REPORT TITLE:
Health-Care Decisions


DESCRIPTION:
Creates a Uniform Health-Care Decisions Act.  (SD2)

 
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THE SENATE                              S.B. NO.           S.D. 2
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 a patient's
 
11 instruction or a power of attorney for health care.
 
12      "Agent" means a person designated in a power of attorney for
 
13 health care to make a health-care decision for the patient
 
14 granting the power.
 
15      "Capacity" means a patient'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 a
 
20 patient.
 

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

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

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

 
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 1 attorney shall be in writing, dated with the date of its
 
 2 execution, signed by the patient, and witnessed by one of the
 
 3 following methods:
 
 4      (1)  Signed by at least two individuals, each of whom
 
 5           witnessed either the signing of the instrument by the
 
 6           patient or the patient's acknowledgment of the
 
 7           signature or of the instrument; or
 
 8      (2)  Acknowledged before a notary public at any place within
 
 9           this State.
 
10      (c)  A witness for a power of attorney for health care shall
 
11 not be:
 
12      (1)  A health-care provider;
 
13      (2)  An employee of a health-care provider or facility;
 
14          or
 
15      (3)  An agent of (1) or (2).
 
16      (d)  At least one witness for a power of attorney for health
 
17 care shall not be:
 
18      (1)  A relative of the patient by blood, marriage, or
 
19           adoption; nor
 
20      (2)  An individual entitled to any portion of the estate of
 
21           the patient under any will or codicil existing at the
 
22           time of execution of the power of attorney for health
 
23           care or by operation of existing law.
 

 
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 1      (e)  Unless otherwise specified in a power of attorney for
 
 2 health care, the authority of an agent shall be effective only
 
 3 upon a determination that the patient lacks capacity, and shall
 
 4 cease to be effective upon a determination that the patient has
 
 5 recovered capacity.
 
 6      (f)  Unless otherwise specified in a written advance health-
 
 7 care directive, a determination that a patient lacks or has
 
 8 recovered capacity, or that another condition exists that affects
 
 9 a patient instruction or the authority of an agent, shall be made
 
10 by the primary physician.
 
11      (g)  An agent shall make a health-care decision in
 
12 accordance with the patient's instructions, if any, and other
 
13 wishes to the extent known to the agent.  Otherwise, the agent
 
14 shall make the decision in accordance with the agent's
 
15 determination of the patient's best interest.  In determining the
 
16 patient's best interest, the agent shall consider the patient's
 
17 personal values to the extent known to the agent.
 
18      (h)  A health-care decision made by an agent for a patient
 
19 shall be effective without judicial approval.
 
20      (i)  A written advance health-care directive may include the
 
21 patient's nomination of a guardian.
 
22      (j)  An advance health-care directive shall be valid for
 
23 purposes of this chapter if it complies with this chapter,
 

 
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 1 regardless of when or where executed or communicated.
 
 2      §    -4  Revocation of advance health-care directive.(a)
 
 3 A patient may revoke the designation of an agent only by a signed
 
 4 writing or by personally informing the supervising health-care
 
 5 provider.
 
 6      (b)  A patient may revoke all or part of an advance health-
 
 7 care directive, other than the designation of an agent, at any
 
 8 time and in any manner that communicates an intent to revoke.
 
 9      (c)  A health-care provider, agent, guardian, or surrogate
 
10 who is informed of a revocation shall promptly communicate the
 
11 fact of the revocation to the supervising health-care provider
 
12 and to any health-care institution at which the patient is
 
13 receiving care.
 
14      (d)  A decree of annulment, divorce, dissolution of
 
15 marriage, or legal separation shall revoke a previous designation
 
16 of a spouse as agent, unless otherwise specified in the decree or
 
17 in a power of attorney for health care.
 
18      (e)  An advance health-care directive that conflicts with an
 
19 earlier advance health-care directive shall revoke the earlier
 
20 directive to the extent of the conflict.
 
21      §    -5  Optional standard form.  The department of health
 
22 shall prepare, make available, and revise as necessary, a
 
23 standard form for optional use to create an advanced health-care
 

 
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 1 directive under this chapter.  The form shall be made available
 
 2 upon request to any person involved with preparing an advanced
 
 3 health-care directive.  The department may charge a reasonable
 
 4 fee for the form.
 
