IC 16-36-4
Chapter 4. Living Wills and Life Prolonging Procedures
IC 16-36-4-1 Life prolonging procedure defined
Sec. 1. (a) As used in this chapter, "life prolonging procedure"
means any medical procedure, treatment, or intervention that does
the following:
(1) Uses mechanical or other artificial means to sustain, restore,
or supplant a vital function.
(2) Serves to prolong the dying process.
(b) The term does not include the performance or provision of any
medical procedure or medication necessary to provide comfort care
or to alleviate pain. As added by P.L.2-1993, SEC.19. Amended by P.L.99-1994, SEC.1.
IC 16-36-4-2 Life prolonging procedures will declarant defined
Sec. 2. As used in this chapter, "life prolonging procedures will
declarant" means a person who has executed a life prolonging
procedures will declaration under section 11 of this chapter. As added by P.L.2-1993, SEC.19.
IC 16-36-4-3 Living will declarant defined
Sec. 3. As used in this chapter, "living will declarant" means a
person who has executed a living will declaration under section 10
of this chapter. As added by P.L.2-1993, SEC.19.
IC 16-36-4-4 Qualified patient defined
Sec. 4. As used in this chapter, "qualified patient" means a patient
who has been certified as a qualified patient under section 13 of this
chapter. As added by P.L.2-1993, SEC.19.
IC 16-36-4-5 Terminal condition defined
Sec. 5. As used in this chapter, "terminal condition" means a
condition caused by injury, disease, or illness from which, to a
reasonable degree of medical certainty:
(1) there can be no recovery; and
(2) death will occur from the terminal condition within a short
period of time without the provision of life prolonging
procedures. As added by P.L.2-1993, SEC.19.
IC 16-36-4-6 Policy
Sec. 6. A competent adult has the right to control the decisions
relating to the competent adult's medical care, including the decision
to have medical or surgical means or procedures calculated to
prolong the competent adult's life provided, withheld, or withdrawn. As added by P.L.2-1993, SEC.19.
IC 16-36-4-7 Consent to medical treatment; immunity from liability for failure
to treat patient after refusal of treatment
Sec. 7. (a) A competent person may consent to or refuse consent
for medical treatment, including life prolonging procedures.
(b) No health care provider is required to provide medical
treatment to a patient who has refused medical treatment under this
section.
(c) No civil or criminal liability is imposed on a health care
provider for the failure to provide medical treatment to a patient who
has refused the treatment in accordance with this section. As added by P.L.2-1993, SEC.19.
IC 16-36-4-8 Life prolonging procedures will declarations; living will
declarations
Sec. 8. (a) A person who is of sound mind and is at least eighteen
(18) years of age may execute a life prolonging procedures will
declaration under section 11 of this chapter or a living will
declaration under section 10 of this chapter.
(b) A declaration under section 10 or 11 of this chapter must meet
the following conditions:
(1) Be voluntary.
(2) Be in writing.
(3) Be signed by the person making the declaration or by
another person in the declarant's presence and at the declarant's
express direction.
(4) Be dated.
(5) Be signed in the presence of at least two (2) competent
witnesses who are at least eighteen (18) years of age.
(c) A witness to a living will declaration under subsection (b)(5)
may not meet any of the following conditions:
(1) Be the person who signed the declaration on behalf of and
at the direction of the declarant.
(2) Be a parent, spouse, or child of the declarant.
(3) Be entitled to any part of the declarant's estate whether the
declarant dies testate or intestate, including whether the witness
could take from the declarant's estate if the declarant's will is
declared invalid.
(4) Be directly financially responsible for the declarant's
medical care.
For the purposes of subdivision (3), a person is not considered to be
entitled to any part of the declarant's estate solely by virtue of being
nominated as a personal representative or as the attorney for the
estate in the declarant's will.
(d) The living will declaration of a person diagnosed as pregnant
by the attending physician has no effect during the person's
pregnancy.
(e) The life prolonging procedures will declarant or the living will
declarant shall notify the declarant's attending physician of the
existence of the declaration. An attending physician who is notified
shall make the declaration or a copy of the declaration a part of the
declarant's medical records.
(f) A living will declaration under section 10 of this chapter:
(1) does not require the physician to use, withhold, or withdraw
life prolonging procedures but is presumptive evidence of the
patient's desires concerning the use, withholding, or withdrawal
of life prolonging procedures under this chapter; and
(2) shall be given great weight by the physician in determining
the intent of the patient who is mentally incompetent.
(g) A life prolonging procedures will declaration under section 11
of this chapter does require the physician to use life prolonging
procedures as requested. As added by P.L.2-1993, SEC.19.
IC 16-36-4-9 Forms of declaration; requisites
Sec. 9. A declaration must be substantially in the form set forth in
either section 10 or 11 of this chapter, but the declaration may
include additional, specific directions. The invalidity of any
additional, specific directions does not affect the validity of the
declaration. As added by P.L.2-1993, SEC.19.
IC 16-36-4-10 Form of living will declaration
Sec. 10. The following is the living will declaration form:
LIVING WILL DECLARATION
Declaration made this _____ day of _______ (month, year). I,
_________, being at least eighteen (18) years of age and of sound
mind, willfully and voluntarily make known my desires that my
dying shall not be artificially prolonged under the circumstances set
forth below, and I declare:
If at any time my attending physician certifies in writing that: (1)
I have an incurable injury, disease, or illness; (2) my death will occur
within a short time; and (3) the use of life prolonging procedures
would serve only to artificially prolong the dying process, I direct
that such procedures be withheld or withdrawn, and that I be
permitted to die naturally with only the performance or provision of
any medical procedure or medication necessary to provide me with
comfort care or to alleviate pain, and, if I have so indicated below,
the provision of artificially supplied nutrition and hydration.
(Indicate your choice by initialling or making your mark before
signing this declaration):
__________ I wish to receive artificially supplied nutrition and
hydration, even if the effort to sustain life is futile or
excessively burdensome to me.
__________ I do not wish to receive artificially supplied
nutrition and hydration, if the effort to sustain life is futile or
excessively burdensome to me.
