REPORT TITLE:
Health-Care Decisions


DESCRIPTION:
Creates a Uniform Health-Care Decisions Act.  (SD1)

 
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THE SENATE                              S.B. NO.           S.D. 1
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                   A  BILL  FOR  AN  ACT

RELATING TO HEALTH-CARE DECISIONS.



BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1      SECTION 1.  The Hawaii Revised Statutes is amended by adding
 
 2 a new chapter to be appropriately designated and to read as
 
 3 follows:
 
 4                             "CHAPTER
 
 5                 UNIFORM HEALTH-CARE DECISIONS ACT
 
 6      §    -1  Short title.  This chapter may be cited as the
 
 7 "Uniform Health-Care Decisions Act".
 
 8      §    -2  Definitions.  Whenever used in this chapter, unless
 
 9 the context otherwise requires:
 
10      "Advance health-care directive" means an individual
 
11 instruction or a power of attorney for health care.
 
12      "Agent" means an individual designated in a power of
 
13 attorney for health care to make a health-care decision for the
 
14 individual granting the power.
 
15      "Capacity" means an individual's ability to understand the
 
16 significant benefits, risks, and alternatives to proposed health
 
17 care and to make and communicate a health-care decision.
 
18      "Guardian" means a judicially appointed guardian or
 
19 conservator having authority to make a health-care decision for
 

 
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 1 an individual.
 
 2      "Health care" means any care, treatment, service, or
 
 3 procedure to maintain, diagnose, or otherwise affect an
 
 4 individual's physical or mental condition.
 
 5      "Health-care decision" means a decision made by an
 
 6 individual or the individual's agent, guardian, or surrogate,
 
 7 regarding the individual's health care, including:
 
 8      (1)  Selection and discharge of health-care providers and
 
 9           institutions;
 
10      (2)  Approval or disapproval of diagnostic tests, surgical
 
11           procedures, programs of medication, and orders not to
 
12           resuscitate; and
 
13      (3)  Directions to provide, withhold, or withdraw artificial
 
14           nutrition and hydration, and all other forms of health
 
15           care.
 
16      "Health-care institution" means an institution, facility, or
 
17 agency licensed, certified, or otherwise authorized or permitted
 
18 by law to provide health care in the ordinary course of business.
 
19      "Health-care provider" means an individual licensed,
 
20 certified, or otherwise authorized or permitted by law to provide
 
21 health care in the ordinary course of business or practice of a
 
22 profession.
 
23      "Individual instruction" means an individual's direction
 

 
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 1 concerning a health-care decision for the individual.
 
 2      "Person" means an individual, corporation, limited liability
 
 3 company, business trust, estate, trust, partnership, association,
 
 4 joint venture, government, governmental subdivision, agency, or
 
 5 instrumentality, or any other legal or commercial entity.
 
 6      "Physician" means an individual authorized to practice
 
 7 medicine or osteopathy under chapter 453 or 460, respectively.
 
 8      "Power of attorney for health care" means the designation of
 
 9 an agent to make health-care decisions for the individual
 
10 granting the power.
 
11      "Primary physician" means a physician designated by an
 
12 individual or the individual's agent, guardian, or surrogate, to
 
13 have primary responsibility for the individual's health care or,
 
14 in the absence of a designation or if the designated physician is
 
15 not reasonably available, a physician who undertakes the
 
16 responsibility.
 
17      "Reasonably available" means readily able to be contacted
 
18 without undue effort and willing and able to act in a timely
 
19 manner considering the urgency of the patient's health-care
 
20 needs.
 
21      "State" means a state of the United States, the District of
 
22 Columbia, the Commonwealth of Puerto Rico, or a territory or
 
23 insular possession subject to the jurisdiction of the United
 

 
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 1 States.
 
 2      "Supervising health-care provider" means the primary
 
 3 physician or, if there is no primary physician or the primary
 
 4 physician is not reasonably available, the health-care provider
 
 5 who has undertaken primary responsibility for an individual's
 
 6 health care.
 
 7      "Surrogate" means an individual, other than a patient's
 
 8 agent or guardian, authorized under this chapter to make a
 
 9 health-care decision for the patient.
 
