maintain a statewide advance directive registry, so distribution is entirely on you. Give a copy to your primary care physician and ask that it be placed in your medical record. If you are admitted to a hospital or nursing home, tell admissions staff immediately that you have a declaration on file.

Keep the original somewhere safe but accessible. A fireproof home safe works better than a bank safe deposit box, which family may not be able to reach quickly in an emergency. Give copies to close family members and anyone you named as a designee.

Under federal rules, hospitals and nursing homes that participate in Medicare or Medicaid must ask you at admission whether you have an advance directive and document your answer. If you bring a copy, the facility should include it in your chart.⁴

How to Revoke It Later

You can cancel your living will at any time, for any reason, using any of five methods. No matter which method you use, the revocation only becomes legally effective once your attending physician is told about it.⁵

Physically destroy the document with the intent to revoke. If you made multiple originals, destroying one revokes all of them, though the revocation only takes effect for the copies you did not destroy once the physician is notified.
Sign a dated written revocation stating your intent to cancel the declaration.
Say so out loud. The person you tell must then communicate the revocation to your attending physician within a reasonable time, and your oral statement must clearly indicate you no longer want the declaration followed.
Have your designee revoke it, in writing or orally, if you named one and are no longer competent to revoke it yourself. The designee’s revocation can be permanent or temporary.
Sign a new declaration, which automatically revokes the previous one.

Your attending physician must record the date, time, and circumstances of any revocation in your medical record.⁵

When the Living Will Will Not Apply

If you are pregnant, your living will has no effect for the duration of the pregnancy, regardless of what stage you are in or what your declaration says. It becomes enforceable again once the pregnancy ends.²

Also understand what this document is not. A living will does not appoint anyone to make broader medical decisions for you if you are incapacitated for reasons other than terminal illness or permanent unconsciousness. For that, you need a separate healthcare power of attorney under South Carolina Code Section 62-5-503, which lets an agent make healthcare decisions on your behalf any time you cannot make them yourself. Many people sign both documents at once so that end-of-life wishes are stated clearly in writing and someone is empowered to handle everything else.⁶

1
South Carolina Legislature. South Carolina Code 44-77-50 – Form of Declaration
2
South Carolina Legislature. South Carolina Code Title 44 Chapter 77 – Death With Dignity Act
3
South Carolina Legislature. South Carolina Code 44-77-40 – Validity of Declaration
4
Centers for Medicare and Medicaid Services. Advance Care Planning
5
South Carolina Legislature. South Carolina Code 44-77-80 – Revocation of Declaration
6
South Carolina Legislature. South Carolina Code 62-5-503 – Requirements for Health Care Power of Attorney