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Statutes > Wyoming > Title35 > Chapter22

CHAPTER 22 - LIVING WILL

 

ARTICLE 1 - IN GENERAL

 

35-22-101. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-102. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-103. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-104. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-105. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-106. Repealed By Laws 2005, ch. 161, 3.

 

35-22-107. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-108. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-109. Repealed By Laws 2005, ch. 161, 3.

 

ARTICLE 2 - CARDIOPULMONARY RESUSCITATION DIRECTIVES

 

35-22-201. Definitions.

 

 

(a) As used in this article, unless the context otherwiserequires:

 

(i) "Cardiopulmonary resuscitation" means measures torestore cardiac function or to support breathing in the event of respiratory orcardiac arrest or malfunction. "Cardiopulmonary resuscitation"includes, but is not limited to, chest compression, delivering electric shockto the chest, or manual or mechanical methods to assist breathing;

 

(ii) "Cardiopulmonary resuscitation directive" meansan advance medical directive pertaining to the administration of cardiopulmonaryresuscitation;

 

(iii) "Emergency medical service personnel" means anyemergency medical technician at any level who is certified by the department ofhealth. "Emergency medical service personnel" includes a firstresponder certified by the department of health.

 

35-22-202. Cardiopulmonary resuscitation directives; who may execute.

 

Anyadult who has the decisional capacity to provide informed consent to or refusalof medical treatment or any other person who is, pursuant to the laws of thisstate or any other state, authorized to make medical treatment decisions onbehalf of a person who lacks such decisional capacity, may execute acardiopulmonary resuscitation directive.

 

35-22-203. Cardiopulmonary resuscitation directive forms; duties ofdepartment of health.

 

 

(a) On or before January 1, 1994, the state department ofhealth shall promulgate rules and protocols for the implementation ofcardiopulmonary resuscitation directives by emergency medical personnel. Theprotocols adopted shall include uniform methods of identifying persons who haveexecuted a cardiopulmonary resuscitation directive. Protocols adopted by thedepartment of health shall include methods for rapid identification of personswho have executed a cardiopulmonary resuscitation directive, controlleddistribution of the methods of identifying persons who have executed acardiopulmonary resuscitation directive, and the information described insubsection (b) of this section. Nothing in this subsection shall be construedto restrict any other manner in which a person may make a cardiopulmonaryresuscitation directive.

 

(b) Cardiopulmonary resuscitation directive protocols to beadopted by the state department of health shall, at a minimum, require thefollowing information concerning the person who is the subject of thecardiopulmonary resuscitation directive:

 

(i) The person's name, date of birth and sex;

 

(ii) The person's eye and hair color;

 

(iii) The person's race or ethnic background;

 

(iv) If applicable, the name of a hospice program in which theperson is enrolled;

 

(v) The name, address and telephone number of the person'sattending physician;

 

(vi) The person's signature or mark or, if applicable, thesignature of a person authorized by this article to execute a cardiopulmonaryresuscitation directive;

 

(vii) The date on which the cardiopulmonary resuscitationdirective was signed;

 

(viii) The person's directive concerning the administration ofcardiopulmonary resuscitation, countersigned by the person's attendingphysician.

 

35-22-204. Duty to comply with cardiopulmonary resuscitation directive;immunity; effect on criminal charges against another person.

 

 

(a) Emergency medical service personnel, health care providersand health care facilities shall comply with a person's cardiopulmonaryresuscitation directive that is apparent and immediately available. Anyemergency medical service personnel, health care provider, health care facilityor any other person who, in good faith, complies with a cardiopulmonaryresuscitation directive which is perceived to be valid shall not be subject tocivil or criminal liability or regulatory sanction for such compliance.

 

(b) Compliance by emergency medical service personnel, healthcare providers or health care facilities with a cardiopulmonary resuscitationdirective shall not affect the criminal prosecution of any person otherwisecharged with the commission of a criminal act.

 

(c) In the absence of a cardiopulmonary resuscitationdirective, a person's consent to cardiopulmonary resuscitation shall bepresumed.

 

35-22-205. Effect of declaration after inpatient admission.

 

Acardiopulmonary resuscitation directive for any person who is admitted to ahealth care facility shall be implemented as a physician's order concerningresuscitation as directed by the person in the cardiopulmonary resuscitationdirective, pending further physicians' orders.

 

35-22-206. Effect of cardiopulmonary resuscitation directive; absence;on life or health insurance.

 

Neithera cardiopulmonary resuscitation directive nor the failure of a person toexecute one shall affect, impair or modify any contract of life or healthinsurance or annuity or be the basis for any delay in issuing or refusing toissue an annuity or policy of life or health insurance or any increase of apremium therefor.

 

35-22-207. Revocation of cardiopulmonary resuscitation directive.

 

Acardiopulmonary resuscitation directive may be revoked at any time by theperson who is the subject of the directive or by any other person who is,pursuant to the laws of this state or any other state, authorized to makemedical treatment decisions on behalf of the person who is the subject of thedirective.

 

35-22-208. Effect of article on euthanasia; mercy killing; constructionof statute.

 

Nothingis this article shall be construed as condoning, authorizing or approvingeuthanasia or mercy killing. In addition, the legislature does not intend thatthis article be construed as permitting any affirmative or deliberate act toend a person's life, except to permit natural death as provided by thisarticle.

 

ARTICLE 3 - PSYCHIATRIC ADVANCE DIRECTIVES

 

35-22-301. Definitions.

 

(a) As used in this act:

 

(i) "Adult" means a person eighteen (18) years of ageor older;

 

(ii) "Agent" means any person authorized in thepsychiatric advance directive to make decisions on behalf of the person whoexecuted the directive;

 

(iii) "Psychiatric advance directive" means an advancemedical directive pertaining to the administration or refusal of psychiatricrestabilization for the care and treatment of mental illness;

 

(iv) "Psychiatric personnel" means any licensed physicianwho specializes in psychiatric care;

 

(v) "Psychiatric restabilization" means measures torestore mental function or to support mental health in the event ofdestabilization of mental health due to lack of appropriate treatment. Psychiatric restabilization measures include administration of prescribedliquid medication by mouth or injection, administration of prescribedmedication orally, physical restraint, seclusion or crisis psychiatriccounseling;

 

(vi) "This act" means W.S. 35-22-301 through35-22-308.

 

35-22-302. Psychiatric advance directives; who may execute.

 

Any adult who has the decisional capacityto provide informed consent to or refusal of psychiatric restabilizationmeasures or any other person who is, pursuant to the laws of this state or anyother state, authorized to consent to or refuse psychiatric restabilizationmeasures on behalf of a person who lacks the decisional capacity, may execute apsychiatric advance directive.

 

35-22-303. Psychiatric advance directive forms; duties of department ofhealth.

 

(a) On or before January 1, 2000, the state department ofhealth shall promulgate rules, protocols and forms for the implementation ofpsychiatric advance directives by psychiatric personnel. The protocols adoptedshall include uniform methods for rapid identification of persons who haveexecuted a psychiatric advance directive, methods to protect theconfidentiality of persons who have executed a psychiatric advance directiveand the information described in subsection (b) of this section. Nothing inthis subsection shall be construed to restrict any other manner in which aperson may make a psychiatric advance directive. Forms which meet therequirements of law and are consistent with patient rights shall be developedand disseminated throughout the state as recommended forms.

