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H0119aa...............................................by HEALTH AND WELFARE MEDICAL CARE DECISIONS - Amends, adds to and repeals existing law relating to medical care decisions to define terms; to revise terminology; to revise provisions applicable to persons who may give consent to care for others; to provide for the refusal to consent; to provide for a specific form of expression relating to form of consent; to delete language referencing lay or professional employees; to revise the statement of policy; to revise provisions applicable to a living will and durable power of attorney for health care; to revise provisions applicable to revocation; to provide for physician orders for scope of treatment; to set forth provisions applicable to adherence to physician orders for scope of treatment protocol; to provide a duty to inspect; to revise provisions relating to immunity; and to revise general provisions. 02/07 House intro - 1st rdg - to printing 02/08 Rpt prt - to Health/Wel 02/23 Rpt out - to Gen Ord 02/27 Rpt out amen - to engros 02/28 Rpt engros - 1st rdg - to 2nd rdg as amen 03/01 2nd rdg - to 3rd rdg as amen 03/05 3rd rdg as amen - PASSED - 66-0-4 AYES -- Anderson, Andrus, Barrett, Bayer, Bedke, Bell, Bilbao, Black, Block, Bock, Boe, Bolz, Brackett, Chadderdon, Chavez, Chew, Clark, Collins, Crane, Durst, Edmunson, Eskridge, Hagedorn, Hart, Harwood, Henbest, Henderson, Jaquet, Killen, King, Kren, Labrador, Lake, LeFavour, Loertscher, Luker, Marriott, Mathews, Mortimer, Nielsen, Nonini, Pasley-Stuart, Patrick, Pence, Raybould, Ring, Ringo, Roberts, Ruchti, Rusche, Sayler, Schaefer, Shepherd(2), Shepherd(8), Shively, Smith(30), Smith(24), Snodgrass, Stevenson, Thayn, Trail, Vander Woude, Wills, Wood(27), Wood(35), Mr. Speaker NAYS -- None Absent and excused -- Bradford, McGeachin, Moyle, Shirley Floor Sponsor - Henbest Title apvd - to Senate 03/06 Senate intro - 1st rdg - to Health/Wel 03/13 Rpt out - rec d/p - to 2nd rdg 03/14 2nd rdg - to 3rd rdg 03/19 3rd rdg - PASSED - 31-1-3 AYES -- Andreason, Bair, Bastian, Bilyeu, Broadsword, Cameron, Coiner, Corder, Darrington, Davis, Geddes, Goedde, Hammond, Heinrich, Hill, Jorgenson, Kelly, Keough, Langhorst, Little, Lodge, McGee, McKague, McKenzie, Pearce, Richardson, Schroeder, Siddoway, Stegner, Stennett, Werk NAYS -- Burkett Absent and excused -- Fulcher, Gannon, Malepeai Floor Sponsors - Coiner & Lodge Title apvd - to House 03/20 To enrol - Rpt enrol - Sp signed 03/21 Pres signed - To Governor 03/27 Governor signed Session Law Chapter 196 Effective: 07/01/07
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]] Fifty-ninth Legislature First Regular Session - 2007IN THE HOUSE OF REPRESENTATIVES HOUSE BILL NO. 119 BY HEALTH AND WELFARE COMMITTEE 1 AN ACT 2 RELATING TO MEDICAL CARE DECISIONS; AMENDING SECTION 39-4501, IDAHO CODE, TO 3 PROVIDE A CODE REFERENCE; AMENDING CHAPTER 45, TITLE 39, IDAHO CODE, BY 4 THE ADDITION OF A NEW SECTION 39-4502, IDAHO CODE, TO DEFINE TERMS; AMEND- 5 ING SECTION 39-4502, IDAHO CODE, TO REDESIGNATE THE SECTION AND TO REVISE 6 TERMINOLOGY; AMENDING SECTION 39-4503, IDAHO CODE, TO REDESIGNATE THE SEC- 7 TION AND TO REVISE PROVISIONS APPLICABLE TO PERSONS WHO MAY GIVE CONSENT 8 TO CARE FOR OTHERS; AMENDING SECTION 39-4504, IDAHO CODE, TO REDESIGNATE 9 THE SECTION AND TO PROVIDE A CORRECT CODE REFERENCE; AMENDING SECTION 10 39-4505, IDAHO CODE, TO REDESIGNATE THE SECTION AND TO PROVIDE FOR THE 11 REFUSAL TO CONSENT; AMENDING SECTION 39-4506, IDAHO CODE, TO REDESIGNATE 12 THE SECTION AND TO PROVIDE FOR A SPECIFIC FORM OF EXPRESSION RELATING TO 13 FORM OF CONSENT; AMENDING SECTION 39-4507, IDAHO CODE, TO REDESIGNATE THE 14 SECTION AND TO DELETE LANGUAGE REFERENCING LAY OR PROFESSIONAL EMPLOYEES; 15 AMENDING SECTION 39-4508, IDAHO CODE, TO REDESIGNATE THE SECTION, TO 16 REVISE DESCRIPTIVE LANGUAGE, TO REVISE THE STATEMENT OF POLICY AND TO 17 DEFINE A TERM; REPEALING SECTION 39-4509, IDAHO CODE, RELATING TO DEFINI- 18 TIONS; AMENDING SECTION 39-4510, IDAHO CODE, TO REVISE PROVISIONS APPLICA- 19 BLE TO A LIVING WILL AND DURABLE POWER OF ATTORNEY FOR HEALTH CARE; AMEND- 20 ING SECTION 39-4511, IDAHO CODE, TO REVISE PROVISIONS APPLICABLE TO REVO- 21 CATION; AMENDING CHAPTER 45, TITLE 39, IDAHO CODE, BY THE ADDITION OF A 22 NEW SECTION 39-4512A, IDAHO CODE, TO PROVIDE FOR PHYSICIAN ORDERS FOR 23 SCOPE OF TREATMENT; AMENDING CHAPTER 45, TITLE 39, IDAHO CODE, BY THE 24 ADDITION OF A NEW SECTION 39-4512B, IDAHO CODE, TO SET FORTH PROVISIONS 25 APPLICABLE TO ADHERENCE TO PHYSICIAN ORDERS FOR SCOPE OF TREATMENT PROTO- 26 COL; AMENDING CHAPTER 45, TITLE 39, IDAHO CODE, BY THE ADDITION OF A NEW 27 SECTION 39-4512C, IDAHO CODE, TO PROVIDE A DUTY TO INSPECT; AMENDING SEC- 28 TION 39-4513, IDAHO CODE, TO REVISE PROVISIONS RELATING TO IMMUNITY; 29 AMENDING SECTION 39-4514, IDAHO CODE, TO REVISE GENERAL PROVISIONS; 30 REPEALING SECTIONS 56-1020 THROUGH 56-1035, IDAHO CODE, RELATING TO DECI- 31 SIONS RELATIVE TO THE RENDERING OR WITHHOLDING OF MEDICAL CARE; AND AMEND- 32 ING SECTION 66-405, IDAHO CODE, TO REVISE A CODE REFERENCE. 33 Be It Enacted by the Legislature of the State of Idaho: 34 SECTION 1. That Section 39-4501, Idaho Code, be, and the same is hereby 35 amended to read as follows: 36 39-4501. PURPOSES -- APPLICATION. (1) The primary purposes of this chap- 37 ter are: 38 (a) To provide and codify Idaho law concerning consent for the furnishing 39 of hospital, medical, dental or surgical care, treatment or procedures, 40 and concerning what constitutes an informed consent for such care, treat- 41 ment or procedures; and 42 (b) To provide certainty and clarity in the law of medical consent in the 43 furtherance of high standards of health care and its ready availability in 2 1 proper cases. 2 (2) Nothing in this chapter shall be deemed to amend or repeal the provi- 3 sions of chapter 3 or chapter 4, title 66, Idaho Code, as those provisions 4 pertain to hospitalization of the mentally ill, nor the provisions of chapter 5 6, title 18, Idaho Code, pertaining to the provision of examinations, pre- 6 scriptions, devices and informational materials regarding prevention of preg- 7 nancy or pertaining to therapeutic abortions and consent to the performance 8 thereof. 9 (3) Nothing in this chapter shall be construed to permit or require the 10 provision of health care for a patient in contravention of the patient's 11 stated or implied objection thereto upon religious grounds nor shall anything 12 in this chapter be construed to require the granting of permission for or on 13 behalf of any patient who is not able to act for himself by his parent, spouse 14 or guardian in violation of the religious beliefs of the patient or the 15 patient's parent or spouse. 16 SECTION 2. That Chapter 45, Title 39, Idaho Code, be, and the same is 17 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 18 ignated as Section 39-4502, Idaho Code, and to read as follows: 19 39-4502. DEFINITIONS. As used in this chapter: 20 (1) "Artificial life-sustaining procedure" means any medical procedure or 21 intervention that utilizes mechanical means to sustain or supplant a vital 22 function which, when applied to a qualified patient, would serve only to arti- 23 ficially prolong life. "Artificial life-sustaining procedure" does not include 24 the administration of pain management medication or the performance of any 25 medical procedure deemed necessary to provide comfort care or to alleviate 26 pain. 27 (2) "Artificial nutrition and hydration" means supplying food and water 28 through a conduit, such as a tube or intravenous line, where the recipient is 29 not required to chew or swallow voluntarily, but does not include assisted 30 feeding, such as spoon feeding or bottle feeding. 31 (3) "Attending physician" means the physician licensed by the state board 32 of medicine who is selected by, or assigned to, the patient and who has pri- 33 mary responsibility for the treatment and care of the patient. 34 (4) "Cardiopulmonary resuscitation" or "CPR" means measures to restore 35 cardiac function and/or to support ventilation in the event of cardiac or 36 respiratory arrest. 37 (5) "Comfort care" means treatment and care to provide comfort and clean- 38 liness. "Comfort care" includes: 39 (a) Oral and body hygiene; 40 (b) Reasonable efforts to offer food and fluids orally; 41 (c) Medication, positioning, warmth, appropriate lighting and other mea- 42 sures to relieve pain and suffering; and 43 (d) Privacy and respect for the dignity and humanity of the patient. 44 (6) "Consent to care" includes refusal to consent to care and/or with- 45 drawal of care. 46 (7) "Directive" or "health care directive" means a document meeting the 47 requirements of section 39-4510(1), Idaho Code, and/or a "Physician Orders for 48 Scope of Treatment (POST)" form signed by a physician. 49 (8) "Emergency medical services personnel" means personnel engaged in 50 providing initial emergency medical assistance including, but not limited to, 51 first responders, emergency medical technicians and paramedics. 52 (9) "Health care provider" or "provider" means any person or entity 53 licensed, certified, or otherwise authorized by law to administer health care 3 1 in the ordinary course of business or practice of a profession, including 2 emergency or other medical services personnel. 3 (10) "Persistent vegetative state" means an irreversible state that has 4 been medically confirmed by a neurological specialist who is an expert in the 5 examination of nonresponsive individuals in which the person has intact brain 6 stem function but no higher cortical function and no awareness of self or 7 environment. 8 (11) "Physician" means a person who holds a current active license to 9 practice medicine and surgery or osteopathic medicine and surgery in Idaho and 10 is in good standing with no restriction upon or actions taken against his or 11 her license. 12 (12) "Physician orders for scope of treatment (POST) form" means a stan- 13 dardized form containing orders by a physician that states a person's treat- 14 ment wishes. 15 (13) "Physician orders for scope of treatment (POST) identification 16 device" means standardized jewelry which can be worn around the wrist, neck or 17 ankle, and which has been approved by the department of health and welfare. 18 (14) "Terminal condition" means an incurable or irreversible condition 19 which, without the administration of life-sustaining procedures, will, in the 20 opinion of a physician, result in death if it runs its usual course. 21 SECTION 3. That Section 39-4502, Idaho Code, be, and the same is hereby 22 amended to read as follows: 23 39-45023. PERSONS WHO MAY CONSENT TO THEIR OWN CARE. Any person of ordi- 24 nary intelligence and awareness sufficient for him or her generally to compre- 25 hend the need for, the nature of and the significant risks ordinarily inherent 26 in, any contemplated hospital, medical, dental or surgical care, treatment or 27 procedure is competent to consent thereto on his or her own behalf. Anyphysi-28cian, dentist, hospital or other duly authorized personhealth care provider 29 may provide such health care and services in reliance upon such a consent if 30 the consenting person appears to thephysician or dentisthealth care provider 31 securing the consent to possess such requisite intelligence and awareness at 32 the time of giving the consent. 33 SECTION 4. That Section 39-4503, Idaho Code, be, and the same is hereby 34 amended to read as follows: 35 39-45034. PERSONS WHO MAY GIVE CONSENT TO CARE FOR OTHERS. (1) Consent 36 for the furnishing of hospital, medical, dental or surgical care, treatment or 37 procedures to any person who is not then capable of giving such consent as 38 provided in this chapter or who is a minor or incompetent person, may be given 39 or refused in the order of priority set forth hereafter unless the patient is 40 a competent person who has refused to give such consent, and provided further 41 that this subsection shall not be deemed to authorize any person to override 42 the express refusal by a competent patient to give such consent himself: 43 (a) The legal guardian of such person; 44 (b) The person named in a "Living Will and Durable Power of Attorney for 45 Health Care" pursuant to section 39-4510, Idaho Code, or a similar docu- 46 ment authorized by this chapter; 47 (c) If married, the spouse of such person; 48 (d) A parent of such person; 49 (e) Any relative representing himself or herself to be an appropriate, 50 responsible person to act under the circumstances; 51 (f) Any other competent individual representing himself or herself to be 4 1 responsible for the health care of such person; or 2 (g) If the subject person presents a medical emergency or there is a sub- 3 stantial likelihood of his or her life or health being seriously endan- 4 gered by withholding or delay in the rendering of such hospital, medical, 5 dental or surgical care to such patient and the subject person has not 6 communicated and is unable to communicate his or her treatment wishes, the 7 attending physician or dentist may, in his or her discretion, authorize 8 and/or provide such care, treatment or procedure as he or she deems appro- 9 priate, and all persons, agencies and institutions thereafter furnishing 10 the same, including such physician or dentist, may proceed as if informed, 11 valid consent therefor had been otherwise duly given. 12 (2) No person who, in good faith, gives consent or authorization for the 13 provision of hospital, medical, dental or surgical care, treatment or proce- 14 dures to another as provided by this chapter shall be subject to civil liabil- 15 ity therefor. 16 (3) Nophysician, dentist, hospital or other duly authorized person17 health care provider who, in good faith, obtains consent from a person pursu- 18 ant to either section 39-45023 or 39-45034(1), Idaho Code, shall be subject to 19 civil liability therefor. 20 SECTION 5. That Section 39-4504, Idaho Code, be, and the same is hereby 21 amended to read as follows: 22 39-45045. BLOOD TESTING. (1) A physician may consent to ordering tests of 23 a patient's or a deceased person's blood or other body fluids for the presence 24 of blood-transmitted or body fluid-transmitted viruses or diseases without the 25 prior consent of the patient if: 26 (a) There has been or is likely to be a significant exposure to the 27 patient's or a deceased person's blood or body fluids by a person provid- 28 ing emergency or medical services to such patient which may result in the 29 transmittal of a virus or disease; and 30 (b) The patient is unconscious or incapable of giving informed consent 31 and the physician is unable to obtain consent pursuant to section 32 39-45034, Idaho Code. 33 (2) The department of health and welfare shall promulgate rules identify- 34 ing the blood-transmitted or body fluid-transmitted viruses or diseases for 35 which blood tests or body fluid tests can be ordered under this section and 36 defining the term "significant exposure" as provided in this section. 