__________ I intentionally make no decision concerning
artificially supplied nutrition and hydration, leaving the
decision to my health care representative appointed under
IC 16-36-1-7 or my attorney in fact with health care powers
under IC 30-5-5.
In the absence of my ability to give directions regarding the use
of life prolonging procedures, it is my intention that this declaration
be honored by my family and physician as the final expression of my
legal right to refuse medical or surgical treatment and accept the
consequences of the refusal.
I understand the full import of this declaration.
Signed _________________________
_______________________________
City, County, and State of Residence
The declarant has been personally known to me, and I believe
(him/her) to be of sound mind. I did not sign the declarant's signature
above for or at the direction of the declarant. I am not a parent,
spouse, or child of the declarant. I am not entitled to any part of the
declarant's estate or directly financially responsible for the
declarant's medical care. I am competent and at least eighteen (18)
years of age.
Witness _______________ Date __________
Witness _______________ Date __________ As added by P.L.2-1993, SEC.19. Amended by P.L.99-1994, SEC.2.
IC 16-36-4-11 Form of life prolonging procedures will declaration
Sec. 11. The following is the life prolonging procedures will
declaration form:
LIFE PROLONGING PROCEDURES DECLARATION
Declaration made this ______ day of ______ (month, year). I,
____________, being at least eighteen (18) years of age and of sound
mind, willfully and voluntarily make known my desire that if at any
time I have an incurable injury, disease, or illness determined to be
a terminal condition I request the use of life prolonging procedures
that would extend my life. This includes appropriate nutrition and
hydration, the administration of medication, and the performance of
all other medical procedures necessary to extend my life, to provide
comfort care, or to alleviate pain.
In the absence of my ability to give directions regarding the use
of life prolonging procedures, it is my intention that this declaration
be honored by my family and physician as the final expression of my
legal right to request medical or surgical treatment and accept the
consequences of the request.
I understand the full import of this declaration.
Signed ___________________
_______________________
City, County, and State of Residence
The declarant has been personally known to me, and I believe
(him/her) to be of sound mind. I am competent and at least eighteen
(18) years of age.
Witness ______________ Date ________
Witness ______________ Date ________ As added by P.L.2-1993, SEC.19.
IC 16-36-4-12 Revocation of living will declaration or life prolonging procedures
will declaration
Sec. 12. (a) A living will declaration or a life prolonging
procedures will declaration may be revoked at any time by the
declarant by any of the following:
(1) A signed, dated writing.
(2) Physical cancellation or destruction of the declaration by the
declarant or another in the declarant's presence and at the
declarant's direction.
(3) An oral expression of intent to revoke.
(b) A revocation is effective when communicated to the attending
physician.
(c) No civil or criminal liability is imposed upon a person for
failure to act upon a revocation unless the person had actual
knowledge of the revocation.
(d) The revocation of a life prolonging procedures will declaration
is not evidence that the declarant desires to have life prolonging
procedures withheld or withdrawn. As added by P.L.2-1993, SEC.19.
IC 16-36-4-13 Certification of qualified patient; procedure where physician
refuses to honor declaration
Sec. 13. (a) The attending physician shall immediately certify in
writing that a person is a qualified patient if the following conditions
are met:
(1) The attending physician has diagnosed the patient as having
a terminal condition.
(2) The patient has executed a living will declaration or a life
prolonging procedures will declaration in accordance with this
chapter and was of sound mind at the time of the execution.
(b) The attending physician shall include a copy of the certificate
in the patient's medical records.
(c) It is lawful for the attending physician to withhold or withdraw
life prolonging procedures from a qualified patient if that patient
properly executed a living will declaration under this chapter.
(d) A health care provider or an employee under the direction of
a health care provider who:
(1) in good faith; and
(2) in accordance with reasonable medical standards;
participates in the withholding or withdrawal of life prolonging
procedures from a qualified patient who has executed a living will
declaration in accordance with this chapter is not subject to criminal
or civil liability and may not be found to have committed an act of
unprofessional conduct.
(e) An attending physician who refuses to use, withhold, or
withdraw life prolonging procedures from a qualified patient shall
transfer the qualified patient to another physician who will honor the
patient's living will declaration or life prolonging procedures will
declaration unless:
(1) the physician has reason to believe the declaration was not
validly executed or there is evidence that the patient no longer
intends the declaration to be enforced; and
(2) the patient is presently unable to validate the declaration.
(f) If the attending physician, after reasonable investigation, finds
no other physician willing to honor the patient's declaration, the
attending physician may refuse to withhold or withdraw life
prolonging procedures.
(g) If the attending physician does not transfer a patient for the
reason set forth in subsection (e), the physician shall attempt to
ascertain the patient's intention and attempt to determine the validity
of the declaration by consulting with any of the following individuals
who are reasonably available, willing, and competent to act:
(1) The judicially appointed guardian of the person of the
patient if one has been appointed. This subdivision does not
require the appointment of a guardian so that a treatment
decision can be made under this section.
(2) The person or persons designated by the patient in writing
to make the treatment decision.
(3) The patient's spouse.
(4) An adult child of the patient or, if the patient has more than
one (1) adult child, by a majority of the children who are
reasonably available for consultation.
(5) The parents of the patient.
(6) An adult sibling of the patient or, if the patient has more
than one (1) adult sibling, by a majority of the siblings who are
reasonably available for consultation.
(7) The patient's clergy or others with firsthand knowledge of
the patient's intention.
The individuals described in subdivisions (1) through (7) shall act in
the best interest of the patient and shall be guided by the patient's
express or implied intentions, if known.
(h) The physician shall list the names of the individuals described
in subsection (g) who were consulted and the information received
in the patient's medical records.
(i) If the attending physician determines from the information
received under subsection (g) that the qualified patient intended to
execute a valid living will declaration, the physician may either:
(1) withhold or withdraw life prolonging procedures, with the
concurrence of one (1) other physician, as documented in the
patient's medical records; or
(2) request a court of competent jurisdiction to appoint a
guardian for the patient to make the consent decision on behalf
of the patient. As added by P.L.2-1993, SEC.19. Amended by P.L.99-1994, SEC.3.