 

(b) Psychiatric advance directive protocols to be adopted bythe state department of health shall, at a minimum, require the followinginformation concerning the person who is the subject of the psychiatric advancedirective:

 

(i) The person's name, date of birth and sex;

 

(ii) The person's eye and hair color;

 

(iii) The person's race or ethnic background;

 

(iv) The person's social security number;

 

(v) If applicable, the name of a treatment program and thesponsoring facility or institution in which the person is enrolled;

 

(vi) The name, address and telephone number of the person'sattending physician or psychiatric personnel;

 

(vii) The person's signature or mark or, if applicable, thesignature of a person authorized by this article to execute a psychiatricadvance directive;

 

(viii) The date on which the psychiatric advance directive wassigned;

 

(ix) The person's directive concerning the administration orrefusal of psychiatric restabilization measures, countersigned by the person'sattending physician or psychiatric personnel;

 

(x) The name, address and telephone number of the persondesignated as an agent, if applicable, to consent to or refuse psychiatricrestabilization measures for the person who has executed a psychiatric advancedirective and the signature of that person, indicating acceptance of thisappointment.

 

35-22-304. Duty to comply; immunity; effect on criminal charges againstanother person.

 

(a) Emergency medical service personnel in emergency situationsif they are aware of the person's psychiatric advance directive, psychiatricpersonnel, health care providers and health care facilities shall comply with aperson's psychiatric advance directive to the extent medically indicated.

 

(b) Any emergency medical service personnel, psychiatricpersonnel, health care provider, health care facility or any other person who,reasonably and in good faith, complies with a psychiatric advance directiveshall not be subject to civil or criminal liability or regulatory sanction forsuch compliance.

 

(c) Compliance by emergency medical service personnel,psychiatric personnel, health care providers or health care facilities with apsychiatric advance directive shall not affect the criminal prosecution of anyperson otherwise charged with the commission of a criminal act.

 

(d) In the absence of a psychiatric advance directive, aperson's consent to psychiatric restabilization measures shall not be presumed.

 

35-22-305. Effect of declaration after inpatient admission.

 

A psychiatric advance directive for anyperson who is admitted to a health care facility or mental health facilityshall be implemented as directed by the psychiatric advance directive, pendingfurther physician's orders. The psychiatric advance directive may be deviatedfrom only with the consent of the admitted person, his agent, the districtcourt or when adherence to the directive threatens permanent physical injury.

 

35-22-306. Effect of directive on life or health insurance.

 

Neither a psychiatric advance directive northe failure of a person to execute one shall affect, impair or modify anycontract of life or health insurance or annuity or be the basis for any delayin issuing or refusing to issue an annuity or policy of life or healthinsurance or any increase of a premium thereof.

 

35-22-307. Revocation of psychiatric advance directive.

 

A psychiatric advance directive may berevoked at any time by the person who is the subject of the directive unless heis mentally incompetent or at any time by any other person who is, pursuant tothe laws of this state or any other state, authorized to consent to or refusepsychiatric restabilization measures on behalf of the person who is the subjectof the directive.

 

35-22-308. Duration of psychiatric advance directive.

 

A psychiatric advance directive shall bevalid for a period not to exceed two (2) years from the date of executionunless reaffirmed by the person who executed the directive, in which case itshall be valid for two (2) years from the date of reaffirmation.

 

ARTICLE 4 - WYOMING HEALTH CARE DECISIONS ACT

 

35-22-401. Short title.

 

This act may be cited as the "WyomingHealth Care Decisions Act."

 

35-22-402. Definitions.

 

(a) As used in this act:

 

(i) "Advance health care directive" means an individualinstruction or a power of attorney for health care, or both;

 

(ii) "Agent" means an individual designated in a powerof attorney for health care to make a health care decision for the individualgranting the power;

 

(iii) "Artificial nutrition and hydration" meanssupplying food and water through a conduit, such as a tube or an intravenousline where the recipient is not required to chew or swallow voluntarily,including, but not limited to, nasogastric tubes, gastrostomies, jejunostomiesand intravenous infusions. Artificial nutrition and hydration does not includeassisted feeding, such as spoon or bottle feeding;

 

(iv) "Capacity" means an individual's ability tounderstand the significant benefits, risks and alternatives to proposed healthcare and to make and communicate a health care decision;

 

(v) "Community care facility" means a public orprivate facility responsible for the day-to-day care of persons withdisabilities;

 

(vi) "Emancipated minor" means a minor who has becomeemancipated as provided in W.S. 14-1-201 through 14-1-206;

 

(vii) "Guardian" means a judicially appointed guardianor conservator having authority to make a health care decision for anindividual;

 

(viii) "Health care" means any care, treatment, serviceor procedure to maintain, diagnose or otherwise affect an individual's physicalor mental condition;

 

(ix) "Health care decision" means a decision made byan individual or the individual's agent, guardian, or surrogate, regarding theindividual's health care, including:

 

(A) Selection and discharge of health care providers andinstitutions;

 

(B) Approval or disapproval of diagnostic tests, surgicalprocedures, programs of medication and orders not to resuscitate; and

 

(C) Directions to provide, withhold or withdraw artificialnutrition and hydration and all other forms of health care.

 

(x) "Health care institution" means an institution,facility or agency licensed, certified or otherwise authorized or permitted bylaw to provide health care in the ordinary course of business;

 

(xi) "Individual instruction" means an individual'sdirection concerning a health care decision for the individual;

 

(xii) "Physician" means an individual authorized topractice medicine under the Wyoming Medical Practice Act;

 

(xiii) "Power of attorney for health care" means thedesignation of an agent to make health care decisions for the individualgranting the power;

 

(xiv) "Primary health care provider" means any personlicensed under the Wyoming statutes practicing within the scope of that licenseas a licensed physician, licensed physician's assistant or licensed advancedpractice registered nurse and who is designated by an individual or theindividual's agent, guardian or surrogate to have primary responsibility forthe individual's health care or, in the absence of a designation or if thedesignated provider is not reasonably available, a provider who undertakes theresponsibility;

 

(xv) "Primary physician" means a physician designatedby an individual or the individual's agent, guardian or surrogate, to haveprimary responsibility for the individual's health care or, in the absence of adesignation or if the designated physician is not reasonably available, aphysician who undertakes the responsibility;

 

(xvi) "Reasonably available" means able to be contactedwith a level of diligence appropriate to the seriousness and urgency of apatient's health care needs and willing and able to act in a timely mannerconsidering the urgency of the patient's health care needs;

 

(xvii) "Residential care facility" means a public orprivate facility providing for the residential and health care needs of theelderly or persons with disabilities or chronic mental illness;

 

(xviii) "State" means a state of the United States, theDistrict of Columbia, the Commonwealth of Puerto Rico or a territory or insularpossession subject to the jurisdiction of the United States;

 

(xix) Repealed By Laws 2007, Ch. 61, 2.

 

(xx) "Surrogate" means an adult individual or individualswho:

 

(A) Have capacity;

 

(B) Are reasonably available;

 

(C) Are willing to make health care decisions, includingdecisions to initiate, refuse to initiate, continue or discontinue the use of alife sustaining procedure on behalf of a patient who lacks capacity; and

 

(D) Are identified by the primary health care provider inaccordance with this act as the person or persons who are to make thosedecisions in accordance with this act.

