HCS CSSSSB 38(JUD): "An Act relating to anatomical gifts, living wills, and do not resuscitate orders."
00HOUSE CS FOR CS FOR SS FOR SENATE BILL NO. 38(JUD) 01 "An Act relating to anatomical gifts, living wills, and do not resuscitate orders." 02 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 03 * Section 1. AS 13.50.010(a) is amended to read: 04 (a) A competent person [OF SOUND MIND] who is 18 or more years of age 05 may make a gift to take effect upon death [,] of all or a part of the person's body for 06 a purpose specified in AS 13.50.020. 07 * Sec. 2. AS 13.50.030(b) is repealed and reenacted to read: 08 (b) A gift of all or a part of the body under AS 13.50.010(a) may be made by 09 a document other than a will, and including a declaration under AS 18.12. The gift 10 takes effect upon the death of the donor. The document, which may be a card 11 designed to be carried on the person, shall be signed by the donor, or another person 12 at the donor's direction. If signed by another person at the donor's direction, the 13 signer shall sign in the presence of two persons or a person who is qualified to take 14 acknowledgments under AS 09.63.010. Delivery of the document of gift during the
01 donor's lifetime is not necessary to make the gift valid. 02 * Sec. 3. AS 13.50.030(d) is amended to read: 03 (d) The donor may designate in a will, card, or other document of gift, 04 including a declaration under AS 18.12, the surgeon or physician to carry out the 05 appropriate procedure for removing or transplanting a part of the decedent's body. In 06 the absence of a designation or if the designee is not available, the donee or other 07 person authorized to accept the gift may employ or authorize any surgeon, any [OR] 08 physician, or any appropriate Alaska organ or tissue bank, for the purpose of 09 removing or transplanting a part of the decedent's body. 10 * Sec. 4. AS 13.50.030 is amended by adding a new subsection to read: 11 (f) A gift may, but need not be, in the following form: 12 In the event of my death, I donate the following part(s) 13 of my body for the purposes identified in AS 13.50.020: 14 Tissue: 15 _________ Eyes 16 _________ Bone and connective tissue 17 _________ Skin 18 _________ Heart 19 _________ Other: ____________________________ 20 Limitations: ___________________________________ 21 Organ: 22 _________ Heart 23 _________ Kidney(s) 24 _________ Liver 25 _________ Lung(s) 26 _________ Pancreas 27 Other: _________________________________________. 28 I designate (name of surgeon or physician) 29 to carry out the appropriate procedure(s) for removing or 30 transplanting the body part(s) identified above. 31 * Sec. 5. AS 13.50.050 is amended by adding a new subsection to read:
01 (d) A gift made in a declaration under AS 18.12 may be amended as provided 02 in (a) of this section, and may be revoked as provided in AS 18.12.020(a) or in (a) of 03 this section. 04 * Sec. 6. AS 13.50 is amended by adding a new section to read: 05 Sec. 13.50.075. Recognition of gifts executed, issued, or authorized in other 06 states. A gift executed, issued, or authorized in another state or a territory or 07 possession of the United States in compliance with the law of that jurisdiction is 08 effective for the purposes of this chapter. 09 * Sec. 7. AS 18.12.010(a) is repealed and reenacted to read: 10 (a) A competent person who is at least 18 years old may execute a declaration 11 at any time directing that life-sustaining procedures be withheld or withdrawn from 12 that person. The declaration is given operative effect only if the declarant's condition 13 is determined to be terminal and the declarant is not able to make treatment decisions, 14 except that, if the declaration contains an anatomical gift under AS 13.50, the gift 15 takes effect upon the death of the person. The declaration shall be signed by the 16 declarant, or another person at the declarant's direction. If signed by another person 17 at the declarant's direction, the signer shall sign in the presence of two persons or a 18 person who is qualified to take acknowledgements under AS 09.63.010. A person may 19 not charge a fee for preparing a declaration. 