IC 16-36-4-14 Presumptions
Sec. 14. If the qualified patient who executed a living will
declaration is incompetent at the time of the decision to withhold or
withdraw life prolonging procedures, a living will declaration
executed in accordance with this chapter is presumed to be valid. For
purposes of this chapter, a health care provider may presume in the
absence of actual notice to the contrary that the declarant was of
sound mind when the living will declaration was executed. The fact
that the declarant executed a declaration may not be considered as an
indication of a declarant's mental incompetency. As added by P.L.2-1993, SEC.19.
IC 16-36-4-15 Cancellation or destruction of declaration; falsification or forgery
of revocation of another's declaration; offense
Sec. 15. A person who knowingly or intentionally:
(1) physically cancels or destroys a living will declaration or a
life prolonging procedures will declaration without the
declarant's consent; or
(2) falsifies or forges a revocation of another person's living
will declaration or life prolonging procedures will declaration;
commits a Class D felony. As added by P.L.2-1993, SEC.19.
IC 16-36-4-16 Falsification or forgery of declaration; concealment or withholding
of revocation of declaration; offense
Sec. 16. A person who knowingly or intentionally:
(1) falsifies or forges the living will declaration of another
person with intent to cause withholding or withdrawal of life
prolonging procedures; or
(2) conceals or withholds personal knowledge of the revocation
of a living will declaration with intent to cause a withholding or
withdrawal of life prolonging procedures;
commits a Class C felony. As added by P.L.2-1993, SEC.19.
IC 16-36-4-17 Effect of living will or life prolonging procedures will declaration;
suicide; life insurance
Sec. 17. (a) A death caused by the withholding or withdrawal of
life prolonging procedures in accordance with this chapter does not
constitute a suicide.
(b) The execution of a living will declaration or a life prolonging
procedures will declaration under this chapter does not:
(1) affect the sale or issuance of any life insurance policy; or
(2) modify the terms of a policy in force when the declaration
is executed.
(c) A policy of life insurance is not legally impaired or invalidated
by the withholding or withdrawal of life prolonging procedures from
an insured qualified patient, notwithstanding any term of the policy
to the contrary.
(d) A person may not require another person to execute a living
will declaration or a life prolonging procedures will declaration as a
condition for being insured for or receiving health care services.
(e) This chapter does not impair or supersede any legal right or
legal responsibility that any person may have to effect the
withholding or withdrawal of life prolonging procedures in any
lawful manner.
(f) A person who has been found:
(1) guilty; or
(2) guilty but mentally ill;
of an offense described in section 16 of this chapter is subject to
IC 29-1-2-12.1. As added by P.L.2-1993, SEC.19.
IC 16-36-4-18 Presumption of intent to consent to withholding or withdrawal of
life prolonging procedures
Sec. 18. This chapter creates no presumption concerning the
intention of a person who has not executed a living will declaration
to consent to the withholding or withdrawal of life prolonging
procedures if a terminal condition exists. As added by P.L.2-1993, SEC.19.
IC 16-36-4-19 Euthanasia distinguished
Sec. 19. This chapter does not authorize euthanasia or any
affirmative or deliberate act or omission to end life other than to
permit the natural process of dying, including the withholding or
withdrawing of life prolonging procedures under this chapter. As added by P.L.2-1993, SEC.19.
IC 16-36-4-20 Intervening forces; proximate causation
Sec. 20. The act of withholding or withdrawing life prolonging
procedures, when done under:
(1) a living will declaration made under this chapter;
(2) a court order or decision of a court appointed guardian; or
(3) a good faith medical decision by the attending physician that
the patient has a terminal condition;
is not an intervening force and does not affect the chain of proximate
cause between the conduct of any person that placed the patient in a
terminal condition and the patient's death. As added by P.L.2-1993, SEC.19.
IC 16-36-4-21 Chapter violations by physician; discipline
Sec. 21. A physician who knowingly violates this chapter is
subject to disciplinary sanctions under IC 25-1-9 as if the physician
had knowingly violated a rule adopted by the medical licensing board
under IC 25-22.5-2-7. As added by P.L.2-1993, SEC.19.
IC 16-36-4
Chapter 4. Living Wills and Life Prolonging Procedures
IC 16-36-4-1 Life prolonging procedure defined
Sec. 1. (a) As used in this chapter, "life prolonging procedure"
means any medical procedure, treatment, or intervention that does
the following:
(1) Uses mechanical or other artificial means to sustain, restore,
or supplant a vital function.
(2) Serves to prolong the dying process.
(b) The term does not include the performance or provision of any
medical procedure or medication necessary to provide comfort care
or to alleviate pain. As added by P.L.2-1993, SEC.19. Amended by P.L.99-1994, SEC.1.
IC 16-36-4-2 Life prolonging procedures will declarant defined
Sec. 2. As used in this chapter, "life prolonging procedures will
declarant" means a person who has executed a life prolonging
procedures will declaration under section 11 of this chapter. As added by P.L.2-1993, SEC.19.
IC 16-36-4-3 Living will declarant defined
Sec. 3. As used in this chapter, "living will declarant" means a
person who has executed a living will declaration under section 10
of this chapter. As added by P.L.2-1993, SEC.19.
IC 16-36-4-4 Qualified patient defined
Sec. 4. As used in this chapter, "qualified patient" means a patient
who has been certified as a qualified patient under section 13 of this
chapter. As added by P.L.2-1993, SEC.19.
IC 16-36-4-5 Terminal condition defined
Sec. 5. As used in this chapter, "terminal condition" means a
condition caused by injury, disease, or illness from which, to a
reasonable degree of medical certainty:
(1) there can be no recovery; and
(2) death will occur from the terminal condition within a short
period of time without the provision of life prolonging
procedures. As added by P.L.2-1993, SEC.19.
IC 16-36-4-6 Policy
Sec. 6. A competent adult has the right to control the decisions
relating to the competent adult's medical care, including the decision
to have medical or surgical means or procedures calculated to
prolong the competent adult's life provided, withheld, or withdrawn. As added by P.L.2-1993, SEC.19.
