Enrolled HB 25: Relating to health care decisions, including do not resuscitate orders, anatomical gifts, and mental health treatment decisions, and to powers of attorney relating to health care, including anatomical gifts and mental health treatment decisions; and providing for an effective date.
00Enrolled HB 25 01 Relating to health care decisions, including do not resuscitate orders, anatomical gifts, and 02 mental health treatment decisions, and to powers of attorney relating to health care, including 03 anatomical gifts and mental health treatment decisions; and providing for an effective date. 04 _______________ 05 * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 06 to read: 07 PURPOSE AND INTENT. (a) A principal purpose of this Act is to provide a 08 comprehensive coordinated approach to the making of health care decisions, including 09 anatomical gifts. To achieve this purpose, this Act repeals the current statutory devices that 10 cover health care decisions and consolidates the subject into one chapter. 11 (b) It is the intent of this Act to 12 (1) establish the right of a patient to control the patient's own health care 13 decisions; and
01 (2) create, in the absence of evidence to the contrary, a presumption, in favor 02 of life consistent with the best interest of the patient. 03 (c) This Act is not intended to condone, authorize, or approve mercy killing, assisted 04 suicide, or euthanasia. 05 * Sec. 2. AS 12.65.100 is amended to read: 06 Sec. 12.65.100. Unclaimed bodies. When a person dies and no person 07 appears to claim the body for burial, and no provision is made for the body under 08 AS 13.52 [AS 13.50], the Department of Health and Social Services, upon 09 notification, shall request a court order authorizing the body to be plainly and decently 10 buried or cremated and the remains decently interred. A judicial officer shall issue the 11 requested order upon the sworn testimony or statement of a representative of the 12 Department of Health and Social Services that a person has not appeared to claim the 13 body for burial and provision is not made for the body under AS 13.52 [AS 13.50]. 14 * Sec. 3. AS 13 is amended by adding a new chapter to read: 15 Chapter 52. Health Care Decisions Act. 16 Sec. 13.52.010. Advance health care directives. (a) Except as provided in 17 AS 13.52.170(a), an adult may give an individual instruction. Except as provided in 18 AS 13.52.170(b), the instruction may be oral or written. The instruction may be 19 limited to take effect only if a specified condition arises. 20 (b) An adult may execute a durable power of attorney for health care, which 21 may authorize the agent to make any health care decision the principal could have 22 made while having capacity. The power remains in effect notwithstanding the 23 principal's later incapacity and may include individual instructions. The power must 24 be in writing, contain the date of its execution, be signed by the principal, and be 25 witnessed by one of the following methods: 26 (1) signed by at least two individuals who are personally known by the 27 principal, each of whom witnessed either the signing of the instrument by the principal 28 or the principal's acknowledgment of the signature of the instrument; or 29 (2) acknowledged before a notary public at a place in this state. 30 (c) Unless related to the principal by blood, marriage, or adoption, an agent 31 under a durable power of attorney for health care may not be an owner, operator, or
01 employee of the health care institution at which the principal is receiving care. 02 (d) A witness for a durable power of attorney for health care may not be 03 (1) a health care provider employed at the health care institution or 04 health care facility where the principal is receiving health care; 05 (2) an employee of the health care provider providing health care to the 06 principal, or of the health care institution or health care facility where the principal is 07 receiving health care; or 08 (3) the agent. 09 (e) At least one of the individuals used as a witness for a durable power of 10 attorney for health care shall be someone who is not 11 (1) related to the principal by blood, marriage, or adoption; or 12 (2) entitled to a portion of the estate of the principal upon the 13 principal's death under a will or codicil of the principal existing at the time of 14 execution of the durable power of attorney for health care or by operation of law then 15 existing. 16 (f) Unless otherwise specified in the durable power of attorney for health care, 17 the authority of an agent becomes effective only upon a determination that the 18 principal lacks capacity and ceases to be effective upon a determination that the 19 principal has recovered capacity. 20 (g) Unless otherwise specified in a written advance health care directive, a 21 determination that a principal lacks or has recovered capacity, or that another 22 condition exists that affects an individual instruction or the authority of an agent, shall 23 be made by 24 (1) the primary physician, except in the case of mental illness; 25 (2) a court in the case of mental illness, unless the situation is an 26 emergency; or 27 (3) the primary physician or another health care provider in the case of 28 mental illness where the situation is an emergency. 29 (h) An agent shall make a health care decision in accordance with the 30 principal's individual instructions, if any, and other wishes to the extent known to the 31 agent. Otherwise, the agent shall make the decision in accordance with the agent's
01 determination of the principal's best interest. In determining the principal's best 02 interest, the agent shall consider the principal's personal values to the extent known to 03 the agent. 04 (i) A health care decision made by an agent for a principal is effective without 05 judicial approval. 06 (j) A written advance health care directive may include the individual's 07 nomination of a guardian of the individual. 08 (k) An advance health care directive, including an advance health care 09 directive that is made in compliance with the laws of another state, is valid for 10 purposes of this chapter to the extent that it complies with the laws of this state. 11 Sec. 13.52.020. Revocation of advance health care directive. (a) Except in 12 the case of mental illness under (c) of this section, a principal may revoke the 13 designation of an agent only by a signed writing or by personally informing the 14 supervising health care provider. 15 (b) Except in the case of mental illness under (c) of this section, a principal 16 may revoke all or part of an advance health care directive, other than the designation 17 of an agent, at any time and in any manner that communicates an intent to revoke. 18 (c) In the case of mental illness, an advance health care directive may be 19 revoked in whole or in part at any time by the principal if the principal does not lack 20 capacity and is competent. A revocation is effective when a competent principal with 21 capacity communicates the revocation to the attending physician or other health care 22 provider. The attending physician or other health care provider shall note the 23 revocation on the principal's medical record. In the case of mental illness, the 24 authority of a named agent and an alternative agent named in the advance health care 25 directive continues in effect as long as the advance health care directive appointing the 26 agent is in effect or until the agent has withdrawn. For the purposes of this subsection, 27 a principal is not considered competent when 28 (1) it is the opinion of the court in a guardianship proceeding under 29 AS 13.26, the opinion of two physicians, at least one of whom is a psychiatrist, or the 30 opinion of a physician and a professional mental health clinician, that the principal is 31 not competent; or
01 (2) a court in a hearing under AS 47.30.735, 47.30.750, or 47.30.770 02 determines that the principal is gravely disabled; in this paragraph, "gravely disabled" 03 has the meaning given in AS 47.30.915(7)(B). 04 (d) A health care provider, agent, guardian, or surrogate who is informed of a 05 revocation shall promptly communicate the fact of the revocation to the supervising 06 health care provider and to any health care institution at which the patient is receiving 07 care. 08 (e) A decree of annulment, divorce, dissolution of marriage, or legal 09 separation revokes a previous designation of a spouse as agent unless otherwise 10 specified in the decree or in a durable power of attorney for health care. 11 (f) An advance health care directive that conflicts with an earlier advance 12 health care directive revokes the earlier directive to the extent of the conflict. 13 Sec. 13.52.025. Rescission of withdrawal by agent. A person who has 14 withdrawn as an agent may rescind the withdrawal by executing an acceptance after 15 the date of the withdrawal. A person who rescinds a withdrawal shall give notice to 16 the principal if the principal has capacity or to the principal's health care provider if 17 the principal does not have capacity. 18 Sec. 13.52.030. Surrogates. (a) Except in the case of mental health treatment 19 and except as provided by AS 13.52.180(a) and (b), a surrogate may make a health 20 care decision for a patient who is an adult if an agent or guardian has not been 21 appointed or the agent or guardian is not reasonably available, and if the patient has 22 been determined by the primary physician to lack capacity. 23 (b) Subject to AS 13.52.055(b), a surrogate may make a decision regarding 24 mental health treatment for a patient who is an adult if 25 (1) an agent or guardian has not been appointed or the agent or 26 guardian is not reasonably available; 27 (2) the mental health treatment is needed on an emergency basis; and 28 (3) the patient has been determined to lack capacity by 29 (A) two physicians, one of whom is a psychiatrist; or 30 (B) a physician and a professional mental health clinician. 31 (c) Except as provided for anatomical gifts in AS 13.52.170(b), an adult may
01 designate an individual to act as surrogate for that adult by personally informing the 02 supervising health care provider. Except as provided by AS 13.52.180(a) and (b), in 03 the absence of a designation, or if the designee is not reasonably available, a member 04 of the following classes of the patient's family who is reasonably available, in 05 descending order of priority, may act as surrogate: 06 (1) the spouse, unless legally separated; 07 (2) an adult child; 08 (3) a parent; or 09 (4) an adult sibling. 10 (d) Except as provided by (l) of this section or AS 13.52.180(a) or (b), if none 11 of the individuals eligible to act as surrogate under (c) of this section is reasonably 12 available, an adult who has exhibited special care and concern for the patient, who is 13 familiar with the patient's personal values, and who is reasonably available may act as 14 surrogate. 15 (e) A surrogate shall communicate the surrogate's assumption of authority as 16 promptly as practicable to the health care provider, the health care institution, and the 17 members of the patient's family specified in (c) of this section who can be readily 18 contacted. 19 (f) If more than one member of a class under (c)(2) - (4) of this section 20 assumes authority to act as surrogate, the members of that class do not agree on a 21 health care decision, and the supervising health care provider is informed of the 22 disagreement, the supervising health care provider shall comply with the decision of a 23 majority of the members of that class who have communicated their views to the 24 provider. If the class is evenly divided concerning the health care decision and the 25 supervising health care provider is informed of the even division, that class and all 26 individuals having a lower priority under (c)(2) - (4) of this section are disqualified 27 from making the decision, and the primary physician, after consulting with all 28 individuals in that evenly divided class who are reasonably available, shall make a 29 decision based on the consultation and the primary physician's own determination of 30 the best interest of the patient. 31 (g) A surrogate shall make a health care decision in accordance with the
01 patient's individual instructions or other advance health care directives, if any, and 02 other wishes to the extent known to the surrogate. Otherwise, the surrogate shall make 03 the decision in accordance with the surrogate's determination of the patient's best 04 interest. In determining the patient's best interest, the surrogate shall consider the 05 patient's personal values to the extent known to the surrogate. 06 (h) If a patient's primary health care provider observes that a surrogate is not 07 abiding by the wishes, values, and best interest of the patient, the primary health care 08 provider may decline to comply with a decision of the surrogate and shall notify the 09 health care institution where the primary health care provider is providing health care 10 to the patient. 11 (i) A health care decision made by a surrogate for a patient is effective without 12 judicial approval. 13 (j) A patient who has capacity may, at any time, disqualify another person, 14 including a member of the patient's family, from acting as the patient's surrogate by a 15 signed writing or by personally informing the supervising health care provider of the 16 disqualification. 17 (k) Unless related to the patient by blood, marriage, or adoption, a surrogate 18 may not be an owner, operator, or employee of the health care facility where the 19 patient is receiving care. 20 (l) A supervising health care provider may require an individual claiming the 21 right to act as a surrogate for a patient to provide a written declaration under penalty of 22 perjury stating facts and circumstances reasonably sufficient to establish the claimed 23 authority. 24 Sec. 13.52.040. Decisions by guardian. (a) A guardian shall comply with 25 the ward's individual instructions and may not revoke a ward's advance health care 26 directive executed before the ward's incapacity unless a court expressly authorizes the 27 revocation. 28 (b) Unless there is a court order to the contrary, a health care decision of an 29 agent takes precedence over that of a guardian. 30 (c) Except as provided in (a) of this section, a health care decision made by a 31 guardian for the ward is effective without judicial approval.
