HOUSE BILL No. 5001 June 26, 1997, Introduced by Reps. Wallace, Baird, Scranton, Hale, Anthony, Dobronski, Dobb, Martinez, Brater, Gire, Willard, Hammerstrom and Cassis and referred to the Committee on Judiciary. A bill to provide for the execution of a declaration direct- ing certain medical procedures be provided, withdrawn, or with- held under certain circumstances; to provide that certain actions be taken and certain actions not be taken with respect to a dec- laration; to provide for the revocation of a declaration; to pro- hibit certain persons and organizations from requiring the execu- tion of such an order as a condition of receiving coverage, bene- fits, or services; to prohibit certain actions by certain insur- ers; to exempt certain persons from penalties and liabilities; and to prescribe liabilities. THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 Sec. 1. This act shall be known and may be cited as the 2 "Michigan medical self-determination act". 3 Sec. 2. As used in this act: 00963'97 CPD 2 1 (a) "Attending physician" means the physician who has 2 responsibility for the treatment and care of a declarant. 3 (b) "Declarant" means an individual who has executed a 4 declaration. 5 (c) "Declaration" means a declaration executed under section 6 3. 7 (d) "Health facility" means a health facility or agency as 8 defined in section 20106 of the public health code, 1978 PA 368, 9 MCL 333.20106. 10 (e) "Medical intervention" means medicine, a procedure, or a 11 device that a physician is not prohibited by law from prescrib- 12 ing, administering, performing, or authorizing. 13 (f) "Permanently unconscious" means a state in which all 14 awareness of self or environment beyond simple reflex or reaction 15 to noxious stimuli is absent, which state is expected, in the 16 opinion of the attending physician, to last indefinitely without 17 improvement. 18 (g) "Physician" means an individual licensed to engage in 19 the practice of medicine or the practice of osteopathic medicine 20 and surgery under article 15 of the public health code, 1978 PA 21 368, MCL 333.16101 to 333.18838. 22 (h) "Terminally ill" means a state in which an incurable, 23 irreversible, and uncontrollable disease or condition will, in 24 the opinion of the attending physician, likely result in death 25 within 1 year. 26 Sec. 3. (1) An individual 18 years of age or older who is 27 of sound mind may execute a declaration to authorize 1 or more 00963'97 3 1 types or all types of medical intervention, to authorize the 2 withholding or withdrawal of 1 or more types or all types of med- 3 ical intervention, or to authorize 1 or more types of medical 4 intervention and the withholding or withdrawal of 1 or more types 5 of medical intervention. 6 (2) A declaration executed under this section shall be writ- 7 ten, dated, and executed voluntarily. The declaration shall be 8 signed by the declarant, or in the declarant's presence at his or 9 her direction. The declaration shall be signed by 2 persons 18 10 years of age or older who witness the signing of the 11 declaration. At least 1 witness shall not be the declarant's 12 spouse, parent, child, sibling, or devisee. 13 Sec. 4. A valid declaration shall be implemented after all 14 of the following occur: 15 (a) The attending physician knows the declaration exists. 16 (b) The declarant has been determined by his or her attend- 17 ing physician and 1 other physician to be terminally ill or per- 18 manently unconscious. 19 (c) In the opinion of the attending physician, the declarant 20 is unable to participate in medical treatment decisions. 21 (d) The attending physician has no knowledge that the decla- 22 ration has been revoked. 23 Sec. 5. (1) A declarant may revoke a declaration at any 24 time and in any manner by which he or she is able to communicate 25 an intent to revoke the declaration. If the revocation is not in 26 writing, an individual who observes a revocation of a declaration 00963'97 4 1 shall describe the circumstances of the revocation in writing and 2 sign the writing. 3 (2) A revocation of a declaration is binding upon a physi- 4 cian or a health facility upon actual notice of the revocation. 5 Sec. 6. (1) A physician or health facility that is provided 6 a copy of a declaration shall immediately make the declaration 7 part of the declarant's medical record. A physician or health 8 facility that has notice of a revocation of a declaration shall 9 immediately make the revocation part of the declarant's medical 10 record and note the revocation on the declaration. 11 (2) Upon determining that a declarant is terminally ill, an 12 attending physician who has notice of a declaration shall record 13 in the declarant's medical record that the declarant is termi- 14 nally ill and shall attempt to communicate that determination to 15 the declarant. Upon determining that a declarant is permanently 16 unconscious, an attending physician who has notice of a declara- 17 tion shall record in the declarant's medical record that the 18 declarant is permanently unconscious. 19 (3) Upon determining that a declarant is terminally ill and 20 unable to participate in medical treatment decisions, an attend- 21 ing physician who has notice of a declaration shall record in the 22 declarant's medical record that the declarant is unable to par- 23 ticipate in medical treatment decisions, and shall attempt to 24 communicate to the declarant that the declaration is about to 25 take effect. 26 Sec. 7. An attending physician shall implement a 27 declaration as provided in section 4, or, if the attending 00963'97 5 1 physician is unwilling to implement the declaration, shall take 2 all reasonable steps to transfer the care and treatment of the 3 declarant to another physician or health facility that is willing 4 to implement the declaration. 5 Sec. 8. A person or health facility is not subject to civil 6 or criminal liability for causing, or participating in, the pro- 7 vision of medical intervention to, or the withholding or with- 8 drawal of medical intervention from, a declarant in accordance 9 with the declarant's declaration and with this act. 10 Sec. 9. A declarant or a declarant's spouse, parent, child, 11 or friend may bring an action for injunctive relief to ensure 12 compliance with the terms of a declaration. 13 Sec. 10. (1) An individual shall not be required to execute 14 a declaration as a condition for insurance coverage, for health 15 care benefits or services, or for any other reason. 16 (2) A health facility shall not deny admission to an indi- 17 vidual because he or she has executed a declaration. 18 (3) A life insurer shall not do any of the following because 19 of the execution or implementation of a declaration: 20 (a) Refuse to provide or continue coverage to the 21 declarant. 22 (b) Charge a declarant higher premiums. 23 (c) Offer a declarant different policy terms. 24 (d) Consider the terms of an existing policy to have been 25 breached or modified. 26 (e) Invoke a suicide or intentional death exemption. 00963'97 6 1 Sec. 11. If the declaration satisfies the requirements of 2 this act, a declaration executed before the effective date of 3 this act is valid. 4 Sec. 12. The provisions of this act are cumulative and do 5 not impair or supersede a legal right that a person has to con- 6 sent to or refuse medical intervention. 00963'97 Final page. CPD