20 * Sec. 8. AS 18.12.010(b) is amended to read: 21 (b) Except as provided under AS 13.50.014 - 13.50.016 for an anatomical 22 gift contained in the declaration, it [IT] is the responsibility of the declarant to 23 provide a copy of the declaration to the declarant's physician. A physician or other 24 health care provider who is provided a copy of the declaration shall make it a part of 25 the declarant's medical records. 26 * Sec. 9. AS 18.12.010(c) is amended to read: 27 (c) A declaration may, but need not, be in the following form: 28 DECLARATION 29 If I should have an incurable or irreversible condition that will 30 cause my death within a relatively short time, it is my desire that my 31 life not be prolonged by administration of life-sustaining procedures. If my condition is terminal and I am unable
01 to participate in 02 decisions regarding my medical treatment, I direct my attending 03 physician to withhold or withdraw procedures that merely prolong the 04 dying process and are not necessary to my comfort or to alleviate pain. 05 I [ ] do [ ] do not desire that nutrition or hydration (food and water) 06 be provided by gastric tube or intravenously if necessary. 07 Notwithstanding the other provisions of this declaration, if 08 I have donated an organ under this declaration or by another 09 method, and if I am in a hospital when a do not resuscitate order 10 is to be implemented for me, I do not want the do not resuscitate 11 order to take effect until the donated organ can be evaluated to 12 determine if the organ is suitable for donation. 13 OPTIONAL: In the event of my death, I donate the 14 following part(s) of my body for the purposes identified in 15 AS 13.50.020: 16 Tissue: 17 Eyes 18 Bone and connective tissue 19 Skin 20 Heart 21 Other: 22 Limitations: 23 Organ: 24 Heart 25 Kidney(s) 26 Liver 27 Lung(s) 28 Pancreas 29 Other: . 30 Signed this ___________ day of __________________, __________. 31 Signature______________________________
01 Place_________________________________ 02 If another person is to sign for the declarant at the 03 declarant's direction, the person signing for the declarant must sign 04 in the presence of two persons or a person who is qualified to take 05 acknowledgments under AS 09.63.010. The witness form below 06 may be used for the two witnesses. The acknowledgement form 07 below may be used for the person qualified to take 08 acknowledgements. [THE DECLARANT IS KNOWN TO ME AND 09 VOLUNTARILY SIGNED OR VOLUNTARILY DIRECTED 10 ANOTHER TO SIGN THIS DOCUMENT IN MY PRESENCE.] 11 WITNESS FORM 12 Witness _______________________________________ 13 Address _______________________________________ 14 Witness _______________________________________ 15 Address _______________________________________ 16 State of _______________________________________ 17 Judicial District 18 ACKNOWLEDGEMENT FORM 19 The foregoing instrument was acknowledged before me this 20 (date) by (name of person who acknowledged). 21 22 Signature of Person Taking 23 Acknowledgement 24 25 Title or Rank 26 27 Serial Number, if any 28 [THIS DECLARATION MUST BE EITHER WITNESSED BY TWO 29 PERSONS OR ACKNOWLEDGED BY A PERSON QUALIFIED TO TAKE 30 ACKNOWLEDGEMENTS UNDER AS 09.63.010]. 31 * Sec. 10. AS 18.12.010(d) is amended to read:
01 (d) A physician or health care provider may presume, in the absence of actual 02 notice to the contrary, that the declaration complies with this chapter, that an 03 anatomical gift in the declaration complies with this chapter and AS 13.50, and 04 that the declaration, including any anatomical gift contained in the declaration, 05 is valid. 06 * Sec. 11. AS 18.12.020(a) is amended to read: 07 (a) Except as provided in AS 13.50.050 for an anatomical gift, a [A] 08 declaration may be revoked at any time and in any manner by which the declarant is 09 able to communicate an intent to revoke, without regard to mental or physical 10 condition. A revocation is only effective as to the attending physician or any health 11 care provider acting under the guidance of that physician upon communication to the 12 physician or health care provider by the declarant or by another to whom the 13 revocation was communicated. 