01 Sec. 13.52.045. Withholding or withdrawing of life-sustaining procedures. 02 Notwithstanding any other provision of this chapter, an agent or a surrogate may 03 determine that life-sustaining procedures may be withheld or withdrawn from a patient 04 with a qualifying condition when there is 05 (1) a durable power of attorney for health care or other writing that 06 clearly expresses the patient's intent that the procedures be withheld or withdrawn; or 07 (2) no durable power of attorney for health care or other writing that 08 clearly expresses the patient's intent to the contrary, the patient has a qualifying 09 condition as determined under AS 13.52.160, and withholding or withdrawing the 10 procedures would be consistent with the patient's best interest. 11 Sec. 13.52.050. Decisions for exceptional procedures. Unless there is a 12 durable power of attorney for health care or another writing clearly expressing an 13 individual's intent to the contrary, an agent or surrogate may not consent on behalf of a 14 patient to an abortion, sterilization, psychosurgery, or removal of bodily organs except 15 when the abortion, sterilization, psychosurgery, or removal of bodily organs is 16 necessary to preserve the life of the patient or to prevent serious impairment of the 17 health of the patient. 18 Sec. 13.52.055. Pregnancy. (a) Before implementing a health care decision 19 for a woman of childbearing age that would affect a fetus if present, the supervising 20 health care provider shall take reasonable steps to determine whether the woman is 21 pregnant. 22 (b) Notwithstanding any other provision of this chapter to the contrary, an 23 advance health care directive by a patient or a decision by the person then authorized 24 to make health care decisions for a patient may not be given effect if 25 (1) the patient is a woman who is pregnant and lacks capacity; 26 (2) the directive or decision is to withhold or withdraw life-sustaining 27 procedures; 28 (3) the withholding or withdrawal of the life-sustaining procedures 29 would, in reasonable medical judgment, be likely to result in the death of the patient; 30 and 31 (4) it is probable that the fetus could develop to the point of live birth
01 if the life-sustaining procedures were provided. 02 (c) This section does not apply to emergency services in the field. 03 Sec. 13.52.060. Obligations of health care providers, institutions, and 04 facilities. (a) Before implementing a health care decision made for a patient, a 05 supervising health care provider, if possible, shall promptly communicate to the 06 patient the decision made and the identity of the person making the decision. 07 (b) Except as provided in AS 13.52.200, a supervising health care provider 08 who knows of the existence of an advance health care directive, a revocation of an 09 advance health care directive, or a designation or disqualification of a surrogate shall 10 promptly record its existence in the patient's health care record, shall request a copy if 11 it is in writing, and shall arrange for its maintenance in the health care record if a copy 12 is furnished. 13 (c) A supervising health care provider who makes or is informed of a 14 determination that a patient lacks or has recovered capacity, or that another condition 15 exists that affects an individual instruction or the authority of an agent, a guardian, or a 16 surrogate, shall promptly record the determination in the patient's health care record 17 and communicate the determination to the patient, if possible, and to any person then 18 authorized to make health care decisions for the patient. 19 (d) Except as provided in (e) and (f) of this section, a health care provider, 20 health care institution, or health care facility providing care to a patient shall comply 21 with 22 (1) an individual instruction of the patient and with a reasonable 23 interpretation of that instruction made by a person then authorized to make health care 24 decisions for the patient; and 25 (2) a health care decision for the patient made by a person then 26 authorized to make health care decisions for the patient to the same extent as if the 27 decision had been made by the patient while having capacity. 28 (e) A health care provider may decline to comply with an individual 29 instruction or a health care decision for reasons of conscience, except for a do not 30 resuscitate order. A health care institution or health care facility may decline to 31 comply with an individual instruction or health care decision if the instruction or
01 decision is contrary to a policy of the institution or facility that is expressly based on 02 reasons of conscience and if the policy was timely communicated to the patient or to a 03 person then authorized to make health care decisions for the patient. 04 (f) A health care provider, health care institution, or health care facility may 05 decline to comply with an individual instruction or a health care decision that requires 06 medically ineffective health care or health care contrary to generally accepted health 07 care standards applicable to the provider, institution, or facility. In this subsection, 08 "medically ineffective health care" means health care that according to reasonable 09 medical judgment cannot cure the patient's illness, cannot diminish its progressive 10 course, and cannot effectively alleviate severe discomfort and distress. 11 (g) A health care provider, health care institution, or health care facility that 12 declines to comply with an individual instruction or a health care decision shall 13 (1) promptly inform the patient, if possible, and any person then 14 authorized to make health care decisions for the patient that the provider, institution, 15 or facility has declined to comply with the instruction or decision; 16 (2) provide continuing care to the patient until a transfer is effected; 17 and 18 (3) unless the patient or person then authorized to make health care 19 decisions for the patient refuses assistance, immediately cooperate and comply with a 20 decision by the patient or a person then authorized to make health care decisions for 21 the patient to transfer the patient to another health care institution, to another health 22 care facility, to the patient's home, or to another location chosen by the patient or by 23 the person then authorized to make health care decisions for the patient. 24 (h) Except as provided for civil commitments under AS 47.30.817, a health 25 care provider, health care institution, or health care facility may not require or prohibit 26 the execution or revocation of an advance health care directive as a condition for 27 providing health care. 28 Sec. 13.52.065. Do not resuscitate protocol and identification 29 requirements. (a) An attending physician may issue a do not resuscitate order for a 30 patient of the physician. The physician shall document the grounds for the order in the 31 patient's medical file.
01 (b) The department shall by regulation adopt a protocol, subject to the 02 approval of the State Medical Board, for do not resuscitate orders that sets out a 03 standardized method of procedure for the withholding of cardiopulmonary 04 resuscitation by health care providers and health care institutions. 05 (c) The department shall develop standardized designs and symbols for do not 06 resuscitate identification cards, forms, necklaces, and bracelets that signify, when 07 carried or worn, that the carrier or wearer is an individual for whom a physician has 08 issued a do not resuscitate order. 09 (d) A health care provider other than a physician shall comply with the 10 protocol adopted under (b) of this section for do not resuscitate orders when the health 11 care provider is presented with a do not resuscitate identification, an oral do not 12 resuscitate order issued directly by a physician if the applicable hospital allows oral do 13 not resuscitate orders, or a written do not resuscitate order entered on and as required 14 by a form prescribed by the department. 15 (e) Notwithstanding (d) of this section, if an individual has made an 16 anatomical gift to occur at death and is in a hospital when a do not resuscitate order or 17 an order to withdraw life-sustaining procedures is to be implemented for the 18 individual, the order may not be implemented until the subject of the anatomical gift 19 can be evaluated to determine if it is suitable for donation. 20 (f) A do not resuscitate order may not be made ineffective unless a physician 21 revokes the do not resuscitate order. A request to revoke a do not resuscitate order 22 may only be made by the person for whom the order is written or, if the person for 23 whom the order is written is under 18 years of age, by the parent or guardian of the 24 person. 25 Sec. 13.52.070. Health care information. (a) Unless otherwise specified in 26 an advance health care directive, a person then authorized to make health care 27 decisions for a patient has the same rights as the patient to request, receive, examine, 28 copy, and consent to the disclosure of medical or other health care information. 29 (b) Notwithstanding (a) of this section, if there is a question about the 30 principal's capacity, an agent or a surrogate of the principal may immediately access 31 the personal health care information necessary to determine the principal's capacity,
01 even if the agency or surrogacy does not become effective until the principal lacks 02 capacity. 03 Sec. 13.52.080. Immunities. (a) If a health care provider or health care 04 institution makes reasonable efforts, with a level of diligence appropriate to the 05 seriousness and urgency of the situation, to ensure the validity of an advance health 06 care directive or a person's assumption of authority to make health care decisions for a 07 patient, a health care provider or institution acting in good faith and in accordance 08 with generally accepted health care standards applicable to the health care provider or 09 institution is not subject to civil or criminal liability or to discipline for unprofessional 10 conduct for 11 (1) providing health care information in good faith under 12 AS 13.52.070; 13 (2) complying with a health care decision of a person based on a 14 reasonable belief that the person has authority to make a health care decision for a 15 patient, including a decision to withhold or withdraw health care; 16 (3) declining to comply with a health care decision of a person based 17 on a reasonable belief that the person then lacked authority; 18 (4) complying with an advance health care directive and reasonably 19 assuming that the directive was valid when made and has not been revoked or 20 terminated; 21 (5) participating in the withholding or withdrawal of cardiopulmonary 22 resuscitation under the direction or with the authorization of a physician or upon 23 discovery of do not resuscitate identification upon an individual; 24 (6) causing or participating in providing cardiopulmonary resuscitation 25 or other life-sustaining procedures 26 (A) under AS 13.52.065(e) when an individual has made an 27 anatomical gift; or 28 (B) because an individual has made a do not resuscitate order 29 ineffective under AS 13.52.065(f) or another provision of this chapter; or 30 (7) acting in good faith under the terms of this chapter or the law of 31 another state relating to anatomical gifts.
