Report Title:

Persons Legally Incapable of Health Decisions; Nutrition

Description:

Prohibits any person to decide for another person who is legally incapable of making health care decisions, to withhold or withdraw hydration or nutrition by way of gastrointestinal tract, except under certain conditions.

HOUSE OF REPRESENTATIVES

H.B. NO.

1577

TWENTY-THIRD LEGISLATURE, 2005

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to health care decisions.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:

"Chapter

HAWAII STARVATION AND DEHYDRATION OF PERSONS

WITH DISABILITIES PREVENTION ACT

§   -1 Definitions. As used in this chapter, unless the context clearly requires otherwise,

"Attending physician" means the physician who has primary responsibility for the overall medical treatment and care of a person.

"Express and informed consent" means consent voluntarily given with sufficient knowledge of the subject matter involved, including a general understanding of the procedure, the medically acceptable alternative procedures or treatments, and the substantial risks and hazards inherent in the proposed treatment or procedures, to enable the person giving consent to make an understanding and enlightened decision without any element of force, fraud, deceit, duress, or other form of constraint or coercion.

"Health care provider" means a person who is licensed, certified, or otherwise authorized by state law to administer health care in the ordinary course of business or practice of a profession.

"Nutrition" means sustenance administered by way of the gastrointestinal tract.

"Person legally incapable of making health care decisions" means any person who:

(1) Has been declared legally incompetent to make decisions affecting medical treatment or care;

(2) In the reasonable judgment of the attending physician, is unable to make decisions affecting medical treatment or other health care services; or

(3) Is a minor.

"Physician" means a physician licensed under chapter 453 or 460.

"Reasonable medical judgment" means a medical judgment that would be made by a reasonably prudent physician, knowledgeable about the case and the treatment possibilities with respect to the medical conditions involved.

§   -2 Presumption of nutrition and hydration sufficient to sustain life. (a) It shall be presumed that every person legally incapable of making health care decisions has directed the person's health care providers to provide the person with nutrition and hydration to a degree that is sufficient to sustain life.

(b) No guardian, surrogate, public or private agency, court, or any other person shall have the authority to make a decision on behalf of a person legally incapable of making health care decisions to withhold or withdraw hydration or nutrition from that person except in the circumstances and under the conditions specifically provided in section    -3.

§   -3 Presumption of nutrition and hydration; when inapplicable. The presumption pursuant to section    -2 shall not apply:

(1) To the extent that, in reasonable medical judgment:

(A) Provision of nutrition and hydration is not medically possible;

(B) Provision of nutrition and hydration would hasten death; or

(C) Because of the medical condition of the person legally incapable of making health care decisions, that person would be incapable of digesting or absorbing the nutrition and hydration so that their provision would not contribute to sustaining the person's life.

(2) If the person executed an advance health care directive in accordance with chapter 327E specifically authorizing the withholding or withdrawal of nutrition or hydration, to the extent the authorization applies; or

(3) If there is clear and convincing evidence that the person, when legally capable of making health care decisions, gave express and informed consent to withdrawing or withholding hydration or nutrition in the applicable circumstances.

§   -4 Civil remedies. (a) A cause of action for injunctive relief may be maintained against any person who is reasonably believed to be about to violate or who is in the course of violating this chapter, or to secure a court determination, notwithstanding the position of a guardian or surrogate, whether there is clear and convincing evidence that the person legally incapable of making health care decisions, when legally capable of making such decisions, gave express and informed consent to withdrawing or withholding hydration or nutrition in the applicable circumstances.

(b) The action may be brought by any person who is:

(1) The spouse, parent, child, or sibling of the person;

(2) A current or former health care provider of the person;

(3) A legally appointed guardian of the person;

(4) The state agency charged with protection and advocacy for adults; or

(5) A public official with appropriate jurisdiction to prosecute or enforce the laws of this state.

(c) Pending the final determination of the court, it shall direct that nutrition and hydration be provided unless the court determines that section    -3(1) is applicable."

SECTION 2. This Act shall take effect upon its approval.

INTRODUCED BY:

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