10      §    -3  Advance health-care directives.(a)  An adult or
 
11 emancipated minor may give to an agent instruction that is oral
 
12 or written; provided that a written instruction shall be made by
 
13 a power of attorney under subsection (b).  The instruction may be
 
14 limited to take effect only if a specified condition arises.
 
15      (b)  An adult or emancipated minor may execute a power of
 
16 attorney for health care that authorizes the agent to make any
 
17 health-care decision the principal could have made while having
 
18 capacity.  The power shall remain in effect notwithstanding the
 
19 principal's later incapacity and may include individual
 
20 instructions.  Unless related to the principal by blood,
 
21 marriage, or adoption, an agent shall not be an owner, operator,
 
22 or employee of a health-care institution at which the principal
 
23 is receiving care.  The power shall be in writing, dated with
 

 
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 1 the date of its execution, signed by the principal, and
 
 2 witnessed by one of the following methods:
 
 3      (1)  Signed by at least two individuals, each of whom
 
 4           witnessed either the signing of the instrument by the
 
 5           principal or the principal's acknowledgment of the
 
 6           signature or of the instrument, with each witness
 
 7           making the following declaration in substance:
 
 8           I declare under penalty of false swearing under
 
 9           section 710-1062, that the principal is personally
 
10           known to me, that the principal signed or acknowledged
 
11           this power of attorney in my presence, that the
 
12           principal appears to be of sound mind and under no
 
13           duress, fraud, or undue influence, that I am not the
 
14           person appointed as agent by this document, and that I
 
15           am not a health-care provider, nor an employee of a
 
16           health-care provider or facility. In addition, the
 
17           declaration of at least one of the witnesses shall
 
18           include the following wording:
 
19           I am not related to the principal by blood, marriage or
 
20           adoption, and to the best of my knowledge, I am not
 
21           entitled to any part of the estate of the principal
 
22           upon the death of the principal under a will now
 
23           existing or by operation of law; or
 

 
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 1      (2)  Acknowledged before a notary public at any place within
 
 2           this State, with the notary public certifying to the
 
 3           substance of the following:
 
 4           State of Hawaii
 
 5           County of _________________
 
 6           On this _______ day of __________, in the year ____,
 
 7           before me, _______________, (insert name of notary
 
 8           public) appeared _______________, personally known to
 
 9           me (or proved to me on the basis of satisfactory
 
10           evidence) to be the person whose name is subscribed to
 
11           this instrument, and acknowledged that he or she
 
12           executed it.  I declare under the penalty of false
 
13           swearing that the person whose name is subscribed to
 
14           this instrument appears to be of sound mind and under
 
15           no duress, fraud or undue influence.
 
16           Notary Seal
 
17           _____________________________
 
18           (Signature of Notary Public)
 
19           My Commission Expires:
 
20      (c)  A witness for a power of attorney for health care shall
 
21 not be:
 
22      (1)  A health-care provider;
 
23      (2)  An employee of a health-care provider or facility;
 

 
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 1          or
 
 2      (3)  An agent of (1) or (2).
 
 3      (d)  At least one witness for a power of attorney for health
 
 4 care shall not be:
 
 5      (1)  A relative of the principal by blood, marriage, or
 
 6           adoption; nor
 
 7      (2)  An individual entitled to any portion of the estate of
 
 8           the principal upon the principal's death under any will
 
 9           or codicil of the principal existing at the time of
 
10           execution of the power of attorney for health care or
 
11           by operation of existing law.
 
12      (e)  Unless otherwise specified in a power of attorney for
 
13 health care, the authority of an agent shall be effective only
 
14 upon a determination that the principal lacks capacity, and shall
 
15 cease to be effective upon a determination that the principal has
 
16 recovered capacity.
 
17      (f)  Unless otherwise specified in a written advance health-
 
18 care directive, a determination that an individual lacks or has
 
19 recovered capacity, or that another condition exists that affects
 
20 an individual instruction or the authority of an agent, shall be
 
21 made by the primary physician.
 
