H*2041 Session 106 (1985-1986)
H*2041(Rat #0360, Act #0341 of 1986) General Bill, By H.H. Keyserling,
R.L. Altman, J.F. Anderson, D. Blackwell, L. Blanding, T.M. Burriss, P. Freeman,
P.B. Harris, L.I. Hendricks, T.E. Huff, T.L. Hughston, W.H. Jones, Kirsh,
J.R. Klapman, E.C. Lewis, D.A. Moss, H.E. Pearce, T.F. Rogers, Sheheen,
P.E. Short, E.W. Simpson, J.J. Snow and D.C. Waldrop
Similar(S 46)
A Bill to authorize an adult to make a written directive instructing his
physician to withhold or withdraw life-sustaining procedures in the event of a
terminal condition.
12/10/84 House Prefiled
12/10/84 House Referred to Committee on Judiciary
01/08/85 House Introduced and read first time HJ-155
01/08/85 House Referred to Committee on Judiciary HJ-155
01/23/85 House Committee report: Majority favorable, minority
unfavorable Judiciary HJ-369
01/30/85 House Debate interrupted HJ-466
01/31/85 House Amended HJ-521
01/31/85 House Read second time HJ-527
02/05/85 House Debate interrupted HJ-552
02/07/85 House Debate interrupted HJ-625
02/13/85 House Debate interrupted HJ-719
02/14/85 House Amended HJ-817
02/14/85 House Read third time and sent to Senate HJ-820
02/19/85 Senate Introduced and read first time SJ-583
02/19/85 Senate Referred to Committee on Judiciary SJ-583
03/20/85 Senate Committee report: Majority favorable, minority
unfavorable Judiciary SJ-948
05/09/85 Senate Special order SJ-2019
06/04/85 Senate Debate interrupted SJ-2804
06/05/85 Senate Amended SJ-2849
06/05/85 Senate Read second time SJ-2853
06/05/85 Senate Ordered to third reading with notice of
amendments SJ-2853
06/06/85 Senate Amended SJ-2883
01/28/86 Senate Amended SJ-275
01/28/86 Senate Debate interrupted SJ-278
01/29/86 Senate Amended SJ-295
01/29/86 Senate Read third time SJ-299
01/29/86 Senate Returned SJ-299
02/19/86 House Debate adjourned on amendments HJ-863
02/20/86 House Senate amendment amended HJ-904
02/20/86 House Returned HJ-905
02/26/86 Senate Concurred in House amendment and enrolled SJ-738
03/04/86 Ratified R 360
03/06/86 Signed By Governor
03/06/86 Effective date 03/06/86
03/06/86 Act No. 341
03/12/86 Copies available
(A341, R360, H2041)
AN ACT TO AUTHORIZE AN ADULT TO MAKE A WRITTEN DIRECTIVE INSTRUCTING HIS
PHYSICIAN TO WITHHOLD OR WITHDRAW LIFE-SUSTAINING PROCEDURES IN THE EVENT OF A
TERMINAL CONDITION.
Whereas, the General Assembly finds that adult persons have the fundamental right
to control the decision relating to the rendering of their own medical care,
including the decision to have life-sustaining procedures withheld or withdrawn
in instances of a terminal condition; and
Whereas, in order that the rights of patients may be respected even after they
are no longer able to participate actively in decisions about themselves, the
General Assembly by this act provides that an adult person may make a written
declaration instructing his physician to withhold or withdraw life-sustaining
procedures in the event of a terminal condition. Now, therefore,
Be it enacted by the General Assembly of the State of South Carolina:
Act may be cited
SECTION 1. This act may be cited as the Death With Dignity Act.