37 (3) Results of tests conducted under this section which confirm the pres- 38 ence of a blood-transmitted or body fluid-transmitted virus or disease shall 39 be reported to the director of the department of health and welfare in the 40 name of the patient or deceased person. The department records containing such 41 test results shall be used only by public health officials who must conduct 42 investigations. The exposed person shall only be informed of the results of 43 the test and shall not be informed of the name of the patient or deceased per- 44 son. Protocols shall be established by hospitals to maintain confidentiality 45 while disseminating the necessary test result information to persons who may 46 have a significant exposure to blood or other body fluids and to maintain 47 records of such tests to preserve the confidentiality of the test results. 48 (4) Any person who willfully or maliciously discloses the results of a 49 test conducted under this section, except pursuant to a written authorization 50 by the person whose blood was tested or by such person's authorized represen- 51 tative, or as otherwise authorized by law, shall be guilty of a misdemeanor. 52 SECTION 6. That Section 39-4505, Idaho Code, be, and the same is hereby 5 1 amended to read as follows: 2 39-45056. SUFFICIENCY OF CONSENT. Consent, or refusal to consent, for the 3 furnishing of hospital, medical, dental or surgical care, treatment or proce- 4 dures shall be valid in all respects if the person giving or refusing the con- 5 sent is sufficiently aware of pertinent facts respecting the need for, the 6 nature of, and the significant risks ordinarily attendant upon, such a patient 7 receiving such care, as to permit the giving or withholding of such consent to 8 be a reasonably informed decision. Any such consent shall be deemed valid and 9 so informed if the physician or dentist to whom it is given or by whom it is 10 secured has made such disclosures and given such advice respecting pertinent 11 facts and considerations as would ordinarily be made and given under the same 12 or similar circumstances, by a like physician or dentist of good standing 13 practicing in the same community. As used in this section, the term "in the 14 same community" refers to that geographic area ordinarily served by the 15 licensed general hospital at or nearest to which such consent is given. 16 SECTION 7. That Section 39-4506, Idaho Code, be, and the same is hereby 17 amended to read as follows: 18 39-45067. FORM OF CONSENT. It is not essential to the validity of any 19 consent for the furnishing of hospital, medical, dental or surgical care, 20 treatment or procedures that the consent be in writing or any other specific 21 form of expression; provided however, when the giving of such consent is 22 recited or documented in writing and expressly authorizes the care, treatment 23 or procedures to be furnished, and when such writing or form has been executed 24 or initialed by a person competent to give such consent for himself or 25 another, such written consent, in the absence of convincing proof that it was 26 secured maliciously or by fraud, is presumed to be valid for the furnishing of 27 such care, treatment or procedures, and the advice and disclosures of the 28 attending physician or dentist, as well as the level of informed awareness of 29 the giver of such consent, shall be presumed to be sufficient. 30 SECTION 8. That Section 39-4507, Idaho Code, be, and the same is hereby 31 amended to read as follows: 32 39-45078. RESPONSIBILITY FOR CONSENT AND DOCUMENTATION. Obtaining consent 33 for health care is the duty of the attending physician or dentist or of 34 another physician or dentist acting on his or her behalf or actually providing 35 the contemplated care, treatment or procedure; provided however, a licensed 36 hospital and any medical or dental officelay or professionalemployee, acting 37 with the approval of such an attending or other physician or dentist, may per- 38 form the ministerial act of documenting such consent by securing the comple- 39 tion and execution of a form or statement in which the giving of consent for 40 such care is documented by or on behalf of the patient. In performing such a 41 ministerial act, the hospital or medical or dental officelay or professional42 employee shall not be deemed to have engaged in the practice of medicine or 43 dentistry. 44 SECTION 9. That Section 39-4508, Idaho Code, be, and the same is hereby 45 amended to read as follows: 46 39-45089. STATEMENT OF POLICY -- DEFINITION. For purposes of sections 47 39-45089 through 39-45145, Idaho Code: 48 (1) The legislaturefinds thatrecognizes the established common law and 6 1 the fundamental right of adult personshave the fundamental rightto control 2 the decisions relating to the rendering of their medical care, including the 3 decision to have life-sustaining procedures withheld or withdrawn. The legis- 4 lature further finds that modern medical technology has made possible the 5 artificial prolongation of human life beyond natural limits. The legislature 6 further finds that patients are sometimes unable to express their desire to 7 withhold or withdraw such artificial life prolongation procedures which pro- 8 vide nothing medically necessary or beneficial to the patient because of the 9 patient's inability to communicate with the physician. 10 (2) In recognition of the dignity and privacy which patients have a right 11 to expect, the legislature hereby declares that the laws of this state shall 12 recognize the right of a competent person to have his or her wishes for medi- 13 cal treatment and for the withdrawal of artificial life-sustaining procedures 14 carried out even though that person is no longer able to communicate with the 15 physician. 16 (3) It is the intent of the legislature to establish an effective means 17 for such communication. It is not the intent of the legislature that the pro- 18 cedures described inthis chaptersections 39-4509 through 39-4515, Idaho 19 Code, are the only effective means of such communication, and nothing inthis20chaptersections 39-4509 through 39-4515, Idaho Code, shall impair or super- 21 sede any legal right or legal responsibility which a person may have to effect 22 the withholding or withdrawal of life-sustaining procedures in any lawful man- 23 ner. Any authentic expression of a person's wishes with respect to health care 24 should be honored. 25 (4) "Competent person" means any emancipated minor or person eighteen 26 (18) or more years of age who is of sound mind. 27 SECTION 10. That Section 39-4509, Idaho Code, be, and the same is hereby 28 repealed. 29 SECTION 11. That Section 39-4510, Idaho Code, be, and the same is hereby 30 amended to read as follows: 31 39-4510. LIVING WILL AND DURABLE POWER OF ATTORNEY FOR HEALTH CARE. (1) 32 Any competent person may execute a document known as a "Living Will and Dura- 33 ble Power of Attorney for Health Care." Such document shall be in substan- 34 tially the following form, or in another form that contains the elements set 35 forth in this chapter.A "Living Will and Durable Power of Attorney for Health36Care" executed prior to the effective date of this act, but which was in the37"Living Will" and/or "Durable Power of Attorney for Health Care" form pursuant38to prior Idaho law at the time of execution, or in another form that contained39the elements set forth in this chapter at the time of execution, shall be40deemed to be in compliance with this chapter. A "Living Will and Durable Power41of Attorney for Health Care" or similar document(s) executed in another state42which substantially complies with this chapter shall be deemed to be in com-43pliance with this chapter. In this chapter, a "Living Will and Durable Power44of Attorney for Health Care" may be referred to as a "directive."Any portions 45 of the "Living Will and Durable Power of Attorney for Health Care" which are 46 left blank by the person executing the document shall be deemed to be inten- 47 tional and shall not invalidate the document. 48 LIVING WILL AND DURABLE POWER OF ATTORNEY FOR HEALTH CARE 49 Date of Directive:.................... 7 1 Name of person executing Directive:........................................... 2 Address of person executing Directive:........................................ 3 A LIVING WILL 4 A Directive to Withhold or to Provide Treatment 5 1.Being of sound mind,I willfully and voluntarily make known my desire that 6 my life shall not be prolonged artificially under the circumstances set forth 7 below. This Directive shall only be effective if I am unable to communicate my 8 instructions and: 9 a. I have an incurable or irreversible injury, disease, illness or condi- 10 tion, andtwo (2)a medical doctorswhohavehas examined mehavehas cer- 11 tified: 12 1. That such injury, disease, illness or condition is terminal; and 13 2. That the application of artificial life-sustaining procedures 14 would serve only to prolong artificially my life; and 15 3. That my death is imminent, whether or not artificial life- 16 sustaining procedures are utilized; or 17 b. I have been diagnosed as being in a persistent vegetative state. 18 In such event, I direct that the following marked expression of my intent be 19 followed, and that I receive any medical treatment or care that may be 20 required to keep me free of pain or distress. 21 Check one box and initial the line after such box: 22 ........ I direct that all medical treatment, care and procedures neces- 23 sary to restore my health,and sustain my life, and to abolish or alleviate24pain or distressbe provided to me. Nutrition and hydration, whether artifi- 25 cial or nonartificial, shall not be withheld or withdrawn from me if I would 26 likely die primarily from malnutrition or dehydration rather than from my 27 injury, disease, illness or condition. 28 OR 29 ........ I direct that all medical treatment, care and procedures, 30 including artificial life-sustaining procedures, be withheld or withdrawn, 31 except that nutrition and hydration, whether artificial or nonartificial shall 32 not be withheld or withdrawn from me if, as a result, I would likely die pri- 33 marily from malnutrition or dehydration rather than from my injury, disease, 34 illness or condition, as follows: (If none of the following boxes are checked 35 and initialed, then both nutrition and hydration, of any nature, whether arti- 36 ficial or nonartificial, shall be administered.) 37 Check one box and initial the line after such box: 38 A. ........ Only hydration of any nature, whether artificial or 39 nonartificial, shall be administered; 40 B. ........ Only nutrition, of any nature, whether artificial or 41 nonartificial, shall be administered; 42 C. ........ Both nutrition and hydration, of any nature, whether 43 artificial or nonartificial shall be administered. 44 OR 45 ........ I direct that all medical treatment, care and procedures be 8 1 withheld or withdrawn, including withdrawal of the administration of artifi- 2 cial nutrition and hydration. 3 2.This Directive shall be the final expression of my legal right to refuse4or accept medical and surgical treatment, and I accept the consequences of5such refusal or acceptance.63.If I have been diagnosed as pregnant, this Directive shall have no force 7 during the course of my pregnancy. 843. I understand the full importance of this Directive and am mentally compe- 9 tent to make this Directive. No participant in the making of this Directive or 10 in its being carried into effect shall be held responsible in any way for com- 11 plying with my directions. 12 4. Check one box and initial the line after such box: 13 ........ I have discussed these decisions with my physician and have also 14 completed a Physician Orders for Scope of Treatment (POST) form that contains 15 directions that may be more specific than, but are compatible with, this 16 Directive. I hereby approve of those orders and incorporate them herein as if 17 fully set forth. 18 OR 19 ........ I have not completed a Physician Orders for Scope of Treatment 20 (POST) form. If a POST form is later signed by my physician, then this living 21 will shall be deemed modified to be compatible with the terms of the POST 22 form. 23 A DURABLE POWER OF ATTORNEY FOR HEALTH CARE 24 1. DESIGNATION OF HEALTH CARE AGENT. None of the following may be designated 25 as your agent: (1) your treating health care provider; (2) a nonrelative 26 employee of your treating health care provider; (3) an operator of a community 27 care facility; or (4) a nonrelative employee of an operator of a community 28 care facility. If the agent or an alternate agent designated in this Directive 29 is my spouse, and our marriage is thereafter dissolved, such designation shall 30 be thereupon revoked. 31 I do hereby designate and appoint the following individual as my attorney in 32 fact (agent) to make health care decisions for me as authorized in this Direc- 33 tive. (Insert name, address and telephone number of one individual only as 34 your agent to make health care decisions for you.) 35 Name of Health Care Agent: ................................................... 36 Address of Health Care Agent: ................................................ 37 Telephone Number of Health Care Agent: ....................................... 38 For the purposes of this Directive, "health care decision" means consent, 39 refusal of consent, or withdrawal of consent to any care, treatment, service 40 or procedure to maintain, diagnose or treat an individual's physical condi- 41 tion. 42 2. CREATION OF DURABLE POWER OF ATTORNEY FOR HEALTH CARE. By this portion of 9 1 this Directive, I create a durable power of attorney for health care. This 2 power of attorney shall not be affected by my subsequent incapacity. This 3 power shall be effective only when I am unable to communicate rationally. 