IC 16-36-4-7 Consent to medical treatment; immunity from liability for failure
to treat patient after refusal of treatment
Sec. 7. (a) A competent person may consent to or refuse consent
for medical treatment, including life prolonging procedures.
(b) No health care provider is required to provide medical
treatment to a patient who has refused medical treatment under this
section.
(c) No civil or criminal liability is imposed on a health care
provider for the failure to provide medical treatment to a patient who
has refused the treatment in accordance with this section. As added by P.L.2-1993, SEC.19.
IC 16-36-4-8 Life prolonging procedures will declarations; living will
declarations
Sec. 8. (a) A person who is of sound mind and is at least eighteen
(18) years of age may execute a life prolonging procedures will
declaration under section 11 of this chapter or a living will
declaration under section 10 of this chapter.
(b) A declaration under section 10 or 11 of this chapter must meet
the following conditions:
(1) Be voluntary.
(2) Be in writing.
(3) Be signed by the person making the declaration or by
another person in the declarant's presence and at the declarant's
express direction.
(4) Be dated.
(5) Be signed in the presence of at least two (2) competent
witnesses who are at least eighteen (18) years of age.
(c) A witness to a living will declaration under subsection (b)(5)
may not meet any of the following conditions:
(1) Be the person who signed the declaration on behalf of and
at the direction of the declarant.
(2) Be a parent, spouse, or child of the declarant.
(3) Be entitled to any part of the declarant's estate whether the
declarant dies testate or intestate, including whether the witness
could take from the declarant's estate if the declarant's will is
declared invalid.
(4) Be directly financially responsible for the declarant's
medical care.
For the purposes of subdivision (3), a person is not considered to be
entitled to any part of the declarant's estate solely by virtue of being
nominated as a personal representative or as the attorney for the
estate in the declarant's will.
(d) The living will declaration of a person diagnosed as pregnant
by the attending physician has no effect during the person's
pregnancy.
(e) The life prolonging procedures will declarant or the living will
declarant shall notify the declarant's attending physician of the
existence of the declaration. An attending physician who is notified
shall make the declaration or a copy of the declaration a part of the
declarant's medical records.
(f) A living will declaration under section 10 of this chapter:
(1) does not require the physician to use, withhold, or withdraw
life prolonging procedures but is presumptive evidence of the
patient's desires concerning the use, withholding, or withdrawal
of life prolonging procedures under this chapter; and
(2) shall be given great weight by the physician in determining
the intent of the patient who is mentally incompetent.
(g) A life prolonging procedures will declaration under section 11
of this chapter does require the physician to use life prolonging
procedures as requested. As added by P.L.2-1993, SEC.19.
IC 16-36-4-9 Forms of declaration; requisites
Sec. 9. A declaration must be substantially in the form set forth in
either section 10 or 11 of this chapter, but the declaration may
include additional, specific directions. The invalidity of any
additional, specific directions does not affect the validity of the
declaration. As added by P.L.2-1993, SEC.19.
IC 16-36-4-10 Form of living will declaration
Sec. 10. The following is the living will declaration form:
LIVING WILL DECLARATION
Declaration made this _____ day of _______ (month, year). I,
_________, being at least eighteen (18) years of age and of sound
mind, willfully and voluntarily make known my desires that my
dying shall not be artificially prolonged under the circumstances set
forth below, and I declare:
If at any time my attending physician certifies in writing that: (1)
I have an incurable injury, disease, or illness; (2) my death will occur
within a short time; and (3) the use of life prolonging procedures
would serve only to artificially prolong the dying process, I direct
that such procedures be withheld or withdrawn, and that I be
permitted to die naturally with only the performance or provision of
any medical procedure or medication necessary to provide me with
comfort care or to alleviate pain, and, if I have so indicated below,
the provision of artificially supplied nutrition and hydration.
(Indicate your choice by initialling or making your mark before
signing this declaration):
__________ I wish to receive artificially supplied nutrition and
hydration, even if the effort to sustain life is futile or
excessively burdensome to me.
__________ I do not wish to receive artificially supplied
nutrition and hydration, if the effort to sustain life is futile or
excessively burdensome to me.
__________ I intentionally make no decision concerning
artificially supplied nutrition and hydration, leaving the
decision to my health care representative appointed under
IC 16-36-1-7 or my attorney in fact with health care powers
under IC 30-5-5.
In the absence of my ability to give directions regarding the use
of life prolonging procedures, it is my intention that this declaration
be honored by my family and physician as the final expression of my
legal right to refuse medical or surgical treatment and accept the
consequences of the refusal.
I understand the full import of this declaration.
Signed _________________________
_______________________________
City, County, and State of Residence
The declarant has been personally known to me, and I believe
(him/her) to be of sound mind. I did not sign the declarant's signature
above for or at the direction of the declarant. I am not a parent,
spouse, or child of the declarant. I am not entitled to any part of the
declarant's estate or directly financially responsible for the
declarant's medical care. I am competent and at least eighteen (18)
years of age.
Witness _______________ Date __________
Witness _______________ Date __________ As added by P.L.2-1993, SEC.19. Amended by P.L.99-1994, SEC.2.
IC 16-36-4-11 Form of life prolonging procedures will declaration
Sec. 11. The following is the life prolonging procedures will
declaration form:
LIFE PROLONGING PROCEDURES DECLARATION
Declaration made this ______ day of ______ (month, year). I,
____________, being at least eighteen (18) years of age and of sound
mind, willfully and voluntarily make known my desire that if at any
time I have an incurable injury, disease, or illness determined to be
a terminal condition I request the use of life prolonging procedures
that would extend my life. This includes appropriate nutrition and
hydration, the administration of medication, and the performance of
all other medical procedures necessary to extend my life, to provide
comfort care, or to alleviate pain.
In the absence of my ability to give directions regarding the use
of life prolonging procedures, it is my intention that this declaration
be honored by my family and physician as the final expression of my
legal right to request medical or surgical treatment and accept the
consequences of the request.
I understand the full import of this declaration.
Signed ___________________
_______________________
City, County, and State of Residence
The declarant has been personally known to me, and I believe
(him/her) to be of sound mind. I am competent and at least eighteen
(18) years of age.
