PRINTER'S NO. 1430
No. 1158 Session of 1989
INTRODUCED BY LEWIS, PORTERFIELD, ARMSTRONG AND AFFLERBACH,
JULY 7, 1989
REFERRED TO PUBLIC HEALTH AND WELFARE, JULY 7, 1989
AN ACT
1 Providing for certain rights of terminally ill persons; and
2 providing penalties.
3 TABLE OF CONTENTS
4 Section 1. Short title.
5 Section 2. Definitions.
6 Section 3. Declaration relating to use of life-sustaining
7 treatment.
8 Section 4. When declaration operative.
9 Section 5. Revocation of declaration.
10 Section 6. Recording determination of terminal condition and
11 declaration.
12 Section 7. Treatment of qualified patients.
13 Section 8. Transfer of patients.
14 Section 9. Immunities.
15 Section 10. Penalties.
16 Section 11. Miscellaneous provisions.
17 Section 12. When health-care provider may presume validity of
1 declaration.
2 Section 13. Recognition of declaration executed in another
3 state.
4 Section 14. Effect of previous declaration.
5 Section 15. Uniformity of construction and application.
6 Section 16. Severability.
7 Section 17. Effective date.
8 The General Assembly of the Commonwealth of Pennsylvania
9 hereby enacts as follows:
10 Section 1. Short title.
11 This act shall be known and may be cited as the Uniform
12 Rights of the Terminally Ill Act.
13 Section 2. Definitions.
14 The following words and phrases when used in this act shall
15 have the meanings given to them in this section unless the
16 context clearly indicates otherwise:
17 "Attending physician." The physician who has primary
18 responsibility for the treatment and care of the patient.
19 "Declaration." A writing executed in accordance with the
20 requirements of section 3(a).
21 "Health-care provider." A person who is licensed, certified
22 or otherwise authorized by the laws of this Commonwealth to
23 administer health care in the ordinary course of business or
24 practice of a profession.
25 "Life-sustaining treatment." Any medical procedure or
26 intervention that, when administered to a qualified patient,
27 will serve only to prolong the process of dying.
28 "Person." An individual, corporation, business trust,
29 estate, trust, partnership, association, joint venture,
30 government, governmental subdivision or agency, or any other
19890S1158B1430 - 2 -
1 legal or commercial entity.
2 "Physician." An individual licensed to practice medicine in
3 this Commonwealth.
4 "Qualified patient." A patient 18 years of age or older who
5 has executed a declaration and who has been determined by the
6 attending physician to be in a terminal condition.
7 "State." A state, territory or possession of the United
8 States or the District of Columbia or the Commonwealth of Puerto
9 Rico.
10 "Terminal condition." An incurable or irreversible condition
11 that, without the administration of life-sustaining treatment,
12 will, in the opinion of the attending physician, result in death
13 within a relatively short time.
14 Section 3. Declaration relating to use of life-sustaining
15 treatment.
16 (a) Execution.--An individual who is of sound mind and 18
17 years of age or older may execute at any time a declaration
18 governing the withholding or withdrawal of life-sustaining
19 treatment. The declaration must be signed by the declarant, or
20 by another at the declarant's direction, and must be witnessed
21 by two individuals.
22 (b) Form.--A declaration may be, but need not be, in the
23 following form:
24 DECLARATION
25 If I should have an incurable or irreversible condition
26 that will cause may death within a relatively short time, and
27 I am no longer able to make decisions regarding my medical
28 treatment, I direct my attending physician, pursuant to the
29 act of , 19 (P.L. , No. ), known as the Uniform
30 Rights of the Terminally Ill Act, to withhold or withdraw
19890S1158B1430 - 3 -
1 treatment that only prolongs the process of dying and is not
2 necessary to my comfort or to alleviate pain.
3 Signed this____ day of__________, ____.
4 Signature __________________________
5 Address __________________________
6 The declarant voluntarily signed this writing in my presence.
7 Witness __________________________
8 Address __________________________
9 Witness __________________________
10 Address __________________________
11 (c) Duty of health-care provider.--A physician or other
12 health-care provider who is furnished a copy of the declaration
13 under this section shall make it a part of the declarant's
14 medical record and, if unwilling to comply with the declaration,
15 shall promptly so advise the declarant.
16 Section 4. When declaration operative.
17 A declaration becomes operative when:
18 (1) it is communicated to the attending physician; and
19 (2) the declarant is determined by the attending
20 physician to be in a terminal condition and no longer able to
21 make decisions regarding administration of life-sustaining
22 treatment.
23 When the declaration become operative, the attending physician
24 and other health-care providers shall act in accordance with its
25 provisions or comply with the transfer provisions of section 8.
26 Section 5. Revocation of declaration.
27 (a) General rule.--A declaration may be revoked by the
28 declarant at any time and in any manner, without regard to the
29 declarant's mental or physical condition. A revocation is
30 effective upon communication to the attending physician or other
19890S1158B1430 - 4 -
1 health-care provider by the declarant or a witness to the
2 revocation.
3 (b) Medical record.--The attending physician or other
4 health-care provider shall make the revocation a part of the
5 declarant's medical record.
6 Section 6. Recording determination of terminal condition and
7 declaration.
8 Upon determining that the declarant is in a terminal
9 condition, the attending physician who knows of a declaration
10 shall record the determination and the terms of the declaration
11 in the declarant's medical record.
12 Section 7. Treatment of qualified patients.
13 (a) General rule.--A qualified patient may make decisions
14 regarding life-sustaining treatment as long as the patient is
15 able to do so.