4 3. GENERAL STATEMENT OF AUTHORITY GRANTED.Subject to any limitations in this5Directive, including as set forth in paragraph 2 immediately above,I hereby 6 grant to my agent full power and authority to make health care decisions for 7 me to the same extent that I could make such decisions for myself if I had the 8 capacity to do so. In exercising this authority, my agent shall make health 9 care decisions that are consistent with my desires as stated in this Directive 10 or otherwise made known to my agent including, but not limited to, my desires 11 concerning obtaining or refusing or withdrawing artificial life-prolongingsus- 12 taining care, treatment, services and procedures, including such desires set 13 forth in a living will, Physician Orders for Scope of Treatment (POST) form, 14 or similar document executed by me, if any. (If you want to limit the author- 15 ity of your agent to make health care decisions for you, you can state the 16 limitations in paragraph 4 ("Statement of Desires, Special Provisions, and 17 Limitations") below. You can indicate your desires by including a statement of 18 your desires in the same paragraph.) 19 4. STATEMENT OF DESIRES, SPECIAL PROVISIONS, AND LIMITATIONS. (Your agent 20 must make health care decisions that are consistent with your known desires. 21 You can, but are not required to, state your desires in the space provided 22 below. You should consider whether you want to include a statement of your 23 desires concerning artificial life-prolongingsustaining care, treatment, ser- 24 vices and procedures. You can also include a statement of your desires con- 25 cerning other matters relating to your health care, including a list of one or 26 more persons whom you designate to be able to receive medical information 27 about you and/or to be allowed to visit you in a medical institution. You can 28 also make your desires known to your agent by discussing your desires with 29 your agent or by some other means. If there are any types of treatment that 30 you do not want to be used, you should state them in the space below. If you 31 want to limit in any other way the authority given your agent by this Direc- 32 tive, you should state the limits in the space below. If you do not state any 33 limits, your agent will have broad powers to make health care decisions for 34 you, except to the extent that there are limits provided by law.) In exercis- 35 ing the authority under this durable power of attorney for health care, my 36 agent shall act consistently with my desires as stated below and is subject to 37 the special provisions and limitations stated in my Physician Orders for Scope 38 of Treatment (POST) form, a living will, or similar document executed by me, 39 if any. Additional statement of desires, special provisions, and limitations:. 40 .......(You may attach additional pages or documents if you need more space to 41 complete your statement.) 42 5. INSPECTION AND DISCLOSURE OF INFORMATION RELATING TO MY PHYSICAL OR MENTAL 43 HEALTH. 44 A. General Grant of Power and Authority. Subject to any limitations in this 45 Directive, my agent has the power and authority to do all of the following: 46 (1) Request, review and receive any information, verbal or written, regarding 47 my physical or mental health including, but not limited to, medical and hospi- 48 tal records; (2) Execute on my behalf any releases or other documents that may 49 be required in order to obtain this information; (3) Consent to the disclosure 50 of this information; and (4) Consent to the donation of any of my organs for 51 medical purposes. (If you want to limit the authority of your agent to receive 10 1 and disclose information relating to your health, you must state the limita- 2 tions in paragraph 4 ("Statement of Desires, Special Provisions, and Limita- 3 tions") above.) 4 B. HIPAA Release Authority. My agent shall be treated as I would be with 5 respect to my rights regarding the use and disclosure of my individually iden- 6 tifiable health information or other medical records. This release authority 7 applies to any information governed by the Health Insurance Portability and 8 Accountability Act of 1996 (HIPAA), 42 U.S.C. 1320d and 45 CFR 160 through 9 164. I authorize any physician, health care professional, dentist, health 10 plan, hospital, clinic, laboratory, pharmacy, or other covered health care 11 provider, any insurance company, and the Medical Information Bureau, Inc. or 12 other health care clearinghouse that has provided treatment or services to me, 13 or that has paid for or is seeking payment from me for such services, to give, 14 disclose and release to my agent, without restriction, all of my individually 15 identifiable health information and medical records regarding any past, pres- 16 ent or future medical or mental health condition, including all information 17 relating to the diagnosis of HIV/AIDS, sexually transmitted diseases, mental 18 illness, and drug or alcohol abuse. The authority given my agent shall super- 19 sede any other agreement that I may have made with my health care providers to 20 restrict access to or disclosure of my individually identifiable health infor- 21 mation. The authority given my agent has no expiration date and shall expire 22 only in the event that I revoke the authority in writing and deliver it to my 23 health care provider. 24 6. SIGNING DOCUMENTS, WAIVERS AND RELEASES. Where necessary to implement the 25 health care decisions that my agent is authorized by this Directive to make, 26 my agent has the power and authority to execute on my behalf all of the fol- 27 lowing: (a) Documents titled, or purporting to be, a "Refusal to Permit Treat- 28 ment" and/or a "Leaving Hospital Against Medical Advice"; and (b) Any neces- 29 sary waiver or release from liability required by a hospital or physician. 30 7. DESIGNATION OF ALTERNATE AGENTS. (You are not required to designate any 31 alternate agents but you may do so. Any alternate agent you designate will be 32 able to make the same health care decisions as the agent you designated in 33 paragraph 1 above, in the event that agent is unable or ineligible to act as 34 your agent. If an alternate agent you designate is your spouse, he or she 35 becomes ineligible to act as your agent if your marriage is thereafter dis- 36 solved.) If the person designated as my agent in paragraph 1 is not available 37 or becomes ineligible to act as my agent to make a health care decision for me 38 or loses the mental capacity to make health care decisions for me, or if I 39 revoke that person's appointment or authority to act as my agent to make 40 health care decisions for me, then I designate and appoint the following per- 41 sons to serve as my agent to make health care decisions for me as authorized 42 in this Directive, such persons to serve in the order listed below: 43 A. First Alternate Agent: 44 Name.......................................................................... 45 Address....................................................................... 46 Telephone Number.............................................................. 47 B. Second Alternate Agent: 48 Name.......................................................................... 49 Address....................................................................... 50 Telephone Number.............................................................. 11 1 C. Third Alternate Agent: 2 Name.......................................................................... 3 Address....................................................................... 4 Telephone Number.............................................................. 5 8. PRIOR DESIGNATIONS REVOKED. I revoke any prior durable power of attorney 6 for health care. 7 DATE AND SIGNATURE OF PRINCIPAL. (You must date and sign this Living Will and 8 Durable Power of Attorney for Health Care.) 9 I sign my name to this Statutory Form Living Will and Durable Power of Attor- 10 ney for Health Care on the date set forth at the beginning of this Form at 11 ............... (City, State).................... 12 .............................. 13 Signature 14 (2) A health care directive meeting the requirements of subsection (1) of 15 this section may be registered with the secretary of state pursuant to the 16 provisions of section 39-4515, Idaho Code. Failure to register the health care 17 directive shall not affect the validity of the health care directive. 18 SECTION 12. That Section 39-4511, Idaho Code, be, and the same is hereby 19 amended to read as follows: 20 39-4511. REVOCATION. (1) A"LlivingWwill andDdurablePpower of 21Aattorney forHhealthCcare"or physician orders for scope of treatment 22 (POST) form may be revoked at any time by the maker thereof, without regard to23his mental state or competence,by any of the following methods: 24 (a) By being canceled, defaced, obliterated or burned, torn, or otherwise 25 destroyed by the maker thereof, or by some person in his presence and by 26 his direction; 27 (b) By a written, signed revocation of the maker thereof expressing his 28 intent to revoke; or 29 (c) By an oral expression by the maker thereof expressing his intent to 30 revoke. 31 (2) The maker of the revoked living will and durable power of attorney 32 for health care is responsible for notifying his physician of the revocation. 33 (3) There shall be no criminal or civil liability on the part of any per- 34 son for the failure to act upon a revocation of a"LlivingWwill andDdurable 35Ppower ofAattorney forHhealthCcare"or physician orders for scope of treat- 36 ment (POST) form made pursuant to this section unless that person has actual 37 knowledge of the revocation. 38(3) A person may register a revocation of a health care directive which39meets the requirements of subsection (1)(b) of this section with the secretary40of state pursuant to the provisions of section 39-4515, Idaho Code. Failure to41register a revocation of the health care directive shall not affect the valid-42ity of the revocation.43 SECTION 13. That Chapter 45, Title 39, Idaho Code, be, and the same is 44 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 45 ignated as Section 39-4512A, Idaho Code, and to read as follows: 46 39-4512A. PHYSICIAN ORDERS FOR SCOPE OF TREATMENT (POST). (1) A physician 12 1 orders for scope of treatment (POST) form is appropriate in cases where a 2 patient has an incurable or irreversible injury, disease, illness or condi- 3 tion, or where a patient is in a persistent vegetative state. A POST form is 4 also appropriate if such conditions are anticipated. 5 (2) The POST form shall be effective from the date of execution unless 6 otherwise revoked. If there is a conflict between the person's expressed 7 directives, the POST form, and the decisions of the durable power of attorney 8 representative or surrogate, the orders contained in the POST form shall be 9 followed. 10 (3) The attending physician shall, upon request of the patient, provide 11 the patient with a copy of the POST form, discuss with the patient the form's 12 content and ramifications and treatment options, and assist the patient in the 13 completion of the form. 14 (4) The attending physician shall review the POST form: 15 (a) Each time the physician examines the patient, or at least every seven 16 (7) days, for patients who are hospitalized; and 17 (b) Each time the patient is transferred from one (1) care setting or 18 care level to another; and 19 (c) Any time there is a substantial change in the patient's health sta- 20 tus; and 21 (d) Any time the patient's treatment preferences change. 22 Failure to meet these review requirements does not affect the POST form's 23 validity or enforceability. As conditions warrant, the physician may issue a 24 superseding POST form. The physician shall, whenever practical, consult with 25 the patient or the patient's agent. 26 (5) A patient who has completed a POST form signed by a physician may 27 wear a POST identification device as provided in section 39-4502(13), Idaho 28 Code. 29 (6) The department of health and welfare shall develop the POST form. 30 SECTION 14. That Chapter 45, Title 39, Idaho Code, be, and the same is 31 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 32 ignated as Section 39-4512B, Idaho Code, and to read as follows: 33 39-4512B. ADHERENCE TO PHYSICIAN ORDERS FOR SCOPE OF TREATMENT (POST) 34 PROTOCOL. (1) Health care providers and emergency medical services personnel 35 shall comply with a patient's physician orders for scope of treatment (POST) 36 instruction when presented with a completed POST form signed by a physician or 37 when a patient is wearing a proper POST identification device pursuant to sec- 38 tion 39-4512A(5), Idaho Code. 39 (2) A completed POST form is deemed to meet the requirements of "Do Not 40 Resuscitate (DNR)" forms of all Idaho health care facilities. Health care 41 providers and emergency medical services personnel shall not require the com- 42 pletion of other forms in order for the patient's wishes to be respected. 43 SECTION 15. That Chapter 45, Title 39, Idaho Code, be, and the same is 44 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 45 ignated as Section 39-4512C, Idaho Code, and to read as follows: 46 39-4512C. DUTY TO INSPECT. Health care providers and emergency medical 47 services personnel shall make reasonable efforts to inquire as to whether the 48 patient has completed a physician orders for scope of treatment (POST) form 49 and inspect the patient for a POST identification device when presented with a 50 situation calling for artificial life-sustaining treatment not caused by 51 severe trauma or involving mass casualties and with no indication of homicide 13 1 or suicide. 2 SECTION 16. That Section 39-4513, Idaho Code, be, and the same is hereby 3 amended to read as follows: 4 39-4513. IMMUNITY. (1) No emergency medical services personnel,orhealth 5 care provider, facility, or individual employed by, acting as the agent of, or 6 under contract with any such health care provider or facility shall be civilly 7 or criminally liable or subject to discipline for unprofessional conduct for 8 acts or omissions carried out or performed in good faith pursuant to the 9 directives in a facially valid living will or by the holder of a facially 10 valid durable power of attorney or directive for health care.if the medical11personnel or health care facility acts in good faith.12 (2) Any physician or other health care provider who for ethical or pro- 13 fessional reasons is incapable or unwilling to conform to the desires of the 14 patient as expressed by the procedures set forth in this chapter may withdraw 15 without incurring any civil or criminal liability provided the physician or 16 other health care provider, before withdrawal of his or her participation, 17 makes a good faith effort to assist the patient in obtaining the services of 18 another physician or other health care providerbefore withdrawalwho is will- 19 ing to provide care for the patient in accordance with the patient's expressed 20 or documented wishes. 