Witness ______________ Date ________
Witness ______________ Date ________ As added by P.L.2-1993, SEC.19.
IC 16-36-4-12 Revocation of living will declaration or life prolonging procedures
will declaration
Sec. 12. (a) A living will declaration or a life prolonging
procedures will declaration may be revoked at any time by the
declarant by any of the following:
(1) A signed, dated writing.
(2) Physical cancellation or destruction of the declaration by the
declarant or another in the declarant's presence and at the
declarant's direction.
(3) An oral expression of intent to revoke.
(b) A revocation is effective when communicated to the attending
physician.
(c) No civil or criminal liability is imposed upon a person for
failure to act upon a revocation unless the person had actual
knowledge of the revocation.
(d) The revocation of a life prolonging procedures will declaration
is not evidence that the declarant desires to have life prolonging
procedures withheld or withdrawn. As added by P.L.2-1993, SEC.19.
IC 16-36-4-13 Certification of qualified patient; procedure where physician
refuses to honor declaration
Sec. 13. (a) The attending physician shall immediately certify in
writing that a person is a qualified patient if the following conditions
are met:
(1) The attending physician has diagnosed the patient as having
a terminal condition.
(2) The patient has executed a living will declaration or a life
prolonging procedures will declaration in accordance with this
chapter and was of sound mind at the time of the execution.
(b) The attending physician shall include a copy of the certificate
in the patient's medical records.
(c) It is lawful for the attending physician to withhold or withdraw
life prolonging procedures from a qualified patient if that patient
properly executed a living will declaration under this chapter.
(d) A health care provider or an employee under the direction of
a health care provider who:
(1) in good faith; and
(2) in accordance with reasonable medical standards;
participates in the withholding or withdrawal of life prolonging
procedures from a qualified patient who has executed a living will
declaration in accordance with this chapter is not subject to criminal
or civil liability and may not be found to have committed an act of
unprofessional conduct.
(e) An attending physician who refuses to use, withhold, or
withdraw life prolonging procedures from a qualified patient shall
transfer the qualified patient to another physician who will honor the
patient's living will declaration or life prolonging procedures will
declaration unless:
(1) the physician has reason to believe the declaration was not
validly executed or there is evidence that the patient no longer
intends the declaration to be enforced; and
(2) the patient is presently unable to validate the declaration.
(f) If the attending physician, after reasonable investigation, finds
no other physician willing to honor the patient's declaration, the
attending physician may refuse to withhold or withdraw life
prolonging procedures.
(g) If the attending physician does not transfer a patient for the
reason set forth in subsection (e), the physician shall attempt to
ascertain the patient's intention and attempt to determine the validity
of the declaration by consulting with any of the following individuals
who are reasonably available, willing, and competent to act:
(1) The judicially appointed guardian of the person of the
patient if one has been appointed. This subdivision does not
require the appointment of a guardian so that a treatment
decision can be made under this section.
(2) The person or persons designated by the patient in writing
to make the treatment decision.
(3) The patient's spouse.
(4) An adult child of the patient or, if the patient has more than
one (1) adult child, by a majority of the children who are
reasonably available for consultation.
(5) The parents of the patient.
(6) An adult sibling of the patient or, if the patient has more
than one (1) adult sibling, by a majority of the siblings who are
reasonably available for consultation.
(7) The patient's clergy or others with firsthand knowledge of
the patient's intention.
The individuals described in subdivisions (1) through (7) shall act in
the best interest of the patient and shall be guided by the patient's
express or implied intentions, if known.
(h) The physician shall list the names of the individuals described
in subsection (g) who were consulted and the information received
in the patient's medical records.
(i) If the attending physician determines from the information
received under subsection (g) that the qualified patient intended to
execute a valid living will declaration, the physician may either:
(1) withhold or withdraw life prolonging procedures, with the
concurrence of one (1) other physician, as documented in the
patient's medical records; or
(2) request a court of competent jurisdiction to appoint a
guardian for the patient to make the consent decision on behalf
of the patient. As added by P.L.2-1993, SEC.19. Amended by P.L.99-1994, SEC.3.
IC 16-36-4-14 Presumptions
Sec. 14. If the qualified patient who executed a living will
declaration is incompetent at the time of the decision to withhold or
withdraw life prolonging procedures, a living will declaration
executed in accordance with this chapter is presumed to be valid. For
purposes of this chapter, a health care provider may presume in the
absence of actual notice to the contrary that the declarant was of
sound mind when the living will declaration was executed. The fact
that the declarant executed a declaration may not be considered as an
indication of a declarant's mental incompetency. As added by P.L.2-1993, SEC.19.
IC 16-36-4-15 Cancellation or destruction of declaration; falsification or forgery
of revocation of another's declaration; offense
Sec. 15. A person who knowingly or intentionally:
(1) physically cancels or destroys a living will declaration or a
life prolonging procedures will declaration without the
declarant's consent; or
(2) falsifies or forges a revocation of another person's living
will declaration or life prolonging procedures will declaration;
commits a Class D felony. As added by P.L.2-1993, SEC.19.
IC 16-36-4-16 Falsification or forgery of declaration; concealment or withholding
of revocation of declaration; offense
Sec. 16. A person who knowingly or intentionally:
(1) falsifies or forges the living will declaration of another
person with intent to cause withholding or withdrawal of life
prolonging procedures; or
(2) conceals or withholds personal knowledge of the revocation
of a living will declaration with intent to cause a withholding or
withdrawal of life prolonging procedures;
commits a Class C felony. As added by P.L.2-1993, SEC.19.
IC 16-36-4-17 Effect of living will or life prolonging procedures will declaration;
suicide; life insurance
Sec. 17. (a) A death caused by the withholding or withdrawal of
life prolonging procedures in accordance with this chapter does not
constitute a suicide.
(b) The execution of a living will declaration or a life prolonging
procedures will declaration under this chapter does not:
(1) affect the sale or issuance of any life insurance policy; or
(2) modify the terms of a policy in force when the declaration
is executed.
(c) A policy of life insurance is not legally impaired or invalidated
by the withholding or withdrawal of life prolonging procedures from
an insured qualified patient, notwithstanding any term of the policy
to the contrary.