Definitions
SECTION 2. As used in this act:
a. "Declarant" means a person who has signed a declaration in
accordance with Section 5.
b. "Life-sustaining procedures" means any medical procedures or
intervention which would serve only to prolong the dying process and where, in
the judgment of the attending physician, death will occur whether or not such
procedures are utilized. Life-sustaining procedures do not include the
administration of medication nor does it affect the responsibility of the
attending physician to provide treatment, nutrition, and hydration for comfort
care or alleviation of pain.
c. "Physician" means any person licensed to practice medicine in
this State.
d. "Terminal condition" means an injury, disease, or illness from
which to a reasonable degree of medical certainty (i) there can be no recovery,
and (ii) death is imminent without the use of life-sustaining procedures.
e. "Active treatment" means the standard of reasonable professional
care that would be rendered by a physician to a patient in the absence of any
terminal condition including but not limited to hospitalization and medication.
Life sustaining procedure may be withheld
SECTION 3. If any adult declares that his dying not be prolonged and the
person's present condition is confirmed by a physician other than the attending
physician to be terminal, then the life-sustaining procedure may be withheld or
discontinued upon the direction and under the supervision of the attending
physician.
All patients with life threatening illnesses that are diagnosed as terminal
shall be administered active treatment for at least six hours prior to the
physician's acceptance of a declaration.
Declaration
SECTION 4. The attending physician may rely upon a signed, witnessed, and dated
declaration:
1. which expresses a desire of the declarant that no life-sustaining
procedures be used to prolong dying if his condition is terminal; and
2. which states that the declarant is aware that the declaration authorizes
a physician to withhold or withdraw life-sustaining procedures; and
3. which has been signed by the declarant in the presence of three witnesses
who state that they are not related to the declarant by blood or marriage, not
directly financially responsible for the person's medical care, and who would not
be entitled to any portion of the estate of the declarant upon his decease under
any will or as an heir by intestate succession under the laws of South Carolina
of the declarant then existing or is a beneficiary of a life insurance policy of
the declarant and has knowledge of such status. No more than one witness may be
an employee of a health facility in which the declarant is a patient. A witness
to a declaration may not be the attending physician or an employee of the
attending physician or any person who has a claim against any portion of the
estate of the declarant upon his decease at the time of the execution of the
declaration.
Form of declaration
SECTION 5. The declaration must be substantially in the following form:
STATE OF SOUTH CAROLINA
DECLARATION OF A DESIRE FOR A NATURAL DEATH
COUNTY OF
I,______________ , a resident of and domiciled in the City of__________________
, County of________________ , State of South Carolina, make this Declaration
this_____________________ day of ____________ , 19________ .
I wilfully and voluntarily make known my desire that no life-sustaining
procedures be used to prolong my dying if my condition is terminal, and I do
hereby declare:
If at any time I have an incurable injury, disease, or illness certified to be
a terminal condition by two physicians who have personally examined me, one of
whom is my attending physician, and the physicians have determined that my death
will occur without the use of life-sustaining procedures and where the
application of life-sustaining procedures would serve only to prolong the dying
process, I direct that such procedures be withheld or withdrawn, and that I be
permitted to die naturally with only the administration of medication or the
performance of any medical procedure necessary to provide me with comfort care.
In the absence of my ability to give directions regarding the use of such
life-sustaining procedures, it is my intention that this Declaration be honored
by my family and physicians as the final expression of my legal right to refuse
medical or surgical treatment and I accept the consequences from such refusal.
I am aware that this Declaration authorizes a physician to withhold or withdraw
life-sustaining procedures. I am emotionally and mentally competent to make this
Declaration.
THIS DECLARATION MAY BE REVOKED BY THE DECLARANT, WITHOUT REGARD TO HIS
PHYSICAL OR MENTAL CONDITION.
(1) BY BEING DEFACED, TORN, OBLITERATED, OR OTHERWISE DESTROYED BY THE
DECLARANT OR BY SOME PERSON IN THE PRESENCE OF AND BY THE DIRECTION OF THE
DECLARANT.