 

(xxi) "This act" means W.S. 35-22-401 through35-22-416.

 

35-22-403. Advance health care directives.

 

(a) An adult or emancipated minor may give an individualinstruction. The instruction may be oral or written. The instruction may belimited to take effect only if a specified condition arises.

 

(b) An adult or emancipated minor may execute a power ofattorney for health care, which may authorize the agent to make any health caredecision the principal could have made while having capacity. The power must bein writing and signed by the principal or by another person in the principal'spresence and at the principal's expressed direction. The power remains ineffect notwithstanding the principal's later incapacity and may includeindividual instructions. Unless related to the principal by blood, marriage oradoption, an agent may not be an owner, operator or employee of a residentialor community care facility at which the principal is receiving care. Thedurable power of attorney must be acknowledged before a notarial officer ormust be signed by at least two (2) witnesses, each of whom witnessed either thesigning of the instrument by the principal or the principal's acknowledgementof the signature or of the instrument, each witness making the followingdeclaration in substance:

 

I declare underpenalty of perjury under the laws of Wyoming that the person who signed oracknowledged this document is known to me to be the principal, and theprincipal signed or acknowledged this document in my presence.

 

(c) None of the following shall be used as a witness for apower of attorney for health care:

 

(i) A treating health care provider or employee of theprovider;

 

(ii) The attorney-in-fact nominated in the writing;

 

(iii) The operator of a community care facility or employee ofthe operator or facility;

 

(iv) The operator of a residential care facility or employee ofthe operator or facility.

 

(d) Unless otherwise specified in a power of attorney forhealth care, the authority of an agent becomes effective only upon adetermination that the principal lacks capacity, and ceases to be effectiveupon a determination that the principal has recovered capacity.

 

(e) Unless otherwise specified in a written advance health caredirective, a determination that an individual lacks or has recovered capacity,or that another condition exists that affects an individual instruction or theauthority of an agent, shall be made by the primary physician, but the treatingprimary health care provider may make the decision if the primary physician isunavailable.

 

(f) An agent shall make a health care decision in accordancewith the principal's advance health care directive and other wishes to theextent known to the agent. Otherwise, the agent shall make the decision inaccordance with the agent's determination of the principal's best interest. Indetermining the principal's best interest, the agent shall consider theprincipal's personal values to the extent known to the agent.

 

(g) A health care decision made by an agent for a principal iseffective without judicial approval.

 

(h) A written advance health care directive may include theindividual's nomination of a guardian of the person.

 

(j) An advance health care directive is valid for purposes ofthis act if it complied with the applicable law at the time of execution orcommunication.

 

35-22-404. Revocation of advance health care directive.

 

(a) An individual with capacity may revoke the designation ofan agent only by a signed writing.

 

(b) An individual with capacity may revoke all or part of anadvance health care directive, other than the designation of an agent, at anytime and in any manner that communicates an intention to revoke. Any oralrevocation shall, as soon as possible after the revocation, be documented in awriting signed and dated by the individual or a witness to the revocation.

 

(c) A health care provider, agent, guardian or surrogate who isinformed of a revocation shall promptly communicate the fact of the revocationto the primary health care provider and to any health care institution at whichthe patient is receiving care.

 

(d) A decree of annulment, divorce, dissolution of marriage orlegal separation revokes a previous designation of a spouse as agent unlessotherwise specified in the decree or in a power of attorney for health care.

 

(e) An advance health care directive that conflicts with anearlier advance health care directive revokes the earlier directive to theextent of the conflict.

 

35-22-405. Repealed By Laws 2007, Ch. 61, 2.

 

 

35-22-406. Decisions by surrogate.

 

(a) If a valid advance health care directive does not exist, asurrogate may make a health care decision for a patient who is an adult oremancipated minor if the patient has been determined by the primary physicianor the primary health care provider to lack capacity and no agent or guardianhas been appointed or the agent or guardian is not reasonably available.

 

(b) An adult or emancipated minor may designate any individualto act as surrogate by personally informing the primary health care provider.In the absence of a designation, or if the designee is not reasonablyavailable, it is suggested that any member of the following classes of thepatient's family who is reasonably available, in descending order of priority,may act as surrogate:

 

(i) The spouse, unless legally separated;

 

(ii) An adult child;

 

(iii) A parent;

 

(iv) A grandparent;

 

(v) An adult brother or sister;

 

(vi) An adult grandchild.

 

(c) If none of the individuals eligible to act as surrogateunder subsection (b) of this section is reasonably available, an adult who hasexhibited special care and concern for the patient, who is familiar with thepatient's personal values, and who is reasonably available may act assurrogate.

 

(d) A surrogate shall communicate his assumption of authorityas promptly as practicable to the members of the patient's family specified insubsection (b) of this section who can be readily contacted.

 

(e) If more than one (1) member of a class assumes authority toact as surrogate, and the other members of the class do not agree on a healthcare decision and the primary health care provider is so informed, the primaryhealth care provider shall comply with the decision of a majority of themembers of that class who have communicated their views to the provider.

 

(f) A surrogate shall make a health care decision in accordancewith the patient's individual instructions, if any, and other wishes to theextent known to the surrogate. Otherwise, the surrogate shall make the decisionin accordance with the surrogate's determination of the patient's bestinterest. In determining the patient's best interest, the surrogate shallconsider the patient's personal, philosophical, religious and ethical values tothe extent known to the surrogate and reliable oral or written statementspreviously made by the patient, including, but not limited to, statements madeto family members, friends, health care providers or religious leaders.

 

(g) A health care decision made by a surrogate for a patient iseffective without judicial approval.

 

(h) The patient at any time may disqualify another, including amember of the individual's family, from acting as the individual's surrogate bya signed writing or by personally informing the primary health care provider ofthe disqualification.

 

(j) Unless related to the patient by blood, marriage oradoption, a surrogate may not be an owner, operator or employee of aresidential or community care facility at which the patient is receiving care.

 

(k) A primary health care provider may require an individual claimingthe right to act as surrogate for a patient to provide a written declarationunder penalty of perjury stating facts and circumstances reasonably sufficientto establish the claimed authority.

 

35-22-407. Decisions by guardian.

 

(a) Repealed By Laws 2007, Ch. 61, 2.

 

(b) Absent a court order to the contrary, a health caredecision of an agent takes precedence over that of a guardian.

 

(c) Repealed By Laws 2007, Ch. 61, 2.

 

(d) Repealed By Laws 2007, Ch. 61, 2.

 

(e) A guardian's authority to make health care decisions forthe ward shall be as provided in W.S. 3-2-201(a)(iii), subject to therestrictions in W.S. 3-2-202 and 35-22-407(b).

 

35-22-408. Obligations of health care provider.

 

(a) Before implementing a health care decision made for apatient who is able to comprehend, a primary health care provider shallpromptly communicate to the patient the decision made and may communicate theidentity of the person making the decision.