 5      §    -6  Decisions by a surrogate.(a)  A surrogate may
 
 6 make a health-care decision for a patient if the patient has been
 
 7 determined by the primary physician to lack capacity and no agent
 
 8 or guardian has been appointed, or the agent or guardian is not
 
 9 reasonably available.
 
10      (b)  A patient may designate any individual to act as a
 
11 surrogate by personally informing the supervising health-care
 
12 provider.  In the absence of a designation, or if the designee is
 
13 not reasonably available, any member of the following classes of
 
14 the patient's family who is reasonably available, in descending
 
15 order of priority, may act as surrogate:
 
16      (1)  The spouse, unless legally separated;
 
17      (2)  A reciprocal beneficiary;
 
18      (3)  An adult child;
 
19      (4)  A parent; or
 
20      (5)  An adult brother or sister.
 
21      (c)  If none of the individuals eligible to act as a
 
22 surrogate under subsection (b) is reasonably available, an adult
 
23 who has exhibited special care and concern for the patient, who
 

 
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 1 is familiar with the patient's personal values, and who is
 
 2 reasonably available may act as surrogate.
 
 3      (d)  A surrogate shall communicate the surrogate's
 
 4 assumption of authority as promptly as practicable to the members
 
 5 of the patient's family specified in subsection (b) who can be
 
 6 readily contacted.
 
 7      (e)  If more than one member of the patient's family assumes
 
 8 authority to act as surrogate, and if the members do not agree on
 
 9 a health-care decision and the supervising health-care provider
 
10 is so informed, the supervising health-care provider shall comply
 
11 with the decision of a majority of the members who have
 
12 communicated their views to the provider.  If the patient's
 
13 family is evenly divided concerning the health-care decision and
 
14 the supervising health-care provider is so informed, all
 
15 individuals having lower priority are disqualified from making
 
16 the decision.
 
17      (f)  A surrogate shall make a health-care decision in
 
18 accordance with the patient's instructions, if any, and other
 
19 wishes to the extent known to the surrogate.  Otherwise, the
 
20 surrogate shall make the decision in accordance with the
 
21 surrogate's determination of the patient's best interest.  In
 
22 determining the patient's best interest, the surrogate shall
 
23 consider the patient's personal values to the extent known to the
 

 
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 1 surrogate.
 
 2      (g)  A health-care decision made by a surrogate for a
 
 3 patient shall be effective without judicial approval.
 
 4      (h)  An individual under subsection (b), may at any time
 
 5 disqualify another, including a member of the patient's family,
 
 6 from acting as the patient's surrogate by a signed writing or by
 
 7 personally informing the supervising health-care provider of the
 
 8 disqualification.
 
 9      (i)  Unless related to the patient by blood, marriage, or
 
10 adoption, a surrogate shall not be an owner, operator, or
 
11 employee of a health-care institution where the patient is
 
12 receiving care.
 
13      (j)  A supervising health-care provider may require an
 
14 individual claiming the right to act as surrogate for a patient
 
15 to provide a written declaration under penalty of false swearing
 
16 stating facts and circumstances reasonably sufficient to
 
17 establish the claimed authority.
 
18      §    -7  Decisions by guardian.(a)  A guardian shall
 
19 comply with the patient's instructions and may not revoke the
 
20 patient's advance health-care directive unless the appointing
 
21 court expressly so authorizes.
 
22      (b)  Absent a court order to the contrary, a health-care
 
23 decision of an agent takes precedence over that of a guardian.
 

 
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 1      (c)  A health-care decision made by a guardian for the
 
 2 patient shall be effective without judicial approval.
 
 3      §    -8  Obligations of health-care provider.(a)  Before
 
 4 implementing a health-care decision made for a patient, a
 
 5 supervising health-care provider, if possible, shall promptly
 
 6 communicate to the patient the decision made and the identity of
 
 7 the person making the decision.
 
 8      (b)  A supervising health-care provider who knows of the
 
 9 existence of an advance health-care directive, a revocation of an
 
10 advance health-care directive, or a designation or
 
11 disqualification of a surrogate, shall promptly record its
 
12 existence in the patient's health-care record and, if it is in
 
13 writing, shall request a copy and if one is furnished shall
 
14 arrange for its maintenance in the health-care record.
 