(2) BY A WRITTEN REVOCATION SIGNED AND DATED BY THE DECLARANT EXPRESSING HIS
OR HER INTENT TO REVOKE. THE REVOCATION SHALL BECOME EFFECTIVE ONLY UPON
COMMUNICATION TO THE ATTENDING PHYSICIAN BY THE DECLARANT OR BY A PERSON ACTING
ON BEHALF OF THE DECLARANT. THE ATTENDING PHYSICIAN SHALL RECORD IN THE
PATIENT'S MEDICAL RECORD THE TIME AND DATE WHEN HE RECEIVED NOTIFICATION OF THE
WRITTEN REVOCATION.
(3) BY A VERBAL EXPRESSION BY THE DECLARANT OF HIS INTENT TO REVOKE THE
DECLARATION. THE REVOCATION SHALL BECOME EFFECTIVE ONLY UPON COMMUNICATION TO
THE ATTENDING PHYSICIAN BY THE DECLARANT. THE ATTENDING PHYSICIAN SHALL RECORD
IN THE PATIENT'S MEDICAL RECORD THE TIME, DATE, AND PLACE OF THE REVOCATION AND
THE TIME, DATE, AND PLACE, IF DIFFERENT, OF WHEN HE RECEIVED NOTIFICATION OF THE
REVOCATION.
__________________________________________
Declarant
STATE OF___________________________________ AFFIDAVIT
COUNTY OF_________________________________
We,______________ ,_________________ ,______________ and , the witnesses whose
names are signed to the foregoing Declaration, dated the_______ day of_________
, 19______ , being first duly sworn, do hereby declare to the undersigned
authority that the Declaration was on that date signed by the said declarant as
and for his DECLARATION OF A DESIRE FOR A NATURAL DEATH in our presence and we,
at his request and in his presence, and in the presence of each other, did
thereunto subscribe our names as witnesses on that date. The declarant is
personally known to us and we believe him to be of sound mind. None of us is
disqualified as a witness to this Declaration by any provision of the South
Carolina Death With Dignity Act. None of us is related to the declarant by blood
or marriage; nor directly financially responsible for the declarant's medical
care; nor entitled to any portion of the declarant's estate upon his decease,
whether under any will or as an heir by intestate succession; nor the beneficiary
of a life insurance policy of the declarant; nor the declarant's attending
physician; nor an employee of such attending physician; nor a person who has a
claim against the declarant's decedent's estate as of this time. No more than
one of us is an employee of a health facility in which the declarant is a
patient. If the declarant is a patient in a hospital or skilled or intermediate
care nursing facility at the date of execution of this Declaration at least one
of us is an ombudsman designated by the State Ombudsman, Office of the Governor.
________________________________
Witness
________________________________
Witness
________________________________
Witness
Subscribed, sworn to, and acknowledged before me by______________
___________________ , the declarant, and subscribed and sworn to before me by
___________________________ ,
____________________ , and__________________________ , the witnesses,
this______________ day of______________ , 19______ .
______________________________
Notary Public for
My commission expires:________________________
SEAL
The declaration must be signed by the declarant in the presence of three
witnesses and shall be attested and subscribed in the presence of the declarant
and of each other by the three witnesses and an officer authorized to administer
oaths under the laws of the State where acknowledgement occurs or else the
declaration shall be utterly void and of no effect. Each will prepared in
accordance with the provisions of this section shall set forth the procedure and
requirements for revocation of the declaration. Requirements for revocation
shall be set forth in bold-face print.
Force and effect of declaration
SECTION 5A. A declaration shall have no force or effect if the declarant is a
patient in a hospital or skilled or intermediate care nursing facility at the
time the directive is executed unless one of the three witnesses to the directive
is an ombudsman as may be designated by the State Ombudsman, Office of the
Governor. The ombudsman shall have the same qualifications as a witness under
Section 4.
The intent of this section is to recognize that some patients in skilled or
intermediate care nursing facilities may be so insulated from a voluntary
decision-making role, by virtue of the custodial nature of their care, as to
require special assurance that they are capable of wilfully and voluntarily
executing a directive.