22      (g)  An agent shall make a health-care decision in
 
23 accordance with the principal's individual instructions, if any,
 

 
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 1 and other wishes to the extent known to the agent.  Otherwise,
 
 2 the agent shall make the decision in accordance with the agent's
 
 3 determination of the principal's best interest.  In determining
 
 4 the principal's best interest, the agent shall consider the
 
 5 principal's personal values to the extent known to the agent.
 
 6      (h)  A health-care decision made by an agent for a principal
 
 7 shall be effective without judicial approval.
 
 8      (i)  A written advance health-care directive may include the
 
 9 individual's nomination of a guardian of the person.
 
10      (j)  An advance health-care directive shall be valid for
 
11 purposes of this chapter if it complies with this chapter,
 
12 regardless of when or where executed or communicated.
 
13      §    -4  Revocation of advance health-care directive.(a)
 
14 An individual may revoke the designation of an agent only by a
 
15 signed writing or by personally informing the supervising health-
 
16 care provider.
 
17      (b)  An individual may revoke all or part of an advance
 
18 health-care directive, other than the designation of an agent, at
 
19 any time and in any manner that communicates an intent to revoke.
 
20      (c)  A health-care provider, agent, guardian, or surrogate
 
21 who is informed of a revocation shall promptly communicate the
 
22 fact of the revocation to the supervising health-care provider
 
23 and to any health-care institution at which the patient is
 

 
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 1 receiving care.
 
 2      (d)  A decree of annulment, divorce, dissolution of
 
 3 marriage, or legal separation shall revoke a previous designation
 
 4 of a spouse as agent, unless otherwise specified in the decree or
 
 5 in a power of attorney for health care.
 
 6      (e)  An advance health-care directive that conflicts with an
 
 7 earlier advance health-care directive shall revoke the earlier
 
 8 directive to the extent of the conflict.
 
 9      §    -5  Optional standard form.  The department of health
 
10 shall prepare, make available, and revise as necessary, a
 
11 standard form for optional use to create an advanced health-care
 
12 directive under this chapter.  The form shall be made available
 
13 upon request to any person or entity involved with preparing an
 
14 advanced health-care directive.  The department may charge a
 
15 reasonable fee for the form.
 
16      §    -6  Decisions by a surrogate.(a)  A surrogate may
 
17 make a health-care decision for a patient who is an adult or
 
18 emancipated minor if the patient has been determined by the
 
19 primary physician to lack capacity and no agent or guardian has
 
20 been appointed or the agent or guardian is not reasonably
 
21 available.
 
22      (b)  An adult or emancipated minor may designate any
 
23 individual to act as surrogate by personally informing the
 

 
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 1 supervising health-care provider.  In the absence of a
 
 2 designation, or if the designee is not reasonably available, any
 
 3 member of the following classes of the patient's family who is
 
 4 reasonably available, in descending order of priority, may act as
 
 5 surrogate:
 
 6      (1)  The spouse, unless legally separated;
 
 7      (2)  An adult child;
 
 8      (3)  A parent; or
 
 9      (4)  An adult brother or sister.
 
10      (c)  If none of the individuals eligible to act as surrogate
 
11 under subsection (b) is reasonably available, an adult who has
 
12 exhibited special care and concern for the patient, who is
 
13 familiar with the patient's personal values, and who is
 
14 reasonably available may act as surrogate.
 
15      (d)  A surrogate shall communicate the surrogate's
 
16 assumption of authority as promptly as practicable to the members
 
17 of the patient's family specified in subsection (b) who can be
 
18 readily contacted.
 
19      (e)  If more than one member of a class assumes authority to
 
20 act as surrogate, and if they do not agree on a health-care
 
21 decision and the supervising health-care provider is so informed,
 
22 the supervising health-care provider shall comply with the
 
23 decision of a majority of the members of that class who have
 

 
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 1 communicated their views to the provider.  If the class is evenly
 
 2 divided concerning the health-care decision and the supervising
 
 3 health-care provider is so informed, that class and all
 
 4 individuals having lower priority are disqualified from making
 
 5 the decision.
 
 6      (f)  A surrogate shall make a health-care decision in
 
 7 accordance with the patient's individual instructions, if any,
 
 8 and other wishes to the extent known to the surrogate.
 