21 (3) No person who exercises the responsibilities of a durable power of 22 attorney for health care in good faith shall be subject to civil or criminal 23 liability as a result. 24 (4) Neither the registration of a health care directive in the health 25 care directive registry under section 39-4515, Idaho Code, nor the revocation 26 of such a directive requires a health care provider to request information 27 from that registry. The decision of a health care provider to request or not 28 to request a health care directive document from the registry shall be immune 29 from civil or criminal liability. A health care provider who in good faith 30 acts in reliance on a facially valid health care directive received from the 31 health care directive registry shall be immune from civil or criminal liabil- 32 ity for those acts done in such reliance. 33 (5) Health care providers and emergency medical services personnel may 34 disregard the POST form or a POST identification device: 35 (a) If they believe in good faith that the order has been revoked; or 36 (b) To avoid oral or physical confrontation; or 37 (c) If ordered to do so by the attending physician. 38 SECTION 17. That Section 39-4514, Idaho Code, be, and the same is hereby 39 amended to read as follows: 40 39-4514. GENERAL PROVISIONS. (1) Application. This chapter shall have no 41 effect or be in any manner construed to apply to persons not executing a 42"LlivingWwill andDdurablePpower ofAattorney forHhealthCare"care or POST 43 form pursuant to this chapter nor shall it in any manner affect the rights of 44 any such persons or of others acting for or on behalf of such persons to give 45 or refuse to give consent or withhold consent for any medical care, neither 46 shall this chapter be construed to affect chapter 3 or chapter 4, title 66, 47 Idaho Code, in any manner. 48 (2)The making of a "Living Will and Durable Power of Attorney for Health49Care" pursuant to this chapter shall not restrict, inhibit or impair in any50manner the sale, procurement or issuance of any policy of life insurance, nor51shall it be deemed to modify the terms of an existing policy of life insur-14 1ance. No policy of life insurance shall be legally impaired or invalidated in2any manner by the withholding or withdrawal of artificial life-sustaining pro-3cedures from an insured patient, notwithstanding any term of the policy to the4contraryEuthanasia, mercy killing, or assisted suicide. This chapter does not 5 make legal, and in no way condones, euthanasia, mercy killing, or assisted 6 suicide or permit an affirmative or deliberate act or omission to end life, 7 other than to allow the natural process of dying. 8 (3)No physician, health facility or other health care provider and no9health care service plan, insurer issuing disability insurance, self-insured10employee plan, welfare benefit plan or nonprofit hospital service plan shall11require any person to execute a "Living Will and Durable Power of Attorney for12Health Care" as a condition for being insured for, or receiving, health care13servicesComfort care. Individuals caring for a patient for whom artificial 14 life-sustaining procedures or artificially administered nutrition and 15 hydration are withheld or withdrawn shall provide comfort care as defined in 16 section 39-4502, Idaho Code. 17 (4) Presumed consent to resuscitation. There is a presumption in favor of 18 consent to cardiopulmonary resuscitation (CPR) unless: 19 (a) A completed living will for that person is in effect, pursuant to 20 section 39-4510, Idaho Code, and the person is in a terminal condition or 21 persistent vegetative state; or 22 (b) A completed durable power of attorney for health care for that person 23 is in effect, pursuant to section 39-4510, Idaho Code, in which the person 24 has indicated that he or she does not wish to receive cardiopulmonary re- 25 suscitation, or his or her representative has determined that the person 26 would not wish to receive cardiopulmonary resuscitation; or 27 (c) The patient has a completed physician orders for scope of treatment 28 (POST) form indicating otherwise and/or proper POST identification pursu- 29 ant to section 39-4502(13), Idaho Code. 30 (5) Futile care. Nothing in this chapter shall be construed to require 31 medical treatment that is medically inappropriate or futile. 32 (6) Existing directives and directives from other states. A health care 33 directive executed prior to July 1, 2007, but which was in the living will, 34 durable power of attorney for health care, DNR, or POST form pursuant to prior 35 Idaho law at the time of execution, or in another form that contained the ele- 36 ments set forth in this chapter at the time of execution, shall be deemed to 37 be in compliance with this chapter. Health care directives or similar docu- 38 ments executed in another state that substantially comply with this chapter 39 shall be deemed to be in compliance with this chapter. 40 (7) Insurance. 41 (a) The making of a living will and/or durable power of attorney for 42 health care or physician orders for scope of treatment (POST) form pursu- 43 ant to this chapter shall not restrict, inhibit or impair in any manner 44 the sale, procurement or issuance of any policy of life insurance, nor 45 shall it be deemed to modify the terms of an existing policy of life 46 insurance. No policy of life insurance shall be legally impaired or inval- 47 idated in any manner by the withholding or withdrawal of artificial life- 48 sustaining procedures from an insured patient, notwithstanding any term of 49 the policy to the contrary. 50 (b) No physician, health care facility or other health care provider and 51 no health care service plan, insurer issuing disability insurance, 52 self-insured employee plan, welfare benefit plan or nonprofit hospital 53 service plan shall require any person to execute a living will and durable 54 power of attorney for health care or physician orders for scope of treat- 55 ment (POST) form as a condition for being insured for, or receiving, 15 1 health care services. 2 (8) Portability and copies. 3 (a) A completed physician orders for scope of treatment (POST) form 4 signed by a physician shall be transferred with the patient to, and be 5 effective in, all care settings including, but not limited to, home care, 6 ambulance or other transport, hospital, residential care facility, and 7 hospice care. The POST form shall remain in effect until such time as 8 there is a valid revocation pursuant to section 39-4511, Idaho Code, or 9 new orders are issued by a physician. 10 (b) A photostatic, facsimile or electronic copy of a valid physician 11 orders for scope of treatment (POST) form may be treated as an original by 12 a health care provider or by an institution receiving or treating a 13 patient. 14 (9) Registration. A directive or the revocation of a directive meeting 15 the requirements of this chapter may be registered with the secretary of state 16 pursuant to section 39-4515, Idaho Code. Failure to register the health care 17 directive shall not affect the validity of the health care directive. 18 (10) Rulemaking authority. 19 (a) The department of health and welfare shall adopt those rules and 20 protocols necessary to administer the provisions of this chapter. 21 (b) In the adoption of a physician orders for scope of treatment (POST) 22 or DNR protocol, the department shall adopt standardized POST identifica- 23 tion to be used statewide. 24 SECTION 18. That Sections 56-1020 through 56-1035, Idaho Code, be, and 25 the same are hereby repealed. 26 SECTION 19. That Section 66-405, Idaho Code, be, and the same is hereby 27 amended to read as follows: 28 66-405. ORDER IN PROTECTIVE PROCEEDINGS. (1) If it is determined that the 29 respondent is not developmentally disabled but appears in need of protective 30 services, the court may cause the proceeding to be expanded or altered for 31 consideration under the uniform probate code. 32 (2) If it is determined that the respondent is able to manage financial 33 resources and meet essential requirements for physical health or safety, the 34 court shall dismiss the petition. 35 (3) If it is determined that the respondent is developmentally disabled 36 and is unable to manage some financial resources or meet some essential 37 requirements for physical health or safety, the court may appoint a partial 38 guardian and/or partial conservator on behalf of the respondent. An order 39 establishing partial guardianship or partial conservatorship shall define the 40 powers and duties of the partial guardian or partial conservator so as to per- 41 mit the respondent to meet essential requirements for physical health or 42 safety and to manage financial resources commensurate with his ability to do 43 so, and shall specify all legal restrictions to which he is subject. A person 44 for whom a partial guardianship or partial conservatorship has been appointed 45 under this chapter retains all legal and civil rights except those which have 46 by court order been limited or which have been specifically granted to the 47 partial guardian or partial conservator by the court. 48 (4) If it is determined that the respondent is developmentally disabled 49 and is unable to manage financial resources or meet essential requirements for 50 physical health or safety even with the appointment of a partial guardian or 51 partial conservator, the court may appoint a total guardian and/or total con- 52 servator. 16 1 (5) In the event that more than one (1) person seeks to be appointed 2 guardian and/or conservator, the court shall appoint the person or persons 3 most capable of serving on behalf of the respondent; the court shall not cus- 4 tomarily or ordinarily appoint the department or any other organization or 5 individual, public or private, that is or is likely to be providing services 6 to the respondent. 7 (6) Subject to the limitations of the provisions of subsection (7) of 8 this section, guardians or conservators may have any of the duties and powers 9 as provided in sections 15-5-312(a)(1) through (4), 15-5-424 and 15-5-425, 10 Idaho Code, and as specified in the order. Any order appointing a partial or 11 total guardian or partial or total conservator under the provisions of this 12 section must require a report to the court at least annually. In addition to 13 such other requirements imposed by law or order, the report shall include: 14 (a) A description of the respondent's current mental, physical and social 15 condition; 16 (b) The respondent's present address and living arrangement; 17 (c) A description of any significant changes in the capacity of the 18 respondent to meet essential requirements for physical health or safety or 19 to manage financial resources; 20 (d) A description of services being provided the respondent; 21 (e) A description of significant actions taken by the guardian or conser- 22 vator during the reporting period; 23 (f) Any significant problems relating to the guardianship or conservator- 24 ship; 25 (g) A complete financial statement of the financial resources under the 26 control or supervision of the guardian or conservator; and 27 (h) A description of the need for continued guardianship or conservator- 28 ship services. 29 (7) No guardian appointed under this chapter shall have the authority to 30 refuse or withhold consent for medically necessary treatment when the effect 31 of withholding such treatment would seriously endanger the life or health and 32 well-being of the person with a developmental disability. To withhold or 33 attempt to withhold such treatment shall constitute neglect of the person and 34 be cause for removal of the guardian. No physician or caregiver shall withhold 35 or withdraw such treatment for a respondent whose condition is not terminal or 36 whose death is not imminent. If the physician or caregiver cannot obtain valid 37 consent for medically necessary treatment from the guardian, he shall provide 38 the medically necessary treatment as authorized by section 39-45034(1)(g), 39 Idaho Code. 40 (8) A guardian appointed under this chapter may consent to withholding or 41 withdrawal of artificial life-sustaining procedures, only if the respondent: 42 (a) Has an incurable injury, disease, illness or condition, certified by 43 the respondent's attending physician and at least one (1) other physician 44 to be terminal such that the application of artificial life-sustaining 45 procedures would not result in the possibility of saving or significantly 46 prolonging the life of the respondent, and would only serve to prolong the 47 moment of the respondent's death for a period of hours, days or weeks, and 48 where both physicians certify that death is imminent, whether or not the 49 life-sustaining procedures are used; or 50 (b) Has been diagnosed by the respondent's attending physician and at 51 least one (1) other physician as being in a persistent vegetative state 52 which is irreversible and from which the respondent will never regain con- 53 sciousness. 54 (9) Any person, who has information that medically necessary treatment of 55 a respondent has been withheld or withdrawn, may report such information to 17 1 adult protective services or to the Idaho protection and advocacy system for 2 people with developmental disabilities, who shall have the authority to inves- 3 tigate the report and in appropriate cases to seek a court order to ensure 4 that medically necessary treatment is provided. 5 If adult protective services or the protection and advocacy system deter- 6 mines that withholding of medical treatment violates the provisions of this 7 section, they may petition the court for an ex parte order to provide or con- 8 tinue the medical treatment in question. If the court finds, based on affida- 9 vits or other evidence, that there is probable cause to believe that the with- 10 holding of medical treatment in a particular case violates the provisions of 11 this section, and that the life or health of the patient is endangered 12 thereby, the court shall issue an ex parte order to continue or to provide the 13 treatment until such time as the court can hear evidence from the parties 14 involved. Petitions for court orders under this section shall be expedited by 15 the courts and heard as soon as possible. No bond shall be required of a peti- 16 tioner under this section. 17 (10) No partial or total guardian or partial or total conservator 18 appointed under the provisions of this section may without specific approval 19 of the court in a proceeding separate from that in which such guardian or con- 20 servator was appointed: 21 (a) Consent to medical or surgical treatment the effect of which perma- 22 nently prohibits the conception of children by the respondent unless the 23 treatment or procedures are necessary to protect the physical health of 24 the respondent and would be prescribed for a person who is not developmen- 25 tally disabled; 26 (b) Consent to experimental surgery, procedures or medications; or 27 (c) Delegate the powers granted by the order.