 

(b) A primary health care provider who knows of the existenceof an advance health care directive, a revocation of an advance health caredirective, or a designation or disqualification of a surrogate, shall promptlyrecord its existence in the patient's health care record and, if it is inwriting, shall request a copy and if one is furnished shall arrange for itsmaintenance in the health care record.

 

(c) The primary physician who makes or is informed of adetermination that a patient lacks or has recovered capacity, or that anothercondition exists which affects an individual instruction or the authority of anagent, guardian or surrogate, shall promptly record the determination in thepatient's health care record and communicate the determination to the patient,if possible, and to any person then authorized to make health care decisionsfor the patient.

 

(d) Except as provided in subsections (e) and (f) of thissection, a health care provider or institution providing care to a patientshall:

 

(i) Comply with an individual instruction of the patient andwith a reasonable interpretation of that instruction made by a person thenauthorized to make health care decisions for the patient; and

 

(ii) Comply with a health care decision for the patient made bya person then authorized to make health care decisions for the patient to thesame extent as if the decision had been made by the patient while havingcapacity.

 

(e) A health care provider may decline to comply with anindividual instruction or health care decision for reasons of conscience. Ahealth care institution may decline to comply with an individual instruction orhealth care decision if the instruction or decision is contrary to a writtenpolicy of the institution which is expressly based on reasons of conscience andif the policy was timely communicated to the patient or to a person thenauthorized to make health care decisions for the patient. The institutionshall deliver the written policy upon receipt of the patient's advancedirective that may conflict with the policy or upon notice from the primaryhealth care provider that the patient's instruction or decision may be inconflict with the health care institution's policy.

 

(f) A health care provider or institution may decline to complywith an individual instruction or health care decision that requires medicallyineffective health care or health care contrary to generally accepted healthcare standards applicable to the health care provider or institution.

 

(g) A health care provider or institution that declines tocomply with an individual instruction or health care decision shall:

 

(i) Promptly so inform the patient, if possible, and any personthen authorized to make health care decisions for the patient;

 

(ii) Provide continuing care, including continuing life sustainingcare, to the patient until a transfer can be effected; and

 

(iii) Unless the patient or person then authorized to make healthcare decisions for the patient refuses assistance, immediately make allreasonable efforts to assist in the transfer of the patient to another healthcare provider or institution that is willing to comply with the instruction ordecision.

 

(h) A health care provider or institution may not require orprohibit the execution or revocation of an advance health care directive as acondition for providing health care.

 

35-22-409. Health care information.

 

Unless otherwise specified in an advancehealth care directive, a person then authorized to make health care decisions fora patient has the same rights as the patient to request, receive, examine, copyand consent to the disclosure of medical or any other health care information.

 

35-22-410. Immunities.

 

(a) A health care provider or institution acting in good faithand in accordance with generally accepted health care standards applicable tothe health care provider or institution is not subject to civil or criminalliability or to discipline for:

 

(i) Complying with a health care decision of a personapparently having authority to make a health care decision for a patient,including a decision to withhold or withdraw health care;

 

(ii) Declining to comply with a health care decision of a personbased on a belief that the person then lacked authority;

 

(iii) Complying with an advance health care directive andassuming that the directive was valid when made and has not been revoked orterminated;

 

(iv) Providing life-sustaining treatment in an emergencysituation when the existence of a health care directive is unknown; or

 

(v) Declining to comply with a health care decision or advancehealth care directive because the instruction is contrary to the conscience orgood faith medical judgment of the health care provider, or the writtenpolicies of the institution.

 

(b) An individual acting in good faith as agent or surrogateunder this act is not subject to civil liability or criminal prosecution or todiscipline by a licensing board for unprofessional conduct for health caredecisions made in good faith.

 

35-22-411. Statutory damages.

 

(a) A health care provider or institution that violates thisact willfully or with reckless disregard of the patient's instruction or healthcare decision is subject to liability to the aggrieved individual for damagesof five hundred dollars ($500.00) or actual damages resulting from theviolation, whichever is greater, plus reasonable attorney's fees.

 

(b) A person who intentionally falsifies, forges, conceals,defaces or obliterates an individual's advance health care directive or arevocation of an advance health care directive without the individual'sconsent, or who coerces or fraudulently induces an individual to give, revokeor not to give an advance health care directive, is subject to liability tothat individual for damages of two thousand five hundred dollars ($2,500.00) oractual damages resulting from the action, whichever is greater, plus reasonableattorney's fees.

 

35-22-412. Capacity.

 

(a) This act does not affect the right of an individual to makehealth care decisions while having capacity to do so.

 

(b) An individual is presumed to have capacity to make a healthcare decision, to give or revoke an advance health care directive, and todesignate or disqualify a surrogate unless the primary physician has certifiedin writing that the patient lacks such capacity.

 

35-22-413. Effect of copy.

 

A copy of a written advance health caredirective, revocation of an advance health care directive, or designation ordisqualification of a surrogate has the same effect as the original.

 

35-22-414. Effect of act.

 

(a) This act does not create a presumption concerning theintention of an individual who has not made or who has revoked an advancehealth care directive.

 

(b) Death resulting from the withholding or withdrawal ofhealth care in accordance with this act does not for any purpose constitute asuicide or homicide or legally impair or invalidate a policy of insurance or anannuity providing a death benefit, notwithstanding any term of the policy orannuity to the contrary.

 

(c) This act does not authorize mercy killing, assistedsuicide, euthanasia or the provision, withholding or withdrawal of health care,to the extent prohibited by other statutes of this state.

 

(d) This act does not authorize or require a health careprovider or institution to provide health care contrary to generally acceptedhealth care standards applicable to the health care provider or institution.

 

(e) This act does not affect other statutes of this stategoverning treatment for mental illness of an individual involuntarily committedto a mental health care institution pursuant to law or a psychiatric advancedirective executed in accordance with W.S. 35-22-301 through 35-22-308.

 

(f) Any cardiopulmonary resuscitation directives developedunder W.S. 35-22-201 through 35-22-208 shall remain in effect unlessspecifically revoked by the advance health care directive.

 

35-22-415. Judicial relief.

 

On petition of a patient, the patient'sagent, guardian or surrogate, a health care provider or institution involvedwith the patient's care, or an individual described in W.S. 35-22-406(b) or (c)the district court may enjoin or direct a health care decision or order otherequitable relief. A proceeding under this section is governed by the WyomingRules of Civil Procedure.

 

35-22-416. Uniformity of application and construction.

 

This act shall be applied and construed toeffectuate its general purpose to make uniform the law with respect to thesubject matter of this act among states enacting it.

 

State Codes and Statutes

Statutes > Wyoming > Title35 > Chapter22

CHAPTER 22 - LIVING WILL

 

ARTICLE 1 - IN GENERAL

 

35-22-101. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-102. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-103. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-104. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-105. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-106. Repealed By Laws 2005, ch. 161, 3.

 

35-22-107. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-108. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-109. Repealed By Laws 2005, ch. 161, 3.

 

ARTICLE 2 - CARDIOPULMONARY RESUSCITATION DIRECTIVES

 

35-22-201. Definitions.