 9 Otherwise, the surrogate shall make the decision in accordance
 
10 with the surrogate's determination of the patient's best
 
11 interest.  In determining the patient's best interest, the
 
12 surrogate shall consider the patient's personal values to the
 
13 extent known to the surrogate.
 
14      (g)  A health-care decision made by a surrogate for a
 
15 patient shall be effective without judicial approval.
 
16      (h)  An individual at any time may disqualify another,
 
17 including a member of the individual's family, from acting as the
 
18 individual's surrogate by a signed writing or by personally
 
19 informing the supervising health-care provider of the
 
20 disqualification.
 
21      (i)  Unless related to the patient by blood, marriage, or
 
22 adoption, a surrogate shall not be an owner, operator, or
 
23 employee of a residential long-term health-care institution at
 

 
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 1 which the patient is receiving care.
 
 2      (j)  A supervising health-care provider may require an
 
 3 individual claiming the right to act as surrogate for a patient
 
 4 to provide a written declaration under penalty of false swearing
 
 5 stating facts and circumstances reasonably sufficient to
 
 6 establish the claimed authority.
 
 7      §    -7  Decisions by guardian.(a)  A guardian shall
 
 8 comply with the ward's individual instructions and may not revoke
 
 9 the ward's advance health-care directive unless the appointing
 
10 court expressly so authorizes.
 
11      (b)  Absent a court order to the contrary, a health-care
 
12 decision of an agent takes precedence over that of a guardian.
 
13      (c)  A health-care decision made by a guardian for the ward
 
14 shall be effective without judicial approval.
 
15      §    -8  Obligations of health-care provider.(a)  Before
 
16 implementing a health-care decision made for a patient, a
 
17 supervising health-care provider, if possible, shall promptly
 
18 communicate to the patient the decision made and the identity of
 
19 the person making the decision.
 
20      (b)  A supervising health-care provider who knows of the
 
21 existence of an advance health-care directive, a revocation of an
 
22 advance health-care directive, or a designation or
 
23 disqualification of a surrogate, shall promptly record its
 

 
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 1 existence in the patient's health-care record and, if it is in
 
 2 writing, shall request a copy and if one is furnished shall
 
 3 arrange for its maintenance in the health-care record.
 
 4      (c)  A primary physician who makes or is informed of a
 
 5 determination that a patient lacks or has recovered capacity, or
 
 6 that another condition exists which affects an individual
 
 7 instruction or the authority of an agent, guardian, or surrogate,
 
 8 shall promptly record the determination in the patient's health-
 
 9 care record and communicate the determination to the patient, if
 
10 possible, and to any person then authorized to make health-care
 
11 decisions for the patient.
 
12      (d)  Except as provided in subsections (e) and (f), a
 
13 health-care provider or institution providing care to a patient
 
14 shall:
 
15      (1)  Comply with an individual instruction of the patient
 
16           and with a reasonable interpretation of that
 
17           instruction made by a person then authorized to make
 
18           health-care decisions for the patient; and
 
19      (2)  Comply with a health-care decision for the patient made
 
20           by a person then authorized to make health-care
 
21           decisions for the patient to the same extent as if the
 
22           decision had been made by the patient while having
 
23           capacity.
 

 
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 1      (e)  A health-care provider may decline to comply with an
 
 2 individual instruction or health-care decision for reasons of
 
 3 conscience.  A health-care institution may decline to comply with
 
 4 an individual instruction or health-care decision if the
 
 5 instruction or decision is contrary to a policy of the
 
 6 institution which is expressly based on reasons of conscience and
 
 7 if the policy was timely communicated to the patient or to a
 
 8 person then authorized to make health-care decisions for the
 
 9 patient.
 
10      (f)  A health-care provider or institution may decline to
 
11 comply with an individual instruction or health-care decision
 
12 that requires medically ineffective health care or health care
 
13 contrary to generally accepted health-care standards applicable
 
14 to the health-care provider or institution.
 