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]] Fifty-ninth Legislature First Regular Session - 2007Moved by Rusche Seconded by Henbest IN THE HOUSE OF REPRESENTATIVES HOUSE AMENDMENT TO H.B. NO. 119 1 AMENDMENT TO SECTION 16 2 On page 13 of the printed bill, in line 9, following "valid" insert: "POST 3 form or".
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]] Fifty-ninth Legislature First Regular Session - 2007IN THE HOUSE OF REPRESENTATIVES HOUSE BILL NO. 119, As Amended BY HEALTH AND WELFARE COMMITTEE 1 AN ACT 2 RELATING TO MEDICAL CARE DECISIONS; AMENDING SECTION 39-4501, IDAHO CODE, TO 3 PROVIDE A CODE REFERENCE; AMENDING CHAPTER 45, TITLE 39, IDAHO CODE, BY 4 THE ADDITION OF A NEW SECTION 39-4502, IDAHO CODE, TO DEFINE TERMS; AMEND- 5 ING SECTION 39-4502, IDAHO CODE, TO REDESIGNATE THE SECTION AND TO REVISE 6 TERMINOLOGY; AMENDING SECTION 39-4503, IDAHO CODE, TO REDESIGNATE THE SEC- 7 TION AND TO REVISE PROVISIONS APPLICABLE TO PERSONS WHO MAY GIVE CONSENT 8 TO CARE FOR OTHERS; AMENDING SECTION 39-4504, IDAHO CODE, TO REDESIGNATE 9 THE SECTION AND TO PROVIDE A CORRECT CODE REFERENCE; AMENDING SECTION 10 39-4505, IDAHO CODE, TO REDESIGNATE THE SECTION AND TO PROVIDE FOR THE 11 REFUSAL TO CONSENT; AMENDING SECTION 39-4506, IDAHO CODE, TO REDESIGNATE 12 THE SECTION AND TO PROVIDE FOR A SPECIFIC FORM OF EXPRESSION RELATING TO 13 FORM OF CONSENT; AMENDING SECTION 39-4507, IDAHO CODE, TO REDESIGNATE THE 14 SECTION AND TO DELETE LANGUAGE REFERENCING LAY OR PROFESSIONAL EMPLOYEES; 15 AMENDING SECTION 39-4508, IDAHO CODE, TO REDESIGNATE THE SECTION, TO 16 REVISE DESCRIPTIVE LANGUAGE, TO REVISE THE STATEMENT OF POLICY AND TO 17 DEFINE A TERM; REPEALING SECTION 39-4509, IDAHO CODE, RELATING TO DEFINI- 18 TIONS; AMENDING SECTION 39-4510, IDAHO CODE, TO REVISE PROVISIONS APPLICA- 19 BLE TO A LIVING WILL AND DURABLE POWER OF ATTORNEY FOR HEALTH CARE; AMEND- 20 ING SECTION 39-4511, IDAHO CODE, TO REVISE PROVISIONS APPLICABLE TO REVO- 21 CATION; AMENDING CHAPTER 45, TITLE 39, IDAHO CODE, BY THE ADDITION OF A 22 NEW SECTION 39-4512A, IDAHO CODE, TO PROVIDE FOR PHYSICIAN ORDERS FOR 23 SCOPE OF TREATMENT; AMENDING CHAPTER 45, TITLE 39, IDAHO CODE, BY THE 24 ADDITION OF A NEW SECTION 39-4512B, IDAHO CODE, TO SET FORTH PROVISIONS 25 APPLICABLE TO ADHERENCE TO PHYSICIAN ORDERS FOR SCOPE OF TREATMENT PROTO- 26 COL; AMENDING CHAPTER 45, TITLE 39, IDAHO CODE, BY THE ADDITION OF A NEW 27 SECTION 39-4512C, IDAHO CODE, TO PROVIDE A DUTY TO INSPECT; AMENDING SEC- 28 TION 39-4513, IDAHO CODE, TO REVISE PROVISIONS RELATING TO IMMUNITY; 29 AMENDING SECTION 39-4514, IDAHO CODE, TO REVISE GENERAL PROVISIONS; 30 REPEALING SECTIONS 56-1020 THROUGH 56-1035, IDAHO CODE, RELATING TO DECI- 31 SIONS RELATIVE TO THE RENDERING OR WITHHOLDING OF MEDICAL CARE; AND AMEND- 32 ING SECTION 66-405, IDAHO CODE, TO REVISE A CODE REFERENCE. 33 Be It Enacted by the Legislature of the State of Idaho: 34 SECTION 1. That Section 39-4501, Idaho Code, be, and the same is hereby 35 amended to read as follows: 36 39-4501. PURPOSES -- APPLICATION. (1) The primary purposes of this chap- 37 ter are: 38 (a) To provide and codify Idaho law concerning consent for the furnishing 39 of hospital, medical, dental or surgical care, treatment or procedures, 40 and concerning what constitutes an informed consent for such care, treat- 41 ment or procedures; and 42 (b) To provide certainty and clarity in the law of medical consent in the 43 furtherance of high standards of health care and its ready availability in 2 1 proper cases. 2 (2) Nothing in this chapter shall be deemed to amend or repeal the provi- 3 sions of chapter 3 or chapter 4, title 66, Idaho Code, as those provisions 4 pertain to hospitalization of the mentally ill, nor the provisions of chapter 5 6, title 18, Idaho Code, pertaining to the provision of examinations, pre- 6 scriptions, devices and informational materials regarding prevention of preg- 7 nancy or pertaining to therapeutic abortions and consent to the performance 8 thereof. 9 (3) Nothing in this chapter shall be construed to permit or require the 10 provision of health care for a patient in contravention of the patient's 11 stated or implied objection thereto upon religious grounds nor shall anything 12 in this chapter be construed to require the granting of permission for or on 13 behalf of any patient who is not able to act for himself by his parent, spouse 14 or guardian in violation of the religious beliefs of the patient or the 15 patient's parent or spouse. 16 SECTION 2. That Chapter 45, Title 39, Idaho Code, be, and the same is 17 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 18 ignated as Section 39-4502, Idaho Code, and to read as follows: 19 39-4502. DEFINITIONS. As used in this chapter: 20 (1) "Artificial life-sustaining procedure" means any medical procedure or 21 intervention that utilizes mechanical means to sustain or supplant a vital 22 function which, when applied to a qualified patient, would serve only to arti- 23 ficially prolong life. "Artificial life-sustaining procedure" does not include 24 the administration of pain management medication or the performance of any 25 medical procedure deemed necessary to provide comfort care or to alleviate 26 pain. 27 (2) "Artificial nutrition and hydration" means supplying food and water 28 through a conduit, such as a tube or intravenous line, where the recipient is 29 not required to chew or swallow voluntarily, but does not include assisted 30 feeding, such as spoon feeding or bottle feeding. 31 (3) "Attending physician" means the physician licensed by the state board 32 of medicine who is selected by, or assigned to, the patient and who has pri- 33 mary responsibility for the treatment and care of the patient. 34 (4) "Cardiopulmonary resuscitation" or "CPR" means measures to restore 35 cardiac function and/or to support ventilation in the event of cardiac or 36 respiratory arrest. 37 (5) "Comfort care" means treatment and care to provide comfort and clean- 38 liness. "Comfort care" includes: 39 (a) Oral and body hygiene; 40 (b) Reasonable efforts to offer food and fluids orally; 41 (c) Medication, positioning, warmth, appropriate lighting and other mea- 42 sures to relieve pain and suffering; and 43 (d) Privacy and respect for the dignity and humanity of the patient. 44 (6) "Consent to care" includes refusal to consent to care and/or with- 45 drawal of care. 46 (7) "Directive" or "health care directive" means a document meeting the 47 requirements of section 39-4510(1), Idaho Code, and/or a "Physician Orders for 48 Scope of Treatment (POST)" form signed by a physician. 49 (8) "Emergency medical services personnel" means personnel engaged in 50 providing initial emergency medical assistance including, but not limited to, 51 first responders, emergency medical technicians and paramedics. 52 (9) "Health care provider" or "provider" means any person or entity 53 licensed, certified, or otherwise authorized by law to administer health care 3 1 in the ordinary course of business or practice of a profession, including 2 emergency or other medical services personnel. 3 (10) "Persistent vegetative state" means an irreversible state that has 4 been medically confirmed by a neurological specialist who is an expert in the 5 examination of nonresponsive individuals in which the person has intact brain 6 stem function but no higher cortical function and no awareness of self or 7 environment. 8 (11) "Physician" means a person who holds a current active license to 9 practice medicine and surgery or osteopathic medicine and surgery in Idaho and 10 is in good standing with no restriction upon or actions taken against his or 11 her license. 12 (12) "Physician orders for scope of treatment (POST) form" means a stan- 13 dardized form containing orders by a physician that states a person's treat- 14 ment wishes. 15 (13) "Physician orders for scope of treatment (POST) identification 16 device" means standardized jewelry which can be worn around the wrist, neck or 17 ankle, and which has been approved by the department of health and welfare. 18 (14) "Terminal condition" means an incurable or irreversible condition 19 which, without the administration of life-sustaining procedures, will, in the 20 opinion of a physician, result in death if it runs its usual course. 21 SECTION 3. That Section 39-4502, Idaho Code, be, and the same is hereby 22 amended to read as follows: 23 39-45023. PERSONS WHO MAY CONSENT TO THEIR OWN CARE. Any person of ordi- 24 nary intelligence and awareness sufficient for him or her generally to compre- 25 hend the need for, the nature of and the significant risks ordinarily inherent 26 in, any contemplated hospital, medical, dental or surgical care, treatment or 27 procedure is competent to consent thereto on his or her own behalf. Anyphysi-28cian, dentist, hospital or other duly authorized personhealth care provider 29 may provide such health care and services in reliance upon such a consent if 30 the consenting person appears to thephysician or dentisthealth care provider 31 securing the consent to possess such requisite intelligence and awareness at 32 the time of giving the consent. 33 SECTION 4. That Section 39-4503, Idaho Code, be, and the same is hereby 34 amended to read as follows: 35 39-45034. PERSONS WHO MAY GIVE CONSENT TO CARE FOR OTHERS. (1) Consent 36 for the furnishing of hospital, medical, dental or surgical care, treatment or 37 procedures to any person who is not then capable of giving such consent as 38 provided in this chapter or who is a minor or incompetent person, may be given 39 or refused in the order of priority set forth hereafter unless the patient is 40 a competent person who has refused to give such consent, and provided further 41 that this subsection shall not be deemed to authorize any person to override 42 the express refusal by a competent patient to give such consent himself: 43 (a) The legal guardian of such person; 44 (b) The person named in a "Living Will and Durable Power of Attorney for 45 Health Care" pursuant to section 39-4510, Idaho Code, or a similar docu- 46 ment authorized by this chapter; 47 (c) If married, the spouse of such person; 48 (d) A parent of such person; 49 (e) Any relative representing himself or herself to be an appropriate, 50 responsible person to act under the circumstances; 51 (f) Any other competent individual representing himself or herself to be 4 1 responsible for the health care of such person; or 2 (g) If the subject person presents a medical emergency or there is a sub- 3 stantial likelihood of his or her life or health being seriously endan- 4 gered by withholding or delay in the rendering of such hospital, medical, 5 dental or surgical care to such patient and the subject person has not 6 communicated and is unable to communicate his or her treatment wishes, the 7 attending physician or dentist may, in his or her discretion, authorize 8 and/or provide such care, treatment or procedure as he or she deems appro- 9 priate, and all persons, agencies and institutions thereafter furnishing 10 the same, including such physician or dentist, may proceed as if informed, 11 valid consent therefor had been otherwise duly given. 12 (2) No person who, in good faith, gives consent or authorization for the 13 provision of hospital, medical, dental or surgical care, treatment or proce- 14 dures to another as provided by this chapter shall be subject to civil liabil- 15 ity therefor. 16 (3) Nophysician, dentist, hospital or other duly authorized person17 health care provider who, in good faith, obtains consent from a person pursu- 18 ant to either section 39-45023 or 39-45034(1), Idaho Code, shall be subject to 19 civil liability therefor. 20 SECTION 5. That Section 39-4504, Idaho Code, be, and the same is hereby 21 amended to read as follows: 22 39-45045. BLOOD TESTING. (1) A physician may consent to ordering tests of 23 a patient's or a deceased person's blood or other body fluids for the presence 24 of blood-transmitted or body fluid-transmitted viruses or diseases without the 25 prior consent of the patient if: 26 (a) There has been or is likely to be a significant exposure to the 27 patient's or a deceased person's blood or body fluids by a person provid- 28 ing emergency or medical services to such patient which may result in the 29 transmittal of a virus or disease; and 30 (b) The patient is unconscious or incapable of giving informed consent 31 and the physician is unable to obtain consent pursuant to section 32 39-45034, Idaho Code. 33 (2) The department of health and welfare shall promulgate rules identify- 34 ing the blood-transmitted or body fluid-transmitted viruses or diseases for 35 which blood tests or body fluid tests can be ordered under this section and 36 defining the term "significant exposure" as provided in this section. 37 (3) Results of tests conducted under this section which confirm the pres- 38 ence of a blood-transmitted or body fluid-transmitted virus or disease shall 39 be reported to the director of the department of health and welfare in the 40 name of the patient or deceased person. The department records containing such 41 test results shall be used only by public health officials who must conduct 42 investigations. The exposed person shall only be informed of the results of 43 the test and shall not be informed of the name of the patient or deceased per- 44 son. Protocols shall be established by hospitals to maintain confidentiality 45 while disseminating the necessary test result information to persons who may 46 have a significant exposure to blood or other body fluids and to maintain 47 records of such tests to preserve the confidentiality of the test results. 48 (4) Any person who willfully or maliciously discloses the results of a 49 test conducted under this section, except pursuant to a written authorization 50 by the person whose blood was tested or by such person's authorized represen- 51 tative, or as otherwise authorized by law, shall be guilty of a misdemeanor. 