H*3090 Session 109 (1991-1992)
H*3090(Rat #0220, Act #0149 of 1991) General Bill, By H.H. Keyserling,
P.B. Harris, J.H. Hodges, K.G. Kempe, S.G. Manly, J.G. Mattos, I.K. Rudnick,
C.Y. Waites, D.C. Waldrop, L.S. Whipper and J.B. Wilder
A Bill to amend Chapter 77, Title 44, Code of Laws of South Carolina, 1976,
relating to the Death with Dignity Act, by adding Section 44-77-65 so as to
allow a declarant to supplement a declaration with a document providing
instructions for artificial nutrition and hydration and by adding Section
44-77-85 so as to authorize a declarant to designate an agent to act on his
behalf to ensure that the declaration is given effect; to amend Section
44-77-20, as amended, relating to definitions, so as to revise the definitions
of "life-sustaining procedures" and "terminal condition" and add the
definition of "permanent unconsciousness"; Section 44-77-30, as amended,
relating to withholding life-sustaining procedures, so as to provide that
life-sustaining procedures may be withheld pursuant to a declaration when a
person has been in a state of permanent unconsciousness for at least ninety
days or at any time if other criteria is met and to clarify that active
treatment must be administered after a terminal diagnosis before giving effect
to a declaration; Section 44-77-40, as amended, relating to qualifications for
witnesses to a death with dignity declaration, so as to further limit who may
be a witness to a declaration and to clarify execution procedures; Section
44-77-50, as amended, relating to the form of a declaration, so as to include
the revised definition of terminal condition, provide specific directions
regarding nutrition and hydration which a declarant may choose, provide for
the appointment of an agent, and revise the language pertaining to the
revocation of a declaration; Section 44-77-80, as amended, relating to
revocation of a declaration, so as to include that the declarant may revoke a
declaration by executing a subsequent declaration; Section 44-77-90, as
amended, relating to immunity from liability so as to include immunity to one
who in good faith relies on a certification of permanent unconsciousness and
to extend immunity to a physician who in good faith and within standards of
reasonable medical care certifies a terminal condition or permanent
unconsciousness; Section 44-77-100, as amended, relating to circumstances in
which physician's failure to effect the declaration constitutes unprofessional
conduct so as to provide that when an employee of a health care facility
states they do not wish to participate in the withholding of life-sustaining
procedures, the physician must make reasonable efforts to effectuate the
declaration without the employee; and Section 44-77-140, as amended, relating
to absence of declaration not giving rise to presumption so as to provide that
this Chapter applies only to persons who have executed a declaration in
accordance with this Chapter.-amended title
12/27/90 House Prefiled
12/27/90 House Referred to Committee on Judiciary
01/08/91 House Introduced and read first time HJ-62
01/08/91 House Referred to Committee on Judiciary HJ-62
03/07/91 House Committee report: Majority favorable with amend.,
minority unfavorable Judiciary HJ-2
03/20/91 House Debate adjourned until Tuesday, March 26, 1991 HJ-4
03/28/91 House Debate adjourned HJ-26
04/10/91 House Debate adjourned until Tuesday, April 16, 1991 HJ-3
04/24/91 House Amended HJ-46
04/24/91 House Debate interrupted HJ-59
04/25/91 House Amended HJ-88