14 * Sec. 12. AS 18.12.035 is amended by adding new subsections to read: 15 (d) Notwithstanding (c) of this section, if a person has made an anatomical gift 16 of an organ under AS 13.50 or this chapter, and is in a hospital when a do not 17 resuscitate order is to be implemented for the person, the do not resuscitate order may 18 not be implemented until the donated organ can be evaluated to determine if it is 19 suitable for donation. 20 (e) A physician may not revoke a do not resuscitate order at the request of a 21 person, and a person may not make a do not resuscitate order ineffective, unless the 22 person making the request or proposing to make the order ineffective is the person for 23 whom the order has been issued, or, if the person for whom the order has been issued 24 is not capable of expressing an opinion on the subject, 25 (1) the parent or guardian of the person for whom the order has been 26 issued if the person for whom the order has been issued is under 18 years of age; or 27 (2) a person to whom the person for whom the order has been issued 28 has communicated the decision to make the order ineffective. 29 * Sec. 13. AS 18.12.037 is amended to read: 30 Sec. 18.12.037. Living will, organ donation, and DNR identification. The 31 Department of Health and Social Services shall develop standardized designs and
01 symbols for DNR identification cards, forms, necklaces, and bracelets that signify, 02 when carried or worn, that the possessor has executed a declaration under this chapter, 03 that the declaration contains an anatomical gift, or that the possessor is a patient 04 for whom a physician has issued a do not resuscitate order. 05 * Sec. 14. AS 18.12.040(a) is amended to read: 06 (a) A qualified patient or a patient for whom a physician has issued a do not 07 resuscitate order has the right to make decisions regarding use of cardiopulmonary 08 resuscitation and other life-sustaining procedures as long as the patient is able to do 09 so. If a qualified patient or patient for whom a physician has issued a do not 10 resuscitate order is not able to make these decisions, the declaration or do not 11 resuscitate protocol governs decisions regarding use of cardiopulmonary resuscitation 12 and other life-sustaining procedures, unless the do not resuscitate order is revoked 13 or made ineffective under AS 18.12.035(e). 14 * Sec. 15. AS 18.12.060(a) is amended to read: 15 (a) In the absence of actual notice of the revocation of a declaration or do not 16 resuscitate order, as applicable, the following, while acting in accordance with the do 17 not resuscitate protocol adopted under AS 18.12.035 or with the other requirements of 18 this chapter, are not subject to civil or criminal liability or guilty of unprofessional 19 conduct: 20 (1) a physician who causes the withholding or withdrawal of life- 21 sustaining procedures from a qualified patient or the withholding or withdrawal of 22 cardiopulmonary resuscitation from a patient for whom a do not resuscitate order has been 23 issued or who possesses DNR identification; 24 (2) a person who participates in the withholding or withdrawal of 25 cardiopulmonary resuscitation or other life-sustaining procedures under the direction 26 or with the authorization of a physician or upon discovery of DNR identification upon 27 a person; 28 (3) persons, including emergency medical technicians, who cause or 29 participate in providing cardiopulmonary resuscitation or other life-sustaining 30 procedures under AS 18.12.035(d) or because a person has made a do not 31 resuscitate order ineffective under AS 18.12.035(e) [AFTER AN ORAL OR
01 WRITTEN REQUEST COMMUNICATED TO THEM BY A PERSON WHO 02 POSSESSES DNR IDENTIFICATION]; 03 (4) the health care facility in which the providing, withholding, or 04 withdrawal occurs. 05 * Sec. 16. AS 18.12.090 is amended to read: 06 Sec. 18.12.090. Recognition of declarations and orders executed, [OR] 07 issued, or authorized in other states. A declaration, including a declaration 08 containing an anatomical gift, do not resuscitate order, or DNR identification 09 executed, issued, or authorized in another state or a territory or possession of the 10 United States in compliance with the law of that jurisdiction is effective for purposes 11 of this chapter. 12 * Sec. 17. AS 18.12.100 is amended by adding a new paragraph to read: 13 (12) "anatomical gift" means an anatomical gift under AS 13.50. 