15      (g)  A health-care provider or institution that declines to
 
16 comply with an individual instruction or health-care decision
 
17 shall:
 
18      (1)  Promptly so inform the patient, if possible, and any
 
19           person then authorized to make health-care decisions
 
20           for the patient;
 
21      (2)  Provide continuing care to the patient until a transfer
 
22           can be effected; and
 
23      (3)  Unless the patient or person then authorized to make
 

 
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 1           health-care decisions for the patient refuses
 
 2           assistance, immediately make all reasonable efforts to
 
 3           assist in the transfer of the patient to another
 
 4           health-care provider or institution that is willing to
 
 5           comply with the instruction or decision.
 
 6      (h)  A health-care provider or institution shall not require
 
 7 or prohibit the execution or revocation of advance health-care
 
 8 directive as a condition for providing health care.
 
 9      §    -9  Health-care information.  Unless otherwise
 
10 specified in an advance health-care directive, a person
 
11 authorized to make health-care decisions for a patient has the
 
12 same rights as the patient to request, receive, examine, copy,
 
13 and consent to the disclosure of medical or any other health-care
 
14 information.
 
15      §    -10  Immunities.(a)  A health-care provider or
 
16 institution acting in good faith and in accordance with generally
 
17 accepted health-care standards applicable to the health-care
 
18 provider or institution shall not be subject to civil or criminal
 
19 liability or to discipline for unprofessional conduct for:
 
20      (1)  Complying with a health-care decision of a person
 
21           apparently having authority to make a health-care
 
22           decision for a patient, including a decision to
 
23           withhold or withdraw health care;
 

 
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 1      (2)  Declining to comply with a health-care decision of a
 
 2           person based on a belief that the person then lacked
 
 3           authority; or
 
 4      (3)  Complying with an advance health-care directive on the
 
 5           assumption that the directive was valid when made and
 
 6           has not been revoked or terminated.
 
 7      (b)  An individual acting as agent or surrogate under this
 
 8 chapter shall not be subject to civil or criminal liability or to
 
 9 discipline for unprofessional conduct for health-care decisions
 
10 made in good faith.
 
11      §    -11  Statutory damages.(a)  A health-care provider or
 
12 institution that intentionally violates this chapter shall be
 
13 subject to liability to the aggrieved individual for damages of
 
14 $500, or for actual damages resulting from the violation,
 
15 whichever is greater, plus reasonable attorney's fees.
 
16      (b)  A person who intentionally falsifies, forges, conceals,
 
17 defaces, or obliterates an individual's advance health-care
 
18 directive or a revocation of an advance health-care directive
 
19 without the individual's consent, or who coerces or fraudulently
 
20 induces an individual to give, revoke, or not to give an advance
 
21 health-care directive, shall be subject to liability to that
 
22 individual for damages of $2,500, or actual damages resulting
 
23 from the action, whichever is greater, plus reasonable attorney's
 

 
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 1 fees.
 
 2      §    -12  Capacity.(a)  This chapter shall not affect the
 
 3 right of an individual to make health-care decisions while having
 
 4 capacity to do so.
 
 5      (b)  An individual is presumed to have capacity to make a
 
 6 health-care decision, to give or revoke an advance health-care
 
 7 directive, and to designate or disqualify a surrogate.
 
 8      §    -13  Effect of copy.  A copy of a written advance
 
 9 health-care directive, revocation of an advance health-care
 
10 directive, or designation or disqualification of a surrogate
 
11 shall have the same effect as the original.
 
12      §    -14  Effect of this chapter.(a)  This chapter shall
 
13 not create a presumption concerning the intention of an
 
14 individual who has not made or who has revoked an advance health-
 
15 care directive.
 
16      (b)  Death resulting from the withholding or withdrawal of
 
17 health care in accordance with this chapter shall not for any
 
18 purpose constitute a suicide or homicide, or legally impair or
 
19 invalidate a policy of insurance or an annuity providing a death
 
20 benefit, notwithstanding any term of the policy or annuity to the
 
21 contrary.
 
22      (c)  This chapter shall not authorize mercy killing,
 
23 assisted suicide, euthanasia, or the provision, withholding, or
 

 
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 1 withdrawal of health care, to the extent prohibited by other
 
 2 statutes of this State.
 