15      (c)  A primary physician who makes or is informed of a
 
16 determination that a patient lacks or has recovered capacity, or
 
17 that another condition exists which affects a patient's
 
18 instruction, or the authority of an agent, guardian, or
 
19 surrogate, shall promptly record the determination in the
 
20 patient's health-care record and communicate the determination to
 
21 the patient, if possible, and to the agent, guardian, or
 
22 surrogate then authorized to make health-care decisions for the
 
23 patient.
 

 
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 1      (d)  Except as provided in subsections (e) and (f), a
 
 2 health-care provider or institution providing care to a patient
 
 3 shall:
 
 4      (1)  Comply with a patient's instruction and with a
 
 5           reasonable interpretation of that instruction made by
 
 6           the agent, guardian, or surrogate then authorized to
 
 7           make health-care decisions for the patient; and
 
 8      (2)  Comply with a health-care decision for the patient made
 
 9           by the agent, guardian, or surrogate then authorized to
 
10           make health-care decisions for the patient to the same
 
11           extent as if the decision had been made by the patient
 
12           while having capacity.
 
13      (e)  A health-care provider may decline to comply with a
 
14 patient's instruction or health-care decision for reasons of
 
15 conscience.  A health-care institution may decline to comply with
 
16 a patient's instruction or health-care decision if the
 
17 instruction or decision is contrary to a policy of the
 
18 institution which is expressly based on reasons of conscience and
 
19 if the policy was timely communicated to the patient or to the
 
20 agent, guardian, or surrogate then authorized to make health-care
 
21 decisions for the patient.
 
22      (f)  A health-care provider or institution may decline to
 
23 comply with a patient instruction or health-care decision that
 

 
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 1 requires medically ineffective health care or health care
 
 2 contrary to generally accepted health-care standards applicable
 
 3 to the health-care provider or institution.
 
 4      (g)  A health-care provider or institution that declines to
 
 5 comply with a patient instruction or health-care decision shall:
 
 6      (1)  Promptly inform the patient, if possible, and the
 
 7           agent, guardian, or surrogate then authorized to make
 
 8           health-care decisions for the patient;
 
 9      (2)  Provide continuing care to the patient until a transfer
 
10           can be effected; and
 
11      (3)  Unless the patient or the agent, guardian, or surrogate
 
12           then authorized to make health-care decisions for the
 
13           patient refuses assistance, immediately make all
 
14           reasonable efforts to assist in the transfer of the
 
15           patient to another health-care provider or institution
 
16           that is willing to comply with the instruction or
 
17           decision.
 
18      (h)  A health-care provider or institution shall not require
 
19 or prohibit the execution or revocation of advance health-care
 
20 directive as a condition for providing health care.
 
21      §    -9  Health-care information.  Unless otherwise
 
22 specified in an advance health-care directive, the agent,
 
23 guardian, or surrogate authorized to make health-care decisions
 

 
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 1 for a patient has the same rights as the patient to request,
 
 2 receive, examine, copy, and consent to the disclosure of medical
 
 3 or any other health-care information.
 
 4      §    -10  Immunities.(a)  A health-care provider or
 
 5 institution acting in good faith and in accordance with generally
 
 6 accepted health-care standards applicable to the health-care
 
 7 provider or institution shall not be subject to civil or criminal
 
 8 liability or to discipline for unprofessional conduct for:
 
 9      (1)  Complying with a health-care decision of the agent,
 
10           guardian, or surrogate apparently having authority to
 
11           make a health-care decision for a patient, including a
 
12           decision to withhold or withdraw health care;
 
13      (2)  Declining to comply with a health-care decision of the
 
14           agent, guardian, or surrogate based on a belief that
 
15           the agent, guardian, or surrogate then lacked
 
16           authority; or
 
17      (3)  Complying with an advance health-care directive on the
 
18           assumption that the directive was valid when made and
 
19           has not been revoked or terminated.
 
20      (b)  An agent, guardian, or surrogate under this chapter
 
21 shall not be subject to civil or criminal liability or to
 
22 discipline for unprofessional conduct for health-care decisions
 
23 made in good faith.
 

 
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 1      §    -11  Statutory damages.(a)  A health-care provider or
 
 2 institution that intentionally violates this chapter shall be
 
 3 subject to liability to the aggrieved individual for damages of
 
 4 $500, or for actual damages resulting from the violation,
 
 5 whichever is greater, plus reasonable attorney's fees.
 
