144A.3 DECLARATION RELATING TO USE OF LIFE-SUSTAINING
PROCEDURES.
1. A competent adult may execute a declaration at any time
directing that life-sustaining procedures be withheld or withdrawn.
The declaration shall be given operative effect only if the
declarant's condition is determined to be terminal and the declarant
is not able to make treatment decisions.
2. The declaration must be signed by the declarant or another
person acting on behalf of the declarant at the direction of the
declarant, must contain the date of the declaration's execution, and
must be witnessed or acknowledged by one of the following methods:
a. Is signed by at least two individuals who, in the presence
of each other and the declarant, witnessed the signing of the
declaration by the declarant or by another person acting on behalf of
the declarant at the declarant's direction. At least one of the
witnesses shall be an individual who is not a relative of the
declarant by blood, marriage, or adoption within the third degree of
consanguinity. The following individuals shall not be witnesses for
a declaration:
(1) A health care provider attending the declarant on the date of
execution of the declaration.
(2) An employee of a health care provider attending the declarant
on the date of execution of the declaration.
(3) An individual who is less than eighteen years of age.
b. Is acknowledged before a notarial officer within this
state.
3. It is the responsibility of the declarant to provide the
declarant's attending physician or health care provider with the
declaration. An attending physician or health care provider may
presume, in the absence of actual notice to the contrary, that the
declaration complies with this chapter and is valid.
4. A declaration or similar document executed in another state or
jurisdiction in compliance with the law of that state or jurisdiction
shall be deemed valid and enforceable in this state, to the extent
the declaration or similar document is consistent with the laws of
this state. A declaration or similar document executed by a veteran
of the armed forces which is in compliance with the federal
department of veterans affairs advance directive requirements shall
be deemed valid and enforceable.
5. A declaration executed pursuant to this chapter may, but need
not, be in the following form:
DECLARATION
If I should have an incurable or irreversible condition that will
result either in death within a relatively short period of time or a
state of permanent unconsciousness from which, to a reasonable degree
of medical certainty, there can be no recovery, it is my desire that
my life not be prolonged by the administration of life-sustaining
procedures. If I am unable to participate in my health care
decisions, I direct my attending physician to withhold or withdraw
life-sustaining procedures that merely prolong the dying process and
are not necessary to my comfort or freedom from pain.
Section History: Recent Form
85 Acts, ch 3, § 4; 92 Acts, ch 1132, § 4; 98 Acts, ch 1083, §1;
2002 Acts, ch 1061, §2, 3
Referred to in § 144A.2, 144A.11
144A.3 DECLARATION RELATING TO USE OF LIFE-SUSTAINING
PROCEDURES.
1. A competent adult may execute a declaration at any time
directing that life-sustaining procedures be withheld or withdrawn.
The declaration shall be given operative effect only if the
declarant's condition is determined to be terminal and the declarant
is not able to make treatment decisions.
2. The declaration must be signed by the declarant or another
person acting on behalf of the declarant at the direction of the
declarant, must contain the date of the declaration's execution, and
must be witnessed or acknowledged by one of the following methods:
a. Is signed by at least two individuals who, in the presence
of each other and the declarant, witnessed the signing of the
declaration by the declarant or by another person acting on behalf of
the declarant at the declarant's direction. At least one of the
witnesses shall be an individual who is not a relative of the
declarant by blood, marriage, or adoption within the third degree of
consanguinity. The following individuals shall not be witnesses for
a declaration:
(1) A health care provider attending the declarant on the date of
execution of the declaration.
(2) An employee of a health care provider attending the declarant
on the date of execution of the declaration.
(3) An individual who is less than eighteen years of age.
b. Is acknowledged before a notarial officer within this
state.
3. It is the responsibility of the declarant to provide the
declarant's attending physician or health care provider with the
declaration. An attending physician or health care provider may
presume, in the absence of actual notice to the contrary, that the
declaration complies with this chapter and is valid.
4. A declaration or similar document executed in another state or
jurisdiction in compliance with the law of that state or jurisdiction
shall be deemed valid and enforceable in this state, to the extent
the declaration or similar document is consistent with the laws of
this state. A declaration or similar document executed by a veteran
of the armed forces which is in compliance with the federal
department of veterans affairs advance directive requirements shall
be deemed valid and enforceable.
5. A declaration executed pursuant to this chapter may, but need
not, be in the following form:
DECLARATION
If I should have an incurable or irreversible condition that will
result either in death within a relatively short period of time or a
state of permanent unconsciousness from which, to a reasonable degree
of medical certainty, there can be no recovery, it is my desire that
my life not be prolonged by the administration of life-sustaining
procedures. If I am unable to participate in my health care
decisions, I direct my attending physician to withhold or withdraw
life-sustaining procedures that merely prolong the dying process and
are not necessary to my comfort or freedom from pain.
Section History: Recent Form
85 Acts, ch 3, § 4; 92 Acts, ch 1132, § 4; 98 Acts, ch 1083, §1;
2002 Acts, ch 1061, §2, 3
Referred to in § 144A.2, 144A.11
144A.3 DECLARATION RELATING TO USE OF LIFE-SUSTAINING
PROCEDURES.
1. A competent adult may execute a declaration at any time
directing that life-sustaining procedures be withheld or withdrawn.
The declaration shall be given operative effect only if the
declarant's condition is determined to be terminal and the declarant
is not able to make treatment decisions.
2. The declaration must be signed by the declarant or another
person acting on behalf of the declarant at the direction of the
declarant, must contain the date of the declaration's execution, and
must be witnessed or acknowledged by one of the following methods:
a. Is signed by at least two individuals who, in the presence
of each other and the declarant, witnessed the signing of the
declaration by the declarant or by another person acting on behalf of
the declarant at the declarant's direction. At least one of the
witnesses shall be an individual who is not a relative of the
declarant by blood, marriage, or adoption within the third degree of
consanguinity. The following individuals shall not be witnesses for
a declaration:
(1) A health care provider attending the declarant on the date of
execution of the declaration.
(2) An employee of a health care provider attending the declarant
on the date of execution of the declaration.
(3) An individual who is less than eighteen years of age.
b. Is acknowledged before a notarial officer within this
state.
3. It is the responsibility of the declarant to provide the
declarant's attending physician or health care provider with the
declaration. An attending physician or health care provider may
presume, in the absence of actual notice to the contrary, that the
declaration complies with this chapter and is valid.
4. A declaration or similar document executed in another state or
jurisdiction in compliance with the law of that state or jurisdiction
shall be deemed valid and enforceable in this state, to the extent
the declaration or similar document is consistent with the laws of
this state. A declaration or similar document executed by a veteran
of the armed forces which is in compliance with the federal
department of veterans affairs advance directive requirements shall
be deemed valid and enforceable.
5. A declaration executed pursuant to this chapter may, but need
not, be in the following form:
DECLARATION
If I should have an incurable or irreversible condition that will
result either in death within a relatively short period of time or a
state of permanent unconsciousness from which, to a reasonable degree
of medical certainty, there can be no recovery, it is my desire that
my life not be prolonged by the administration of life-sustaining
procedures. If I am unable to participate in my health care
decisions, I direct my attending physician to withhold or withdraw
life-sustaining procedures that merely prolong the dying process and
are not necessary to my comfort or freedom from pain.
Section History: Recent Form
85 Acts, ch 3, § 4; 92 Acts, ch 1132, § 4; 98 Acts, ch 1083, §1;
2002 Acts, ch 1061, §2, 3
Referred to in § 144A.2, 144A.11