16 (b) Duty of physician, etc.--This act does not affect the
17 responsibility of the attending physician or other health-care
18 provider to provide treatment, including nutrition and
19 hydration, for a patient's comfort care or alleviation of pain.
20 (c) Pregnancy.--Unless the declaration provides otherwise,
21 the declaration of a qualified patient known to the attending
22 physician to be pregnant must not be given effect as long as it
23 is probable that the fetus could develop to the point of live
24 birth with continued application of life-sustaining treatment.
25 Section 8. Transfer of patients.
26 An attending physician or other health-care provider who is
27 unwilling to comply with this act shall as promptly as
28 practicable take all reasonable steps to transfer care of the
29 declarant to another physician or health-care provider.
30 Section 9. Immunities.
19890S1158B1430 - 5 -
1 (a) Declaration.--In the absence of knowledge of the
2 revocation of a declaration, a person shall not be subject to
3 civil or criminal liability or discipline for unprofessional
4 conduct for carrying out the declaration pursuant to the
5 requirements of this act.
6 (b) Reasonable medical standards.--A physician or other
7 health-care provider whose actions under this act are in accord
8 with reasonable medical standards shall not be subject to
9 criminal or civil liability or discipline for unprofessional
10 conduct with respect to those actions.
11 Section 10. Penalties.
12 (a) Failure to transfer.--A physician or other health-care
13 provider who willfully fails to transfer in accordance with
14 section 8 is guilty of a misdemeanor of the third degree.
15 (b) Failure to record.--A physician who willfully fails to
16 record the determination of terminal condition in accordance
17 with section 6 is guilty of a misdemeanor of the third degree.
18 (c) Concealment, etc.--An individual who willfully conceals,
19 cancels, defaces or obliterates the declaration of another
20 without the declarant's consent or who falsifies or forges a
21 revocation of the declaration of another is guilty of a
22 misdemeanor of the third degree.
23 (d) Forgery, etc.--An individual who falsifies or forges the
24 declaration of another, or who willfully conceals or withholds
25 personal knowledge of a revocation as provided in section 5, is
26 guilty of a misdemeanor of the third degree.
27 (e) Condition for insurance.--A person who requires or
28 prohibits the execution of a declaration as a condition for
29 being insured for, or receiving, health-care services is guilty
30 of a misdemeanor of the third degree.
19890S1158B1430 - 6 -
1 (f) Coercion, etc.--A person who coerces or fraudulently
2 induces another to execute a declaration under this act is
3 guilty of a misdemeanor of the third degree.
4 (g) Penalties and sanctions cumulative.--The penalties
5 provided in this section do not displace any sanction applicable
6 under any other statute.
7 Section 11. Miscellaneous provisions.
8 (a) Nature of death.--Death resulting from the withholding
9 or withdrawal of life-sustaining treatment pursuant to a
10 declaration and in accordance with this act does not constitute,
11 for any purpose, a suicide or homicide.
12 (b) Insurance.--
13 (1) The making of a declaration pursuant to section 3
14 does not affect in any manner the sale, procurement or
15 issuance of any policy of life insurance or annuity, nor does
16 it affect, impair or modify the terms of an existing policy
17 of life insurance or annuity. A policy of life insurance or
18 annuity is not legally impaired or invalidated in any manner
19 by the withholding or withdrawal of life-sustaining treatment
20 from an insured qualified patient, notwithstanding any term
21 to the contrary.
22 (2) A person may not prohibit or require the execution
23 of a declaration as a condition for being insured for, or
24 receiving, health-care services.
25 (c) Life-sustaining treatment.--
26 (1) This act creates no presumption concerning the
27 intention of an individual who has revoked or has not
28 executed a declaration with respect to the use, withholding
29 or withdrawal of life-sustaining treatment in the event of a
30 terminal condition.
19890S1158B1430 - 7 -
1 (2) This act does not affect the right of a patient to
2 make decisions regarding the use of life-sustaining
3 treatment, so long as the patient is able to do so, nor does
4 it impair or supersede any right or responsibility that a
5 person has to effect the withholding or withdrawal of medical
6 care.
7 (d) Reasonable medical standards.--This act does not require
8 any physician or other health-care provider to take any action
9 contrary to reasonable medical standards.
10 (e) Euthanasia.--This act does not condone, authorize or
11 approve mercy killing or euthanasia.
12 Section 12. When health-care provider may presume validity of
13 declaration.
14 In the absence of knowledge to the contrary, a physician or
15 other health-care provider may presume that a declaration
16 complies with this act and is valid.
17 Section 13. Recognition of declaration executed in another
18 state.
19 A declaration executed in another state in compliance with
20 the law of that state or of this State is validly executed for
21 purposes of this act.
22 Section 14. Effect of previous declaration.
23 An instrument executed before the effective date of this act
24 which substantially complies with section 3(a) must be given
25 effect pursuant to the provisions of this act.
26 Section 15. Uniformity of construction and application.
27 This act shall be applied and construed to effectuate its
28 general purpose to make uniform the law with respect to the
29 subject of this act among states enacting.
30 Section 16. Severability.
19890S1158B1430 - 8 -
1 The provisions of this act are severable. If any provision of
2 this act or its application to any person or circumstance is
3 held invalid, the invalidity shall not affect other provisions
4 or applications of this act which can be given effect without
5 the invalid provision or application.
6 Section 17. Effective date.
7 This act shall take effect in 60 days.
D19L35DGS/19890S1158B1430 - 9 -