04/25/91 House Debate interrupted HJ-90
05/01/91 House Amended HJ-51
05/01/91 House Read second time HJ-55
05/08/91 House Amended HJ-35
05/08/91 House Read third time and sent to Senate HJ-35
05/09/91 Senate Introduced and read first time SJ-6
05/09/91 Senate Referred to Committee on Judiciary SJ-7
05/16/91 Senate Recalled from Committee on Judiciary SJ-9
05/16/91 Senate Special order SJ-9
05/21/91 Senate Read second time SJ-154
05/21/91 Senate Ordered to third reading with notice of
amendments SJ-154
05/27/91 Senate Amended SJ-26
05/27/91 Senate Read third time and returned to House with
amendments SJ-28
05/28/91 House Concurred in Senate amendment and enrolled HJ-6
06/06/91 Ratified R 220
06/12/91 Signed By Governor
06/12/91 Effective date 06/12/91
06/12/91 Act No. 149
06/26/91 Copies available
(A149, R220, H3090)
AN ACT TO AMEND CHAPTER 77, TITLE 44, CODE OF LAWS
OF SOUTH CAROLINA, 1976, RELATING TO THE DEATH WITH
DIGNITY ACT, BY ADDING SECTION 44-77-65 SO AS TO ALLOW A
DECLARANT TO SUPPLEMENT A DECLARATION WITH A
DOCUMENT PROVIDING INSTRUCTIONS FOR ARTIFICIAL
NUTRITION AND HYDRATION AND BY ADDING SECTION
44-77-85 SO AS TO AUTHORIZE A DECLARANT TO DESIGNATE
AN AGENT TO ACT ON HIS BEHALF TO ENSURE THAT THE
DECLARATION IS GIVEN EFFECT; TO AMEND SECTION 44-77-20,
AS AMENDED, RELATING TO DEFINITIONS, SO AS TO REVISE
THE DEFINITIONS OF "LIFE-SUSTAINING
PROCEDURES" AND "TERMINAL CONDITION"
AND TO ADD THE DEFINITION OF "PERMANENT
UNCONSCIOUSNESS"; SECTION 44-77-30, AS AMENDED,
RELATING TO WITHHOLDING LIFE-SUSTAINING PROCEDURES,
SO AS TO PROVIDE THAT LIFE-SUSTAINING PROCEDURES MAY
BE WITHHELD PURSUANT TO A DECLARATION WHEN A
PERSON HAS BEEN IN A STATE OF PERMANENT
UNCONSCIOUSNESS FOR AT LEAST NINETY DAYS OR AT ANY
TIME IF OTHER CRITERIA IS MET AND TO CLARIFY THAT
ACTIVE TREATMENT MUST BE ADMINISTERED AFTER A
TERMINAL DIAGNOSIS BEFORE GIVING EFFECT TO A
DECLARATION; SECTION 44-77-40, AS AMENDED, RELATING TO
QUALIFICATIONS FOR WITNESSES TO A DEATH WITH DIGNITY
DECLARATION, SO AS TO FURTHER LIMIT WHO MAY BE A
WITNESS TO A DECLARATION AND TO CLARIFY EXECUTION
PROCEDURES; SECTION 44-77-50, AS AMENDED, RELATING TO
THE FORM OF A DECLARATION, SO AS TO INCLUDE THE
REVISED DEFINITION OF TERMINAL CONDITION, PROVIDE
SPECIFIC DIRECTIONS REGARDING NUTRITION AND
HYDRATION WHICH A DECLARANT MAY CHOOSE, PROVIDE
FOR THE APPOINTMENT OF AN AGENT, AND REVISE THE
LANGUAGE PERTAINING TO THE REVOCATION OF A
DECLARATION; SECTION 44-77-80, AS AMENDED, RELATING TO
REVOCATION OF A DECLARATION, SO AS TO INCLUDE THAT
THE DECLARANT MAY REVOKE A DECLARATION BY
EXECUTING A SUBSEQUENT DECLARATION; SECTION 44-77-90,
AS AMENDED, RELATING TO IMMUNITY FROM LIABILITY SO AS
TO INCLUDE IMMUNITY TO ONE WHO IN GOOD FAITH RELIES
ON A CERTIFICATION OF PERMANENT UNCONSCIOUSNESS AND
TO EXTEND IMMUNITY TO A PHYSICIAN WHO IN GOOD FAITH
AND WITHIN STANDARDS OF REASONABLE MEDICAL CARE
CERTIFIES A TERMINAL CONDITION OR PERMANENT
UNCONSCIOUSNESS; SECTION 44-77-100, AS AMENDED,
RELATING TO CIRCUMSTANCES IN WHICH PHYSICIAN'S
FAILURE TO EFFECT THE DECLARATION CONSTITUTES
UNPROFESSIONAL CONDUCT SO AS TO PROVIDE THAT WHEN
AN EMPLOYEE OF A HEALTH CARE FACILITY STATES THEY DO
NOT WISH TO PARTICIPATE IN THE WITHHOLDING OF LIFE-SUSTAINING PROCEDURES, THE PHYSICIAN MUST MAKE
REASONABLE EFFORTS TO EFFECTUATE THE DECLARATION
WITHOUT THE EMPLOYEE; AND SECTION 44-77-140, AS
AMENDED, RELATING TO ABSENCE OF DECLARATION NOT
GIVING RISE TO PRESUMPTION SO AS TO PROVIDE THAT THIS
CHAPTER APPLIES ONLY TO PERSONS WHO HAVE EXECUTED A
DECLARATION IN ACCORDANCE WITH THIS CHAPTER.