 6      (b)  A person who intentionally falsifies, forges, conceals,
 
 7 defaces, or obliterates an individual's advance health-care
 
 8 directive or a revocation of an advance health-care directive
 
 9 without the individual's consent, or who coerces or fraudulently
 
10 induces an individual to give, revoke, or not to give an advance
 
11 health-care directive, shall be subject to liability to that
 
12 individual for damages of $2,500, or actual damages resulting
 
13 from the action, whichever is greater, plus reasonable attorney's
 
14 fees.
 
15      §    -12  Capacity.(a)  This chapter shall not affect the
 
16 right of a patient to make health-care decisions while having
 
17 capacity to do so.
 
18      (b)  An patient is presumed to have capacity to make a
 
19 health-care decision, to give or revoke an advance health-care
 
20 directive, and to designate or disqualify a surrogate.
 
21      §    -13  Effect of copy.  A copy of a written advance
 
22 health-care directive, revocation of an advance health-care
 
23 directive, or designation or disqualification of a surrogate
 

 
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 1 shall have the same effect as the original.
 
 2      §    -14  Effect of this chapter.(a)  This chapter shall
 
 3 not create a presumption concerning the intention of a patient
 
 4 who has not made or who has revoked an advance health-care
 
 5 directive.
 
 6      (b)  Death resulting from the withholding or withdrawal of
 
 7 health care in accordance with this chapter shall not for any
 
 8 purpose constitute a suicide or homicide, or legally impair or
 
 9 invalidate a policy of insurance or an annuity providing a death
 
10 benefit, notwithstanding any term of the policy or annuity to the
 
11 contrary.
 
12      (c)  This chapter shall not authorize mercy killing,
 
13 assisted suicide, euthanasia, or the provision, withholding, or
 
14 withdrawal of health care, to the extent prohibited by other
 
15 statutes of this State.
 
16      (d)  This chapter shall not authorize or require a health-
 
17 care provider or institution to provide health care contrary to
 
18 generally accepted health-care standards applicable to the
 
19 health-care provider or institution.
 
20      (e)  This chapter shall not authorize an agent, guardian, or
 
21 surrogate to consent to the admission of an individual to a
 
22 psychiatric facility as defined in chapter 334, unless the
 
23 patient's written advance health-care directive expressly so
 

 
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 1 provides.
 
 2      (f)  This chapter shall not affect other laws of this State
 
 3 governing treatment for mental illness of an individual
 
 4 involuntarily committed to a psychiatric facility.
 
 5      (g)  This chapter shall not apply to a patient diagnosed as
 
 6 pregnant by the attending physician.
 
 7      §    -15  Judicial relief.  On petition of a patient, the
 
 8 patient's agent, guardian, or surrogate, a health-care provider
 
 9 or institution involved with the patient's care, or an individual
 
10 described in section   -6(b) or (c), any court of competent
 
11 jurisdiction may enjoin or direct a health-care decision or order
 
12 other equitable relief.  A proceeding under this section shall be
 
13 governed by part 3 of article V of chapter 560."
 
14      SECTION 2.  Section 551D-2.5, Hawaii Revised Statutes, is
 
15 amended to read as follows:
 
16      "[[]§551D-2.5[]]  Durable power of attorney for health care
 
17 decisions.  [(a)]  A competent person who has attained the age of
 
18 majority may execute a durable power of attorney authorizing an
 
19 agent to make any lawful health care decisions [that could have
 
20 been made by the principal at the time of election.] pursuant to
 
21 chapter  .
 
22      [(b)  The durable power of attorney made pursuant to this
 
23 section:
 

 
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 1      (1)  Shall be in writing;
 
 2      (2)  Shall be signed by the principal, or by another person
 
 3           in the principal's presence and at the principal's
 
 4           expressed direction;
 
 5      (3)  Shall be dated;
 
 6      (4)  Shall be signed in the presence of two or more
 
 7           witnesses who:
 
 8           (A)  Are at least eighteen years of age;
 
 9           (B)  Are not related to the principal by blood,
 
10                marriage, or adoption; and
 
11           (C)  Are not, at the time that the durable power of
 
12                attorney is executed, attending physicians,
 
13                employees of an attending physician, or employees
 
14                of a health care facility in which the principal
 
15                is a patient; and
 
16      (5)  Shall have all signatures notarized at the same time.
 
