Public Act 096-0492
 		





SB2258 Enrolled
LRB096 04251 AJO 14297 b






    AN ACT concerning civil law.

 
    Be it enacted by the People of the State of Illinois,
 
represented in the General Assembly:


 
    Section 5. The Health Care Surrogate Act is amended  by 
changing Sections 15 and 25 as follows:
 



    (755 ILCS 40/15)  (from Ch. 110 1/2, par. 851-15)


    Sec. 15. Applicability. This Act applies to patients who 
lack
decisional capacity
or who have a qualifying condition.  
This Act does not
apply to instances in which the patient has 
an operative and unrevoked
living will under the Illinois 
Living Will Act, an operative and unrevoked
declaration for 
mental health treatment under the Mental Health Treatment

Preferences Declaration Act, or an authorized agent under
a 
power of attorney for health care under the Illinois Power of 
Attorney
Act and the patient's condition falls within the 
coverage of the living
will, the declaration for mental health 
treatment, or the power of attorney
for health care.  In those 
instances, the
living will, declaration for mental health 
treatment, or power of
attorney for health care, as the case 
may be, shall
be given effect according to its terms.  This Act 
does apply in
circumstances in which a patient has a qualifying 
condition but the
patient's condition does not fall within the 
coverage of the living will, the
declaration for mental health 
treatment, or
the power of attorney for health care.

    Each health care facility shall maintain any advance

directives proffered by the patient or other authorized person,

including a do not resuscitate order, a living will, a 
declaration for mental
health treatment, or a
power of attorney 
for health care, in the patient's medical records for the

duration of the patient's stay. This Act does apply to patients 
without
a qualifying condition.  If a patient is an adult with

decisional
capacity, then the right to refuse medical treatment

or life-sustaining
treatment does
not require the presence of a 
qualifying condition.

(Source: P.A. 90-246, eff. 1-1-98.)


 



    (755 ILCS 40/25)  (from Ch. 110 1/2, par. 851-25)


    Sec. 25. Surrogate decision making. 

    (a) When a patient lacks
decisional capacity, the health 
care provider must make a reasonable
inquiry as to the 
availability and authority of a health care agent under
the 
Powers of Attorney for Health Care Law.  When no health care 
agent is
authorized and available, the health care provider 
must make a reasonable
inquiry as to the availability of 
possible surrogates listed in items (1)
through (4) of this

subsection.  For purposes of this Section, a reasonable inquiry 
includes,
but is not
limited to, identifying a member of the 
patient's family or other health care
agent by
examining the 
patient's personal effects or medical records.  If a family

member or other
health care agent is identified, an attempt to 
contact that person by telephone
must be
made within 24 hours 
after a determination by the provider that the patient
lacks

decisional capacity.
No person shall be liable for civil 
damages or subject to
professional discipline based on a claim 
of violating a patient's
right to confidentiality as a result 
of making a reasonable
inquiry as to the availability of a 
patient's family member
or health care agent, except for 
willful or wanton misconduct.

    The surrogate decision makers, as
identified by the 
attending physician, are then authorized to make decisions
as 
follows:  (i) for patients who lack decisional capacity and do 
not have a
qualifying condition, medical treatment decisions 
may be made in
accordance with subsection (b-5) of Section 20; 
and (ii) for patients who
lack decisional capacity and have a 
qualifying condition, medical treatment
decisions including

whether to forgo life-sustaining treatment on behalf of the

patient may be made without court order or judicial involvement 
in the
following order of
priority:


        (1) the patient's guardian of the person;


        (2) the patient's spouse;


        (3) any adult son or daughter of the patient;


        (4) either parent of the patient;


        (5) any adult brother or sister of the patient;


        (6) any adult grandchild of the patient;


        (7) a close friend of the patient;


        (8) the patient's guardian of the estate.

    The health care provider shall have the right to rely on 
any of the above
surrogates if the provider believes after 
reasonable inquiry that neither a
health care agent under the 
Powers of Attorney for Health Care Law nor a
surrogate of 
higher priority is available.

    Where there are multiple surrogate decision makers at the 
same
priority level in the hierarchy, it shall be the 
responsibility of
those surrogates to make reasonable efforts 
to reach a consensus as
to their decision on behalf of the 
patient regarding the forgoing
of life-sustaining treatment.  
If 2 or more surrogates who are in
the same category and have 
equal priority indicate to the attending
physician that they 
disagree about the health care matter at issue,
a majority of 
the available persons in that category (or the parent
with 
custodial rights) shall control, unless the minority (or the

parent without custodial rights) initiates guardianship 
proceedings in
accordance with the Probate Act of 1975.  No 
health care provider or other
person is required to seek 
appointment of a guardian.

    (b) After a surrogate has been identified, the name, 
address,
telephone number, and relationship of that person to 
the patient
shall be recorded in the patient's medical record.

    (c) Any surrogate who becomes unavailable for any reason 
may be replaced
by applying the provisions of Section 25 in the 
same manner as for the
initial choice of surrogate.

    (d) In the event an individual of a higher priority to an 
identified
surrogate becomes available and willing to be the 
surrogate, the individual
with higher priority may be 
identified as the surrogate.  In the event
an individual in a 
higher, a lower, or the same priority level or a health
care 
provider seeks to challenge the priority of or the 
life-sustaining
treatment decision of the recognized surrogate 
decision maker, the
challenging party may initiate 
guardianship proceedings in accordance with
the Probate Act of 
1975.

    (e) The surrogate decision maker shall have the same right 
as
the patient to receive medical information and medical 
records and to
consent to disclosure.

    (f) Any surrogate shall have the authority to make 
decisions for the patient until removed by the patient who no 
longer lacks decisional capacity, appointment of a guardian of 
the person, or the patient's death. 
(Source: P.A. 92-364, eff. 8-15-01.)



 

    Section 99. Effective date. This Act takes effect upon 
becoming law.