 

 

(a) As used in this article, unless the context otherwiserequires:

 

(i) "Cardiopulmonary resuscitation" means measures torestore cardiac function or to support breathing in the event of respiratory orcardiac arrest or malfunction. "Cardiopulmonary resuscitation"includes, but is not limited to, chest compression, delivering electric shockto the chest, or manual or mechanical methods to assist breathing;

 

(ii) "Cardiopulmonary resuscitation directive" meansan advance medical directive pertaining to the administration of cardiopulmonaryresuscitation;

 

(iii) "Emergency medical service personnel" means anyemergency medical technician at any level who is certified by the department ofhealth. "Emergency medical service personnel" includes a firstresponder certified by the department of health.

 

35-22-202. Cardiopulmonary resuscitation directives; who may execute.

 

Anyadult who has the decisional capacity to provide informed consent to or refusalof medical treatment or any other person who is, pursuant to the laws of thisstate or any other state, authorized to make medical treatment decisions onbehalf of a person who lacks such decisional capacity, may execute acardiopulmonary resuscitation directive.

 

35-22-203. Cardiopulmonary resuscitation directive forms; duties ofdepartment of health.

 

 

(a) On or before January 1, 1994, the state department ofhealth shall promulgate rules and protocols for the implementation ofcardiopulmonary resuscitation directives by emergency medical personnel. Theprotocols adopted shall include uniform methods of identifying persons who haveexecuted a cardiopulmonary resuscitation directive. Protocols adopted by thedepartment of health shall include methods for rapid identification of personswho have executed a cardiopulmonary resuscitation directive, controlleddistribution of the methods of identifying persons who have executed acardiopulmonary resuscitation directive, and the information described insubsection (b) of this section. Nothing in this subsection shall be construedto restrict any other manner in which a person may make a cardiopulmonaryresuscitation directive.

 

(b) Cardiopulmonary resuscitation directive protocols to beadopted by the state department of health shall, at a minimum, require thefollowing information concerning the person who is the subject of thecardiopulmonary resuscitation directive:

 

(i) The person's name, date of birth and sex;

 

(ii) The person's eye and hair color;

 

(iii) The person's race or ethnic background;

 

(iv) If applicable, the name of a hospice program in which theperson is enrolled;

 

(v) The name, address and telephone number of the person'sattending physician;

 

(vi) The person's signature or mark or, if applicable, thesignature of a person authorized by this article to execute a cardiopulmonaryresuscitation directive;

 

(vii) The date on which the cardiopulmonary resuscitationdirective was signed;

 

(viii) The person's directive concerning the administration ofcardiopulmonary resuscitation, countersigned by the person's attendingphysician.

 

35-22-204. Duty to comply with cardiopulmonary resuscitation directive;immunity; effect on criminal charges against another person.

 

 

(a) Emergency medical service personnel, health care providersand health care facilities shall comply with a person's cardiopulmonaryresuscitation directive that is apparent and immediately available. Anyemergency medical service personnel, health care provider, health care facilityor any other person who, in good faith, complies with a cardiopulmonaryresuscitation directive which is perceived to be valid shall not be subject tocivil or criminal liability or regulatory sanction for such compliance.

 

(b) Compliance by emergency medical service personnel, healthcare providers or health care facilities with a cardiopulmonary resuscitationdirective shall not affect the criminal prosecution of any person otherwisecharged with the commission of a criminal act.

 

(c) In the absence of a cardiopulmonary resuscitationdirective, a person's consent to cardiopulmonary resuscitation shall bepresumed.

 

35-22-205. Effect of declaration after inpatient admission.

 

Acardiopulmonary resuscitation directive for any person who is admitted to ahealth care facility shall be implemented as a physician's order concerningresuscitation as directed by the person in the cardiopulmonary resuscitationdirective, pending further physicians' orders.

 

35-22-206. Effect of cardiopulmonary resuscitation directive; absence;on life or health insurance.

 

Neithera cardiopulmonary resuscitation directive nor the failure of a person toexecute one shall affect, impair or modify any contract of life or healthinsurance or annuity or be the basis for any delay in issuing or refusing toissue an annuity or policy of life or health insurance or any increase of apremium therefor.

 

35-22-207. Revocation of cardiopulmonary resuscitation directive.

 

Acardiopulmonary resuscitation directive may be revoked at any time by theperson who is the subject of the directive or by any other person who is,pursuant to the laws of this state or any other state, authorized to makemedical treatment decisions on behalf of the person who is the subject of thedirective.

 

35-22-208. Effect of article on euthanasia; mercy killing; constructionof statute.

 

Nothingis this article shall be construed as condoning, authorizing or approvingeuthanasia or mercy killing. In addition, the legislature does not intend thatthis article be construed as permitting any affirmative or deliberate act toend a person's life, except to permit natural death as provided by thisarticle.

 

ARTICLE 3 - PSYCHIATRIC ADVANCE DIRECTIVES

 

35-22-301. Definitions.

 

(a) As used in this act:

 

(i) "Adult" means a person eighteen (18) years of ageor older;

 

(ii) "Agent" means any person authorized in thepsychiatric advance directive to make decisions on behalf of the person whoexecuted the directive;

 

(iii) "Psychiatric advance directive" means an advancemedical directive pertaining to the administration or refusal of psychiatricrestabilization for the care and treatment of mental illness;

 

(iv) "Psychiatric personnel" means any licensed physicianwho specializes in psychiatric care;

 

(v) "Psychiatric restabilization" means measures torestore mental function or to support mental health in the event ofdestabilization of mental health due to lack of appropriate treatment. Psychiatric restabilization measures include administration of prescribedliquid medication by mouth or injection, administration of prescribedmedication orally, physical restraint, seclusion or crisis psychiatriccounseling;

 

(vi) "This act" means W.S. 35-22-301 through35-22-308.

 

35-22-302. Psychiatric advance directives; who may execute.

 

Any adult who has the decisional capacityto provide informed consent to or refusal of psychiatric restabilizationmeasures or any other person who is, pursuant to the laws of this state or anyother state, authorized to consent to or refuse psychiatric restabilizationmeasures on behalf of a person who lacks the decisional capacity, may execute apsychiatric advance directive.

 

35-22-303. Psychiatric advance directive forms; duties of department ofhealth.

 

(a) On or before January 1, 2000, the state department ofhealth shall promulgate rules, protocols and forms for the implementation ofpsychiatric advance directives by psychiatric personnel. The protocols adoptedshall include uniform methods for rapid identification of persons who haveexecuted a psychiatric advance directive, methods to protect theconfidentiality of persons who have executed a psychiatric advance directiveand the information described in subsection (b) of this section. Nothing inthis subsection shall be construed to restrict any other manner in which aperson may make a psychiatric advance directive. Forms which meet therequirements of law and are consistent with patient rights shall be developedand disseminated throughout the state as recommended forms.

 

(b) Psychiatric advance directive protocols to be adopted bythe state department of health shall, at a minimum, require the followinginformation concerning the person who is the subject of the psychiatric advancedirective:

 

(i) The person's name, date of birth and sex;

 

(ii) The person's eye and hair color;

 

(iii) The person's race or ethnic background;

 

(iv) The person's social security number;

 

(v) If applicable, the name of a treatment program and thesponsoring facility or institution in which the person is enrolled;

 

(vi) The name, address and telephone number of the person'sattending physician or psychiatric personnel;

 

(vii) The person's signature or mark or, if applicable, thesignature of a person authorized by this article to execute a psychiatricadvance directive;

 

(viii) The date on which the psychiatric advance directive wassigned;

 

(ix) The person's directive concerning the administration orrefusal of psychiatric restabilization measures, countersigned by the person'sattending physician or psychiatric personnel;

 

(x) The name, address and telephone number of the persondesignated as an agent, if applicable, to consent to or refuse psychiatricrestabilization measures for the person who has executed a psychiatric advancedirective and the signature of that person, indicating acceptance of thisappointment.

