Current Status Introducing Body:House Bill Number:3925 Primary Sponsor:Fair Committee Number:25 Type of Legislation:GB Subject:Death with Dignity Act Residing Body:House Current Committee:Judiciary Computer Document Number:DKA/4428AL.93 Introduced Date:19930413 Last History Body:House Last History Date:19930413 Last History Type:Introduced, read first time, referred to Committee Scope of Legislation:Statewide All Sponsors:Fair Type of Legislation:General Bill
Bill Body Date Action Description CMN Leg Involved
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3925 House 19930413 Introduced, read first time, 25
referred to Committee
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TO AMEND SECTION 44-77-20, AS AMENDED, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO DEFINITIONS IN THE DEATH WITH DIGNITY ACT, SO AS TO REVISE THE DEFINITION OF "LIFE-SUSTAINING PROCEDURES" AND TO DEFINE "ARTIFICIAL NUTRITION AND HYDRATION"; TO AMEND SECTION 44-77-30, AS AMENDED, RELATING TO CONDITIONS FOR WITHHOLDING LIFE-SUSTAINING PROCEDURES, SO AS TO ADD THE INABILITY TO GIVE DIRECTIONS REGARDING THE USE OF LIFE-SUSTAINING PROCEDURES AS A CONDITION; TO AMEND SECTION 44-77-80, AS AMENDED, RELATING TO REVOCATION OF DECLARATION, SO AS TO PROVIDE THAT ANY DOUBT ON REVOCATION MUST BE RESOLVED IN FAVOR OF LIFE-SUSTAINING PROCEDURES; TO AMEND SECTION 44-77-100, AS AMENDED, RELATING TO EFFECTUATION OF DECLARATION WHEN A HEALTH CARE PROFESSIONAL DOES NOT WISH TO PARTICIPATE, SO AS TO SPECIFY THE BASIS FOR REFUSAL TO PARTICIPATE AND TO PROHIBIT ANY DISCIPLINARY OR EMPLOYMENT ACTION AGAINST THE PERSON; AND TO AMEND SECTION 44-77-130, AS AMENDED, RELATING TO CONSTRUCTION OF CHAPTER, SO AS TO PROVIDE THAT THE CHAPTER DOES NOT AUTHORIZE ASSISTED SUICIDE.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Section 44-77-20 of the 1976 Code, as last amended by Act 149 of 1991, 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 whether or not 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 reasonable 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.
(8) `Artificial nutrition and hydration' means nutrition and hydration through medically or surgically implanted tubes. The declarant shall indicate in the declaration whether artificial nutrition and hydration is to be withheld. 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 will be provided."
SECTION 2. Section 44-77-30 of the 1976 Code, as last amended by Act 149 of 1991, is further amended to read:
"Section 44-77-30. Life-sustaining procedures may be withheld or withdrawn upon direction and under the supervision of the attending physician If if:
(1) 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,;
(2) 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,;
(3) 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; and
(4) the person is not presently able nor is likely to be able in the reasonable future to give directions regarding the use of life-sustaining procedures.
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."
SECTION 3. Section 44-77-80 of the 1976 Code, as last amended by Act 149 of 1991, is further amended to read:
"Section 44-77-80. (A) The Declaration may be revoked:
(1) by being defaced, torn, obliterated, or otherwise destroyed in expression of the declarant's intent to revoke by the declarant or by some person in the presence of and by the direction of the declarant. Revocation by destruction of one or more of multiple original declarations revokes all of the original declarations. The revocation of the original declarations actually not destroyed becomes effective only upon communication to the attending physician. The attending physician shall record in the declarant's medical record the time and date when the physician received notification of the revocation;
(2) by a written revocation signed and dated by the declarant expressing his intent to revoke. The revocation becomes effective only upon communication to the attending physician. The attending physician shall record in the declarant's medical record the time and date when the physician received notification of the written revocation;
(3) by an oral expression by the declarant of his intent to revoke the Declaration. The revocation becomes effective only upon communication to the attending physician by the declarant. However, an oral revocation made by the declarant becomes effective upon communication to the attending physician by a person other than the declarant 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) the physical or mental condition of the declarant makes it impossible for the physician to confirm through subsequent conversation with the declarant that the revocation has occurred. The attending physician shall record in the declarant's medical record the time, date, and place of the revocation and the time, date, and place, if different, of when the physician received notification of the revocation. To be effective as a revocation, the oral expression clearly must indicate the declarant's desire that the declaration not be given effect or that life-sustaining procedures be administered;
(4) by a written, signed, and dated revocation or by an oral revocation by the declarant's designee, the designee's name and address being supplied in the declaration, expressing the designee's intent to permanently or temporarily revoke the declaration. The revocation becomes effective only upon communication to the attending physician by the designee. The attending physician shall record in the declarant's medical record the time, date, and place of the revocation and the time, date, and place, if different, of when the physician received notification of the revocation. A designee may revoke only if the declarant is incompetent to do so;
(5) by the declarant's execution of a subsequent declaration.
(B) Any doubt, whether a statement or conduct amounts to a revocation of a living will, must be resolved in favor of the affirmative provision of care."
SECTION 4. Section 44-77-100 of the 1976 Code, as last amended by Act 149 of 1991, 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.
(A) A health care provider, employee, or member of the staff of a health care facility, or a home caregiver may not be required to perform or participate in the performance of an act or omission intended to hasten the death of a patient, if the health care provider, employee, staff member, or caregiver objects to the act on personal, ethical, moral, or religious grounds.
(B) A health care facility is not required to:
(1) make its facilities available for the performance of an act or omission which may cause or hasten the death of a patient if the act is prohibited by the entity on the basis of religious or moral convictions; or
(2) provide personnel for the performance or assistance in the performance of an act or omission which may cause or hasten the death of a patient if the act or assistance would be contrary to the religious beliefs or moral convictions of the personnel.
(C) A person making a claim of conscience, or who states an intention to make a claim of conscience, must not be denied employment, disciplined, or discriminated against in any manner because of his refusal to perform or participate in any act or omission for the purpose of causing or hastening the death of a patient.
(D) A person, as a condition of training, employment, pay, promotion, or privileges, must not be required to agree to perform or participate in the performance of an act or omission for the purpose of causing or hastening the death of a patient."
SECTION 5. Section 44-77-130 of the 1976 Code, as last amended by Act 586 of 1988, is further amended to read:
"Section 44-77-130. Nothing in this chapter may be construed to authorize or approve mercy killing, or assisted suicide, or to permit any affirmative or deliberate act or omission to end life other than to permit the natural process of dying except as specifically provided in this chapter."
SECTION 6. This act takes effect upon approval by the Governor.