Be it enacted by the General Assembly of the State of South Carolina:
Agent may be appointed to effectuate declaration
SECTION 1. The 1976 Code is amended by adding:
"Section 44-77-85. The declarant may indicate in the declaration
whether he wants to appoint an agent to act on his behalf in assuring that
the declaration is given effect by petitioning the court of common pleas for
an order directing providers to withhold or withdraw treatment as provided
in the declaration. The authority of a person designated pursuant to this
section is not affected by the subsequent appointment of a guardian or by
the declarant's execution of a durable power of attorney before or after
execution of the declaration. If the agent is not reasonably available, or is
unable or unwilling to ensure that the declaration be given effect, an
interested person may petition the court of common pleas for an order
directing providers to withhold or withdraw treatment as provided in the
declaration. Nothing in this section alters the self-executing nature of a
declaration or requires that a court order be obtained or other affirmative
action be taken to make the declaration valid or to bring about its
implementation. This section does not apply to a declaration that has been
revoked as provided in Section 44-77-80."
Definitions revised
SECTION 2. Section 44-77-20 of the 1976 Code, as last amended by Act
586 of 1988, is further amended to read:
"Section 44-77-20. As used in this chapter:
(1) `Declarant' means a person who has signed a declaration in
accordance with Sections 44-77-40 and 44-77-50, in accordance with
earlier, current, or future versions of this chapter, or in accordance with the
law of another state if the declaration provided for by the law expresses an
intent that is substantially the same as the intent of the declaration provided
in Section 44-77-40.
(2) `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 the procedures are utilized. Life-sustaining procedures do not
include the administration of medication or other treatment for comfort care
or alleviation of pain. The declarant shall indicate in the declaration
whether the provision of nutrition and hydration through medically or
surgically implanted tubes is to be treated as a life-sustaining procedure.
Pursuant to a lawfully executed declaration if the declarant fails to give
instructions by initialing the appropriate statements concerning nutrition
and hydration, nutrition and hydration necessary for comfort care or
alleviation of pain will be provided.
(3) `Physician' means a person licensed to practice medicine.
(4) `Terminal condition' means an incurable or irreversible condition
that, within reasonable medical judgment, could cause death within a
reasonably short period of time if life-sustaining procedures are not
used.
(5) `Active treatment' means the standard of reasonable professional
care that would be rendered by a physician to a patient in the absence of a
declaration including, but not limited to, hospitalization and medication.
(6) `Person' means an individual, partnership, committee, association,
corporation, hospital, or other organization or group.
(7) `Permanent unconsciousness' means a medical diagnosis,
consistent with accepted standards of medical practice, that a person is in a
persistent vegetative state or some other irreversible condition in which the
person has no neocortical functioning, but only involuntary vegetative or
primitive reflex functions controlled by the brain stem."
Criteria to withhold life-sustaining procedures includes state of
permanent unconsciousness
SECTION 3. Section 44-77-30 of the 1976 Code, as last amended by Act
586 of 1988, is further amended to read:
"Section 44-77-30. If a person eighteen years of age or older
adopts a declaration that is substantially in the form provided in Section
44-77-50, whether executed before or after an amendment is made to the
form, and that on its face is duly executed, witnessed, and authenticated as
provided in Section 44-77-40 or on its face is in compliance with the law of
the state of the declarant's domicile at the time that the declaration is
adopted, if the declaration provided for by the law expresses an intent that
is substantially the same as the intent of the declaration provided in Section
44-77-40, and the person's present condition is certified to be terminal or to
be in a state of permanent unconsciousness by two physicians who
personally have examined the declarant, one of whom is the declarant's
attending physician, and the other of whom is a physician other than the
attending physician, then life-sustaining procedures may be withheld or
withdrawn upon the direction and under the supervision of the attending
physician. A certification based upon a diagnosis of permanent
unconsciousness may not be made until the declarant has remained
unconscious for at least ninety consecutive days, or at any time if the
declarant has experienced massive destruction or atrophy of the cortex as
evidenced by neurodiagnostic studies or gross inspection of the brain, or
some other characteristic of the declarant's condition allows a diagnosis of
permanent unconsciousness to be made with a high degree of medical
certainty.