 

35-22-304. Duty to comply; immunity; effect on criminal charges againstanother person.

 

(a) Emergency medical service personnel in emergency situationsif they are aware of the person's psychiatric advance directive, psychiatricpersonnel, health care providers and health care facilities shall comply with aperson's psychiatric advance directive to the extent medically indicated.

 

(b) Any emergency medical service personnel, psychiatricpersonnel, health care provider, health care facility or any other person who,reasonably and in good faith, complies with a psychiatric advance directiveshall not be subject to civil or criminal liability or regulatory sanction forsuch compliance.

 

(c) Compliance by emergency medical service personnel,psychiatric personnel, health care providers or health care facilities with apsychiatric advance directive shall not affect the criminal prosecution of anyperson otherwise charged with the commission of a criminal act.

 

(d) In the absence of a psychiatric advance directive, aperson's consent to psychiatric restabilization measures shall not be presumed.

 

35-22-305. Effect of declaration after inpatient admission.

 

A psychiatric advance directive for anyperson who is admitted to a health care facility or mental health facilityshall be implemented as directed by the psychiatric advance directive, pendingfurther physician's orders. The psychiatric advance directive may be deviatedfrom only with the consent of the admitted person, his agent, the districtcourt or when adherence to the directive threatens permanent physical injury.

 

35-22-306. Effect of directive on life or health insurance.

 

Neither a psychiatric advance directive northe failure of a person to execute one shall affect, impair or modify anycontract of life or health insurance or annuity or be the basis for any delayin issuing or refusing to issue an annuity or policy of life or healthinsurance or any increase of a premium thereof.

 

35-22-307. Revocation of psychiatric advance directive.

 

A psychiatric advance directive may berevoked at any time by the person who is the subject of the directive unless heis mentally incompetent or at any time by any other person who is, pursuant tothe laws of this state or any other state, authorized to consent to or refusepsychiatric restabilization measures on behalf of the person who is the subjectof the directive.

 

35-22-308. Duration of psychiatric advance directive.

 

A psychiatric advance directive shall bevalid for a period not to exceed two (2) years from the date of executionunless reaffirmed by the person who executed the directive, in which case itshall be valid for two (2) years from the date of reaffirmation.

 

ARTICLE 4 - WYOMING HEALTH CARE DECISIONS ACT

 

35-22-401. Short title.

 

This act may be cited as the "WyomingHealth Care Decisions Act."

 

35-22-402. Definitions.

 

(a) As used in this act:

 

(i) "Advance health care directive" means an individualinstruction or a power of attorney for health care, or both;

 

(ii) "Agent" means an individual designated in a powerof attorney for health care to make a health care decision for the individualgranting the power;

 

(iii) "Artificial nutrition and hydration" meanssupplying food and water through a conduit, such as a tube or an intravenousline where the recipient is not required to chew or swallow voluntarily,including, but not limited to, nasogastric tubes, gastrostomies, jejunostomiesand intravenous infusions. Artificial nutrition and hydration does not includeassisted feeding, such as spoon or bottle feeding;

 

(iv) "Capacity" means an individual's ability tounderstand the significant benefits, risks and alternatives to proposed healthcare and to make and communicate a health care decision;

 

(v) "Community care facility" means a public orprivate facility responsible for the day-to-day care of persons withdisabilities;

 

(vi) "Emancipated minor" means a minor who has becomeemancipated as provided in W.S. 14-1-201 through 14-1-206;

 

(vii) "Guardian" means a judicially appointed guardianor conservator having authority to make a health care decision for anindividual;

 

(viii) "Health care" means any care, treatment, serviceor procedure to maintain, diagnose or otherwise affect an individual's physicalor mental condition;

 

(ix) "Health care decision" means a decision made byan individual or the individual's agent, guardian, or surrogate, regarding theindividual's health care, including:

 

(A) Selection and discharge of health care providers andinstitutions;

 

(B) Approval or disapproval of diagnostic tests, surgicalprocedures, programs of medication and orders not to resuscitate; and

 

(C) Directions to provide, withhold or withdraw artificialnutrition and hydration and all other forms of health care.

 

(x) "Health care institution" means an institution,facility or agency licensed, certified or otherwise authorized or permitted bylaw to provide health care in the ordinary course of business;

 

(xi) "Individual instruction" means an individual'sdirection concerning a health care decision for the individual;

 

(xii) "Physician" means an individual authorized topractice medicine under the Wyoming Medical Practice Act;

 

(xiii) "Power of attorney for health care" means thedesignation of an agent to make health care decisions for the individualgranting the power;

 

(xiv) "Primary health care provider" means any personlicensed under the Wyoming statutes practicing within the scope of that licenseas a licensed physician, licensed physician's assistant or licensed advancedpractice registered nurse and who is designated by an individual or theindividual's agent, guardian or surrogate to have primary responsibility forthe individual's health care or, in the absence of a designation or if thedesignated provider is not reasonably available, a provider who undertakes theresponsibility;

 

(xv) "Primary physician" means a physician designatedby an individual or the individual's agent, guardian or surrogate, to haveprimary responsibility for the individual's health care or, in the absence of adesignation or if the designated physician is not reasonably available, aphysician who undertakes the responsibility;

 

(xvi) "Reasonably available" means able to be contactedwith a level of diligence appropriate to the seriousness and urgency of apatient's health care needs and willing and able to act in a timely mannerconsidering the urgency of the patient's health care needs;

 

(xvii) "Residential care facility" means a public orprivate facility providing for the residential and health care needs of theelderly or persons with disabilities or chronic mental illness;

 

(xviii) "State" means a state of the United States, theDistrict of Columbia, the Commonwealth of Puerto Rico or a territory or insularpossession subject to the jurisdiction of the United States;

 

(xix) Repealed By Laws 2007, Ch. 61, 2.

 

(xx) "Surrogate" means an adult individual or individualswho:

 

(A) Have capacity;

 

(B) Are reasonably available;

 

(C) Are willing to make health care decisions, includingdecisions to initiate, refuse to initiate, continue or discontinue the use of alife sustaining procedure on behalf of a patient who lacks capacity; and

 

(D) Are identified by the primary health care provider inaccordance with this act as the person or persons who are to make thosedecisions in accordance with this act.

 

(xxi) "This act" means W.S. 35-22-401 through35-22-416.

 

35-22-403. Advance health care directives.

 

(a) An adult or emancipated minor may give an individualinstruction. The instruction may be oral or written. The instruction may belimited to take effect only if a specified condition arises.

