North Carolina Surrogate Decision Maker Lookup

Who can make medical and money decisions for an adult in North Carolina who cannot decide: an agent, a guardian, or North Carolina's default surrogate order. Runs in your browser; nothing is stored.

North Carolina law checked against official sources on October 26, 2026.

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What needs deciding?
Can the person understand this decision and make it, with help if needed?
Which of these exist? (tick all that apply)

Who has authority in North Carolina

  1. With no agent and no guardian, this state's default surrogate law lets a family member or other listed person make health-care decisions, in the order below.
  2. If nobody is available or the family disagrees, a court can appoint a guardian. That is slower and costs more than documents signed in advance.

North Carolina's default surrogate order

  1. Guardian of the person (A valid health care agent keeps authority to the extent of the health care power of attorney)
  2. Health care agent under a valid health care power of attorney (To the extent of the authority granted)
  3. Another agent the patient appointed with health care powers (To the extent of the authority granted)
  4. Spouse
  5. A majority of reasonably available parents and adult children, together (Parents and adult children form one class)
  6. A majority of reasonably available adult siblings
  7. Someone with an established relationship who can reliably convey the patient's wishes (Must act in good faith)
What it covers
Lists who may consent to medical treatment for a patient who is comatose or otherwise cannot make or communicate health care decisions. Withholding life-prolonging measures is governed by 90-322.
If more than one person is in the same group
Parents and adult children decide together by majority of those reasonably available; adult siblings also decide by majority.
If nobody on the list is available
If no one on the list is reasonably available, the attending physician may treat without consent, generally after a second physician confirms the condition and need for treatment.
Who decides the person cannot decide
Applies to a patient who is comatose or otherwise lacks capacity to make or communicate health care decisions; the section does not say who determines that.
Limits
  • Where this section conflicts with listed statutes, including the Natural Death Act (90-322), those statutes control.

Source: N.C. Gen. Stat. 90-21.13(c) · Checked October 26, 2026

Narrower laws in this state

  • N.C. Gen. Stat. 90-322: Withholding or discontinuing life-prolonging measures needs an incurable condition expected to cause death soon or permanent unconsciousness, written confirmation by a second physician, and concurrence of persons in a set order.

Next steps

Who decides in North Carolina without a power of attorney?

North Carolina's default surrogate law (N.C. Gen. Stat. 90-21.13(c)) covers health-care decisions generally. Without a health-care agent or guardian, the first person in line under the statute is: Spouse.

North Carolina's default surrogate law in full

North Carolina's default surrogate order

  1. Guardian of the person (A valid health care agent keeps authority to the extent of the health care power of attorney)
  2. Health care agent under a valid health care power of attorney (To the extent of the authority granted)
  3. Another agent the patient appointed with health care powers (To the extent of the authority granted)
  4. Spouse
  5. A majority of reasonably available parents and adult children, together (Parents and adult children form one class)
  6. A majority of reasonably available adult siblings
  7. Someone with an established relationship who can reliably convey the patient's wishes (Must act in good faith)
What it covers
Lists who may consent to medical treatment for a patient who is comatose or otherwise cannot make or communicate health care decisions. Withholding life-prolonging measures is governed by 90-322.
If more than one person is in the same group
Parents and adult children decide together by majority of those reasonably available; adult siblings also decide by majority.
If nobody on the list is available
If no one on the list is reasonably available, the attending physician may treat without consent, generally after a second physician confirms the condition and need for treatment.
Who decides the person cannot decide
Applies to a patient who is comatose or otherwise lacks capacity to make or communicate health care decisions; the section does not say who determines that.
Limits
  • Where this section conflicts with listed statutes, including the Natural Death Act (90-322), those statutes control.

Source: N.C. Gen. Stat. 90-21.13(c) · Checked October 26, 2026

Narrower laws in this state

  • N.C. Gen. Stat. 90-322: Withholding or discontinuing life-prolonging measures needs an incurable condition expected to cause death soon or permanent unconsciousness, written confirmation by a second physician, and concurrence of persons in a set order.

How authority works when someone cannot decide

An adult who can understand a decision makes it, even when family disagrees. Authority passes to someone else only when the person cannot decide, and the source of that authority matters.

The strongest source is a document the person signed while able: a health-care power of attorney or advance directive naming an agent for medical decisions, and a durable power of attorney for money and property. A court appointment (a guardian, or in some states a conservator for money) comes next, and it is slower and more expensive.

For health-care decisions only, most states also have a default surrogate law, sometimes called a family consent law. It lists who may decide when there is no agent and no guardian, usually starting with a spouse, then adult children, then parents and siblings. Doctors and hospitals apply it at the bedside.

There is no "next of kin" list for money

Default surrogate laws cover health care, not bank accounts, bills or property. Being a spouse, child or next of kin does not by itself let you sign checks or sell a house for another adult. Without a durable power of attorney, managing someone else's money usually needs a court appointment.

Federal benefits follow their own rules. Social Security says a power of attorney, an authorized representative or a joint account is not the same as being a payee; SSA appoints a representative payee. VA appoints a fiduciary for a beneficiary who cannot manage VA benefits.

What this tool does not do

  • It reports what each state's statute says. It does not decide whether a person has capacity; the treating doctor does.
  • It does not decide disputes between family members or replace a court order. A guardianship order or a power of attorney can change who decides.
  • Hospitals, nursing homes and other states' laws can add steps. Ask the facility's patient-relations or legal office which law it applies.
  • It is general legal information, not legal advice for your situation.

Frequently Asked Questions

Who makes medical decisions in North Carolina if there is no power of attorney?

North Carolina's default surrogate law (N.C. Gen. Stat. 90-21.13(c)) covers health-care decisions generally. Without a health-care agent or guardian, the first person in line under the statute is: Spouse. The full order, tie rule and limits are in N.C. Gen. Stat. 90-21.13(c).

Does next of kin in North Carolina have authority over money?

No default surrogate law covers money. In North Carolina, as everywhere, managing another adult's accounts or property takes a durable power of attorney or a court appointment.

Sources

North Carolina law checked against the official text on October 26, 2026.

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