14 * Sec. 18. AS 18.65.311 is amended to read: 15 Sec. 18.65.311. Anatomical gift or living will. (a) The department shall 16 provide, at the time that an identification card is issued, a form for a document by 17 which the card holder may make an anatomical gift under AS 13.50 (Uniform 18 Anatomical Gifts Act) or a living will under AS 18.12 (Living Wills and Do Not 19 Resuscitate Orders). The document (1) may not be larger than an identification card, 20 (2) must contain sufficient space for the signature of two witnesses or a person who 21 is qualified to take acknowledgments under AS 09.63.010, [TO THE DONOR'S 22 ACT IF THE DONOR CANNOT SIGN, AND] (3) must use the forms and designs 23 developed under AS 18.12.037, and (4) must provide a means by which the card 24 holder [DONOR] may cancel the gift or the living will. If the document [MAKING 25 AN ANATOMICAL GIFT] is executed by the applicant, it shall be sealed in plastic 26 and attached to the identification card. A symbol developed under AS 18.12.037 27 indicating the existence of the anatomical gift or living will document must be 28 displayed in the lower right-hand corner on the face of the identification card. 29 (b) An employee of the department who processes an identification card 30 application, other than an application received by mail, shall ask the applicant orally 31 whether the applicant wishes to execute an anatomical gift or a living will. The
01 department shall, by placement of posters and brochures in the office where the 02 application is taken, and by oral advice, if requested, make known to the applicant the 03 procedure necessary to execute a gift under AS 13.50 or a living will under AS 18.12. 04 * Sec. 19. AS 28.10.021(c) is amended to read: 05 (c) An employee of the department who processes an application for 06 registration or renewal of registration, other than an application received by mail, shall 07 ask the applicant orally whether the applicant wishes to execute an anatomical gift or 08 a living will. The department shall make known to all applicants the procedure for 09 executing a gift under AS 13.50 (Uniform Anatomical Gifts Act) or a living will 10 under AS 18.12 (Living Wills and Do No Resuscitate Orders) by displaying posters 11 in the offices in which applications are taken, by providing a brochure or other written 12 information to each person who applies in person or by mail, and, if requested, by 13 providing oral advice. 14 * Sec. 20. AS 28.15.061(d) is amended to read: 15 (d) An employee of the department who processes a driver's license 16 application, other than an application received by mail, shall ask the applicant orally 17 whether the applicant wishes to execute an anatomical gift or a living will. The 18 department shall make known to all applicants the procedure for executing a gift under 19 AS 13.50 (Uniform Anatomical Gifts Act) or a living will under AS 18.12 (Living 20 Wills and Do Not Resuscitate Orders) by displaying posters in the offices in which 21 applications are taken, by providing a brochure or other written information to each 22 person who applies in person or by mail, and, if requested, by providing oral advice. 23 * Sec. 21. AS 28.15.111(b) is amended to read: 24 (b) The department shall provide, at the time that an operator's license is 25 issued, a form for a document by which the owner of a license may make an 26 anatomical gift under AS 13.50 or a living will under AS 18.12. The document (1) 27 may not be larger than an operator's license, (2) must contain sufficient space for the 28 signature of two witnesses or a person who is qualified to take acknowledgments 29 under AS 09.63.010, [TO THE DONOR'S ACT OF EXECUTION OF THE 30 DOCUMENT, AND] (3) must use the forms and designs developed under 31 AS 18.12.037, and (4) must provide a means by which the owner [DONOR] may
01 cancel the gift or the living will. If the document [MAKING AN ANATOMICAL 02 GIFT] is executed by the applicant, it shall be sealed in plastic and attached to the 03 license. A symbol developed under AS 18.12.037 indicating the existence of the 04 anatomical gift or living will document must be displayed in the lower right-hand 05 corner on the face of the driver's license.