01 (b) An individual acting as an agent, a guardian, or a surrogate under this 02 chapter is not subject to civil or criminal liability or to discipline for unprofessional 03 conduct for health care decisions made in good faith. 04 Sec. 13.52.090. Statutory damages. (a) A health care provider or institution 05 that intentionally violates this chapter is liable to the aggrieved individual or the 06 individual's estate for damages of $10,000 or actual damages resulting from the 07 violation, whichever is greater, plus attorney fees as provided by court rule. 08 (b) A person who intentionally falsifies, forges, conceals, defaces, or 09 obliterates an individual's advance health care directive or a revocation of an advance 10 health care directive without the individual's consent, or who coerces or fraudulently 11 induces an individual to give, revoke, or not to give an advance health care directive, 12 is liable to that individual for damages of $10,000 or actual damages resulting from 13 the action, whichever is greater, plus attorney fees as provided by court rule. 14 Sec. 13.52.100. Capacity. (a) This chapter does not affect the right of an 15 individual to make health care decisions while having capacity to make health care 16 decisions. 17 (b) An individual is rebuttably presumed to have capacity to make a health 18 care decision, to give or revoke an advance health care directive, and to designate or 19 disqualify a surrogate. 20 (c) An individual who is a qualified patient, including an individual for whom 21 a physician has issued a do not resuscitate order, has the right to make a decision 22 regarding the use of cardiopulmonary resuscitation and other life-sustaining 23 procedures as long as the individual is able to make the decision. If an individual who 24 is a qualified patient, including an individual for whom a physician has issued a do not 25 resuscitate order, is not able to make the decision, the protocol adopted under 26 AS 13.52.065 for do not resuscitate orders governs a decision regarding the use of 27 cardiopulmonary resuscitation and other life-sustaining procedures. 28 Sec. 13.52.110. Status of copy. A copy of a written advance health care 29 directive, revocation of an advance health care directive, or designation or 30 disqualification of an agent or a surrogate has the same effect as the original. 31 Sec. 13.52.120. Effect of this chapter. (a) In the absence of evidence to the
01 contrary of the patient's intent, this chapter establishes a presumption in favor of life, 02 consistent with the best interest of the patient. 03 (b) Notwithstanding any other provision of law, death resulting from the 04 withholding or withdrawal of cardiopulmonary resuscitation or other life-sustaining 05 procedures does not, for any purpose, constitute a suicide or homicide if the 06 withholding or withdrawal is 07 (1) consistent with this chapter; and 08 (2) from an individual 09 (A) for whom a do not resuscitate order has not been issued; 10 (B) for whom a do not resuscitate order has been issued under 11 (i) the protocol for do not resuscitate orders established 12 under AS 13.52.065; or 13 (ii) a do not resuscitate identification found on the 14 individual. 15 (c) The issuance of a do not resuscitate order under this chapter, the 16 possession of do not resuscitate identification under this chapter, or the making of a 17 health care directive under this chapter does not affect in any manner the sale, 18 procurement, or issuance of a policy of life insurance, and does not modify the terms 19 of an existing policy of life insurance. A policy of life insurance is not legally 20 impaired or invalidated in any manner by the withholding or withdrawal of life- 21 sustaining procedures from an insured individual or the withholding or withdrawal of 22 cardiopulmonary resuscitation from an individual who possesses do not resuscitate 23 identification or for whom a do not resuscitate order has been issued, notwithstanding 24 any term of the policy to the contrary. 25 (d) This chapter does not authorize mercy killing, assisted suicide, or 26 euthanasia. 27 (e) This chapter does not authorize or require a health care provider or 28 institution to provide health care contrary to generally accepted health care standards 29 applicable to the health care provider or institution. 30 (f) This chapter does not authorize an agent or a surrogate to consent to the 31 admission of an individual to a mental health facility unless the individual's written
01 advance health care directive expressly so provides, and the period of admission may 02 not exceed 17 days. 03 (g) This chapter does not affect other statutes of this state governing treatment 04 for mental illness of an individual involuntarily committed to a mental health facility. 05 Sec. 13.52.130. Prohibited requirements. As a condition of receiving or 06 being insured for health care services, a health care provider, a health care institution, 07 a health care service plan, an insurer issuing health insurance, a self-insured employee 08 welfare benefit plan, or a nonprofit hospital plan may not require an individual to 09 execute a health care directive, obtain a do not resuscitate order from a physician, or 10 possess do not resuscitate identification. 11 Sec. 13.52.135. Discriminatory treatment prohibited. When determining 12 the best interest of a patient under this chapter, health care treatment may not be 13 denied to a patient because the patient has a disability or is expected to have a 14 disability. 15 Sec. 13.52.140. Judicial relief. On petition of a patient, the patient's agent, 16 guardian, or surrogate, or a health care provider or institution involved with the 17 patient's care, the superior court may enjoin or direct a health care decision or order 18 other equitable relief. A proceeding under this section is governed by AS 13.26.165 - 19 13.26.320. 20 Sec. 13.52.150. Do not resuscitate orders and identification of other 21 jurisdictions. A do not resuscitate order or a do not resuscitate identification 22 executed, issued, or authorized in another state or a territory or possession of the 23 United States in compliance with the law of that jurisdiction is recognized for the 24 purposes of this chapter. However, the do not resuscitate order or the do not 25 resuscitate identification may be implemented only to the extent that the 26 implementation does not conflict with the laws of this state. 27 Sec. 13.52.160. Determination of qualifying condition. Whether a patient 28 has a qualifying condition under this chapter shall be determined by the primary 29 physician of the patient and by at least one other physician, when another physician is 30 available. A physician making the determination shall document the grounds for the 31 determination in the patient's medical record. Permanent unconsciousness shall be
01 determined in consultation with a neurologist. 02 Sec. 13.52.170. Making, amending, revoking, and refusing to make 03 anatomical gifts by individual. (a) An individual who is at least 18 years of age 04 may 05 (1) make an anatomical gift for any of the purposes stated in 06 AS 13.52.210(a); 07 (2) limit an anatomical gift to one or more of those purposes; or 08 (3) refuse to make an anatomical gift. 09 (b) An anatomical gift may be made only by a document of gift signed by the 10 donor. If the donor cannot sign, the document of gift shall be signed by another 11 individual and by two witnesses, all of whom have signed at the direction and in the 12 presence of the donor and of each other, and state that it has been signed at the 13 direction and in the presence of the donor and of each other. 14 (c) If a document of gift is attached to or imprinted on a donor's motor vehicle 15 driver's license, revocation, suspension, expiration, or cancellation of the license does 16 not invalidate the anatomical gift. 17 (d) A document of gift may designate a particular physician or surgeon to 18 carry out the appropriate procedures. In the absence of a designation or if the designee 19 is not available, the donee or other person authorized to accept the anatomical gift may 20 employ or authorize any physician, surgeon, or technician to carry out the appropriate 21 procedures. 22 (e) An anatomical gift by will takes effect upon death of the testator, whether 23 or not the will is probated. If, after death, the will is declared invalid for testamentary 24 purposes, the validity of the anatomical gift is unaffected. 25 (f) Notwithstanding AS 13.52.020, a donor may amend or revoke an 26 anatomical gift, not made by will, only by 27 (1) a signed statement; 28 (2) an oral statement made in the presence of two individuals; 29 (3) any form of communication during a terminal illness or injury 30 addressed to a physician or surgeon; or 31 (4) the delivery of a signed statement to a specified donee to whom a
01 document of gift had been delivered. 02 (g) Notwithstanding AS 13.52.020, the donor of an anatomical gift made by 03 will may amend or revoke the gift in the manner provided for amendment or 04 revocation of wills, or as provided in (f) of this section. 05 (h) An anatomical gift that is not revoked by the donor before death is 06 irrevocable and does not require the consent or concurrence of any person after the 07 donor's death. 08 (i) An individual may refuse to make an anatomical gift of the individual's 09 body or part by 10 (1) a writing signed in the same manner as a document of gift; 11 (2) a statement attached to or imprinted on a donor's motor vehicle 12 operator's or chauffeur's license; 13 (3) any other writing used to identify the individual as refusing to 14 make an anatomical gift; 15 (4) during a terminal illness or injury, an oral statement or other form 16 of communication. 17 Sec. 13.52.180. Making, revoking, and objecting to anatomical gifts by 18 others. (a) Any member of the following classes of persons, in the order of priority 19 listed, may make an anatomical gift of all or a part of the decedent's body for an 20 authorized purpose, unless the decedent, at the time of death, has made an unrevoked 21 refusal to make that anatomical gift: 22 (1) the spouse of the decedent; 23 (2) an adult son or daughter of the decedent; 24 (3) either parent of the decedent; 25 (4) an adult brother or sister of the decedent; 26 (5) a grandparent of the decedent; and 27 (6) an agent or a surrogate of the decedent at the time of death. 28 (b) An anatomical gift may not be made by a person listed in (a) of this section 29 if 30 (1) a person in a prior class is available at the time of death to make an 31 anatomical gift;
01 (2) the person proposing to make an anatomical gift knows of a refusal 02 or contrary indications by the decedent; or 03 (3) the person proposing to make an anatomical gift knows of an 04 objection to making an anatomical gift by a member of the person's class or a prior 05 class. 06 (c) An anatomical gift by a person authorized under (a) of this section shall be 07 made by 08 (1) a document of gift signed by the person; 09 (2) the person's telegraphic, recorded telephonic, or other recorded 10 message, or another form of communication from the person that is 11 contemporaneously reduced to writing and signed by the recipient; or 12 (3) the person's agent or surrogate. 13 (d) An anatomical gift by a person authorized under (a) of this section may be 14 revoked by any member of the same or a prior class if, before procedures have begun 15 for the removal of a part from the body of the decedent, the physician, surgeon, or 16 technician removing the part knows of the revocation. 17 Sec. 13.52.190. Optional form for anatomical gift by another person. 18 ANATOMICAL GIFT BY NEXT OF KIN, 19 GUARDIAN, AGENT, OR SURROGATE 20 Under AS 13.52.170 - 13.52.280, I make this anatomical gift 21 from the body of 22 ___________________________________________________ 23 (name of decedent) 24 who died on 25 ___________________________________________________ 26 (date) 27 at 28 ___________________________________________________ 29 (place) (city) 30 in 31 ___________________________________________________.