Declaration to have no force of effect if
declarant is pregnant
SECTION 5B. If a declarant has been diagnosed as pregnant, the declaration shall
have no force of effect during the course of the declarant's pregnancy.
The declaration shall also contain an affidavit in the form of a verification
by each witness that he is not disqualified by any provision of this act and such
disqualification shall be set forth in the text of the affidavit.
Declaration may be revoked
SECTION 6. The declaration may be revoked by the declarant, without regard to
his physical or mental condition:
1. By being defaced, torn, obliterated, or otherwise destroyed by the
declarant or by some person in the presence of and by the direction of the
declarant.
2. By a written revocation signed and dated by the declarant expressing his
or her intent to revoke. The revocation shall become effective only upon
communication to the attending physician by the declarant or by a person acting
on behalf of the declarant. The attending physician shall record in the
patient's medical record the time and date when he received notification of the
written revocation.
3. By a verbal expression by the declarant of his intent to revoke the
declaration. The revocation shall become effective only upon communication to
the attending physician by the declarant. The attending physician shall record
in the patient's medical record the time, date, and place of the revocation and
the time, date, and place, if different, of when he received notification of the
revocation.
Relies upon declaration
SECTION 7. After certification of a terminal condition, a physician who relies
on a declaration executed under this act, of which he has no actual notice of
revocation and who withholds life-sustaining procedures from the terminally ill
patient who executed the declaration, is presumed to be acting in good faith.
Unless it is alleged and proved that the physician's action violated the standard
of reasonable professional care and judgment under the circumstances, he is
immune from civil or criminal liability.
Failure to effectuate declaration
SECTION 8. A failure by a physician to effectuate the declaration of a terminal
patient shall constitute unprofessional conduct if the physician fails or refuses
to make reasonable efforts to effect the transfer of the patient to another
physician who will effectuate the declaration.
Execution and consummation of declaration not
to constitute suicide
SECTION 9. The execution and consummation of declarations made in accordance
with Section 4 or 5 does not constitute suicide for any purpose.
Persons not required to sign declaration
SECTION 10. No person is required to sign a declaration in accordance with
Section 4 or 5 as a condition for becoming insured under any insurance contract
or for receiving any medical treatment or as a condition of being admitted to a
hospital or nursing home facility.
Nothing in act may be construed as mercy
killing
SECTION 11. Nothing in this act may be construed to authorize or approve mercy
killing, or to permit any affirmative or deliberate act or omission to end life
other than to permit the natural process of dying.
Absence of declaration may not give rise to
presumption
SECTION 12. The absence of a declaration by an adult patient shall not give rise
to any presumption as to his intent to consent to or refuse death prolonging
procedures.
Penalty
SECTION 13. (A) If any person knowingly provides or aids another in providing
any false information of any nature in any manner relative to a declaration of
a desire for a natural death under this act, including, but not limited to, the
contents of the declaration or the execution or the revocation of the
declaration, and lifesustaining procedures are withheld or withdrawn from the
declarant and the declarant then dies as a result of that withdrawal or
nontreatment, the person is guilty of murder and must be punished in accordance
with the laws of this State.
(B) If any person knowingly provides or aids another in providing any false
information of any nature in any manner relative to a declaration of a desire for
a natural death under this act, including, but not limited to, the contents of
the declaration or the execution or the revocation of the declaration, and life-
sustaining procedures are withheld or withdrawn from the declarant and the
declarant does not die but further expenses are incurred as a result of the
withdrawal or nontreatment, in caring for the declarant, the person is
responsible for the payment of those further expenses.
Coerces or fraudulently induces person to
execute declaration
SECTION 14. Any person who coerces or fraudulently induces another person to
execute a declaration under this act and the declarant dies as a result of the
withdrawal of treatment or nontreatment in reliance on the declaration, that
person is guilty of murder and must be punished in accordance with the laws of
this State.
Time effective
SECTION 15. This act shall take effect upon approval by the Governor. |