(a)An attending physician, advanced
practice registered nurse, or physician assistant who does not issue an
out of hospital DNR order for a patient who is a qualified person may
transfer the patient to another physician, who may issue an out of
hospital DNR order, unless:
(1)the attending physician, advanced practice registered nurse, or
physician assistant has reason to believe the patient's declaration
was not validly executed, or there is evidence the patient no
longer intends the declaration to be enforced; and
(2)the patient is unable to validate the declaration.
(b)Notwithstanding section 10 of this chapter, if an attending
physician, advanced practice registered nurse, or physician assistant,
after reasonable investigation, does not find any other physician willing
to honor the
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(a) An attending physician, advanced
practice registered nurse, or physician assistant who does not issue an
out of hospital DNR order for a patient who is a qualified person may
transfer the patient to another physician, who may issue an out of
hospital DNR order, unless:
(1) the attending physician, advanced practice registered nurse, or
physician assistant has reason to believe the patient's declaration
was not validly executed, or there is evidence the patient no
longer intends the declaration to be enforced; and
(2) the patient is unable to validate the declaration.
(b) Notwithstanding section 10 of this chapter, if an attending
physician, advanced practice registered nurse, or physician assistant,
after reasonable investigation, does not find any other physician willing
to honor the patient's out of hospital DNR declaration and issue an out
of hospital DNR order, the attending physician, advanced practice
registered nurse, or physician assistant may refuse to issue an out of
hospital DNR order.
(c) If the attending physician, advanced practice registered nurse, or
physician assistant does not transfer a patient under subsection (a), the
attending physician, advanced practice registered nurse, or physician
assistant may attempt to ascertain the patient's intent and attempt to
determine the validity of the declaration by consulting with any of the
following individuals who are reasonably available, willing, and
competent to act:
(1) A court appointed guardian of the patient, if one has been
appointed. This subdivision does not require the appointment of
a guardian so that a treatment decision may be made under this
section.
(2) A person designated by the patient in writing to make a
treatment decision.
(3) The patient's spouse.
(4) An adult child of the patient or a majority of any adult
children of the patient who are reasonably available for
consultation.
(5) An adult sibling of the patient or a majority of any adult
siblings of the patient who are reasonably available for
consultation.
(6) The patient's clergy.
(7) Another person who has firsthand knowledge of the patient's
intent.
(d) The individuals described in subsection (c)(1) through (c)(7)
shall act in the best interest of the patient and shall follow the patient's
express or implied intent, if known.
(e) The attending physician, advanced practice registered nurse, or
physician assistant acting under subsection (c) shall list the names of
the individuals described in subsection (c) who were consulted and
include the information received in the patient's medical file.
(f) If the attending physician, advanced practice registered nurse, or
physician assistant determines from the information received under
subsection (c) that the patient intended to execute a valid out of
hospital DNR declaration, the attending physician, advanced practice
registered nurse, or physician assistant may:
(1) issue an out of hospital DNR order, with the concurrence of at
least one (1) physician documented in the patient's medical file;
or
(2) request a court to appoint a guardian for the patient to make
the consent decision on behalf of the patient.
(g) An out of hospital DNR order must be issued on the form
specified in section 15 of this chapter.