01 (state) 02 The marks in the appropriate squares and the words filled into 03 the blanks below indicate my relationship to the decedent and my 04 wishes respecting the gift. 05 I survive the decedent as [ ] spouse; [ ] adult son or daughter; 06 [ ] parent; [ ] adult brother or sister; [ ] grandparent; or I am the 07 decedent's [ ] agent under AS 13.52 or [ ] surrogate under AS 13.52. 08 I hereby give (check boxes applicable): 09 [ ] any needed organs, tissues, or parts; 10 [ ] the following organs, tissues, or parts only: 11 ___________________________________________________; 12 [ ] the following purposes only: 13 ___________________________________________________. 14 ___________________________________________________ 15 (date) (signature of survivor) 16 ___________________________________________________ 17 (address of survivor) 18 Sec. 13.52.200. Routine inquiry and required request; search and 19 notification. (a) If, at or near the time of death of a patient, there is no medical 20 record that the patient has made or refused to make an anatomical gift, the hospital 21 administrator or a designee of the hospital shall contact an organ procurement 22 organization so that the organ procurement organization may discuss the potential to 23 make a gift with the family, agent, or surrogate of the patient. The organ procurement 24 organization shall discuss the potential gift with reasonable discretion and sensitivity 25 to the circumstances of the family. 26 (b) Notwithstanding (a) of this section, a hospital administrator or other 27 designee of the hospital is not required to contact an organ procurement organization if 28 the gift is not suitable, based on accepted medical standards, for a purpose specified in 29 AS 13.52.210. 30 (c) An entry shall be made in the medical record of the patient, stating the 31 name and affiliation of the individual from the organ procurement organization who
01 discusses the potential gift with the family, agent, or surrogate under (a) of this 02 section, and the relationship to the patient of the family member, agent, or surrogate 03 with whom the potential gift was discussed. 04 (d) The following persons shall make a reasonable search for a document of 05 gift or other information identifying the bearer as a donor or as an individual who has 06 refused to make an anatomical gift: 07 (1) a law enforcement officer, fire fighter, paramedic, or other 08 emergency rescuer finding an individual who the searcher believes is dead or near 09 death; and 10 (2) a hospital or an organ procurement organization, upon the 11 admission of an individual at or near the time of death, if there is not immediately 12 available any other source of that information. 13 (e) If a document of gift or evidence of refusal to make an anatomical gift is 14 located by the search required by (d)(1) of this section, and the individual or body to 15 whom it relates is taken to a hospital, the hospital must be notified of the contents, and 16 the document or other evidence must be sent to the hospital. 17 (f) If, at or near the time of death of a patient, a hospital knows that an 18 anatomical gift has been made under AS 13.52.170 or 13.52.180(a), or that a patient or 19 an individual identified as in transit to the hospital is a donor, the hospital shall notify 20 an organ procurement organization. The hospital shall cooperate in the 21 implementation of the anatomical gift or release and removal of a part. 22 (g) Notwithstanding AS 13.52.090, a person who fails to discharge the duties 23 imposed by this section is not subject to criminal or civil liability but is subject to 24 appropriate administrative sanctions. 25 (h) The commissioner of health and social services shall adopt regulations to 26 implement (a) - (c) of this section. 27 Sec. 13.52.210. Persons who may become donees; purposes for which 28 anatomical gifts may be made. (a) The following persons may become donees of 29 anatomical gifts for the purposes stated: 30 (1) a hospital, physician, surgeon, or procurement organization for 31 transplantation, therapy, medical or dental education, research, or advancement of
01 medical or dental science; 02 (2) an accredited medical or dental school, college, or university for 03 education, research, or advancement of medical or dental science; or 04 (3) a designated individual for transplantation or therapy needed by 05 that individual. 06 (b) An anatomical gift may be made to a designated donee or without 07 designating a donee. If a donee is not designated or if the donee is not available or 08 rejects the anatomical gift, the anatomical gift may be accepted by any hospital. 09 (c) If the donee knows of the decedent's refusal or contrary indications to 10 make an anatomical gift or that an anatomical gift by a member of a class having 11 priority to act is opposed by a member of the same class or a prior class under 12 AS 13.52.180(a), the donee may not accept the anatomical gift. 13 Sec. 13.52.220. Delivery of document of gift. (a) Delivery of a document of 14 gift during the donor's lifetime is not required for the validity of an anatomical gift. 15 (b) If an anatomical gift is made to a designated donee, the document of gift, 16 or a copy, may be delivered to the donee to expedite the appropriate procedures after 17 death. The document of gift, or a copy, may be deposited in any hospital, procurement 18 organization, or registry office that accepts it for safekeeping or for facilitation of 19 procedures after death. On request of an interested person, upon or after the donor's 20 death, the person in possession shall allow the interested person to examine or copy 21 the document of gift. 22 Sec. 13.52.230. Rights and duties at death. (a) Rights of a donee created by 23 an anatomical gift are superior to rights of others except with respect to autopsies 24 under AS 13.52.260(b). A donee may accept or reject an anatomical gift. If a donee 25 accepts an anatomical gift of an entire body, the donee, subject to the terms of the gift, 26 may allow embalming and use of the body in funeral services. If the gift is of a part of 27 a body, the donee, upon the death of the donor and before embalming, shall cause the 28 part to be removed without unnecessary mutilation. After removal of the part, custody 29 of the remainder of the body vests in the person under obligation to dispose of the 30 body. 31 (b) The time of death of a donor shall be determined by a physician or nurse
01 under AS 09.68.120. A physician who attends the donor at death and a physician who 02 determines the time of death may not participate in the procedures for removing or 03 transplanting a part unless the document of gift designates a particular physician under 04 AS 13.52.170(d). 05 (c) If there has been an anatomical gift, a technician may remove any donated 06 parts after determination of death by a physician or nurse. 07 Sec. 13.52.240. Coordination of procurement and use. Each hospital in this 08 state, after consultation with other hospitals and procurement organizations, shall 09 establish agreements or affiliations for coordination of procurement and use of human 10 bodies and parts. 11 Sec. 13.52.250. Sale or purchase of parts prohibited. (a) A person may not 12 knowingly, for valuable consideration, sell or purchase a part for any purpose. 13 (b) In (a) of this section, "valuable consideration" does not include reasonable 14 payment for the removal, processing, disposal, preservation, quality control, storage, 15 transportation, or implantation of the part or entire body. 16 (c) A person who violates this section is guilty of a class C felony. 17 Sec. 13.52.260. Examination, autopsy, liability. (a) An anatomical gift 18 authorizes any reasonable examination necessary to assure medical acceptability of the 19 gift for the purposes intended. 20 (b) The provisions of AS 13.52.170 - 13.52.280 are subject to the autopsy 21 provisions of AS 12.65. 22 (c) A hospital, physician, surgeon, coroner, medical examiner, local public 23 health officer, technician, or other person who acts in accordance with AS 13.52.170 - 24 13.52.280 or with the applicable anatomical gift law of another state or attempts in 25 good faith to act in accordance with AS 13.52.170 - 13.52.280 or with the applicable 26 anatomical gift law of another state is not liable for that act in a civil action or criminal 27 proceeding. 28 (d) An individual who makes an anatomical gift under AS 13.52.170 or 29 13.52.180 and the individual's estate are not liable for any injury or damage that may 30 result from the making or the use of the anatomical gift. 31 Sec. 13.52.265. Prohibition against authorization by coroner, state
01 medical examiner, or local public health official. The coroner, the state medical 02 examiner, or a local public health official may not release or permit the removal of a 03 part from a body within that official's custody based on the fact that the official does 04 not know of 05 (1) a refusal to make a gift; 06 (2) an indication by the decedent that is contrary to making a gift; or 07 (3) an objection to a gift by a person having priority to act under 08 AS 13.52.180(a). 09 Sec. 13.52.270. Applicability provisions. AS 13.52.170 - 13.52.280 apply to 10 a document of gift, revocation, or refusal to make an anatomical gift signed by the 11 donor or a person authorized to make or object to making an anatomical gift before, 12 on, or after the effective date of this bill section. 13 Sec. 13.52.275. Construction where mental illness. In the case of mental 14 illness, nothing in this chapter may be construed to override or undermine the validity 15 of a properly executed durable power of attorney for health care. 16 Sec. 13.52.280. Uniformity of application and construction. AS 13.52.170 17 - 13.52.280 shall be applied and construed to carry out their general purpose to make 18 uniform the law with respect to the subject of AS 13.52.170 - 13.52.280 among states 19 enacting these provisions. 20 Sec. 13.52.290. Severability. If a provision of this chapter, or the application 21 of this chapter to a person or circumstance is held invalid, including being held 22 unconstitutional, the invalidity does not affect the other provisions or applications of 23 this chapter that can be given effect without the invalid provision or application. 24 Sec. 13.52.300. Optional form. The following sample form may be used to 25 create an advance health care directive. The other sections of this chapter govern the 26 effect of this or any other writing used to create an advance health care directive. This 27 form may be duplicated. This form may be modified to suit the needs of the person, or 28 a different form that complies with this chapter may be used, including the mandatory 29 witnessing requirements: 30 ADVANCE HEALTH CARE DIRECTIVE 31 Explanation
01 You have the right to give instructions about your own health 02 care to the extent allowed by law. You also have the right to name 03 someone else to make health care decisions for you to the extent 04 allowed by law. This form lets you do either or both of these things. It 05 also lets you express your wishes regarding the designation of your 06 health care provider. If you use this form, you may complete or modify 07 all or any part of it. You are free to use a different form if the form 08 complies with the requirements of AS 13.52. 09 Part 1 of this form is a durable power of attorney for health 10 care. A "durable power of attorney for health care" means the 11 designation of an agent to make health care decisions for you. Part 1 12 lets you name another individual as an agent to make health care 13 decisions for you if you do not have the capacity to make your own 14 decisions or if you want someone else to make those decisions for you 15 now even though you still have the capacity to make those decisions. 16 You may name an alternate agent to act for you if your first choice is 17 not willing, able, or reasonably available to make decisions for you. 18 Unless related to you, your agent may not be an owner, operator, or 19 employee of a health care institution where you are receiving care. 20 Unless the form you sign limits the authority of your agent, 21 your agent may make all health care decisions for you that you could 22 legally make for yourself. This form has a place for you to limit the 23 authority of your agent. You do not have to limit the authority of your 24 agent if you wish to rely on your agent for all health care decisions that 25 may have to be made. If you choose not to limit the authority of your 26 agent, your agent will have the right, to the extent allowed by law, to 27 (a) consent or refuse consent to any care, treatment, service, or 28 procedure to maintain, diagnose, or otherwise affect a physical or 29 mental condition, including the administration or discontinuation of 30 psychotropic medication; 31 (b) select or discharge health care providers and institutions;