All patients with life-threatening conditions that are diagnosed as
terminal or in a state of permanent unconsciousness must be administered
active treatment for at least six hours following the diagnosis before the
physician may give effect to a declaration."
Qualifications and procedures for witnessing declaration
SECTION 4. Section 44-77-40 of the 1976 Code, as last amended by Act
586 of 1988, is further amended to read:
"Section 44-77-40. A declaration is valid:
(1) which expresses substantially in the form set forth in Section
44-77-50 a desire of the declarant that no life-sustaining procedures be used
to prolong dying if his condition is terminal or if he is permanently
unconscious and states that the declarant is aware that the declaration
authorizes a physician to withhold or withdraw life-sustaining procedures;
(2) which has been dated and signed by the declarant in the presence
of an officer authorized to administer oaths under the laws of the state
where the signing occurs and in the presence of two witnesses, one of
whom may be the officer authorized to administer oaths, who state in an
affidavit as set forth in Section 44-77-50 that, to the extent they have
knowledge of their status, they are not related to the declarant by blood,
marriage, or adoption, either as a spouse, lineal ancestor, descendant of the
parents of the declarant, or spouse of any of them, not directly financially
responsible for the person's medical care, not entitled to a portion of the
estate of the declarant upon his decease under a will of the declarant then
existing or as an heir by intestate succession, and not a beneficiary of a life
insurance policy of the declarant, and who state that no more than one
witness is an employee of a health facility in which the declarant is a
patient and that no witness to the declaration is the attending physician or
an employee of the attending physician or a person who has a claim against
a portion of the estate of the declarant upon his decease at the time of the
execution of the declaration;
(3) which, if the declarant is a patient in a hospital or a resident in a
nursing care facility at the time the declaration is executed, has been
witnessed by an ombudsman as designated by the State Ombudsman,
Office of the Governor, with the ombudsman acting as one of the two
witnesses and having the same qualifications as a witness as provided in
this section. The intent of this item is to recognize that some residents in
nursing care 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 declaration; and
(4) which accompanying affidavit has been subscribed by the two
witnesses and sworn to by at least one of the two witnesses in the presence
of the declarant, and of each other, and of an officer authorized to
administer oaths under the laws of the state where the signing occurs. A
witness to a declaration who is also an officer authorized to administer
oaths under the laws of this State may notarize the signature of the other
witness of the declaration in the manner provided by Section
44-77-50."
Revisions to form of declaration including instructions concerning
nutrition and hydration
SECTION 5. Section 44-77-50 of the 1976 Code, as last amended by Act
586 of 1988, is further amended to read:
"Section 44-77-50. The declaration must be substantially in the
following form with the procedure and requirements for revocation of the
declaration appearing either in boldface print or in all upper case letters, the
characters in either case being of at least the same size as used in the rest of
the declaration:
STATE OF SOUTH CAROLINA DECLARATION
COUNTY OF _______________ OF A DESIRE FOR A NATURAL DEATH
I, _____________, Declarant, being at least eighteen years of age and 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 or if I
am in a state of permanent unconsciousness, and I declare:
If at any time I have a condition 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
could occur within a reasonably short period of time without the use of
life-sustaining procedures or if the physicians certify that I am in a state of
permanent unconsciousness and where the application of life-sustaining
procedures would serve only to prolong the dying process, I direct that the
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.
INSTRUCTIONS CONCERNING ARTIFICIAL NUTRITION AND
HYDRATION
INITIAL ONE OF THE FOLLOWING STATEMENTS
If my condition is terminal and could result in death within a reasonably
short time,
_________ I direct that nutrition and hydration BE PROVIDED through
any medically indicated means, including medically or surgically implanted
tubes.
_________ I direct that nutrition and hydration NOT BE PROVIDED
through any medically indicated means, including medically or surgically
implanted tubes.