 

(b) An adult or emancipated minor may execute a power ofattorney for health care, which may authorize the agent to make any health caredecision the principal could have made while having capacity. The power must bein writing and signed by the principal or by another person in the principal'spresence and at the principal's expressed direction. The power remains ineffect notwithstanding the principal's later incapacity and may includeindividual instructions. Unless related to the principal by blood, marriage oradoption, an agent may not be an owner, operator or employee of a residentialor community care facility at which the principal is receiving care. Thedurable power of attorney must be acknowledged before a notarial officer ormust be signed by at least two (2) witnesses, each of whom witnessed either thesigning of the instrument by the principal or the principal's acknowledgementof the signature or of the instrument, each witness making the followingdeclaration in substance:

 

I declare underpenalty of perjury under the laws of Wyoming that the person who signed oracknowledged this document is known to me to be the principal, and theprincipal signed or acknowledged this document in my presence.

 

(c) None of the following shall be used as a witness for apower of attorney for health care:

 

(i) A treating health care provider or employee of theprovider;

 

(ii) The attorney-in-fact nominated in the writing;

 

(iii) The operator of a community care facility or employee ofthe operator or facility;

 

(iv) The operator of a residential care facility or employee ofthe operator or facility.

 

(d) Unless otherwise specified in a power of attorney forhealth care, the authority of an agent becomes effective only upon adetermination that the principal lacks capacity, and ceases to be effectiveupon a determination that the principal has recovered capacity.

 

(e) Unless otherwise specified in a written advance health caredirective, a determination that an individual lacks or has recovered capacity,or that another condition exists that affects an individual instruction or theauthority of an agent, shall be made by the primary physician, but the treatingprimary health care provider may make the decision if the primary physician isunavailable.

 

(f) An agent shall make a health care decision in accordancewith the principal's advance health care directive and other wishes to theextent known to the agent. Otherwise, the agent shall make the decision inaccordance with the agent's determination of the principal's best interest. Indetermining the principal's best interest, the agent shall consider theprincipal's personal values to the extent known to the agent.

 

(g) A health care decision made by an agent for a principal iseffective without judicial approval.

 

(h) A written advance health care directive may include theindividual's nomination of a guardian of the person.

 

(j) An advance health care directive is valid for purposes ofthis act if it complied with the applicable law at the time of execution orcommunication.

 

35-22-404. Revocation of advance health care directive.

 

(a) An individual with capacity may revoke the designation ofan agent only by a signed writing.

 

(b) An individual with capacity may revoke all or part of anadvance health care directive, other than the designation of an agent, at anytime and in any manner that communicates an intention to revoke. Any oralrevocation shall, as soon as possible after the revocation, be documented in awriting signed and dated by the individual or a witness to the revocation.

 

(c) A health care provider, agent, guardian or surrogate who isinformed of a revocation shall promptly communicate the fact of the revocationto the primary health care provider and to any health care institution at whichthe patient is receiving care.

 

(d) A decree of annulment, divorce, dissolution of marriage orlegal separation revokes a previous designation of a spouse as agent unlessotherwise specified in the decree or in a power of attorney for health care.

 

(e) An advance health care directive that conflicts with anearlier advance health care directive revokes the earlier directive to theextent of the conflict.

 

35-22-405. Repealed By Laws 2007, Ch. 61, 2.

 

 

35-22-406. Decisions by surrogate.

 

(a) If a valid advance health care directive does not exist, asurrogate may make a health care decision for a patient who is an adult oremancipated minor if the patient has been determined by the primary physicianor the primary health care provider to lack capacity and no agent or guardianhas been appointed or the agent or guardian is not reasonably available.

 

(b) An adult or emancipated minor may designate any individualto act as surrogate by personally informing the primary health care provider.In the absence of a designation, or if the designee is not reasonablyavailable, it is suggested that any member of the following classes of thepatient's family who is reasonably available, in descending order of priority,may act as surrogate:

 

(i) The spouse, unless legally separated;

 

(ii) An adult child;

 

(iii) A parent;

 

(iv) A grandparent;

 

(v) An adult brother or sister;

 

(vi) An adult grandchild.

 

(c) If none of the individuals eligible to act as surrogateunder subsection (b) of this section is reasonably available, an adult who hasexhibited special care and concern for the patient, who is familiar with thepatient's personal values, and who is reasonably available may act assurrogate.

 

(d) A surrogate shall communicate his assumption of authorityas promptly as practicable to the members of the patient's family specified insubsection (b) of this section who can be readily contacted.

 

(e) If more than one (1) member of a class assumes authority toact as surrogate, and the other members of the class do not agree on a healthcare decision and the primary health care provider is so informed, the primaryhealth care provider shall comply with the decision of a majority of themembers of that class who have communicated their views to the provider.

 

(f) A surrogate shall make a health care decision in accordancewith the patient's individual instructions, if any, and other wishes to theextent known to the surrogate. Otherwise, the surrogate shall make the decisionin accordance with the surrogate's determination of the patient's bestinterest. In determining the patient's best interest, the surrogate shallconsider the patient's personal, philosophical, religious and ethical values tothe extent known to the surrogate and reliable oral or written statementspreviously made by the patient, including, but not limited to, statements madeto family members, friends, health care providers or religious leaders.

 

(g) A health care decision made by a surrogate for a patient iseffective without judicial approval.

 

(h) The patient at any time may disqualify another, including amember of the individual's family, from acting as the individual's surrogate bya signed writing or by personally informing the primary health care provider ofthe disqualification.

 

(j) Unless related to the patient by blood, marriage oradoption, a surrogate may not be an owner, operator or employee of aresidential or community care facility at which the patient is receiving care.

 

(k) A primary health care provider may require an individual claimingthe right to act as surrogate for a patient to provide a written declarationunder penalty of perjury stating facts and circumstances reasonably sufficientto establish the claimed authority.

 

35-22-407. Decisions by guardian.

 

(a) Repealed By Laws 2007, Ch. 61, 2.

 

(b) Absent a court order to the contrary, a health caredecision of an agent takes precedence over that of a guardian.

 

(c) Repealed By Laws 2007, Ch. 61, 2.

 

(d) Repealed By Laws 2007, Ch. 61, 2.

 

(e) A guardian's authority to make health care decisions forthe ward shall be as provided in W.S. 3-2-201(a)(iii), subject to therestrictions in W.S. 3-2-202 and 35-22-407(b).

 

35-22-408. Obligations of health care provider.

 

(a) Before implementing a health care decision made for apatient who is able to comprehend, a primary health care provider shallpromptly communicate to the patient the decision made and may communicate theidentity of the person making the decision.

 

(b) A primary health care provider who knows of the existenceof an advance health care directive, a revocation of an advance health caredirective, or a designation or disqualification of a surrogate, shall promptlyrecord its existence in the patient's health care record and, if it is inwriting, shall request a copy and if one is furnished shall arrange for itsmaintenance in the health care record.

 

(c) The primary physician who makes or is informed of adetermination that a patient lacks or has recovered capacity, or that anothercondition exists which affects an individual instruction or the authority of anagent, guardian or surrogate, shall promptly record the determination in thepatient's health care record and communicate the determination to the patient,if possible, and to any person then authorized to make health care decisionsfor the patient.

 

(d) Except as provided in subsections (e) and (f) of thissection, a health care provider or institution providing care to a patientshall:

 

(i) Comply with an individual instruction of the patient andwith a reasonable interpretation of that instruction made by a person thenauthorized to make health care decisions for the patient; and

 

(ii) Comply with a health care decision for the patient made bya person then authorized to make health care decisions for the patient to thesame extent as if the decision had been made by the patient while havingcapacity.