01 (c) approve or disapprove proposed diagnostic tests, surgical 02 procedures, and programs of medication; 03 (d) direct the provision, withholding, or withdrawal of artificial 04 nutrition and hydration and all other forms of health care; and 05 (e) make an anatomical gift following your death. 06 Part 2 of this form lets you give specific instructions for any 07 aspect of your health care to the extent allowed by law, except you may 08 not authorize mercy killing, assisted suicide, or euthanasia. Choices are 09 provided for you to express your wishes regarding the provision, 10 withholding, or withdrawal of treatment to keep you alive, including 11 the provision of artificial nutrition and hydration, as well as the 12 provision of pain relief medication. Space is provided for you to add to 13 the choices you have made or for you to write out any additional 14 wishes. 15 Part 3 of this form lets you express an intention to make an 16 anatomical gift following your death. 17 Part 4 of this form lets you make decisions in advance about 18 certain types of mental health treatment. 19 Part 5 of this form lets you designate a physician to have 20 primary responsibility for your health care. 21 After completing this form, sign and date the form at the end 22 and have the form witnessed by one of the two alternative methods 23 listed below. Give a copy of the signed and completed form to your 24 physician, to any other health care providers you may have, to any 25 health care institution at which you are receiving care, and to any health 26 care agents you have named. You should talk to the person you have 27 named as your agent to make sure that the person understands your 28 wishes and is willing to take the responsibility. 29 You have the right to revoke this advance health care directive 30 or replace this form at any time, except that you may not revoke this 31 declaration when you are determined not to be competent by a court, by
01 two physicians, at least one of whom shall be a psychiatrist, or by both 02 a physician and a professional mental health clinician. In this advance 03 health care directive, "competent" means that you have the capacity 04 (1) to assimilate relevant facts and to appreciate and 05 understand your situation with regard to those facts; and 06 (2) to participate in treatment decisions by means of a 07 rational thought process. 08 PART 1 09 DURABLE POWER OF ATTORNEY FOR 10 HEALTH CARE DECISIONS 11 (1) DESIGNATION OF AGENT. I designate the 12 following individual as my agent to make health care decisions for me: 13 _________________________________________________________ 14 (name of individual you choose as agent) 15 _________________________________________________________ 16 (address) (city) (state) (zip code) 17 _________________________________________________________ 18 (home telephone) (work telephone) 19 OPTIONAL: If I revoke my agent's authority or if my agent is 20 not willing, able, or reasonably available to make a health care decision 21 for me, I designate as my first alternate agent 22 _________________________________________________________ 23 (name of individual you choose as first alternate agent) 24 _________________________________________________________ 25 (address) (city) (state) (zip code) 26 _________________________________________________________ 27 (home telephone) (work telephone) 28 OPTIONAL: If I revoke the authority of my agent and first 29 alternate agent or if neither is willing, able, or reasonably available to 30 make a health care decision for me, I designate as my second alternate 31 agent
01 _________________________________________________________ 02 (name of individual you choose as second alternate agent) 03 _________________________________________________________ 04 (address) (city) (state) (zip code) 05 _________________________________________________________ 06 (home telephone) (work telephone) 07 (2) AGENT'S AUTHORITY. My agent is authorized 08 and directed to follow my individual instructions and my other wishes 09 to the extent known to the agent in making all health care decisions for 10 me. If these are not known, my agent is authorized to make these 11 decisions in accordance with my best interest, including decisions to 12 provide, withhold, or withdraw artificial hydration and nutrition and 13 other forms of health care to keep me alive, except as I state here: 14 _________________________________________________________ 15 _________________________________________________________ 16 _________________________________________________________ 17 (Add additional sheets if needed.) 18 Under this authority, "best interest" means that the benefits to you 19 resulting from a treatment outweigh the burdens to you resulting from 20 that treatment after assessing 21 (A) the effect of the treatment on your physical, 22 emotional, and cognitive functions; 23 (B) the degree of physical pain or discomfort 24 caused to you by the treatment or the withholding or withdrawal 25 of the treatment; 26 (C) the degree to which your medical condition, 27 the treatment, or the withholding or withdrawal of treatment, 28 results in a severe and continuing impairment; 29 (D) the effect of the treatment on your life 30 expectancy; 31 (E) your prognosis for recovery, with and
01 without the treatment; 02 (F) the risks, side effects, and benefits of the 03 treatment or the withholding of treatment; and 04 (G) your religious beliefs and basic values, to 05 the extent that these may assist in determining benefits and 06 burdens. 07 (3) WHEN AGENT'S AUTHORITY BECOMES 08 EFFECTIVE. Except in the case of mental illness, my agent's authority 09 becomes effective when my primary physician determines that I am 10 unable to make my own health care decisions unless I mark the 11 following box. In the case of mental illness, unless I mark the 12 following box, my agent's authority becomes effective when a court 13 determines I am unable to make my own decisions, or, in an 14 emergency, if my primary physician or another health care provider 15 determines I am unable to make my own decisions. If I mark this box 16 [ ], my agent's authority to make health care decisions for me takes 17 effect immediately. 18 (4) AGENT'S OBLIGATION. My agent shall make 19 health care decisions for me in accordance with this durable power of 20 attorney for health care, any instructions I give in Part 2 of this form, 21 and my other wishes to the extent known to my agent. To the extent 22 my wishes are unknown, my agent shall make health care decisions for 23 me in accordance with what my agent determines to be in my best 24 interest. In determining my best interest, my agent shall consider my 25 personal values to the extent known to my agent. 26 (5) NOMINATION OF GUARDIAN. If a guardian of 27 my person needs to be appointed for me by a court, I nominate the 28 agent designated in this form. If that agent is not willing, able, or 29 reasonably available to act as guardian, I nominate the alternate agents 30 whom I have named under (1) above, in the order designated. 31 PART 2
01 INSTRUCTIONS FOR HEALTH CARE 02 If you are satisfied to allow your agent to determine what is best 03 for you in making health care decisions, you do not need to fill out this 04 part of the form. If you do fill out this part of the form, you may strike 05 any wording you do not want. There is a state protocol that governs the 06 use of do not resuscitate orders by physicians and other health care 07 providers. You may obtain a copy of the protocol from the Alaska 08 Department of Health and Social Services. A "do not resuscitate order" 09 means a directive from a licensed physician that emergency 10 cardiopulmonary resuscitation should not be administered to you. 11 (6) END-OF-LIFE DECISIONS. Except to the extent 12 prohibited by law, I direct that my health care providers and others 13 involved in my care provide, withhold, or withdraw treatment in 14 accordance with the choice I have marked below: (Check only one 15 box.) 16 [ ] (A) Choice To Prolong Life 17 I want my life to be prolonged as long as 18 possible within the limits of generally accepted health care 19 standards; OR 20 [ ] (B) Choice Not To Prolong Life 21 I want comfort care only and I do not want my 22 life to be prolonged with medical treatment if, in the judgment 23 of my physician, I have (check all choices that represent your 24 wishes) 25 [ ] (i) a condition of permanent 26 unconsciousness: a condition that, to a high degree of 27 medical certainty, will last permanently without 28 improvement; in which, to a high degree of medical 29 certainty, thought, sensation, purposeful action, social 30 interaction, and awareness of myself and the 31 environment are absent; and for which, to a high degree
01 of medical certainty, initiating or continuing life- 02 sustaining procedures for me, in light of my medical 03 outcome, will provide only minimal medical benefit for 04 me; or 05 [ ] (ii) a terminal condition: an 06 incurable or irreversible illness or injury that without the 07 administration of life-sustaining procedures will result in 08 my death in a short period of time, for which there is no 09 reasonable prospect of cure or recovery, that imposes 10 severe pain or otherwise imposes an inhumane burden 11 on me, and for which, in light of my medical condition, 12 initiating or continuing life-sustaining procedures will 13 provide only minimal medical benefit; 14 [ ] Additional instructions: ________________ 15 ___________________________________________________ 16 (C) Artificial Nutrition and Hydration. If I am 17 unable to safely take nutrition, fluids, or nutrition and fluids 18 (check your choices or write your instructions), 19 [ ] I wish to receive artificial nutrition and 20 hydration indefinitely; 21 [ ] I wish to receive artificial nutrition and 22 hydration indefinitely, unless it clearly increases my suffering 23 and is no longer in my best interest; 24 [ ] I wish to receive artificial nutrition and 25 hydration on a limited trial basis to see if I can improve; 26 [ ] In accordance with my choices in (6)(B) 27 above, I do not wish to receive artificial nutrition and hydration. 28 [ ] Other instructions:_____________________ 29 ___________________________________________________ 30 (D) Relief from Pain. 31 [ ] I direct that adequate treatment be
01 provided at all times for the sole purpose of the 02 alleviation of pain or discomfort; or 03 [ ] I give these instructions: 04 _____________________________________________ 05 _____________________________________________ 06 (E) Should I become unconscious and I 07 am pregnant, I direct that ________________________ 08 _____________________________________________ 09 _____________________________________________ 10 (7) OTHER WISHES. (If you do not agree with any of 11 the optional choices above and wish to write your own, or if you wish 12 to add to the instructions you have given above, you may do so here.) I 13 direct that 14 _________________________________________________________ 15 _________________________________________________________ 16 Conditions or limitations: ______________________________ 17 _________________________________________________________. 18 (Add additional sheets if needed.) 19 PART 3 20 ANATOMICAL GIFT AT DEATH 21 (OPTIONAL) 22 If you are satisfied to allow your agent to determine whether to 23 make an anatomical gift at your death, you do not need to fill out this 24 part of the form. 25 (8) Upon my death: (mark applicable box) 26 [ ] (A) I give any needed organs, tissues, or 27 other body parts, OR 28 [ ] (B) I give the following organs, tissues, or 29 other body parts only ________________________________ 30 __________________________________________________ 31 [ ] (C) My gift is for the following purposes