INITIAL ONE OF THE FOLLOWING STATEMENTS
If I am in a persistent vegetative state or other condition of permanent
unconsciousness,
_________ I direct that nutrition and hydration BE PROVIDED through
any medically indicated means, including medically or surgically implanted
tubes.
_________ I direct that nutrition and hydration NOT BE PROVIDED
through any medically indicated means, including medically or surgically
implanted tubes.
In the absence of my ability to give directions regarding the use of
life-sustaining procedures, it is my intention that this Declaration be
honored by my family and physicians and any health facility in which I
may be a patient as the final expression of my legal right to refuse medical
or surgical treatment, and I accept the consequences from the 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.
APPOINTMENT OF AN AGENT (OPTIONAL)
1. You may give another person authority to revoke this declaration on
your behalf. If you wish to do so, please enter that person's name in the
space below.
Name of Agent with Power to
Revoke:______________________________
Address:________________________________________________________Telephone
Number:________________________________________________
2. You may give another person authority to enforce this declaration on
your behalf. If you wish to do so, please enter that person's name in the
space below.
Name of Agent with Power to
Enforce:____________________________
Address:________________________________________________________Telephone
Number:_______________________________________________
REVOCATION PROCEDURES
THIS DECLARATION MAY BE REVOKED BY ANY ONE OF THE
FOLLOWING METHODS. HOWEVER, A REVOCATION IS NOT
EFFECTIVE UNTIL IT IS COMMUNICATED TO THE ATTENDING
PHYSICIAN.
(1) BY BEING DEFACED, TORN, OBLITERATED, OR
OTHERWISE DESTROYED, IN EXPRESSION OF YOUR INTENT TO
REVOKE, BY YOU OR BY SOME PERSON IN YOUR PRESENCE
AND BY YOUR DIRECTION. REVOCATION BY DESTRUCTION OF
ONE OR MORE OF MULTIPLE ORIGINAL DECLARATIONS
REVOKES ALL OF THE ORIGINAL DECLARATIONS;
(2) BY A WRITTEN REVOCATION SIGNED AND DATED BY
YOU EXPRESSING YOUR INTENT TO REVOKE;
(3) BY YOUR ORAL EXPRESSION OF YOUR INTENT TO
REVOKE THE DECLARATION. AN ORAL REVOCATION
COMMUNICATED TO THE ATTENDING PHYSICIAN BY A PERSON
OTHER THAN YOU IS EFFECTIVE ONLY IF:
(a) THE PERSON WAS PRESENT WHEN THE ORAL
REVOCATION WAS MADE;
(b) THE REVOCATION WAS COMMUNICATED TO THE
PHYSICIAN WITHIN A REASONABLE TIME;
(c) YOUR PHYSICAL OR MENTAL CONDITION MAKES IT
IMPOSSIBLE FOR THE PHYSICIAN TO CONFIRM THROUGH
SUBSEQUENT CONVERSATION WITH YOU THAT THE
REVOCATION HAS OCCURRED.
TO BE EFFECTIVE AS A REVOCATION, THE ORAL
EXPRESSION CLEARLY MUST INDICATE YOUR DESIRE THAT
THE DECLARATION NOT BE GIVEN EFFECT OR THAT
LIFE-SUSTAINING PROCEDURES BE ADMINISTERED;
(4) IF YOU, IN THE SPACE ABOVE, HAVE AUTHORIZED AN
AGENT TO REVOKE THE DECLARATION, THE AGENT MAY
REVOKE ORALLY OR BY A WRITTEN, SIGNED, AND DATED
INSTRUMENT. AN AGENT MAY REVOKE ONLY IF YOU ARE
INCOMPETENT TO DO SO. AN AGENT MAY REVOKE THE
DECLARATION PERMANENTLY OR TEMPORARILY.
(5) BY YOUR EXECUTING ANOTHER DECLARATION AT A
LATER TIME.
