HAWAII STARVATION
AND DEHYDRATION OF PERSONS WITH DISABILITIES PREVENTION
ACT
Section 1. Hawaii's Sustain Life Bill
This act shall be known and may be cited as the “Hawaii
Starvation and Dehydration of Persons with Disabilities Prevention
Act”.
Section 2.
Definitions
A. “Attending physician” means the physician who has primary
responsibility for the overall medical treatment and care of a
person.
B. “Health care provider” means a person who is licensed,
certified, or otherwise authorized by the law of this state to
administer health care in the ordinary course of business or
practice of a profession.
C. “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.
D. “Nutrition” means sustenance administered by way of the
gastrointestinal tract.
E.
“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, or
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.
F. “Physician” means a physician licensed by [relevant state
statute].
G. “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.
Section 3.
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 his or her health care
providers to provide him or her 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 such a person
except in the circumstances and under the conditions specifically
provided for in Section 4 of this act.
Section 4. Presumption of Nutrition and Hydration, When
Inapplicable
The presumption pursuant to Section 3 of this act shall not
apply:
A. 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 its provision would
not contribute to sustaining the person’s life.
B. If the person executed a directive in accordance with
[state advance directive statute] specifically authorizing the
withholding or withdrawal of nutrition and/or hydration, to the
extent the authorization applies.
C. 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.
Section 5.
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 act, 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:
(a)
The spouse, parent, child, or sibling of the person;
(b) A
current or former health care provider of the person;
(c) A
legally appointed guardian of the person;
(d) The state
protection and advocacy agency, or
(e) 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 it determines
that Section 4A is applicable. |