01 (mark any of the following you want): 02 [ ] (i) transplant; 03 [ ] (ii) therapy; 04 [ ] (iii) research; 05 [ ] (iv) education. 06 [ ] (D) I refuse to make an anatomical gift. 07 PART 4 08 MENTAL HEALTH TREATMENT 09 This part of the declaration allows you to make decisions in 10 advance about mental health treatment. The instructions that you 11 include in this declaration will be followed only if a court, two 12 physicians that include a psychiatrist, or a physician and a professional 13 mental health clinician believe that you are not competent and cannot 14 make treatment decisions. Otherwise, you will be considered to be 15 competent and to have the capacity to give or withhold consent for the 16 treatments. 17 If you are satisfied to allow your agent to determine what is best 18 for you in making these mental health decisions, you do not need to fill 19 out this part of the form. If you do fill out this part of the form, you 20 may strike any wording you do not want. 21 (9) PSYCHOTROPIC MEDICATIONS. If I do not 22 have the capacity to give or withhold informed consent for mental 23 health treatment, my wishes regarding psychotropic medications are as 24 follows: 25 ________ I consent to the administration of the following 26 medications: ______________________________________________ 27 ________ I do not consent to the administration of the 28 following medications: ______________________________________ 29 Conditions or limitations:_______________________________ 30 _________________________________________________________. 31 (10) ELECTROCONVULSIVE TREATMENT. If I do
01 not have the capacity to give or withhold informed consent for mental 02 health treatment, my wishes regarding electroconvulsive treatment are 03 as follows: 04 ________ I consent to the administration of electroconvulsive 05 treatment. 06 ________ I do not consent to the administration of 07 electroconvulsive treatment. 08 Conditions or limitations: ______________________________ 09 _________________________________________________________. 10 (11) ADMISSION TO AND RETENTION IN 11 FACILITY. If I do not have the capacity to give or withhold informed 12 consent for mental health treatment, my wishes regarding admission to 13 and retention in a mental health facility for mental health treatment are 14 as follows: 15 ________ I consent to being admitted to a mental health facility 16 for mental health treatment for up to ________ days. (The number of 17 days not to exceed 17.) 18 ________ I do not consent to being admitted to a mental health 19 facility for mental health treatment. 20 Conditions or limitations: ______________________________ 21 _________________________________________________________. 22 OTHER WISHES OR INSTRUCTIONS 23 _________________________________________________________ 24 _________________________________________________________ 25 _________________________________________________________ 26 Conditions or limitations: ______________________________ 27 _________________________________________________________. 28 PART 5 29 PRIMARY PHYSICIAN 30 (OPTIONAL) 31 (12) I designate the following physician as my primary
01 physician: 02 _________________________________________________________ 03 (name of physician) 04 _________________________________________________________ 05 (address) (city) (state) (zip code) 06 _________________________________________________________ 07 (telephone) 08 OPTIONAL: If the physician I have designated above is 09 not willing, able, or reasonably available to act as my primary 10 physician, I designate the following physician as my primary physician: 11 _________________________________________________________ 12 (name of physician) 13 _________________________________________________________ 14 (address) (city) (state) (zip code) 15 _________________________________________________________ 16 (telephone) 17 (13) EFFECT OF COPY. A copy of this form has the 18 same effect as the original. 19 (14) SIGNATURES. Sign and date the form here: 20 _________________________________________________________ 21 (date) (sign your name) 22 _________________________________________________________ 23 (print your name) 24 _________________________________________________________ 25 (address) (city) (state) (zip code) 26 (15) WITNESSES. This advance care health directive 27 will not be valid for making health care decisions unless it is 28 (A) signed by two qualified adult witnesses who 29 are personally known to you and who are present when you sign 30 or acknowledge your signature; the witnesses may not be a 31 health care provider employed at the health care institution or
01 health care facility where you are receiving health care, an 02 employee of the health care provider who is providing health 03 care to you, an employee of the health care institution or health 04 care facility where you are receiving health care, or the person 05 appointed as your agent by this document; at least one of the 06 two witnesses may not be related to you by blood, marriage, or 07 adoption or entitled to a portion of your estate upon your death 08 under your will or codicil; or 09 (B) acknowledged before a notary public in the 10 state. 11 ALTERNATIVE NO. 1 12 Witness Who is Not Related to or a Devisee of the Principal 13 I swear under penalty of perjury under 14 AS 11.56.200 that the principal is personally known to me, that 15 the principal signed or acknowledged this durable power of 16 attorney for health care in my presence, that the principal 17 appears to be of sound mind and under no duress, fraud, or 18 undue influence, and that I am not 19 (1) a health care provider employed at the health care 20 institution or health care facility where the principal is receiving health 21 care; 22 (2) an employee of the health care provider providing 23 health care to the principal; 24 (3) an employee of the health care institution or health 25 care facility where the principal is receiving health care; 26 (4) the person appointed as agent by this document; 27 (5) related to the principal by blood, marriage, or 28 adoption; or 29 (6) entitled to a portion of the principal's estate upon the 30 principal's death under a will or codicil. 31 ________________________________________________________
01 (date) (signature of witness) 02 ________________________________________________________ 03 (printed name of witness) 04 ________________________________________________________ 05 (address) (city) (state) (zip code) 06 Witness Who May be Related to or a Devisee of the Principal 07 I swear under penalty of perjury under AS 11.56.200 08 that the principal is personally known to me, that the principal signed or 09 acknowledged this durable power of attorney for health care in my 10 presence, that the principal appears to be of sound mind and under no 11 duress, fraud, or undue influence, and that I am not 12 (1) a health care provider employed at the health care 13 institution or health care facility where the principal is receiving health 14 care; 15 (2) an employee of the health care provider who is 16 providing health care to the principal; 17 (3) an employee of the health care institution or health 18 care facility where the principal is receiving health care; or 19 (4) the person appointed as agent by this document. 20 _______________________________________________________ 21 (date) (signature of witness) 22 _______________________________________________________ 23 (printed name of witness) 24 _______________________________________________________ 25 (address) (city) (state) (zip code) 26 ALTERNATIVE NO. 2 27 State of Alaska 28 ________________ Judicial District 29 On this ____ day of ___________________, in the year 30 ______________, before me, _______________________________ 31 (insert name of notary public) appeared
01 _______________________________, personally known to me (or 02 proved to me on the basis of satisfactory evidence) to be the person 03 whose name is subscribed to this instrument, and acknowledged that 04 the person executed it. 05 Notary Seal 06 ___________________________ 07 (signature of notary public) 08 Sec. 13.52.390. Definitions. In this chapter, unless the context otherwise 09 requires, 10 (1) "advance health care directive" means an individual instruction or a 11 durable power of attorney for health care; 12 (2) "agent" means an individual designated in a durable power of 13 attorney for health care to make a health care decision for the individual granting the 14 power; 15 (3) "anatomical gift" means an individual instruction that makes a 16 donation of all or a part of an individual's body to take effect upon or after death; 17 (4) "artificial nutrition and hydration" means medically appropriate 18 nutrition and hydration delivered 19 (A) through an intravenous needle placed directly in a vein; or 20 (B) by a tube that is inserted into a functioning gastrointestinal 21 tract; 22 (5) "available" means, when referring to a person, that the 23 (A) person's existence is known; 24 (B) person can be contacted; 25 (C) person does not lack capacity; 26 (D) person does not refuse to accept the position; and 27 (E) person is willing to make a health care decision; 28 (6) "best interest" means that the benefits to the individual resulting 29 from a treatment outweigh the burdens to the individual resulting from that treatment 30 after assessing 31 (A) the effect of the treatment on the physical, emotional, and
01 cognitive functions of the patient; 02 (B) the degree of physical pain or discomfort caused to the 03 individual by the treatment or the withholding or withdrawal of the treatment; 04 (C) the degree to which the individual's medical condition, the 05 treatment, or the withholding or withdrawal of treatment results in a severe and 06 continuing impairment; 07 (D) the effect of the treatment on the life expectancy of the 08 patient; 09 (E) the prognosis of the patient for recovery, with and without 10 the treatment; 11 (F) the risks, side effects, and benefits of the treatment or the 12 withholding of treatment; and 13 (G) the religious beliefs and basic values of the individual 14 receiving treatment, to the extent that these may assist the decision-maker to 15 determine benefits and burdens; 16 (7) "capacity," except in (9) of this section, means an individual's 17 ability to receive and evaluate information effectively or communicate decisions to the 18 extent necessary to make mental health treatment decisions; 19 (8) "cardiopulmonary resuscitation" means an attempt to restore 20 spontaneous circulation; 21 (9) "competent" means that an individual has the capacity 22 (A) to assimilate relevant facts and to appreciate and 23 understand the individual's situation with regard to those facts; and 24 (B) to participate in treatment decisions by means of a rational 25 thought process; 26 (10) "decedent" means a deceased individual or infant, but does not 27 include a dead or stillborn fetus; 28 (11) "department" means the Department of Health and Social 29 Services; 30 (12) "document of gift" means a card, a statement attached to or 31 imprinted on a driver's license, a will, an advance health care directive under