52 SECTION 6. That Section 39-4505, Idaho Code, be, and the same is hereby 5 1 amended to read as follows: 2 39-45056. SUFFICIENCY OF CONSENT. Consent, or refusal to consent, for the 3 furnishing of hospital, medical, dental or surgical care, treatment or proce- 4 dures shall be valid in all respects if the person giving or refusing the con- 5 sent is sufficiently aware of pertinent facts respecting the need for, the 6 nature of, and the significant risks ordinarily attendant upon, such a patient 7 receiving such care, as to permit the giving or withholding of such consent to 8 be a reasonably informed decision. Any such consent shall be deemed valid and 9 so informed if the physician or dentist to whom it is given or by whom it is 10 secured has made such disclosures and given such advice respecting pertinent 11 facts and considerations as would ordinarily be made and given under the same 12 or similar circumstances, by a like physician or dentist of good standing 13 practicing in the same community. As used in this section, the term "in the 14 same community" refers to that geographic area ordinarily served by the 15 licensed general hospital at or nearest to which such consent is given. 16 SECTION 7. That Section 39-4506, Idaho Code, be, and the same is hereby 17 amended to read as follows: 18 39-45067. FORM OF CONSENT. It is not essential to the validity of any 19 consent for the furnishing of hospital, medical, dental or surgical care, 20 treatment or procedures that the consent be in writing or any other specific 21 form of expression; provided however, when the giving of such consent is 22 recited or documented in writing and expressly authorizes the care, treatment 23 or procedures to be furnished, and when such writing or form has been executed 24 or initialed by a person competent to give such consent for himself or 25 another, such written consent, in the absence of convincing proof that it was 26 secured maliciously or by fraud, is presumed to be valid for the furnishing of 27 such care, treatment or procedures, and the advice and disclosures of the 28 attending physician or dentist, as well as the level of informed awareness of 29 the giver of such consent, shall be presumed to be sufficient. 30 SECTION 8. That Section 39-4507, Idaho Code, be, and the same is hereby 31 amended to read as follows: 32 39-45078. RESPONSIBILITY FOR CONSENT AND DOCUMENTATION. Obtaining consent 33 for health care is the duty of the attending physician or dentist or of 34 another physician or dentist acting on his or her behalf or actually providing 35 the contemplated care, treatment or procedure; provided however, a licensed 36 hospital and any medical or dental officelay or professionalemployee, acting 37 with the approval of such an attending or other physician or dentist, may per- 38 form the ministerial act of documenting such consent by securing the comple- 39 tion and execution of a form or statement in which the giving of consent for 40 such care is documented by or on behalf of the patient. In performing such a 41 ministerial act, the hospital or medical or dental officelay or professional42 employee shall not be deemed to have engaged in the practice of medicine or 43 dentistry. 44 SECTION 9. That Section 39-4508, Idaho Code, be, and the same is hereby 45 amended to read as follows: 46 39-45089. STATEMENT OF POLICY -- DEFINITION. For purposes of sections 47 39-45089 through 39-45145, Idaho Code: 48 (1) The legislaturefinds thatrecognizes the established common law and 6 1 the fundamental right of adult personshave the fundamental rightto control 2 the decisions relating to the rendering of their medical care, including the 3 decision to have life-sustaining procedures withheld or withdrawn. The legis- 4 lature further finds that modern medical technology has made possible the 5 artificial prolongation of human life beyond natural limits. The legislature 6 further finds that patients are sometimes unable to express their desire to 7 withhold or withdraw such artificial life prolongation procedures which pro- 8 vide nothing medically necessary or beneficial to the patient because of the 9 patient's inability to communicate with the physician. 10 (2) In recognition of the dignity and privacy which patients have a right 11 to expect, the legislature hereby declares that the laws of this state shall 12 recognize the right of a competent person to have his or her wishes for medi- 13 cal treatment and for the withdrawal of artificial life-sustaining procedures 14 carried out even though that person is no longer able to communicate with the 15 physician. 16 (3) It is the intent of the legislature to establish an effective means 17 for such communication. It is not the intent of the legislature that the pro- 18 cedures described inthis chaptersections 39-4509 through 39-4515, Idaho 19 Code, are the only effective means of such communication, and nothing inthis20chaptersections 39-4509 through 39-4515, Idaho Code, shall impair or super- 21 sede any legal right or legal responsibility which a person may have to effect 22 the withholding or withdrawal of life-sustaining procedures in any lawful man- 23 ner. Any authentic expression of a person's wishes with respect to health care 24 should be honored. 25 (4) "Competent person" means any emancipated minor or person eighteen 26 (18) or more years of age who is of sound mind. 27 SECTION 10. That Section 39-4509, Idaho Code, be, and the same is hereby 28 repealed. 29 SECTION 11. That Section 39-4510, Idaho Code, be, and the same is hereby 30 amended to read as follows: 31 39-4510. LIVING WILL AND DURABLE POWER OF ATTORNEY FOR HEALTH CARE. (1) 32 Any competent person may execute a document known as a "Living Will and Dura- 33 ble Power of Attorney for Health Care." Such document shall be in substan- 34 tially the following form, or in another form that contains the elements set 35 forth in this chapter.A "Living Will and Durable Power of Attorney for Health36Care" executed prior to the effective date of this act, but which was in the37"Living Will" and/or "Durable Power of Attorney for Health Care" form pursuant38to prior Idaho law at the time of execution, or in another form that contained39the elements set forth in this chapter at the time of execution, shall be40deemed to be in compliance with this chapter. A "Living Will and Durable Power41of Attorney for Health Care" or similar document(s) executed in another state42which substantially complies with this chapter shall be deemed to be in com-43pliance with this chapter. In this chapter, a "Living Will and Durable Power44of Attorney for Health Care" may be referred to as a "directive."Any portions 45 of the "Living Will and Durable Power of Attorney for Health Care" which are 46 left blank by the person executing the document shall be deemed to be inten- 47 tional and shall not invalidate the document. 48 LIVING WILL AND DURABLE POWER OF ATTORNEY FOR HEALTH CARE 49 Date of Directive:.................... 7 1 Name of person executing Directive:........................................... 2 Address of person executing Directive:........................................ 3 A LIVING WILL 4 A Directive to Withhold or to Provide Treatment 5 1.Being of sound mind,I willfully and voluntarily make known my desire that 6 my life shall not be prolonged artificially under the circumstances set forth 7 below. This Directive shall only be effective if I am unable to communicate my 8 instructions and: 9 a. I have an incurable or irreversible injury, disease, illness or condi- 10 tion, andtwo (2)a medical doctorswhohavehas examined mehavehas cer- 11 tified: 12 1. That such injury, disease, illness or condition is terminal; and 13 2. That the application of artificial life-sustaining procedures 14 would serve only to prolong artificially my life; and 15 3. That my death is imminent, whether or not artificial life- 16 sustaining procedures are utilized; or 17 b. I have been diagnosed as being in a persistent vegetative state. 18 In such event, I direct that the following marked expression of my intent be 19 followed, and that I receive any medical treatment or care that may be 20 required to keep me free of pain or distress. 21 Check one box and initial the line after such box: 22 ........ I direct that all medical treatment, care and procedures neces- 23 sary to restore my health,and sustain my life, and to abolish or alleviate24pain or distressbe provided to me. Nutrition and hydration, whether artifi- 25 cial or nonartificial, shall not be withheld or withdrawn from me if I would 26 likely die primarily from malnutrition or dehydration rather than from my 27 injury, disease, illness or condition. 28 OR 29 ........ I direct that all medical treatment, care and procedures, 30 including artificial life-sustaining procedures, be withheld or withdrawn, 31 except that nutrition and hydration, whether artificial or nonartificial shall 32 not be withheld or withdrawn from me if, as a result, I would likely die pri- 33 marily from malnutrition or dehydration rather than from my injury, disease, 34 illness or condition, as follows: (If none of the following boxes are checked 35 and initialed, then both nutrition and hydration, of any nature, whether arti- 36 ficial or nonartificial, shall be administered.) 37 Check one box and initial the line after such box: 38 A. ........ Only hydration of any nature, whether artificial or 39 nonartificial, shall be administered; 40 B. ........ Only nutrition, of any nature, whether artificial or 41 nonartificial, shall be administered; 42 C. ........ Both nutrition and hydration, of any nature, whether 43 artificial or nonartificial shall be administered. 44 OR 45 ........ I direct that all medical treatment, care and procedures be 8 1 withheld or withdrawn, including withdrawal of the administration of artifi- 2 cial nutrition and hydration. 3 2.This Directive shall be the final expression of my legal right to refuse4or accept medical and surgical treatment, and I accept the consequences of5such refusal or acceptance.63.If I have been diagnosed as pregnant, this Directive shall have no force 7 during the course of my pregnancy. 843. I understand the full importance of this Directive and am mentally compe- 9 tent to make this Directive. No participant in the making of this Directive or 10 in its being carried into effect shall be held responsible in any way for com- 11 plying with my directions. 12 4. Check one box and initial the line after such box: 13 ........ I have discussed these decisions with my physician and have also 14 completed a Physician Orders for Scope of Treatment (POST) form that contains 15 directions that may be more specific than, but are compatible with, this 16 Directive. I hereby approve of those orders and incorporate them herein as if 17 fully set forth. 18 OR 19 ........ I have not completed a Physician Orders for Scope of Treatment 20 (POST) form. If a POST form is later signed by my physician, then this living 21 will shall be deemed modified to be compatible with the terms of the POST 22 form. 23 A DURABLE POWER OF ATTORNEY FOR HEALTH CARE 24 1. DESIGNATION OF HEALTH CARE AGENT. None of the following may be designated 25 as your agent: (1) your treating health care provider; (2) a nonrelative 26 employee of your treating health care provider; (3) an operator of a community 27 care facility; or (4) a nonrelative employee of an operator of a community 28 care facility. If the agent or an alternate agent designated in this Directive 29 is my spouse, and our marriage is thereafter dissolved, such designation shall 30 be thereupon revoked. 31 I do hereby designate and appoint the following individual as my attorney in 32 fact (agent) to make health care decisions for me as authorized in this Direc- 33 tive. (Insert name, address and telephone number of one individual only as 34 your agent to make health care decisions for you.) 35 Name of Health Care Agent: ................................................... 36 Address of Health Care Agent: ................................................ 37 Telephone Number of Health Care Agent: ....................................... 38 For the purposes of this Directive, "health care decision" means consent, 39 refusal of consent, or withdrawal of consent to any care, treatment, service 40 or procedure to maintain, diagnose or treat an individual's physical condi- 41 tion. 42 2. CREATION OF DURABLE POWER OF ATTORNEY FOR HEALTH CARE. By this portion of 9 1 this Directive, I create a durable power of attorney for health care. This 2 power of attorney shall not be affected by my subsequent incapacity. This 3 power shall be effective only when I am unable to communicate rationally. 4 3. GENERAL STATEMENT OF AUTHORITY GRANTED.Subject to any limitations in this5Directive, including as set forth in paragraph 2 immediately above,I hereby 6 grant to my agent full power and authority to make health care decisions for 7 me to the same extent that I could make such decisions for myself if I had the 8 capacity to do so. In exercising this authority, my agent shall make health 9 care decisions that are consistent with my desires as stated in this Directive 10 or otherwise made known to my agent including, but not limited to, my desires 11 concerning obtaining or refusing or withdrawing artificial life-prolongingsus- 12 taining care, treatment, services and procedures, including such desires set 13 forth in a living will, Physician Orders for Scope of Treatment (POST) form, 14 or similar document executed by me, if any. (If you want to limit the author- 15 ity of your agent to make health care decisions for you, you can state the 16 limitations in paragraph 4 ("Statement of Desires, Special Provisions, and 17 Limitations") below. You can indicate your desires by including a statement of 18 your desires in the same paragraph.) 19 4. STATEMENT OF DESIRES, SPECIAL PROVISIONS, AND LIMITATIONS. (Your agent 20 must make health care decisions that are consistent with your known desires. 21 You can, but are not required to, state your desires in the space provided 22 below. You should consider whether you want to include a statement of your 23 desires concerning artificial life-prolongingsustaining care, treatment, ser- 24 vices and procedures. You can also include a statement of your desires con- 25 cerning other matters relating to your health care, including a list of one or 26 more persons whom you designate to be able to receive medical information 27 about you and/or to be allowed to visit you in a medical institution. You can 28 also make your desires known to your agent by discussing your desires with 29 your agent or by some other means. If there are any types of treatment that 30 you do not want to be used, you should state them in the space below. If you 31 want to limit in any other way the authority given your agent by this Direc- 32 tive, you should state the limits in the space below. If you do not state any 33 limits, your agent will have broad powers to make health care decisions for 34 you, except to the extent that there are limits provided by law.) In exercis- 35 ing the authority under this durable power of attorney for health care, my 36 agent shall act consistently with my desires as stated below and is subject to 37 the special provisions and limitations stated in my Physician Orders for Scope 38 of Treatment (POST) form, a living will, or similar document executed by me, 39 if any. Additional statement of desires, special provisions, and limitations:. 