(d) A person may not require another person to execute a living
will declaration or a life prolonging procedures will declaration as a
condition for being insured for or receiving health care services.
(e) This chapter does not impair or supersede any legal right or
legal responsibility that any person may have to effect the
withholding or withdrawal of life prolonging procedures in any
lawful manner.
(f) A person who has been found:
(1) guilty; or
(2) guilty but mentally ill;
of an offense described in section 16 of this chapter is subject to
IC 29-1-2-12.1. As added by P.L.2-1993, SEC.19.
IC 16-36-4-18 Presumption of intent to consent to withholding or withdrawal of
life prolonging procedures
Sec. 18. This chapter creates no presumption concerning the
intention of a person who has not executed a living will declaration
to consent to the withholding or withdrawal of life prolonging
procedures if a terminal condition exists. As added by P.L.2-1993, SEC.19.
IC 16-36-4-19 Euthanasia distinguished
Sec. 19. This chapter does not authorize euthanasia or any
affirmative or deliberate act or omission to end life other than to
permit the natural process of dying, including the withholding or
withdrawing of life prolonging procedures under this chapter. As added by P.L.2-1993, SEC.19.
IC 16-36-4-20 Intervening forces; proximate causation
Sec. 20. The act of withholding or withdrawing life prolonging
procedures, when done under:
(1) a living will declaration made under this chapter;
(2) a court order or decision of a court appointed guardian; or
(3) a good faith medical decision by the attending physician that
the patient has a terminal condition;
is not an intervening force and does not affect the chain of proximate
cause between the conduct of any person that placed the patient in a
terminal condition and the patient's death. As added by P.L.2-1993, SEC.19.
IC 16-36-4-21 Chapter violations by physician; discipline
Sec. 21. A physician who knowingly violates this chapter is
subject to disciplinary sanctions under IC 25-1-9 as if the physician
had knowingly violated a rule adopted by the medical licensing board
under IC 25-22.5-2-7. As added by P.L.2-1993, SEC.19.
IC 16-36-4
Chapter 4. Living Wills and Life Prolonging Procedures
IC 16-36-4-1 Life prolonging procedure defined
Sec. 1. (a) As used in this chapter, "life prolonging procedure"
means any medical procedure, treatment, or intervention that does
the following:
(1) Uses mechanical or other artificial means to sustain, restore,
or supplant a vital function.
(2) Serves to prolong the dying process.
(b) The term does not include the performance or provision of any
medical procedure or medication necessary to provide comfort care
or to alleviate pain. As added by P.L.2-1993, SEC.19. Amended by P.L.99-1994, SEC.1.
IC 16-36-4-2 Life prolonging procedures will declarant defined
Sec. 2. As used in this chapter, "life prolonging procedures will
declarant" means a person who has executed a life prolonging
procedures will declaration under section 11 of this chapter. As added by P.L.2-1993, SEC.19.
IC 16-36-4-3 Living will declarant defined
Sec. 3. As used in this chapter, "living will declarant" means a
person who has executed a living will declaration under section 10
of this chapter. As added by P.L.2-1993, SEC.19.
IC 16-36-4-4 Qualified patient defined
Sec. 4. As used in this chapter, "qualified patient" means a patient
who has been certified as a qualified patient under section 13 of this
chapter. As added by P.L.2-1993, SEC.19.
IC 16-36-4-5 Terminal condition defined
Sec. 5. As used in this chapter, "terminal condition" means a
condition caused by injury, disease, or illness from which, to a
reasonable degree of medical certainty:
(1) there can be no recovery; and
(2) death will occur from the terminal condition within a short
period of time without the provision of life prolonging
procedures. As added by P.L.2-1993, SEC.19.
IC 16-36-4-6 Policy
Sec. 6. A competent adult has the right to control the decisions
relating to the competent adult's medical care, including the decision
to have medical or surgical means or procedures calculated to
prolong the competent adult's life provided, withheld, or withdrawn. As added by P.L.2-1993, SEC.19.
IC 16-36-4-7 Consent to medical treatment; immunity from liability for failure
to treat patient after refusal of treatment
Sec. 7. (a) A competent person may consent to or refuse consent
for medical treatment, including life prolonging procedures.
(b) No health care provider is required to provide medical
treatment to a patient who has refused medical treatment under this
section.
(c) No civil or criminal liability is imposed on a health care
provider for the failure to provide medical treatment to a patient who
has refused the treatment in accordance with this section. As added by P.L.2-1993, SEC.19.
IC 16-36-4-8 Life prolonging procedures will declarations; living will
declarations
Sec. 8. (a) A person who is of sound mind and is at least eighteen
(18) years of age may execute a life prolonging procedures will
declaration under section 11 of this chapter or a living will
declaration under section 10 of this chapter.
(b) A declaration under section 10 or 11 of this chapter must meet
the following conditions:
(1) Be voluntary.
(2) Be in writing.
(3) Be signed by the person making the declaration or by
another person in the declarant's presence and at the declarant's
express direction.
(4) Be dated.
(5) Be signed in the presence of at least two (2) competent
witnesses who are at least eighteen (18) years of age.
(c) A witness to a living will declaration under subsection (b)(5)
may not meet any of the following conditions:
(1) Be the person who signed the declaration on behalf of and
at the direction of the declarant.
(2) Be a parent, spouse, or child of the declarant.
(3) Be entitled to any part of the declarant's estate whether the
declarant dies testate or intestate, including whether the witness
could take from the declarant's estate if the declarant's will is
declared invalid.
(4) Be directly financially responsible for the declarant's
medical care.
For the purposes of subdivision (3), a person is not considered to be
entitled to any part of the declarant's estate solely by virtue of being
nominated as a personal representative or as the attorney for the
estate in the declarant's will.
(d) The living will declaration of a person diagnosed as pregnant
by the attending physician has no effect during the person's
pregnancy.
(e) The life prolonging procedures will declarant or the living will
declarant shall notify the declarant's attending physician of the
existence of the declaration. An attending physician who is notified
shall make the declaration or a copy of the declaration a part of the
declarant's medical records.