01 AS 13.52.300, or another writing used to make an anatomical gift; 02 (13) "donor" means an individual who makes an anatomical gift; 03 (14) "do not resuscitate identification" means an identification card, 04 form, necklace, or bracelet that carries the standardized design or symbol developed 05 by the department under AS 13.52.065 to signify, when carried or worn, that the 06 carrier or wearer is an individual for whom a physician has issued a do not resuscitate 07 order; 08 (15) "do not resuscitate order" means a directive from a licensed 09 physician that emergency cardiopulmonary resuscitation should not be administered to 10 a qualified patient; 11 (16) "durable power of attorney for health care" means a power of 12 attorney that remains in effect when the principal lacks capacity; in this paragraph, 13 "power of attorney" means the designation of an agent to make health care decisions 14 for the individual granting the power; 15 (17) "generally accepted health care standards" includes the protocol 16 for do not resuscitate orders that is adopted under AS 13.52.065; 17 (18) "guardian" means a judicially appointed person having authority 18 to make a health care decision for an individual; 19 (19) "health care" means any care, treatment, service, or procedure to 20 maintain, diagnose, or otherwise affect an individual's physical or mental condition; 21 (20) "health care decision" means a decision made by an individual or 22 the individual's agent, guardian, or surrogate regarding the individual's health care, 23 including 24 (A) selection and discharge of health care providers and 25 institutions; 26 (B) approval or disapproval of proposed diagnostic tests, 27 surgical procedures, and programs of medication; 28 (C) direction to provide, withhold, or withdraw artificial 29 nutrition and hydration if providing, withholding, or withdrawing artificial 30 nutrition, artificial hydration, or artificial nutrition and hydration is in accord 31 with generally accepted health care standards applicable to health care
01 providers or institutions; 02 (D) the administration or withdrawal of psychotropic 03 medications, the use of electroconvulsive treatment, and the admission to a 04 mental health facility; and 05 (E) making an anatomical gift at death; 06 (21) "health care facility" means a nursing home, a rehabilitation 07 center, a long-term care facility, and any other health care institution that administers 08 health care and that provides overnight stays in the ordinary course of the facility's 09 business; 10 (22) "health care institution" means an institution, facility, or agency 11 licensed, certified, or otherwise authorized or permitted by law to provide health care 12 in the ordinary course of business; 13 (23) "health care provider" means an individual licensed, certified, or 14 otherwise authorized or permitted by law to provide health care in the ordinary course 15 of business or practice of a profession; 16 (24) "hospital" means a facility 17 (A) licensed, accredited, or approved as a hospital under the 18 laws of this state; or 19 (B) operated as a hospital by the United States government, this 20 state, or a subdivision of this state; 21 (25) "individual instruction" means an individual's direction 22 concerning a health care decision for the individual; 23 (26) "life-sustaining procedures" means any medical treatment, 24 procedure, or intervention that, in the judgment of the primary physician, when 25 applied to a patient with a qualifying condition, would not be effective to remove the 26 qualifying condition, would serve only to prolong the dying process, or, when 27 administered to a patient with a condition of permanent unconsciousness, may keep 28 the patient alive but is not expected to restore consciousness; in this paragraph, 29 "medical treatment, procedure, or intervention" includes assisted ventilation, renal 30 dialysis, surgical procedures, blood transfusions, and the administration of drugs, 31 including antibiotics, or artificial nutrition and hydration;
01 (27) "mental health facility" has the meaning given to "designated 02 treatment facility" in AS 47.30.915; 03 (28) "mental health treatment" means electroconvulsive treatment, 04 treatment with psychotropic medication, or admission to and retention in a health care 05 institution for mental health treatment; 06 (29) "organ procurement organization" means an organization that has 07 been designated by the United States Department of Health and Human Services to 08 coordinate activities for the procurement of body parts for any portion of this state; 09 (30) "part" means an organ, tissue, an eye, a bone, an artery, blood, 10 fluid, or another portion of a human body, except fetal tissue; 11 (31) "permanent unconsciousness" means a condition 12 (A) that, to a high degree of medical certainty, will last 13 permanently without improvement; 14 (B) in which, to a high degree of medical certainty, thought, 15 sensation, purposeful action, social interaction, and awareness of self and the 16 environment are absent; and 17 (C) for which, to a high degree of medical certainty, initiating 18 or continuing life-sustaining procedures, in light of the patient's medical 19 outcome, provides only minimal medical benefit; 20 (32) "person" means an individual, corporation, business trust, estate, 21 trust, partnership, joint venture, association, government, governmental subdivision, 22 governmental agency, or another legal or commercial entity; 23 (33) "physician" or "surgeon" means an individual licensed or 24 otherwise authorized to practice medicine and surgery or osteopathy and surgery under 25 the laws of any state; 26 (34) "primary physician" means a physician designated by an 27 individual, or by the individual's agent, guardian, or surrogate, to have primary 28 responsibility for the individual's health care or, in the absence of a designation or if 29 the designated physician is not reasonably available, a physician who undertakes the 30 responsibility; 31 (35) "qualified patient" means a patient with a qualifying condition
01 who is eligible for do not resuscitate identification; 02 (36) "qualifying condition" means a terminal condition or permanent 03 unconsciousness in a patient; 04 (37) "reasonably available" means available using a level of diligence 05 appropriate to the seriousness and urgency of an individual's health care needs; 06 (38) "state" means a state, territory, or possession of the United States, 07 the District of Columbia, or the Commonwealth of Puerto Rico; 08 (39) "supervising health care provider" means the primary physician or 09 the physician's designee, or the health care provider or the provider's designee who has 10 undertaken primary responsibility for an individual's health care; 11 (40) "surrogate" means an individual, other than a patient's agent or 12 guardian, authorized under this chapter to make a health care decision for the patient; 13 (41) "technician" means an individual who is licensed or certified by 14 the State Medical Board to remove or process a part; 15 (42) "terminal condition" means an incurable or irreversible illness or 16 injury 17 (A) that without administration of life-sustaining procedures 18 will result in death in a short period of time; 19 (B) for which there is no reasonable prospect of cure or 20 recovery; 21 (C) that imposes severe pain or otherwise imposes an inhumane 22 burden on the patient; and 23 (D) for which, in light of the patient's medical condition, 24 initiating or continuing life-sustaining procedures will provide only minimal 25 medical benefit. 26 Sec. 13.52.395. Short title. This chapter may be cited as the Health Care 27 Decisions Act. 28 * Sec. 4. AS 18.65.311 is amended to read: 29 Sec. 18.65.311. Anatomical gift [OR LIVING WILL DOCUMENT]. (a) 30 The department shall provide, at the time that an identification card is issued, a form 31 for a document by which the card holder may make an anatomical gift under AS 13.52
01 [AS 13.50 (UNIFORM ANATOMICAL GIFTS ACT) OR A LIVING WILL UNDER 02 AS 18.12 (LIVING WILLS AND DO NOT RESUSCITATE ORDERS)]. The 03 document (1) may not be larger than an identification card, (2) must contain sufficient 04 space for the signature of two witnesses [OR A PERSON WHO IS QUALIFIED TO 05 TAKE ACKNOWLEDGMENTS UNDER AS 09.63.010], and (3) [MUST USE THE 06 FORMS AND DESIGNS DEVELOPED UNDER AS 18.12.037, AND (4)] must 07 provide a means by which the card holder may cancel the gift [OR THE LIVING 08 WILL]. If the document is executed by the applicant, it shall be sealed in plastic and 09 attached to the identification card. [A SYMBOL DEVELOPED UNDER 10 AS 18.12.037 INDICATING THE EXISTENCE OF THE ANATOMICAL GIFT OR 11 LIVING WILL DOCUMENT MUST BE DISPLAYED IN THE LOWER RIGHT- 12 HAND CORNER ON THE FACE OF THE IDENTIFICATION CARD.] 13 (b) An employee of the department who processes an identification card 14 application, other than an application received by mail, shall ask the applicant orally 15 whether the applicant wishes to execute an anatomical gift [OR A LIVING WILL]. 16 The department shall, by placement of posters and brochures in the office where the 17 application is taken, and by oral advice, if requested, make known to the applicant the 18 procedure necessary to execute an anatomical [A] gift under AS 13.52 [AS 13.50 OR 19 A LIVING WILL UNDER AS 18.12]. 20 * Sec. 5. AS 28.10.021(c) is amended to read: 21 (c) An employee of the department who processes an application for 22 registration or renewal of registration, other than an application received by mail or an 23 application for registration under AS 28.10.152, shall ask the applicant orally whether 24 the applicant wishes to execute an anatomical gift [OR A LIVING WILL]. The 25 department shall make known to all applicants the procedure for executing an 26 anatomical [A] gift under AS 13.52 (Health Care Decisions Act) [AS 13.50 27 (UNIFORM ANATOMICAL GIFTS ACT) OR A LIVING WILL UNDER AS 18.12 28 (LIVING WILLS AND DO NOT RESUSCITATE ORDERS)] by displaying posters 29 in the offices in which applications are taken, by providing a brochure or other written 30 information to each person who applies in person or by mail, and, if requested, by 31 providing oral advice.
01 * Sec. 6. AS 28.15.061(d) is amended to read: 02 (d) An employee of the department who processes a driver's license 03 application, other than an application received by mail, shall ask the applicant orally 04 whether the applicant wishes to execute an anatomical gift [OR A LIVING WILL]. 05 The department shall make known to all applicants the procedure for executing an 06 anatomical [A] gift under AS 13.52 (Health Care Decisions Act) [AS 13.50 07 (UNIFORM ANATOMICAL GIFTS ACT) OR A LIVING WILL UNDER AS 18.12 08 (LIVING WILLS AND DO NOT RESUSCITATE ORDERS)] by displaying posters 09 in the offices in which applications are taken, by providing a brochure or other written 10 information to each person who applies in person or by mail, and, if requested, by 11 providing oral advice. 12 * Sec. 7. AS 28.15.111(b) is amended to read: 13 (b) The department shall provide, at the time that an operator's license is 14 issued, a form for a document by which the owner of a license may make an 15 anatomical gift under AS 13.52 [AS 13.50 OR A LIVING WILL UNDER AS 18.12]. 16 The document (1) may not be larger than an operator's license, (2) must contain 17 sufficient space for the signature of two witnesses [OR A PERSON WHO IS 18 QUALIFIED TO TAKE ACKNOWLEDGMENTS UNDER AS 09.63.010], and (3) 19 [MUST USE THE FORMS AND DESIGNS DEVELOPED UNDER AS 18.12.037, 20 AND (4)] must provide a means by which the owner may cancel the anatomical gift 21 [OR THE LIVING WILL]. If the document is executed by the applicant, it shall be 22 sealed in plastic and attached to the license. [A SYMBOL DEVELOPED UNDER 23 AS 18.12.037 INDICATING THE EXISTENCE OF THE ANATOMICAL GIFT OR 24 LIVING WILL DOCUMENT MUST BE DISPLAYED IN THE LOWER RIGHT- 25 HAND CORNER ON THE FACE OF THE DRIVER'S LICENSE.] 26 * Sec. 8. AS 47.30 is amended by adding a new section to article 9 to read: 27 Sec. 47.30.817. Advance health care directives. A health care provider or a 28 health care institution may not require or prohibit the execution or revocation of an 29 advance health care directive as a condition for admission, discharge, or providing 30 health care. In this section, "advance health care directive," "health care institution," 31 and "health care provider" have the meanings given in AS 13.52.390.