40 .......(You may attach additional pages or documents if you need more space to 41 complete your statement.) 42 5. INSPECTION AND DISCLOSURE OF INFORMATION RELATING TO MY PHYSICAL OR MENTAL 43 HEALTH. 44 A. General Grant of Power and Authority. Subject to any limitations in this 45 Directive, my agent has the power and authority to do all of the following: 46 (1) Request, review and receive any information, verbal or written, regarding 47 my physical or mental health including, but not limited to, medical and hospi- 48 tal records; (2) Execute on my behalf any releases or other documents that may 49 be required in order to obtain this information; (3) Consent to the disclosure 50 of this information; and (4) Consent to the donation of any of my organs for 51 medical purposes. (If you want to limit the authority of your agent to receive 10 1 and disclose information relating to your health, you must state the limita- 2 tions in paragraph 4 ("Statement of Desires, Special Provisions, and Limita- 3 tions") above.) 4 B. HIPAA Release Authority. My agent shall be treated as I would be with 5 respect to my rights regarding the use and disclosure of my individually iden- 6 tifiable health information or other medical records. This release authority 7 applies to any information governed by the Health Insurance Portability and 8 Accountability Act of 1996 (HIPAA), 42 U.S.C. 1320d and 45 CFR 160 through 9 164. I authorize any physician, health care professional, dentist, health 10 plan, hospital, clinic, laboratory, pharmacy, or other covered health care 11 provider, any insurance company, and the Medical Information Bureau, Inc. or 12 other health care clearinghouse that has provided treatment or services to me, 13 or that has paid for or is seeking payment from me for such services, to give, 14 disclose and release to my agent, without restriction, all of my individually 15 identifiable health information and medical records regarding any past, pres- 16 ent or future medical or mental health condition, including all information 17 relating to the diagnosis of HIV/AIDS, sexually transmitted diseases, mental 18 illness, and drug or alcohol abuse. The authority given my agent shall super- 19 sede any other agreement that I may have made with my health care providers to 20 restrict access to or disclosure of my individually identifiable health infor- 21 mation. The authority given my agent has no expiration date and shall expire 22 only in the event that I revoke the authority in writing and deliver it to my 23 health care provider. 24 6. SIGNING DOCUMENTS, WAIVERS AND RELEASES. Where necessary to implement the 25 health care decisions that my agent is authorized by this Directive to make, 26 my agent has the power and authority to execute on my behalf all of the fol- 27 lowing: (a) Documents titled, or purporting to be, a "Refusal to Permit Treat- 28 ment" and/or a "Leaving Hospital Against Medical Advice"; and (b) Any neces- 29 sary waiver or release from liability required by a hospital or physician. 30 7. DESIGNATION OF ALTERNATE AGENTS. (You are not required to designate any 31 alternate agents but you may do so. Any alternate agent you designate will be 32 able to make the same health care decisions as the agent you designated in 33 paragraph 1 above, in the event that agent is unable or ineligible to act as 34 your agent. If an alternate agent you designate is your spouse, he or she 35 becomes ineligible to act as your agent if your marriage is thereafter dis- 36 solved.) If the person designated as my agent in paragraph 1 is not available 37 or becomes ineligible to act as my agent to make a health care decision for me 38 or loses the mental capacity to make health care decisions for me, or if I 39 revoke that person's appointment or authority to act as my agent to make 40 health care decisions for me, then I designate and appoint the following per- 41 sons to serve as my agent to make health care decisions for me as authorized 42 in this Directive, such persons to serve in the order listed below: 43 A. First Alternate Agent: 44 Name.......................................................................... 45 Address....................................................................... 46 Telephone Number.............................................................. 47 B. Second Alternate Agent: 48 Name.......................................................................... 49 Address....................................................................... 50 Telephone Number.............................................................. 11 1 C. Third Alternate Agent: 2 Name.......................................................................... 3 Address....................................................................... 4 Telephone Number.............................................................. 5 8. PRIOR DESIGNATIONS REVOKED. I revoke any prior durable power of attorney 6 for health care. 7 DATE AND SIGNATURE OF PRINCIPAL. (You must date and sign this Living Will and 8 Durable Power of Attorney for Health Care.) 9 I sign my name to this Statutory Form Living Will and Durable Power of Attor- 10 ney for Health Care on the date set forth at the beginning of this Form at 11 ............... (City, State).................... 12 .............................. 13 Signature 14 (2) A health care directive meeting the requirements of subsection (1) of 15 this section may be registered with the secretary of state pursuant to the 16 provisions of section 39-4515, Idaho Code. Failure to register the health care 17 directive shall not affect the validity of the health care directive. 18 SECTION 12. That Section 39-4511, Idaho Code, be, and the same is hereby 19 amended to read as follows: 20 39-4511. REVOCATION. (1) A"LlivingWwill andDdurablePpower of 21Aattorney forHhealthCcare"or physician orders for scope of treatment 22 (POST) form may be revoked at any time by the maker thereof, without regard to23his mental state or competence,by any of the following methods: 24 (a) By being canceled, defaced, obliterated or burned, torn, or otherwise 25 destroyed by the maker thereof, or by some person in his presence and by 26 his direction; 27 (b) By a written, signed revocation of the maker thereof expressing his 28 intent to revoke; or 29 (c) By an oral expression by the maker thereof expressing his intent to 30 revoke. 31 (2) The maker of the revoked living will and durable power of attorney 32 for health care is responsible for notifying his physician of the revocation. 33 (3) There shall be no criminal or civil liability on the part of any per- 34 son for the failure to act upon a revocation of a"LlivingWwill andDdurable 35Ppower ofAattorney forHhealthCcare"or physician orders for scope of treat- 36 ment (POST) form made pursuant to this section unless that person has actual 37 knowledge of the revocation. 38(3) A person may register a revocation of a health care directive which39meets the requirements of subsection (1)(b) of this section with the secretary40of state pursuant to the provisions of section 39-4515, Idaho Code. Failure to41register a revocation of the health care directive shall not affect the valid-42ity of the revocation.43 SECTION 13. That Chapter 45, Title 39, Idaho Code, be, and the same is 44 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 45 ignated as Section 39-4512A, Idaho Code, and to read as follows: 46 39-4512A. PHYSICIAN ORDERS FOR SCOPE OF TREATMENT (POST). (1) A physician 12 1 orders for scope of treatment (POST) form is appropriate in cases where a 2 patient has an incurable or irreversible injury, disease, illness or condi- 3 tion, or where a patient is in a persistent vegetative state. A POST form is 4 also appropriate if such conditions are anticipated. 5 (2) The POST form shall be effective from the date of execution unless 6 otherwise revoked. If there is a conflict between the person's expressed 7 directives, the POST form, and the decisions of the durable power of attorney 8 representative or surrogate, the orders contained in the POST form shall be 9 followed. 10 (3) The attending physician shall, upon request of the patient, provide 11 the patient with a copy of the POST form, discuss with the patient the form's 12 content and ramifications and treatment options, and assist the patient in the 13 completion of the form. 14 (4) The attending physician shall review the POST form: 15 (a) Each time the physician examines the patient, or at least every seven 16 (7) days, for patients who are hospitalized; and 17 (b) Each time the patient is transferred from one (1) care setting or 18 care level to another; and 19 (c) Any time there is a substantial change in the patient's health sta- 20 tus; and 21 (d) Any time the patient's treatment preferences change. 22 Failure to meet these review requirements does not affect the POST form's 23 validity or enforceability. As conditions warrant, the physician may issue a 24 superseding POST form. The physician shall, whenever practical, consult with 25 the patient or the patient's agent. 26 (5) A patient who has completed a POST form signed by a physician may 27 wear a POST identification device as provided in section 39-4502(13), Idaho 28 Code. 29 (6) The department of health and welfare shall develop the POST form. 30 SECTION 14. That Chapter 45, Title 39, Idaho Code, be, and the same is 31 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 32 ignated as Section 39-4512B, Idaho Code, and to read as follows: 33 39-4512B. ADHERENCE TO PHYSICIAN ORDERS FOR SCOPE OF TREATMENT (POST) 34 PROTOCOL. (1) Health care providers and emergency medical services personnel 35 shall comply with a patient's physician orders for scope of treatment (POST) 36 instruction when presented with a completed POST form signed by a physician or 37 when a patient is wearing a proper POST identification device pursuant to sec- 38 tion 39-4512A(5), Idaho Code. 39 (2) A completed POST form is deemed to meet the requirements of "Do Not 40 Resuscitate (DNR)" forms of all Idaho health care facilities. Health care 41 providers and emergency medical services personnel shall not require the com- 42 pletion of other forms in order for the patient's wishes to be respected. 43 SECTION 15. That Chapter 45, Title 39, Idaho Code, be, and the same is 44 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 45 ignated as Section 39-4512C, Idaho Code, and to read as follows: 46 39-4512C. DUTY TO INSPECT. Health care providers and emergency medical 47 services personnel shall make reasonable efforts to inquire as to whether the 48 patient has completed a physician orders for scope of treatment (POST) form 49 and inspect the patient for a POST identification device when presented with a 50 situation calling for artificial life-sustaining treatment not caused by 51 severe trauma or involving mass casualties and with no indication of homicide 13 1 or suicide. 2 SECTION 16. That Section 39-4513, Idaho Code, be, and the same is hereby 3 amended to read as follows: 4 39-4513. IMMUNITY. (1) No emergency medical services personnel,orhealth 5 care provider, facility, or individual employed by, acting as the agent of, or 6 under contract with any such health care provider or facility shall be civilly 7 or criminally liable or subject to discipline for unprofessional conduct for 8 acts or omissions carried out or performed in good faith pursuant to the 9 directives in a facially valid POST form or living will or by the holder of a 10 facially valid durable power of attorney or directive for health care.if the11medical personnel or health care facility acts in good faith.12 (2) Any physician or other health care provider who for ethical or pro- 13 fessional reasons is incapable or unwilling to conform to the desires of the 14 patient as expressed by the procedures set forth in this chapter may withdraw 15 without incurring any civil or criminal liability provided the physician or 16 other health care provider, before withdrawal of his or her participation, 17 makes a good faith effort to assist the patient in obtaining the services of 18 another physician or other health care providerbefore withdrawalwho is will- 19 ing to provide care for the patient in accordance with the patient's expressed 20 or documented wishes. 21 (3) No person who exercises the responsibilities of a durable power of 22 attorney for health care in good faith shall be subject to civil or criminal 23 liability as a result. 24 (4) Neither the registration of a health care directive in the health 25 care directive registry under section 39-4515, Idaho Code, nor the revocation 26 of such a directive requires a health care provider to request information 27 from that registry. The decision of a health care provider to request or not 28 to request a health care directive document from the registry shall be immune 29 from civil or criminal liability. A health care provider who in good faith 30 acts in reliance on a facially valid health care directive received from the 31 health care directive registry shall be immune from civil or criminal liabil- 32 ity for those acts done in such reliance. 33 (5) Health care providers and emergency medical services personnel may 34 disregard the POST form or a POST identification device: 35 (a) If they believe in good faith that the order has been revoked; or 36 (b) To avoid oral or physical confrontation; or 37 (c) If ordered to do so by the attending physician. 38 SECTION 17. That Section 39-4514, Idaho Code, be, and the same is hereby 39 amended to read as follows: 40 39-4514. GENERAL PROVISIONS. (1) Application. This chapter shall have no 41 effect or be in any manner construed to apply to persons not executing a 42"LlivingWwill andDdurablePpower ofAattorney forHhealthCare"care or POST 43 form pursuant to this chapter nor shall it in any manner affect the rights of 44 any such persons or of others acting for or on behalf of such persons to give 45 or refuse to give consent or withhold consent for any medical care, neither 46 shall this chapter be construed to affect chapter 3 or chapter 4, title 66, 47 Idaho Code, in any manner. 