§ 34-B §11001 — Medical treatment of psychotic disorders

1.
Definitions.
As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings.
2.
Execution of declaration.
Any person 18 years of age or older who suffers from a psychotic condition but is competent and in a state of remission at the time of execution may execute a declaration directing that medical treatment, including the administration of psychotropic drugs, be provided at a time when the person has lapsed and is not able to make decisions regarding medical treatment.
3.
Declaration requirements.
A declaration made pursuant to this chapter must:
4.
Declaration sample form.
The following declaration sample form may be copied and used by filling in the blanks or may be changed to add more individualized instructions or an entirely different format may be used to provide health care instructions.DECLARATIONI. Statement of DeclarantDeclaration made this .......... day of .......... (month, year). I, ................................, being of sound mind, willfully and voluntarily make known my desire that medical treatment as outlined below, including the administration of psychotropic drugs if necessary, be provided to me under the circumstances set forth below, and do hereby declare:If at any time I should lapse into a psychotic condition as determined by 2 physicians who have personally examined me, one of whom is my attending physician and the physicians have determined that I am unable to make decisions concerning my medical treatment, and that without medical treatment my condition will result in my being gravely disabled and in my posing a serious danger to myself or to others and when medical treatment would serve to remedy the condition and prevent potential or further harm to myself or to others, I direct that the following personal medical treatment plan, including the elements checked below, be provided to me and be carried out:(....) Psychotropic drugs (specify) ...................................................................................(....) Hospitalization if necessary(....) Counseling(....) Therapy involving my family members or friends(....) (Other treatment) ...............................................................................................In the absence of my ability to give directions regarding the provision of medical treatment, it is my intention that this declaration be honored by my family and physician(s) as my legal informed consent to receive medical treatment.My instructions must prevail even if they create a conflict with the desires of my relatives. This declaration controls in all circumstances.I understand the full import of this declaration and declare that I am emotionally and mentally competent at this time to make this declaration.Signed ..................................................................Address ...............................................................II. Statement of WitnessesI am at least 18 years of age and am not related to the declarant by blood, marriage or adoption or the attending physician, an employee of the attending physician or an employee of the health care facility in which the declarant is a patient.The declarant is personally known to me and I believe the declarant to be of sound mind at this time of execution.Witness .....................................................................Address ....................................................................Witness .....................................................................Address.....................................................................III. NotarizationSubscribed, sworn to and acknowledged before me by ................................................, the declarant, and subscribed and sworn to before me by ................................................................. and ...................................................., witnesses, this ............ day of ............, 19....(SEAL)Signed ............................................................................. ............................................................................ (official capacity of officer)
5.
Presumed validity of declaration.
If a patient is incompetent at the time of the decision to give medical treatment, a declaration executed in accordance with subsection 2 is presumed valid.
6.
Patient's wishes supersede declaration.
The wishes of a declarant, at all times when the declarant is in a state of remission and is competent, supersede the declaration.
7.
Declaration becomes part of medical records.
The declarant must provide for delivery of the notarized declaration to the attending physician. If the declarant is comatose, incompetent or otherwise mentally or physically incapable after executing the declaration, any other person may deliver the notarized declaration to the physician. An attending physician who is notified under this subsection shall promptly make the declaration a part of the declarant's medical records.
8.
Duty to deliver.
A person who has a declaration of another in that person's possession and who becomes aware that the declarant is in circumstances under which the terms of the declaration may become applicable shall deliver the declaration to the declarant's attending physician or to the health care facility in which the declarant is a patient.
9.
Written certification.
An attending physician who has been notified of the existence of a declaration executed under this chapter shall make all reasonable efforts to obtain the notarized declaration and shall ascertain without delay whether the declarant's current condition corresponds to the condition under which the declaration would take effect.
10.
Identification of declarant.
All inpatient health care facilities shall develop a system to visibly identify a patient's chart that contains a declaration as set forth in this chapter.
11.
Transfer to another physician.
An attending physician and any other physician under the attending physician's direction or control who possesses the patient's declaration or knows that the declaration is part of the patient's record in the health care facility in which the declarant is receiving care shall follow as closely as possible the terms of the declaration.
12.
Revocation.
At any time the declarant is in a state of remission and is competent, the declaration may be revoked by:
13.
Health care or health insurance.
A person or entity may not require any person to execute a declaration as a condition for being insured for or for receiving insurance benefits or health care services.
14.
Criminal penalties.
A person who threatens, directly or indirectly, coerces or intimidates any person to execute a declaration commits a Class C crime.
15.
Health personnel protections.
In the absence of actual notice of the revocation of a declaration, a health care provider, health care facility, physician or other person acting under the direction of an attending physician is not subject to criminal prosecution or civil liability and may not be deemed to have engaged in unprofessional conduct as a result of the provision of medical treatment to a declarant in accordance with this chapter unless the absence of actual notice resulted from the negligence of the health care provider, physician or other person.
16.
Petition for guardianship.
A person may petition the court for appointment of a guardian for a declarant if that person has good reason to believe that the provision of medical treatment in a particular case:
17.
Procedure in absence of declaration.
In the absence of a declaration, ordinary standards of current medical practice must be followed. Nothing in this chapter may be construed to require a declaration in order for medical treatment to be given. If there is no declaration, a verbal statement made by the patient to either a physician or to the patient's friend or relative may be considered by the physician in deciding whether the patient would want the physician to provide medical treatment. Unambiguous verbal statements by the patient or reliable reports of these statements must be documented in the patient's medical record.
18.
Preservation of existing rights.
Nothing in this chapter impairs or supersedes any legal right or legal responsibility that a person may have to provide medical treatment in a lawful manner. In this respect, the provisions of this chapter are cumulative.
19.
No presumption.
This chapter does not create a presumption concerning the intention of a person who has revoked or has not executed a declaration to receive medical treatment.
20.
Declaration executed before effective date.
The declaration of any patient executed prior to the effective date of this chapter must be given effect as provided in this chapter.
21.
Recognition of document executed in another state.
A document executed in another state is valid for purposes of this chapter if the document and the execution of the document substantially comply with the requirements of this chapter.
22.
Effect of multiple documents.
Medical treatment instructions contained in a declaration executed in accordance with this chapter supersede:

Legislative History

PL 1993, c. 454, §1 (NEW).