01 * Sec. 9. AS 47.30.825(b) is amended to read: 02 (b) The patient and the following persons, at the request of the patient, are 03 entitled to participate in formulating the patient's individualized treatment plan and to 04 participate in the evaluation process as much as possible, at minimum to the extent of 05 requesting specific forms of therapy, inquiring why specific therapies are or are not 06 included in the treatment program, and being informed as to the patient's present 07 medical and psychological condition and prognosis: (1) the patient's counsel, (2) the 08 patient's guardian, (3) a mental health professional previously engaged in the patient's 09 care outside of the evaluation facility or designated treatment facility, (4) a 10 representative of the patient's choice, (5) a person designated as the patient's agent or 11 surrogate [ATTORNEY-IN-FACT] with regard to mental health treatment decisions 12 under AS 13.52 [AS 13.26.332 - 13.26.358, AS 47.30.950 - 47.30.980, OR OTHER 13 POWER-OF-ATTORNEY], and (6) the adult designated under AS 47.30.725. The 14 mental health care professionals may not withhold any of the information described in 15 this subsection from the patient or from others if the patient has signed a waiver of 16 confidentiality or has designated the person who would receive the information as an 17 agent or surrogate under AS 13.52 [ATTORNEY-IN-FACT] with regard to mental 18 health treatment. 19 * Sec. 10. AS 47.30.825(f) is amended to read: 20 (f) A patient capable of giving informed consent has the absolute right to 21 accept or refuse electroconvulsive therapy or aversive conditioning. A patient who 22 lacks substantial capacity to make this decision may not be given this therapy or 23 conditioning without a court order unless the patient expressly authorized that 24 particular form of treatment in an advance health care directive [A 25 DECLARATION] properly executed under AS 13.52 [AS 47.30.950 - 47.30.980] or 26 has authorized an agent or surrogate under AS 13.52 [ATTORNEY-IN-FACT] to 27 make this decision and the agent or surrogate [ATTORNEY-IN-FACT] consents to 28 the treatment on behalf of the patient. 29 * Sec. 11. AS 47.30.836 is amended to read: 30 Sec. 47.30.836. Psychotropic medication in nonemergency. An evaluation 31 facility or designated treatment facility may not administer psychotropic medication to
01 a patient in a situation that does not involve a crisis under AS 47.30.838(a)(1) unless 02 the patient 03 (1) has the capacity to give informed consent to the medication, as 04 described in AS 47.30.837, and gives that consent; the facility shall document the 05 consent in the patient's medical chart; 06 (2) authorized the use of psychotropic medication in an advance 07 health care directive [A DECLARATION] properly executed under AS 13.52 08 [AS 47.30.950 - 47.30.980] or authorized an agent or surrogate under AS 13.52 09 [ATTORNEY-IN-FACT] to consent to the use of psychotropic medication for the 10 patient and the agent or surrogate [ATTORNEY-IN-FACT] does consent; or 11 (3) is determined by a court to lack the capacity to give informed 12 consent to the medication and the court approves use of the medication under 13 AS 47.30.839. 14 * Sec. 12. AS 47.30.838(d) is amended to read: 15 (d) An evaluation facility or designated treatment facility may administer 16 psychotropic medication to a patient without the patient's informed consent if the 17 patient is unable to give informed consent but has authorized the use of psychotropic 18 medication in an advance health care directive [A DECLARATION] properly 19 executed under AS 13.52 [AS 47.30.950 - 47.30.980] or has authorized an agent or 20 surrogate under AS 13.52 [ATTORNEY-IN-FACT] to consent to this form of 21 treatment for the patient and the agent or surrogate [ATTORNEY-IN-FACT] does 22 consent. 23 * Sec. 13. AS 47.30.839(d) is amended to read: 24 (d) Upon the filing of a petition under (b) of this section, the court shall direct 25 the office of public advocacy to provide a visitor to assist the court in investigating the 26 issue of whether the patient has the capacity to give or withhold informed consent to 27 the administration of psychotropic medication. The visitor shall gather pertinent 28 information and present it to the court in written or oral form at the hearing. The 29 information must include documentation of the following: 30 (1) the patient's responses to a capacity assessment instrument 31 administered at the request of the visitor;
01 (2) any expressed wishes of the patient regarding medication, 02 including wishes that may have been expressed in a power of attorney, a living will, 03 an advance health care directive under AS 13.52, or oral statements of the patient, 04 including conversations with relatives and friends that are significant persons in the 05 patient's life as those conversations are remembered by the relatives and friends; oral 06 statements of the patient should be accompanied by a description of the circumstances 07 under which the patient made the statements, when possible. 08 * Sec. 14. AS 47.33.070(a) is amended to read: 09 (a) An assisted living home shall maintain, for each resident of the home, a 10 file that includes 11 (1) the name and birth date, and, if provided by the resident, the social 12 security number of the resident; 13 (2) the name, address, and telephone number of the resident's closest 14 relative, service coordinator, if any, and representative, if any; 15 (3) a statement of what actions, if any, the resident's representative is 16 authorized to take on the resident's behalf; 17 (4) a copy of the resident's assisted living plan; 18 (5) a copy of the residential services contract between the home and 19 the resident; 20 (6) a notice, as required under AS 47.33.030, regarding the depository 21 in which the resident's advance payment money is being held; 22 (7) written acknowledgment [ACKNOWLEDGEMENT] by the 23 resident or the resident's representative that the resident has received a copy of and has 24 read, or has been read the 25 (A) resident's rights under AS 47.33.300; 26 (B) resident's right to pursue a grievance under AS 47.33.340; 27 (C) resident's right to protection from retaliation under 28 AS 47.33.350; 29 (D) provisions of AS 47.33.510, regarding immunity; and 30 (E) home's house rules; 31 (8) an acknowledgment [ACKNOWLEDGEMENT] and agreement
01 relating to home safekeeping and management of the resident's money, as required by 02 AS 47.33.040; 03 (9) a copy of the resident's living will, if any, or an advance health 04 care directive made under AS 13.52, if any; and 05 (10) a copy of a power of attorney or other written designation, 06 including an advance health care directive made under AS 13.52, of an agent, 07 representative, or surrogate by the resident. 08 * Sec. 15. AS 13.26.332(L), 13.26.335(1), 13.26.344(l); AS 13.50.010, 13.50.014, 09 13.50.016, 13.50.020, 13.50.030, 13.50.040, 13.50.050, 13.50.060, 13.50.065, 13.50.068, 10 13.50.070, 13.50.080, 13.50.090; AS 18.12.010, 18.12.020, 18.12.030, 18.12.035, 18.12.037, 11 18.12.040, 18.12.050, 18.12.060, 18.12.070, 18.12.080, 18.12.090, 18.12.100; AS 47.30.950, 12 47.30.952, 47.30.954, 47.30.956, 47.30.958, 47.30.960, 47.30.962, 47.30.964, 47.30.966, 13 47.30.968, 47.30.970, 47.30.972, and 47.30.980 are repealed. 14 * Sec. 16. The uncodified law of the State of Alaska is amended by adding a new section to 15 read: 16 CONTINUING EFFECT OF EXISTING DOCUMENTS. (a) An anatomical gift 17 made under AS 13.50 or AS 18.12, repealed by sec. 15 of this Act, before the effective date of 18 secs. 1 - 15 of this Act continues in effect under AS 13.50 or AS 18.12, as those chapters exist 19 before the effective date of secs. 1 - 15 of this Act, until the donation is revoked. 20 (b) A power of attorney that is made under AS 13.26.332(L), 13.26.335(1), or 21 13.26.344(l), repealed by sec. 15 of this Act, before the effective date of secs. 1 - 15 of this 22 Act and that contains authority for health care services under AS 13.26.332(L), 23 AS 13.26.335(1), or 13.26.344(l), repealed by sec. 15 of this Act, continues in effect under 24 AS 13.26.332(L), 13.26.335(1), and 13.26.344(l), as those provisions exist before the 25 effective date of secs. 1 - 15 of this Act, until the power of attorney is revoked. 26 (c) A declaration made under AS 18.12, repealed by sec. 15 of this Act, before the 27 effective date of secs. 1 - 15 of this Act continues in effect under AS 18.12, as that chapter 28 exists before the effective date of secs. 1 - 15 of this Act, until the declaration is revoked. 29 (d) A declaration made under AS 47.30.950 - 47.30.980, repealed by sec. 15 of this 30 Act, before the effective date of secs. 1 - 15 of this Act continues in effect under 31 AS 47.30.950 - 47.30.980, as those sections exist before the effective date of secs. 1 - 15 of
01 this Act, until the declaration is revoked. 02 * Sec. 17. The uncodified law of the State of Alaska is amended by adding a new section to 03 read: 04 EFFECT ON EXISTING INSURANCE POLICIES AND ANNUITIES. 05 AS 13.52.120(c), added by sec. 3 of this Act, does not apply to a policy of insurance or an 06 annuity that was entered into before the effective date of secs. 1 - 15 of this Act. 07 * Sec. 18. The uncodified law of the State of Alaska is amended by adding a new section to 08 read: 09 TRANSITION: REGULATIONS. The Department of Health and Social Services 10 may proceed to adopt regulations necessary to implement the changes made by secs. 1 - 15 of 11 this Act. The regulations take effect under AS 44.62 (Administrative Procedure Act), but not 12 before January 1, 2005. 13 * Sec. 19. The uncodified law of the State of Alaska is amended by adding a new section to 14 read: 15 CONTINUING EFFECT OF CURRENT REGULATIONS. (a) The regulations 16 found at 7 AAC 16, as modified by (b) of this section, continue in effect on and after 17 January 1, 2005, until the Department of Health and Social Services adopts the regulations 18 authorized under sec. 18 of this Act. 19 (b) The regulations attorney in the Department of Law shall 20 (1) in 7 AAC 16.010(a), replace the reference to "AS 18.12.035(b)" with 21 "AS 13.52.065(b)"; 22 (2) in 7 AAC 16.010(d)(4), replace the reference to "AS 18.12.090" with 23 "AS 13.52.150"; 24 (3) in 7 AAC 16.010(f) and (g), replace the reference to "AS 18.12" with 25 "AS 13.52"; 26 (4) in 7 AAC 16.090(1), replace the reference to "AS 18.12.100" with 27 "AS 13.52.390"; 28 (5) in 7 AAC 16.090(3), replace ""do-not-resuscitate order" in AS 18.12.100" 29 with ""do not resuscitate order" in AS 13.52.390." 30 * Sec. 20. Section 18 of this Act takes effect immediately under AS 01.10.070(c). 31 * Sec. 21. Except as provided in sec. 20 of this Act, this Act takes effect January 1, 2005.