48 (2)The making of a "Living Will and Durable Power of Attorney for Health49Care" pursuant to this chapter shall not restrict, inhibit or impair in any50manner the sale, procurement or issuance of any policy of life insurance, nor51shall it be deemed to modify the terms of an existing policy of life insur-14 1ance. No policy of life insurance shall be legally impaired or invalidated in2any manner by the withholding or withdrawal of artificial life-sustaining pro-3cedures from an insured patient, notwithstanding any term of the policy to the4contraryEuthanasia, mercy killing, or assisted suicide. This chapter does not 5 make legal, and in no way condones, euthanasia, mercy killing, or assisted 6 suicide or permit an affirmative or deliberate act or omission to end life, 7 other than to allow the natural process of dying. 8 (3)No physician, health facility or other health care provider and no9health care service plan, insurer issuing disability insurance, self-insured10employee plan, welfare benefit plan or nonprofit hospital service plan shall11require any person to execute a "Living Will and Durable Power of Attorney for12Health Care" as a condition for being insured for, or receiving, health care13servicesComfort care. Individuals caring for a patient for whom artificial 14 life-sustaining procedures or artificially administered nutrition and 15 hydration are withheld or withdrawn shall provide comfort care as defined in 16 section 39-4502, Idaho Code. 17 (4) Presumed consent to resuscitation. There is a presumption in favor of 18 consent to cardiopulmonary resuscitation (CPR) unless: 19 (a) A completed living will for that person is in effect, pursuant to 20 section 39-4510, Idaho Code, and the person is in a terminal condition or 21 persistent vegetative state; or 22 (b) A completed durable power of attorney for health care for that person 23 is in effect, pursuant to section 39-4510, Idaho Code, in which the person 24 has indicated that he or she does not wish to receive cardiopulmonary re- 25 suscitation, or his or her representative has determined that the person 26 would not wish to receive cardiopulmonary resuscitation; or 27 (c) The patient has a completed physician orders for scope of treatment 28 (POST) form indicating otherwise and/or proper POST identification pursu- 29 ant to section 39-4502(13), Idaho Code. 30 (5) Futile care. Nothing in this chapter shall be construed to require 31 medical treatment that is medically inappropriate or futile. 32 (6) Existing directives and directives from other states. A health care 33 directive executed prior to July 1, 2007, but which was in the living will, 34 durable power of attorney for health care, DNR, or POST form pursuant to prior 35 Idaho law at the time of execution, or in another form that contained the ele- 36 ments set forth in this chapter at the time of execution, shall be deemed to 37 be in compliance with this chapter. Health care directives or similar docu- 38 ments executed in another state that substantially comply with this chapter 39 shall be deemed to be in compliance with this chapter. 40 (7) Insurance. 41 (a) The making of a living will and/or durable power of attorney for 42 health care or physician orders for scope of treatment (POST) form pursu- 43 ant to this chapter shall not restrict, inhibit or impair in any manner 44 the sale, procurement or issuance of any policy of life insurance, nor 45 shall it be deemed to modify the terms of an existing policy of life 46 insurance. No policy of life insurance shall be legally impaired or inval- 47 idated in any manner by the withholding or withdrawal of artificial life- 48 sustaining procedures from an insured patient, notwithstanding any term of 49 the policy to the contrary. 50 (b) No physician, health care facility or other health care provider and 51 no health care service plan, insurer issuing disability insurance, 52 self-insured employee plan, welfare benefit plan or nonprofit hospital 53 service plan shall require any person to execute a living will and durable 54 power of attorney for health care or physician orders for scope of treat- 55 ment (POST) form as a condition for being insured for, or receiving, 15 1 health care services. 2 (8) Portability and copies. 3 (a) A completed physician orders for scope of treatment (POST) form 4 signed by a physician shall be transferred with the patient to, and be 5 effective in, all care settings including, but not limited to, home care, 6 ambulance or other transport, hospital, residential care facility, and 7 hospice care. The POST form shall remain in effect until such time as 8 there is a valid revocation pursuant to section 39-4511, Idaho Code, or 9 new orders are issued by a physician. 10 (b) A photostatic, facsimile or electronic copy of a valid physician 11 orders for scope of treatment (POST) form may be treated as an original by 12 a health care provider or by an institution receiving or treating a 13 patient. 14 (9) Registration. A directive or the revocation of a directive meeting 15 the requirements of this chapter may be registered with the secretary of state 16 pursuant to section 39-4515, Idaho Code. Failure to register the health care 17 directive shall not affect the validity of the health care directive. 18 (10) Rulemaking authority. 19 (a) The department of health and welfare shall adopt those rules and 20 protocols necessary to administer the provisions of this chapter. 21 (b) In the adoption of a physician orders for scope of treatment (POST) 22 or DNR protocol, the department shall adopt standardized POST identifica- 23 tion to be used statewide. 24 SECTION 18. That Sections 56-1020 through 56-1035, Idaho Code, be, and 25 the same are hereby repealed. 26 SECTION 19. That Section 66-405, Idaho Code, be, and the same is hereby 27 amended to read as follows: 28 66-405. ORDER IN PROTECTIVE PROCEEDINGS. (1) If it is determined that the 29 respondent is not developmentally disabled but appears in need of protective 30 services, the court may cause the proceeding to be expanded or altered for 31 consideration under the uniform probate code. 32 (2) If it is determined that the respondent is able to manage financial 33 resources and meet essential requirements for physical health or safety, the 34 court shall dismiss the petition. 35 (3) If it is determined that the respondent is developmentally disabled 36 and is unable to manage some financial resources or meet some essential 37 requirements for physical health or safety, the court may appoint a partial 38 guardian and/or partial conservator on behalf of the respondent. An order 39 establishing partial guardianship or partial conservatorship shall define the 40 powers and duties of the partial guardian or partial conservator so as to per- 41 mit the respondent to meet essential requirements for physical health or 42 safety and to manage financial resources commensurate with his ability to do 43 so, and shall specify all legal restrictions to which he is subject. A person 44 for whom a partial guardianship or partial conservatorship has been appointed 45 under this chapter retains all legal and civil rights except those which have 46 by court order been limited or which have been specifically granted to the 47 partial guardian or partial conservator by the court. 48 (4) If it is determined that the respondent is developmentally disabled 49 and is unable to manage financial resources or meet essential requirements for 50 physical health or safety even with the appointment of a partial guardian or 51 partial conservator, the court may appoint a total guardian and/or total con- 52 servator. 16 1 (5) In the event that more than one (1) person seeks to be appointed 2 guardian and/or conservator, the court shall appoint the person or persons 3 most capable of serving on behalf of the respondent; the court shall not cus- 4 tomarily or ordinarily appoint the department or any other organization or 5 individual, public or private, that is or is likely to be providing services 6 to the respondent. 7 (6) Subject to the limitations of the provisions of subsection (7) of 8 this section, guardians or conservators may have any of the duties and powers 9 as provided in sections 15-5-312(a)(1) through (4), 15-5-424 and 15-5-425, 10 Idaho Code, and as specified in the order. Any order appointing a partial or 11 total guardian or partial or total conservator under the provisions of this 12 section must require a report to the court at least annually. In addition to 13 such other requirements imposed by law or order, the report shall include: 14 (a) A description of the respondent's current mental, physical and social 15 condition; 16 (b) The respondent's present address and living arrangement; 17 (c) A description of any significant changes in the capacity of the 18 respondent to meet essential requirements for physical health or safety or 19 to manage financial resources; 20 (d) A description of services being provided the respondent; 21 (e) A description of significant actions taken by the guardian or conser- 22 vator during the reporting period; 23 (f) Any significant problems relating to the guardianship or conservator- 24 ship; 25 (g) A complete financial statement of the financial resources under the 26 control or supervision of the guardian or conservator; and 27 (h) A description of the need for continued guardianship or conservator- 28 ship services. 29 (7) No guardian appointed under this chapter shall have the authority to 30 refuse or withhold consent for medically necessary treatment when the effect 31 of withholding such treatment would seriously endanger the life or health and 32 well-being of the person with a developmental disability. To withhold or 33 attempt to withhold such treatment shall constitute neglect of the person and 34 be cause for removal of the guardian. No physician or caregiver shall withhold 35 or withdraw such treatment for a respondent whose condition is not terminal or 36 whose death is not imminent. If the physician or caregiver cannot obtain valid 37 consent for medically necessary treatment from the guardian, he shall provide 38 the medically necessary treatment as authorized by section 39-45034(1)(g), 39 Idaho Code. 40 (8) A guardian appointed under this chapter may consent to withholding or 41 withdrawal of artificial life-sustaining procedures, only if the respondent: 42 (a) Has an incurable injury, disease, illness or condition, certified by 43 the respondent's attending physician and at least one (1) other physician 44 to be terminal such that the application of artificial life-sustaining 45 procedures would not result in the possibility of saving or significantly 46 prolonging the life of the respondent, and would only serve to prolong the 47 moment of the respondent's death for a period of hours, days or weeks, and 48 where both physicians certify that death is imminent, whether or not the 49 life-sustaining procedures are used; or 50 (b) Has been diagnosed by the respondent's attending physician and at 51 least one (1) other physician as being in a persistent vegetative state 52 which is irreversible and from which the respondent will never regain con- 53 sciousness. 54 (9) Any person, who has information that medically necessary treatment of 55 a respondent has been withheld or withdrawn, may report such information to 17 1 adult protective services or to the Idaho protection and advocacy system for 2 people with developmental disabilities, who shall have the authority to inves- 3 tigate the report and in appropriate cases to seek a court order to ensure 4 that medically necessary treatment is provided. 5 If adult protective services or the protection and advocacy system deter- 6 mines that withholding of medical treatment violates the provisions of this 7 section, they may petition the court for an ex parte order to provide or con- 8 tinue the medical treatment in question. If the court finds, based on affida- 9 vits or other evidence, that there is probable cause to believe that the with- 10 holding of medical treatment in a particular case violates the provisions of 11 this section, and that the life or health of the patient is endangered 12 thereby, the court shall issue an ex parte order to continue or to provide the 13 treatment until such time as the court can hear evidence from the parties 14 involved. Petitions for court orders under this section shall be expedited by 15 the courts and heard as soon as possible. No bond shall be required of a peti- 16 tioner under this section. 17 (10) No partial or total guardian or partial or total conservator 18 appointed under the provisions of this section may without specific approval 19 of the court in a proceeding separate from that in which such guardian or con- 20 servator was appointed: 21 (a) Consent to medical or surgical treatment the effect of which perma- 22 nently prohibits the conception of children by the respondent unless the 23 treatment or procedures are necessary to protect the physical health of 24 the respondent and would be prescribed for a person who is not developmen- 25 tally disabled; 26 (b) Consent to experimental surgery, procedures or medications; or 27 (c) Delegate the powers granted by the order.
STATEMENT OF PURPOSE RS 16757 Last year, the legislature adopted House Concurrent Resolution 40 ("HCR4O"), which directed the Department of Health and Welfare and the Attorney General to develop a form that could replace "do not resuscitate" ("DNR") orders used at hospitals and other health care institutions within the State of Idaho. HCR4O also directed the Department of Health and Welfare and the Attorney General to suggest necessary statutory changes to allow for the adoption of such a form. This legislation is in response to HCR4O. The physician orders for scope of treatment ("POST") form envisioned by this legislation would be recognized by all medical care providers and health institutions within the State of Idaho. The POST form provides greater flexibility over the old DNR forms and, more importantly, provides a high degree of portability. In other words, the POST form stays with the patient, rather than staying with the institution. Another advantage to the POST form is that it is signed by both the doctor and the patient or the patient s health care agent. Both the doctor and the patient are involved in the process that results in the issuance of the POST. The POST form does not replace a living will, although it does replace the statutes on DNR orders. While health care institutions may continue to utilize their own DNR orders within the confines of the institution, the POST form proposed by this legislation is intended to be portable. It is hoped that the POST form will become the standard DNR form. FISCAL NOTE None. Contact Name: Bill von Tagen, Office of the Attorney General Phone: 208 334-4140 STATEMENT OF PURPOSE/FISCAL NOTE H 119