SB 254

This bill makes the following changes regarding certifications for advance

directives and health care powers of attorney:

1. Allows, unless a health care power of attorney instrument specifies

otherwise, one physician and one qualified physician assistant or nurse practitioner

to personally examine principals and make findings of incapacity upon which a

health care power of attorney becomes effective. Under a health care power of

attorney instrument executed under current law, unless specified otherwise, two

physicians or one physician and one psychologist must personally examine and

determine that a principal has incapacity for a health care power of attorney to

become effective. Also, a physician assistant may make findings of incapacity under

the bill only if a physician who oversees the physician assistant's practice affirms

that the physician assistant is competent to evaluate the capacity of patients to

manage health care decisions. A health care power of attorney instrument

designates another person as an agent to make health care decisions on behalf of an

individual who is incapable of making those decisions.

2. Allows an attending physician assistant or attending advanced practice

registered nurse to issue do-not-resuscitate orders. Current law allows only

attending physicians to issue do-not-resuscitate orders. Under current law, if a

person has a serious medical condition that satisfies certain requirements, the

person may request a do-not-resuscitate order which directs medical personnel to

not attempt various types of resuscitation procedures on a person if the person

suffers cardiac or respiratory arrest.

3. Specifies that under a declaration to physicians, also called a living will,

unless specified otherwise, a physician assistant or advanced practice registered

nurse may certify that a patient is afflicted with a terminal condition or is in a

persistent vegetative state. Under current law, unless a declaration specifies

otherwise, only physicians may make those certifications. If a patient has executed

a declaration, and is certified to have a terminal condition or to be in a persistent

vegetative state, in certain situations the declaration authorizes the withholding or

withdrawal of life-sustaining procedures or of feeding tubes from the patient.