 3      (d)  This chapter shall not authorize or require a health-
 
 4 care provider or institution to provide health care contrary to
 
 5 generally accepted health-care standards applicable to the
 
 6 health-care provider or institution.
 
 7      (e)  This chapter shall not authorize an agent or surrogate
 
 8 to consent to the admission of an individual to a psychiatric
 
 9 facility as defined in chapter 334, unless the individual's
 
10 written advance health-care directive expressly so provides.
 
11      (f)  This chapter shall not affect other laws of this State
 
12 governing treatment for mental illness of an individual
 
13 involuntarily committed to a psychiatric facility.
 
14      (g)  This chapter shall not apply to a patient diagnosed as
 
15 pregnant by the attending physician.
 
16      §    -15  Judicial relief.  On petition of a patient, the
 
17 patient's agent, guardian, or surrogate, a health-care provider
 
18 or institution involved with the patient's care, or an individual
 
19 described in section   -6(b) or (c), any court of competent
 
20 jurisdiction may enjoin or direct a health-care decision or order
 
21 other equitable relief.  A proceeding under this section shall be
 
22 governed by part 3 of article V of chapter 560."
 
23      SECTION 2.  Section 551D-2.5, Hawaii Revised Statutes, is
 

 
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 1 amended to read as follows:
 
 2      "[[]§551D-2.5[]]  Durable power of attorney for health care
 
 3 decisions.(a)  A competent person who has attained the age of
 
 4 majority may execute a durable power of attorney authorizing an
 
 5 agent to make any lawful health care decisions [that could have
 
 6 been made by the principal at the time of election.] pursuant to
 
 7 chapter  .
 
 8      [(b)  The durable power of attorney made pursuant to this
 
 9 section:
 
10      (1)  Shall be in writing;
 
11      (2)  Shall be signed by the principal, or by another person
 
12           in the principal's presence and at the principal's
 
13           expressed direction;
 
14      (3)  Shall be dated;
 
15      (4)  Shall be signed in the presence of two or more
 
16           witnesses who:
 
17           (A)  Are at least eighteen years of age;
 
18           (B)  Are not related to the principal by blood,
 
19                marriage, or adoption; and
 
20           (C)  Are not, at the time that the durable power of
 
21                attorney is executed, attending physicians,
 
22                employees of an attending physician, or employees
 
23                of a health care facility in which the principal
 

 
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 1                is a patient; and
 
 2      (5)  Shall have all signatures notarized at the same time.
 
 3      (c)  A durable power of attorney for health care decisions
 
 4 shall be presumed not to grant authority to decide that the
 
 5 principal's life should not be prolonged through surgery,
 
 6 resuscitation, life sustaining medicine or procedures or the
 
 7 provision of nutrition or hydration, unless such authority is
 
 8 explicitly stated.
 
 9      (d)  A durable power of attorney for health care decisions
 
10 shall only be effective during the period of incapacity of the
 
11 principal as determined by a licensed physician.
 
12      (e)  No person shall serve as both the treating physician
 
13 and attorney-in-fact for any principal for matters relating to
 
14 health care decisions.
 
15      (f)  A durable power of attorney for health care decisions
 
16 executed prior to June 12, 1992, that substantially complies with
 
17 the requirements of this chapter shall be considered valid
 
18 provided that the powers relating to the health care decisions
 
19 granted in the power of attorney have not been previously revoked
 
20 by the principal or otherwise terminated.]"
 
21      SECTION 3.  Chapter 327D, Hawaii Revised Statutes, is
 
22 repealed.
 
23      SECTION 4.  Act 332, Session Laws of Hawaii 1997, is
 

 
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 1 repealed.
 
 2      SECTION 5.  Section 551D-2.6, Hawaii Revised Statutes, is
 
 3 repealed.
 
 4      ["[§551D-2.6]  Durable power of attorney sample form.  The
 
 5 following sample form may be copied and used by filling in the
 
 6 blanks or may be changed to add more individualized instructions;
 
 7 or an entirely different format may be used to provide health
 
 8 care instructions.
 
