HB 356: "An Act relating to living wills and do not resuscitate orders; and providing for an effective date."
00HOUSE BILL NO. 356 01 "An Act relating to living wills and do not resuscitate orders; and providing for 02 an effective date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 18.12 is amended by adding new sections to read: 05 Sec. 18.12.035. DO NOT RESUSCITATE ORDERS AND PROTOCOLS. (a) 06 An attending physician may issue a do not resuscitate order for a patient of the 07 physician. The physician shall document the grounds for the order in the patient's 08 medical file. 09 (b) The Department of Health and Social Services shall, by regulation, adopt 10 a do not resuscitate protocol that sets out a standardized method of procedure for the 11 withholding of cardiopulmonary resuscitation by physicians and other health care 12 providers. The regulations may not be adopted unless they have been approved by the 13 State Medical Board. 14 (c) A health care provider other than a physician shall comply with the do not
01 resuscitate protocol adopted under (b) of this section when presented with any of the 02 following: DNR identification, an oral do not resuscitate order issued directly by a 03 physician, or a written do not resuscitate order entered on a form prescribed by the 04 Department of Health and Social Services. 05 Sec. 18.12.037. LIVING WILL AND DNR IDENTIFICATION. The 06 Department of Health and Social Services shall develop standardized designs for DNR 07 identification cards, forms, necklaces, and bracelets that signify, when carried or worn, 08 that the possessor has executed a declaration under this chapter or is a patient for 09 whom a physician has issued a do not resuscitate order. 10 * Sec. 2. AS 18.12.040(a) is amended to read: 11 (a) A qualified patient or a patient for whom a physician has issued a do 12 not resuscitate order has the right to make decisions regarding use of 13 cardiopulmonary resuscitation and other life-sustaining procedures as long as the 14 patient is able to do so. If a qualified patient or patient for whom a physician has 15 issued a do not resuscitate order is not able to make these decisions, the declaration 16 or do not resuscitate protocol governs decisions regarding use of cardiopulmonary 17 resuscitation and other life-sustaining procedures. 18 * Sec. 3. AS 18.12.050(b) is amended to read: 19 (b) If the policies of a health care facility preclude compliance with the 20 declaration of a qualified patient under this chapter or a do not resuscitate order 21 issued by an attending physician, or the facility is unwilling to accept DNR 22 identification as evidence of the existence of a declaration or do not resuscitate 23 order, that facility shall take all reasonable steps to notify the patient or, if the patient 24 is not able to make treatment decisions, the patient's guardian, of the facility's policy 25 and shall take all reasonable steps to effect the transfer of the patient to the patient's 26 home or to a facility where the provisions of this chapter can be carried out. 27 * Sec. 4. AS 18.12.060(a) is amended to read: 28 (a) In the absence of actual notice of the revocation of a declaration or do not 29 resuscitate order, as applicable, the following, while acting in accordance with the 30 do not resuscitate protocol adopted under AS 18.12.035 or with the other 31 requirements of this chapter, are not subject to civil or criminal liability or guilty of
01 unprofessional conduct: 02 (1) a physician who causes the withholding or withdrawal of 03 life-sustaining procedures from a qualified patient or the withholding or withdrawal 04 of cardiopulmonary resuscitation from a patient for whom a do not resuscitate 05 order has been issued or who possesses DNR identification; 06 (2) a person who participates in the withholding or withdrawal of 07 cardiopulmonary resuscitation or other life-sustaining procedures under the direction 08 or with the authorization of a physician or upon discovery of DNR identification 09 upon a person; 10 (3) persons who cause or participate in providing cardiopulmonary 11 resuscitation or other life-sustaining procedures after an oral or written request 12 communicated to them by a person who possesses DNR identification; 13 (4) the health care facility in which the providing, withholding, or 14 withdrawal occurs. 15 * Sec. 5. AS 18.12.070 is amended to read: 16 Sec. 18.12.070. PENALTIES. (a) An attending physician who fails to comply 17 with a do not resuscitate order or the declaration of a qualified patient or to make 18 the necessary arrangements to effect a transfer under AS 18.12.050 has no right to 19 compensation for medical services provided to a [QUALIFIED] patient after 20 withholding or withdrawal should have been effective or after transfer should have 21 occurred and may be liable to the [QUALIFIED] patient and to the heirs of the 22 [QUALIFIED] patient for a civil penalty not to exceed $1,000.00 plus the actual costs 23 associated with the failure to comply with the order or declaration, and this shall be 24 the exclusive remedy at law for damages. 25 (b) A person who wilfully conceals, cancels, defaces, obliterates, or damages 26 the DNR identification or declaration of another person without the other's 27 [DECLARANT'S] consent or who falsifies or forges a revocation of the DNR 28 identification or declaration of another person may be civilly liable to the other 29 person [QUALIFIED PATIENT] and to the heirs of the other person [QUALIFIED 30 PATIENT]. 31 * Sec. 6. AS 18.12.080(a) is amended to read:
01 (a) Death resulting from the withholding or withdrawal of cardiopulmonary 02 resuscitation or other life-sustaining procedures under a do not resuscitate order or 03 protocol, under a declaration, or upon discovery of DNR identification on a person 04 and in accordance with this chapter does not, for any purpose, constitute a suicide or 05 homicide. 06 * Sec. 7. AS 18.12.080(b) is amended to read: 07 (b) The issuing of a do not resuscitate order, the possession of DNR 08 identification, or the making of a declaration under AS 18.12.010 does not affect in 09 any manner the sale, procurement, or issuance of a policy of life insurance, nor does 10 it modify the terms of an existing policy of life insurance. A policy of life insurance 11 is not legally impaired or invalidated in any manner by the withholding or withdrawal 12 of life-sustaining procedures from an insured qualified patient or the withholding or 13 withdrawal of cardiopulmonary resuscitation from an insured patient who 14 possesses DNR identification or for whom a do not resuscitate order has been 15 issued, notwithstanding any term of the policy to the contrary. 16 * Sec. 8. AS 18.12.080(c) is amended to read: 17 (c) A physician, health care facility, or other health care provider, and a health 18 care service plan, insurer issuing disability insurance, self-insured employee welfare 19 benefit plant, or nonprofit hospital plan, may not require a person to execute a 20 declaration, obtain a do not resuscitate order from a physician, or possess DNR 21 identification as a condition for being insured for, or receiving, health care services. 22 * Sec. 9. AS 18.12.080(d) is amended to read: 23 (d) This chapter creates no presumption concerning the intention or intended 24 treatment of an individual who does not have DNR identification, has not executed 25 a declaration, or for whom a do not resuscitate order has not been issued with 26 respect to the use, withholding, or withdrawal of cardiopulmonary resuscitation or 27 other life-sustaining procedures [IN THE EVENT OF A TERMINAL CONDITION]. 28 * Sec. 10. AS 18.12.080(e) is amended to read: 29 (e) Nothing in this chapter increases or decreases the right of a patient to make 30 decisions regarding use of cardiopulmonary resuscitation or other life-sustaining 31 procedures as long as the patient is able to do so, or impairs or supersedes any right
01 or responsibility that a person has to effect the withholding or withdrawal of medical 02 care in a lawful manner. In that respect, the provisions of this chapter are cumulative. 03 * Sec. 11. AS 18.12.090 is amended to read: 04 Sec. 18.12.090. RECOGNITION OF DECLARATIONS AND ORDERS 05 EXECUTED OR ISSUED IN OTHER STATES. A declaration, do not resuscitate 06 order, or DNR identification executed, issued, or authorized in another state or a 07 territory or possession of the United States in compliance with the law of that 08 jurisdiction is effective for purposes of this chapter. 09 * Sec. 12. AS 18.12.100 is amended by adding new paragraphs to read: 10 (8) "cardiopulmonary resuscitation" means cardiopulmonary 11 resuscitation or a component of cardiopulmonary resuscitation; 12 (9) "DNR identification" means identification substantially similar to 13 that approved under AS 18.12.037; 14 (10) "do not resuscitate order" means a directive from a licensed 15 physician that emergency cardiopulmonary resuscitation should not be administered to 16 a particular person; 17 (11) "do not resuscitate protocol" means the protocol developed under 18 AS 18.12.035(b). 19 * Sec. 13. The commissioner of health and social services shall promptly begin the 20 procedure to adopt regulations implementing AS 18.12.035 and 18.12.037, enacted by sec. 1 21 of this Act, so that the regulations can take effect as soon as practicable. 22 * Sec. 14. AS 18.12.035(b) and 18.12.037, enacted by sec. 1 of this Act, and sec. 13 of 23 this Act take effect immediately under AS 01.70.070(c). 24 * Sec. 15. Except as provided in sec. 14 of this Act, this Act takes effect on the effective 25 date of the regulations adopted under AS 18.12.035 or 18.12.037, enacted by sec. 1 of this 26 Act, whichever is later. The commissioner of health and social services shall notify the 27 revisor of statutes and the lieutenant governor of that date.