HB 1087 -- Adult Health Care Consent Act

Sponsor:  White

This bill establishes the Adult Health Care Consent Act which
specifies an order of priority of persons who can make health
care decisions for an individual who has been certified as
physically and cognitively unable to consent to his or her own
health care.  The order of priority is:

(1)  A court-appointed guardian;

(2)  An attorney-in-fact appointed in a durable power of
attorney;

(3)  An individual appointed by law;

(4)  A spouse, unless the spouse and the patient are separated or
have a divorce pending;

(5)  A parent or adult child;

(6)  An adult sibling, grandparent, or adult grandchild;

(7)  Any other relative by blood or marriage who has a close
personal relationship with the patient;

(8)  Any nonrelative who reasonably is believed by the health
care professional to have a close personal relationship with the
patient; and

(9)  A person given authority to make health care decisions for
the patient by another statutory provision.

These provisions cannot prohibit any person interested in the
welfare of a patient from petitioning the probate court for an
order determining the care to be provided or the appointment of a
guardian for the patient.

Any person in the order of priority who is not reasonably
available, is not willing to make a health care decision, or is
unable to consent as determined by the responsible health care
provider will not be given a priority.  If persons of equal
priority disagree on whether certain health care should be given,
an authorized person, an involved health care provider, or any
other interested person can petition the probate court for an
order to determine what care is to be provided to the patient or
for the appointment of a temporary or permanent guardian.  If a
health care professional has reasonable cause to make a report of
an alleged perpetrator of abuse or neglect of a patient, the
alleged perpetrator will not be given priority or authority to
make health care decisions for the patient.

If a patient communicates to his or her physician prior to
becoming unable to consent to care that a certain person should
not be involved in any health care decisions, the physician
cannot give priority or authority to that individual.  Any person
authorized to make a health care decision must base that decision
on any known wishes of the patient or, if the patient's wishes
cannot be determined, on the patient's best interest.  Health
care decisions on behalf of a patient who is unable to consent
may be made by a person on the priority list if no person having
higher priority is available immediately and, in the reasonable
judgment of the attending health care professional, the delay in
attempting to locate a person having higher priority presents a
substantial risk or serious threat to the health of the patient.
If no one on the priority list is available under these
circumstances, the attending health care professional is
authorized to make health care decisions for the patient.
Treatment for the relief of suffering can be provided without
consent at any time that an authorized person is unavailable, but
a physician cannot make health care decisions that contradict a
patient's religious beliefs or expressed instructions stated by
the patient when he or she was able to consent.

A person acting in good faith regarding a health care decision
cannot be subject to criminal or civil liability for the outcome
of the decision, and any health care provider acting in good
faith cannot be subject to criminal or civil liability or
disciplinary action as long as the care was not provided in a
negligent manner.  Nothing in the act will limit an individual
from seeking guardianship, prohibit a state agency or health care
provider from conducting tests or providing treatment which is
mandated or allowed by other provisions of law, or affect the
ability of the Department of Mental Health from executing its
specified authority.

Missouri House of Representatives
Last Updated January 4, 2012 at 1:26 pm