 9        DURABLE POWER OF ATTORNEY FOR HEALTH CARE DECISIONS
 
10 A.   Statement of Principal
 
11      Declaration made this ________ day of ___________ (month,
 
12 year).  I, _________________, being of sound mind, and
 
13 understanding that I have the right to request that my life be
 
14 prolonged to the greatest extent possible, willfully and
 
15 voluntarily make known my desire that my attorney-in-fact
 
16 ("agent") shall be authorized as set forth below and do hereby
 
17 declare:
 
18      My instructions shall prevail even if they create a conflict
 
19 with the desires of my relatives, hospital policies, or the
 
20 principles of those providing my care.
 
21                             CHECKLIST
 
22      I have considered the extent of the authority 
 
23 I want my agent to have with respect to health care decisions if
 

 
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 1 I should develop a terminal condition or a permanent loss of the
 
 2 ability to communicate concerning medical treatment decisions
 
 3 with no reasonable chance of regaining this ability.  I want my
 
 4 agent to request care, including medicine and procedures, for the
 
 5 purpose of providing comfort and pain relief.  I have also
 
 6 considered whether my agent should have the authority to decide
 
 7 whether or not my life should be prolonged, and have selected one
 
 8 of the following provisions by putting a mark in the space
 
 9 provided:
 
10      ( )  My agent is authorized to decide whether my life should
 
11           be prolonged through surgery, resuscitation, life
 
12           sustaining medicine or procedures, and tube or other
 
13           artificial feeding or provisions of fluids by a tube.
 
14      ( )  My agent is authorized to decide whether my life should
 
15           be prolonged through tube or other artificial feeding
 
16           or provisions of fluids by a tube.
 
17      If neither provision is selected, it shall be presumed that
 
18 my agent shall have only the power to request care, including
 
19 medicine and procedures, for the purpose of providing comfort and
 
20 pain relief.
 
21      This durable power of attorney shall control in all
 
22 circumstances.  I understand that my physician may not act as my
 
23 agent under this durable power of attorney.
 

 
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 1      I understand the full meaning of this durable power of
 
 2 attorney and I am emotionally and mentally competent to make this
 
 3 declaration.
 
 4                                      Signed _____________________
 
 5                                      Address ____________________
 
 6 B.  Statement of Witnesses
 
 7      I am at least eighteen years of age and -not related to the
 
 8      principal by blood, marriage, or adoption; and
 
 9      -not currently the attending physician, an employee of the
 
10      attending physician, or an employee of the health care
 
11      facility in which the principal is a patient.
 
12      The principal is personally known to me and I believe the
 
13 principal to be of sound mind.
 
14                                    Witness ______________________
 
15                                    Address ______________________
 
16                                    Witness ______________________
 
17                                    Address ______________________
 
18 C.  Statement of Agent
 
19      I am at least eighteen years of age, I accept the
 
20 appointment under this durable power of attorney as the attorney-
 
21 in-fact ("agent") of the principal, and I am not the physician of
 
22 the principal.  The principal is personally known to me and I
 
23 believe the principal to be of sound mind.
 

 
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                                     S.B. NO.           S.D. 1
                                                        
                                                        

 
 1                                      Agent ______________________
 
 2                                     Address _____________________
 
 3 D.  Notarization.
 
 4      Subscribed, sworn to and acknowledged before me by
 
 5 _________________, the principal, and subscribed and sworn to
 
 6 before me by ______________________ and __________, witnesses,
 
 7 this day of ____________, 19 ____.
 
 8 (SEAL)
 
 9                              Signed _____________________________
 
10                                     _____________________________
 
11                                  (Official capacity of officer)"]
 
12      SECTION 6.  If any provision of this chapter or its
 
13 application to any person or circumstance is held invalid, the
 
14 invalidity does not affect other provisions or applications of
 
15 this chapter which can be given effect without the invalid
 
16 provision or application, and to this end the provisions of this
 
17 chapter are severable.
 
18      SECTION 7.  Statutory material to be repealed is bracketed.
 
19 New statutory material is underscored.
 
20      SECTION 8.  This Act shall take effect on July 1, 1999.
 

 
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