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90_HB1066
755 ILCS 40/20 from Ch. 110 1/2, par. 851-20
Amends the Health Care Surrogate Act. Provides that all
decisions covered by the Act, except decisions to forgo
life-sustaining treatment on behalf of patients without
decisional capacity, are lawful without resort to the courts
or legal process if made in accordance with the Section
concerning surrogate decision making.
LRB9004287DJcd
LRB9004287DJcd
1 AN ACT to amend the Health Care Surrogate Act by changing
2 Section 20.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Health Care Surrogate Act is amended by
6 changing Section 20 as follows:
7 (755 ILCS 40/20) (from Ch. 110 1/2, par. 851-20)
8 Sec. 20. Private decision making process.
9 (a) Decisions whether to forgo life-sustaining or any
10 other form of medical treatment involving an adult patient
11 with decisional capacity may be made by that adult patient.
12 (b) Decisions whether to forgo life-sustaining treatment
13 on behalf of a patient without decisional capacity are
14 lawful, without resort to the courts or legal process, if the
15 patient has a qualifying condition and if the decisions are
16 made in accordance with one of the following paragraphs in
17 this subsection and otherwise meet the requirements of this
18 Act:
19 (1) Decisions whether to forgo life-sustaining
20 treatment on behalf of a minor or an adult patient who
21 lacks decisional capacity may be made by a surrogate
22 decision maker or makers in consultation with the
23 attending physician, in the order or priority provided in
24 Section 25. A surrogate decision maker shall make
25 decisions for the adult patient conforming as closely as
26 possible to what the patient would have done or intended
27 under the circumstances, taking into account evidence
28 that includes, but is not limited to, the patient's
29 personal, philosophical, religious and moral beliefs and
30 ethical values relative to the purpose of life, sickness,
31 medical procedures, suffering, and death. Where
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1 possible, the surrogate shall determine how the patient
2 would have weighed the burdens and benefits of initiating
3 or continuing life-sustaining treatment against the
4 burdens and benefits of that treatment. In the event an
5 unrevoked advance directive, such as a living will or a
6 power of attorney for health care, is no longer valid due
7 to a technical deficiency or is not applicable to the
8 patient's condition, that document may be used as
9 evidence of a patient's wishes. The absence of a living
10 will or power of attorney for health care shall not give
11 rise to any presumption as to the patient's preferences
12 regarding the initiation or continuation of
13 life-sustaining procedures. If the adult patient's
14 wishes are unknown and remain unknown after reasonable
15 efforts to discern them or if the patient is a minor, the
16 decision shall be made on the basis of the patient's best
17 interests as determined by the surrogate decision maker.
18 In determining the patient's best interests, the
19 surrogate shall weigh the burdens on and benefits to the
20 patient of initiating or continuing life-sustaining
21 treatment against the burdens and benefits of that
22 treatment and shall take into account any other
23 information, including the views of family and friends,
24 that the surrogate decision maker believes the patient
25 would have considered if able to act for herself or
26 himself.
27 (2) Decisions whether to forgo life-sustaining
28 treatment on behalf of a minor or an adult patient who
29 lacks decisional capacity, but without any surrogate
30 decision maker or guardian being available determined
31 after reasonable inquiry by the health care provider, may
32 be made by a court appointed guardian. A court appointed
33 guardian shall be treated as a surrogate for the purposes
34 of this Act.
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1 (b-5) All decisions, except decisions to forgo
2 life-sustaining treatment on behalf of patients without
3 decisional capacity, are lawful without resort to the courts
4 or legal process if made in accordance with Section 25.
5 (c) For the purposes of this Act, a patient or surrogate
6 decision maker is presumed to have decisional capacity in the
7 absence of actual notice to the contrary without regard to
8 advanced age. With respect to a patient, a diagnosis of
9 mental illness or mental retardation, of itself, is not a bar
10 to a determination of decisional capacity. A determination
11 that an adult patient lacks decisional capacity shall be made
12 by the attending physician to a reasonable degree of medical
13 certainty. The determination shall be in writing in the
14 patient's medical record and shall set forth the attending
15 physician's opinion regarding the cause, nature, and duration
16 of the patient's lack of decisional capacity. Before
17 implementation of a decision by a surrogate decision maker to
18 forgo life-sustaining treatment, at least one other qualified
19 physician must concur in the determination that an adult
20 patient lacks decisional capacity. The concurring
21 determination shall be made in writing in the patient's
22 medical record after personal examination of the patient.
23 The attending physician shall inform the patient that it has
24 been determined that the patient lacks decisional capacity
25 and that a surrogate decision maker will be making
26 life-sustaining treatment decisions on behalf of the patient.
27 Moreover, the patient shall be informed of the identity of
28 the surrogate decision maker and any decisions made by that
29 surrogate. If the person identified as the surrogate
30 decision maker is not a court appointed guardian and the
31 patient objects to the statutory surrogate decision maker or
32 any decision made by that surrogate decision maker, then the
33 provisions of this Act shall not apply.
34 (d) A surrogate decision maker acting on behalf of the
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1 patient shall express decisions to forgo life-sustaining
2 treatment to the attending physician and one adult witness
3 who is at least 18 years of age. This decision and the
4 substance of any known discussion before making the decision
5 shall be documented by the attending physician in the
6 patient's medical record and signed by the witness.
7 (e) The existence of a qualifying condition shall be
8 documented in writing in the patient's medical record by the
9 attending physician and shall include its cause and nature,
10 if known. The written concurrence of another qualified
11 physician is also required.
12 (f) Once the provisions of this Act are complied with,
13 the attending physician shall thereafter promptly implement
14 the decision to forgo life-sustaining treatment on behalf of
15 the patient unless he or she believes that the surrogate
16 decision maker is not acting in accordance with his or her
17 responsibilities under this Act, or is unable to do so for
18 reasons of conscience or other personal views or beliefs.
19 (g) In the event of a patient's death as determined by a
20 physician, all life-sustaining treatment and other medical
21 care is to be terminated, unless the patient is an organ
22 donor, in which case appropriate organ donation treatment may
23 be continued temporarily.
24 (Source: P.A. 87-749.)
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