(f) A living will declaration under section 10 of this chapter:
(1) does not require the physician to use, withhold, or withdraw
life prolonging procedures but is presumptive evidence of the
patient's desires concerning the use, withholding, or withdrawal
of life prolonging procedures under this chapter; and
(2) shall be given great weight by the physician in determining
the intent of the patient who is mentally incompetent.
(g) A life prolonging procedures will declaration under section 11
of this chapter does require the physician to use life prolonging
procedures as requested. As added by P.L.2-1993, SEC.19.
IC 16-36-4-9 Forms of declaration; requisites
Sec. 9. A declaration must be substantially in the form set forth in
either section 10 or 11 of this chapter, but the declaration may
include additional, specific directions. The invalidity of any
additional, specific directions does not affect the validity of the
declaration. As added by P.L.2-1993, SEC.19.
IC 16-36-4-10 Form of living will declaration
Sec. 10. The following is the living will declaration form:
LIVING WILL DECLARATION
Declaration made this _____ day of _______ (month, year). I,
_________, being at least eighteen (18) years of age and of sound
mind, willfully and voluntarily make known my desires that my
dying shall not be artificially prolonged under the circumstances set
forth below, and I declare:
If at any time my attending physician certifies in writing that: (1)
I have an incurable injury, disease, or illness; (2) my death will occur
within a short time; and (3) the use of life prolonging procedures
would serve only to artificially prolong the dying process, I direct
that such procedures be withheld or withdrawn, and that I be
permitted to die naturally with only the performance or provision of
any medical procedure or medication necessary to provide me with
comfort care or to alleviate pain, and, if I have so indicated below,
the provision of artificially supplied nutrition and hydration.
(Indicate your choice by initialling or making your mark before
signing this declaration):
__________ I wish to receive artificially supplied nutrition and
hydration, even if the effort to sustain life is futile or
excessively burdensome to me.
__________ I do not wish to receive artificially supplied
nutrition and hydration, if the effort to sustain life is futile or
excessively burdensome to me.
__________ I intentionally make no decision concerning
artificially supplied nutrition and hydration, leaving the
decision to my health care representative appointed under
IC 16-36-1-7 or my attorney in fact with health care powers
under IC 30-5-5.
In the absence of my ability to give directions regarding the use
of life prolonging procedures, it is my intention that this declaration
be honored by my family and physician as the final expression of my
legal right to refuse medical or surgical treatment and accept the
consequences of the refusal.
I understand the full import of this declaration.
Signed _________________________
_______________________________
City, County, and State of Residence
The declarant has been personally known to me, and I believe
(him/her) to be of sound mind. I did not sign the declarant's signature
above for or at the direction of the declarant. I am not a parent,
spouse, or child of the declarant. I am not entitled to any part of the
declarant's estate or directly financially responsible for the
declarant's medical care. I am competent and at least eighteen (18)
years of age.
Witness _______________ Date __________
Witness _______________ Date __________ As added by P.L.2-1993, SEC.19. Amended by P.L.99-1994, SEC.2.
IC 16-36-4-11 Form of life prolonging procedures will declaration
Sec. 11. The following is the life prolonging procedures will
declaration form:
LIFE PROLONGING PROCEDURES DECLARATION
Declaration made this ______ day of ______ (month, year). I,
____________, being at least eighteen (18) years of age and of sound
mind, willfully and voluntarily make known my desire that if at any
time I have an incurable injury, disease, or illness determined to be
a terminal condition I request the use of life prolonging procedures
that would extend my life. This includes appropriate nutrition and
hydration, the administration of medication, and the performance of
all other medical procedures necessary to extend my life, to provide
comfort care, or to alleviate pain.
In the absence of my ability to give directions regarding the use
of life prolonging procedures, it is my intention that this declaration
be honored by my family and physician as the final expression of my
legal right to request medical or surgical treatment and accept the
consequences of the request.
I understand the full import of this declaration.
Signed ___________________
_______________________
City, County, and State of Residence
The declarant has been personally known to me, and I believe
(him/her) to be of sound mind. I am competent and at least eighteen
(18) years of age.
Witness ______________ Date ________
Witness ______________ Date ________ As added by P.L.2-1993, SEC.19.
IC 16-36-4-12 Revocation of living will declaration or life prolonging procedures
will declaration
Sec. 12. (a) A living will declaration or a life prolonging
procedures will declaration may be revoked at any time by the
declarant by any of the following:
(1) A signed, dated writing.
(2) Physical cancellation or destruction of the declaration by the
declarant or another in the declarant's presence and at the
declarant's direction.
(3) An oral expression of intent to revoke.
(b) A revocation is effective when communicated to the attending
physician.
(c) No civil or criminal liability is imposed upon a person for
failure to act upon a revocation unless the person had actual
knowledge of the revocation.
(d) The revocation of a life prolonging procedures will declaration
is not evidence that the declarant desires to have life prolonging
procedures withheld or withdrawn. As added by P.L.2-1993, SEC.19.
IC 16-36-4-13 Certification of qualified patient; procedure where physician
refuses to honor declaration
Sec. 13. (a) The attending physician shall immediately certify in
writing that a person is a qualified patient if the following conditions
are met:
(1) The attending physician has diagnosed the patient as having
a terminal condition.
(2) The patient has executed a living will declaration or a life
prolonging procedures will declaration in accordance with this
chapter and was of sound mind at the time of the execution.
(b) The attending physician shall include a copy of the certificate
in the patient's medical records.
(c) It is lawful for the attending physician to withhold or withdraw
life prolonging procedures from a qualified patient if that patient
properly executed a living will declaration under this chapter.
(d) A health care provider or an employee under the direction of
a health care provider who:
(1) in good faith; and
(2) in accordance with reasonable medical standards;
participates in the withholding or withdrawal of life prolonging
procedures from a qualified patient who has executed a living will
declaration in accordance with this chapter is not subject to criminal
or civil liability and may not be found to have committed an act of
unprofessional conduct.