________________________________
Signature of Declarant
STATE OF ______________________ AFFIDAVIT
COUNTY OF ____________________
We, ____________________ and __________________, the
undersigned witnesses to the foregoing Declaration, dated the ______ day
of _____________, 19___, at least one of us being first duly sworn, declare
to the undersigned authority, on the basis of our best information and
belief, that the Declaration was on that date signed by the 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, subscribe our names as witnesses on that date. The declarant
is personally known to us, and we believe him to be of sound mind. Each of
us affirms that he is qualified as a witness to this Declaration under the
provisions of the South Carolina Death With Dignity Act in that he is not
related to the declarant by blood, marriage, or adoption, either as a spouse,
lineal ancestor, descendant of the parents of the declarant, or spouse of any
of them; 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 the 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 resident in a hospital or
nursing care 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
Subscribed before me by _______________, the declarant, and
subscribed and sworn to before me by __________________, the witness,
this ______ day of __________________, 19___.
_____________________________________
Signature
Notary Public for _____________________________________
My commission expires:________________________________
SEAL"
Subsequent declaration revokes prior declaration
SECTION 6. Section 44-77-80(4) of the 1976 Code, as last amended by
Act 586 of 1988, is further amended by adding:
"(5) by the declarant's execution of a subsequent
declaration."
Immunity from liability extended to physician certifying conditions
when standards of reasonable medical care used
SECTION 7. Section 44-77-90 of the 1976 Code, as last amended by Act
586 of 1988, is further amended to read:
"Section 44-77-90. After certification of a terminal condition or
a state of permanent unconsciousness, any person who relies on a
declaration which on its face appears to have been executed in accordance
with the provisions of this chapter, of which he has no actual notice of
revocation, and who withholds or withdraws or participates in the
withholding or withdrawal of life-sustaining procedures from the terminally
ill or permanently unconscious patient who executed the declaration, is
presumed to be acting in good faith. A physician who in good faith
certifies that a patient's condition is terminal or that the patient is
permanently unconscious is not subject to liability merely on account of
certification. Any person who in good faith and in accordance with the
provisions of this chapter participates in the withholding or withdrawal of
life-sustaining procedures from the patient is not subject to criminal or civil
liability on account of the withholding or withdrawal. The immunity from
civil liability does not extend to cases in which a physician deviates from
standards of reasonable medical care in connection with the decision to
withhold or withdraw."
Earlier declarations remain valid
SECTION 8. The validity of a declaration made pursuant to Chapter 77,
Title 44 of the 1976 Code properly executed before the effective date of
this act is not affected by the amendments to Chapter 77, Title 44 of the
1976 Code contained in this act.
Declaration may be supplemented by document with instructions
concerning nutrition and hydration
SECTION 9. The 1976 Code is amended by adding:
"Section 44-77-65. A declarant whose declaration is executed in
accordance with earlier versions of this chapter or in accordance with the
law of another state may supplement that declaration by executing a
document containing the provisions for `Instructions Concerning Artificial
Nutrition and Hydration' as provided for in Section 44-77-50 which must be
signed by the declarant and witnessed in accordance with this
chapter."
Effectuation of declaration when facility, physician, or employee does
not wish to participate
SECTION 10. Section 44-77-100 of the 1976 Code, as last amended by
Act 586 of 1988, is further amended to read:
"Section 44-77-100. A physician or health care facility electing
for any reason not to participate in the withholding or withdrawal of
life-sustaining procedures in accordance with a declaration executed under
this chapter shall make a reasonable effort to locate a physician or health
care facility that will effectuate the declaration and has a duty to transfer
the patient to that physician or facility. A failure by a physician to
effectuate the declaration of a terminal patient constitutes 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. If a nurse or other employee of a health care facility informs
the physician or health care facility that the employee does not wish to
participate in the withholding or withdrawal of life-sustaining procedures
from a declarant, the physician or health care facility shall make a
reasonable effort to effectuate the declaration without the participation of
the employee."
Application of chapter
SECTION 11. Section 44-77-140 of the 1976 Code, as last amended by
Act 586 of 1988, is further amended to read:
"Section 44-77-140. The absence of a declaration by an adult
patient does not give rise to a presumption as to his intent to consent to or
refuse death-prolonging procedures. This chapter applies only to persons
who have executed a declaration in accordance with this chapter. Nothing
in this chapter impairs any other legal right or legal responsibility which a
person may have to effect the withholding or withdrawal or the provision of
life-sustaining procedures in any lawful manner."
Time effective
SECTION 12. This act takes effect upon approval by the Governor.
Approved the 12th day of June, 1991. |