17      (c)  A durable power of attorney for health care decisions
 
18 shall be presumed not to grant authority to decide that the
 
19 principal's life should not be prolonged through surgery,
 
20 resuscitation, life sustaining medicine or procedures or the
 
21 provision of nutrition or hydration, unless such authority is
 
22 explicitly stated.
 
23      (d)  A durable power of attorney for health care decisions
 

 
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 1 shall only be effective during the period of incapacity of the
 
 2 principal as determined by a licensed physician.
 
 3      (e)  No person shall serve as both the treating physician
 
 4 and attorney-in-fact for any principal for matters relating to
 
 5 health care decisions.
 
 6      (f)  A durable power of attorney for health care decisions
 
 7 executed prior to June 12, 1992, that substantially complies with
 
 8 the requirements of this chapter shall be considered valid
 
 9 provided that the powers relating to the health care decisions
 
10 granted in the power of attorney have not been previously revoked
 
11 by the principal or otherwise terminated.]"
 
12      SECTION 3.  Section 432E-4, Hawaii Revised Statutes, is
 
13 amended by amending subsection (c) to read as follows:
 
14      "(c)  The provider shall discuss with the enrollee and the
 
15 enrollee's immediate family both living wills and durable powers
 
16 of attorney in relation to medical treatment, as provided for in
 
17 [chapter 327D] and section 551D-2.5."
 
18      SECTION 4.  Chapter 327D, Hawaii Revised Statutes, is
 
19 repealed.
 
20      SECTION 5.  Section 551D-2.6, Hawaii Revised Statutes, is
 
21 repealed.
 
22      ["[§551D-2.6]  Durable power of attorney sample form.  The
 
23 following sample form may be copied and used by filling in the
 

 
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 1 blanks or may be changed to add more individualized instructions;
 
 2 or an entirely different format may be used to provide health
 
 3 care instructions.
 
 4        DURABLE POWER OF ATTORNEY FOR HEALTH CARE DECISIONS
 
 5 A.   Statement of Principal
 
 6      Declaration made this ________ day of ___________ (month,
 
 7 year).  I, _________________, being of sound mind, and
 
 8 understanding that I have the right to request that my life be
 
 9 prolonged to the greatest extent possible, willfully and
 
10 voluntarily make known my desire that my attorney-in-fact
 
11 ("agent") shall be authorized as set forth below and do hereby
 
12 declare:
 
13      My instructions shall prevail even if they create a conflict
 
14 with the desires of my relatives, hospital policies, or the
 
15 principles of those providing my care.
 
16                             CHECKLIST
 
17      I have considered the extent of the authority 
 
18 I want my agent to have with respect to health care decisions if
 
19 I should develop a terminal condition or a permanent loss of the
 
20 ability to communicate concerning medical treatment decisions
 
21 with no reasonable chance of regaining this ability.  I want my
 
22 agent to request care, including medicine and procedures, for the
 
23 purpose of providing comfort and pain relief.  I have also
 

 
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 1 considered whether my agent should have the authority to decide
 
 2 whether or not my life should be prolonged, and have selected one
 
 3 of the following provisions by putting a mark in the space
 
 4 provided:
 
 5      ( )  My agent is authorized to decide whether my life should
 
 6           be prolonged through surgery, resuscitation, life
 
 7           sustaining medicine or procedures, and tube or other
 
 8           artificial feeding or provisions of fluids by a tube.
 
 9      ( )  My agent is authorized to decide whether my life should
 
10           be prolonged through tube or other artificial feeding
 
11           or provisions of fluids by a tube.
 
12      If neither provision is selected, it shall be presumed that
 
13 my agent shall have only the power to request care, including
 
14 medicine and procedures, for the purpose of providing comfort and
 
15 pain relief.
 
16      This durable power of attorney shall control in all
 
17 circumstances.  I understand that my physician may not act as my
 
18 agent under this durable power of attorney.
 
19      I understand the full meaning of this durable power of
 
20 attorney and I am emotionally and mentally competent to make this
 
21 declaration.
 
22                                      Signed _____________________
 
23                                      Address ____________________
 

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

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

 
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