(e) An attending physician who refuses to use, withhold, or
withdraw life prolonging procedures from a qualified patient shall
transfer the qualified patient to another physician who will honor the
patient's living will declaration or life prolonging procedures will
declaration unless:
(1) the physician has reason to believe the declaration was not
validly executed or there is evidence that the patient no longer
intends the declaration to be enforced; and
(2) the patient is presently unable to validate the declaration.
(f) If the attending physician, after reasonable investigation, finds
no other physician willing to honor the patient's declaration, the
attending physician may refuse to withhold or withdraw life
prolonging procedures.
(g) If the attending physician does not transfer a patient for the
reason set forth in subsection (e), the physician shall attempt to
ascertain the patient's intention and attempt to determine the validity
of the declaration by consulting with any of the following individuals
who are reasonably available, willing, and competent to act:
(1) The judicially appointed guardian of the person of the
patient if one has been appointed. This subdivision does not
require the appointment of a guardian so that a treatment
decision can be made under this section.
(2) The person or persons designated by the patient in writing
to make the treatment decision.
(3) The patient's spouse.
(4) An adult child of the patient or, if the patient has more than
one (1) adult child, by a majority of the children who are
reasonably available for consultation.
(5) The parents of the patient.
(6) An adult sibling of the patient or, if the patient has more
than one (1) adult sibling, by a majority of the siblings who are
reasonably available for consultation.
(7) The patient's clergy or others with firsthand knowledge of
the patient's intention.
The individuals described in subdivisions (1) through (7) shall act in
the best interest of the patient and shall be guided by the patient's
express or implied intentions, if known.
(h) The physician shall list the names of the individuals described
in subsection (g) who were consulted and the information received
in the patient's medical records.
(i) If the attending physician determines from the information
received under subsection (g) that the qualified patient intended to
execute a valid living will declaration, the physician may either:
(1) withhold or withdraw life prolonging procedures, with the
concurrence of one (1) other physician, as documented in the
patient's medical records; or
(2) request a court of competent jurisdiction to appoint a
guardian for the patient to make the consent decision on behalf
of the patient. As added by P.L.2-1993, SEC.19. Amended by P.L.99-1994, SEC.3.
IC 16-36-4-14 Presumptions
Sec. 14. If the qualified patient who executed a living will
declaration is incompetent at the time of the decision to withhold or
withdraw life prolonging procedures, a living will declaration
executed in accordance with this chapter is presumed to be valid. For
purposes of this chapter, a health care provider may presume in the
absence of actual notice to the contrary that the declarant was of
sound mind when the living will declaration was executed. The fact
that the declarant executed a declaration may not be considered as an
indication of a declarant's mental incompetency. As added by P.L.2-1993, SEC.19.
IC 16-36-4-15 Cancellation or destruction of declaration; falsification or forgery
of revocation of another's declaration; offense
Sec. 15. A person who knowingly or intentionally:
(1) physically cancels or destroys a living will declaration or a
life prolonging procedures will declaration without the
declarant's consent; or
(2) falsifies or forges a revocation of another person's living
will declaration or life prolonging procedures will declaration;
commits a Class D felony. As added by P.L.2-1993, SEC.19.
IC 16-36-4-16 Falsification or forgery of declaration; concealment or withholding
of revocation of declaration; offense
Sec. 16. A person who knowingly or intentionally:
(1) falsifies or forges the living will declaration of another
person with intent to cause withholding or withdrawal of life
prolonging procedures; or
(2) conceals or withholds personal knowledge of the revocation
of a living will declaration with intent to cause a withholding or
withdrawal of life prolonging procedures;
commits a Class C felony. As added by P.L.2-1993, SEC.19.
IC 16-36-4-17 Effect of living will or life prolonging procedures will declaration;
suicide; life insurance
Sec. 17. (a) A death caused by the withholding or withdrawal of
life prolonging procedures in accordance with this chapter does not
constitute a suicide.
(b) The execution of a living will declaration or a life prolonging
procedures will declaration under this chapter does not:
(1) affect the sale or issuance of any life insurance policy; or
(2) modify the terms of a policy in force when the declaration
is executed.
(c) A policy of life insurance is not legally impaired or invalidated
by the withholding or withdrawal of life prolonging procedures from
an insured qualified patient, notwithstanding any term of the policy
to the contrary.
(d) A person may not require another person to execute a living
will declaration or a life prolonging procedures will declaration as a
condition for being insured for or receiving health care services.
(e) This chapter does not impair or supersede any legal right or
legal responsibility that any person may have to effect the
withholding or withdrawal of life prolonging procedures in any
lawful manner.
(f) A person who has been found:
(1) guilty; or
(2) guilty but mentally ill;
of an offense described in section 16 of this chapter is subject to
IC 29-1-2-12.1. As added by P.L.2-1993, SEC.19.
IC 16-36-4-18 Presumption of intent to consent to withholding or withdrawal of
life prolonging procedures
Sec. 18. This chapter creates no presumption concerning the
intention of a person who has not executed a living will declaration
to consent to the withholding or withdrawal of life prolonging
procedures if a terminal condition exists. As added by P.L.2-1993, SEC.19.
IC 16-36-4-19 Euthanasia distinguished
Sec. 19. This chapter does not authorize euthanasia or any
affirmative or deliberate act or omission to end life other than to
permit the natural process of dying, including the withholding or
withdrawing of life prolonging procedures under this chapter. As added by P.L.2-1993, SEC.19.
IC 16-36-4-20 Intervening forces; proximate causation
Sec. 20. The act of withholding or withdrawing life prolonging
procedures, when done under:
(1) a living will declaration made under this chapter;
(2) a court order or decision of a court appointed guardian; or
(3) a good faith medical decision by the attending physician that
the patient has a terminal condition;
is not an intervening force and does not affect the chain of proximate
cause between the conduct of any person that placed the patient in a
terminal condition and the patient's death. As added by P.L.2-1993, SEC.19.
IC 16-36-4-21 Chapter violations by physician; discipline
Sec. 21. A physician who knowingly violates this chapter is
subject to disciplinary sanctions under IC 25-1-9 as if the physician
had knowingly violated a rule adopted by the medical licensing board
under IC 25-22.5-2-7. As added by P.L.2-1993, SEC.19.