 

(e) A health care provider may decline to comply with anindividual instruction or health care decision for reasons of conscience. Ahealth care institution may decline to comply with an individual instruction orhealth care decision if the instruction or decision is contrary to a writtenpolicy of the institution which is expressly based on reasons of conscience andif the policy was timely communicated to the patient or to a person thenauthorized to make health care decisions for the patient. The institutionshall deliver the written policy upon receipt of the patient's advancedirective that may conflict with the policy or upon notice from the primaryhealth care provider that the patient's instruction or decision may be inconflict with the health care institution's policy.

 

(f) A health care provider or institution may decline to complywith an individual instruction or health care decision that requires medicallyineffective health care or health care contrary to generally accepted healthcare standards applicable to the health care provider or institution.

 

(g) A health care provider or institution that declines tocomply with an individual instruction or health care decision shall:

 

(i) Promptly so inform the patient, if possible, and any personthen authorized to make health care decisions for the patient;

 

(ii) Provide continuing care, including continuing life sustainingcare, to the patient until a transfer can be effected; and

 

(iii) Unless the patient or person then authorized to make healthcare decisions for the patient refuses assistance, immediately make allreasonable efforts to assist in the transfer of the patient to another healthcare provider or institution that is willing to comply with the instruction ordecision.

 

(h) A health care provider or institution may not require orprohibit the execution or revocation of an advance health care directive as acondition for providing health care.

 

35-22-409. Health care information.

 

Unless otherwise specified in an advancehealth care directive, a person then authorized to make health care decisions fora patient has the same rights as the patient to request, receive, examine, copyand consent to the disclosure of medical or any other health care information.

 

35-22-410. Immunities.

 

(a) A health care provider or institution acting in good faithand in accordance with generally accepted health care standards applicable tothe health care provider or institution is not subject to civil or criminalliability or to discipline for:

 

(i) Complying with a health care decision of a personapparently having authority to make a health care decision for a patient,including a decision to withhold or withdraw health care;

 

(ii) Declining to comply with a health care decision of a personbased on a belief that the person then lacked authority;

 

(iii) Complying with an advance health care directive andassuming that the directive was valid when made and has not been revoked orterminated;

 

(iv) Providing life-sustaining treatment in an emergencysituation when the existence of a health care directive is unknown; or

 

(v) Declining to comply with a health care decision or advancehealth care directive because the instruction is contrary to the conscience orgood faith medical judgment of the health care provider, or the writtenpolicies of the institution.

 

(b) An individual acting in good faith as agent or surrogateunder this act is not subject to civil liability or criminal prosecution or todiscipline by a licensing board for unprofessional conduct for health caredecisions made in good faith.

 

35-22-411. Statutory damages.

 

(a) A health care provider or institution that violates thisact willfully or with reckless disregard of the patient's instruction or healthcare decision is subject to liability to the aggrieved individual for damagesof five hundred dollars ($500.00) or actual damages resulting from theviolation, whichever is greater, plus reasonable attorney's fees.

 

(b) A person who intentionally falsifies, forges, conceals,defaces or obliterates an individual's advance health care directive or arevocation of an advance health care directive without the individual'sconsent, or who coerces or fraudulently induces an individual to give, revokeor not to give an advance health care directive, is subject to liability tothat individual for damages of two thousand five hundred dollars ($2,500.00) oractual damages resulting from the action, whichever is greater, plus reasonableattorney's fees.

 

35-22-412. Capacity.

 

(a) This act does not affect the right of an individual to makehealth care decisions while having capacity to do so.

 

(b) An individual is presumed to have capacity to make a healthcare decision, to give or revoke an advance health care directive, and todesignate or disqualify a surrogate unless the primary physician has certifiedin writing that the patient lacks such capacity.

 

35-22-413. Effect of copy.

 

A copy of a written advance health caredirective, revocation of an advance health care directive, or designation ordisqualification of a surrogate has the same effect as the original.

 

35-22-414. Effect of act.

 

(a) This act does not create a presumption concerning theintention of an individual who has not made or who has revoked an advancehealth care directive.

 

(b) Death resulting from the withholding or withdrawal ofhealth care in accordance with this act does not for any purpose constitute asuicide or homicide or legally impair or invalidate a policy of insurance or anannuity providing a death benefit, notwithstanding any term of the policy orannuity to the contrary.

 

(c) This act does not authorize mercy killing, assistedsuicide, euthanasia or the provision, withholding or withdrawal of health care,to the extent prohibited by other statutes of this state.

 

(d) This act does not authorize or require a health careprovider or institution to provide health care contrary to generally acceptedhealth care standards applicable to the health care provider or institution.

 

(e) This act does not affect other statutes of this stategoverning treatment for mental illness of an individual involuntarily committedto a mental health care institution pursuant to law or a psychiatric advancedirective executed in accordance with W.S. 35-22-301 through 35-22-308.

 

(f) Any cardiopulmonary resuscitation directives developedunder W.S. 35-22-201 through 35-22-208 shall remain in effect unlessspecifically revoked by the advance health care directive.

 

35-22-415. Judicial relief.

 

On petition of a patient, the patient'sagent, guardian or surrogate, a health care provider or institution involvedwith the patient's care, or an individual described in W.S. 35-22-406(b) or (c)the district court may enjoin or direct a health care decision or order otherequitable relief. A proceeding under this section is governed by the WyomingRules of Civil Procedure.

 

35-22-416. Uniformity of application and construction.

 

This act shall be applied and construed toeffectuate its general purpose to make uniform the law with respect to thesubject matter of this act among states enacting it.

 


State Codes and Statutes

State Codes and Statutes

Statutes > Wyoming > Title35 > Chapter22

CHAPTER 22 - LIVING WILL

 

ARTICLE 1 - IN GENERAL

 

35-22-101. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-102. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-103. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-104. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-105. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-106. Repealed By Laws 2005, ch. 161, 3.

 

35-22-107. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-108. Repealed By Laws 2005, ch. 161, 3.

 

 

35-22-109. Repealed By Laws 2005, ch. 161, 3.

 

ARTICLE 2 - CARDIOPULMONARY RESUSCITATION DIRECTIVES

 

35-22-201. Definitions.

 

 

(a) As used in this article, unless the context otherwiserequires:

 

(i) "Cardiopulmonary resuscitation" means measures torestore cardiac function or to support breathing in the event of respiratory orcardiac arrest or malfunction. "Cardiopulmonary resuscitation"includes, but is not limited to, chest compression, delivering electric shockto the chest, or manual or mechanical methods to assist breathing;

 

(ii) "Cardiopulmonary resuscitation directive" meansan advance medical directive pertaining to the administration of cardiopulmonaryresuscitation;

 

(iii) "Emergency medical service personnel" means anyemergency medical technician at any level who is certified by the department ofhealth. "Emergency medical service personnel" includes a firstresponder certified by the department of health.

 

35-22-202. Cardiopulmonary resuscitation directives; who may execute.

 

Anyadult who has the decisional capacity to provide informed consent to or refusalof medical treatment or any other person who is, pursuant to the laws of thisstate or any other state, authorized to make medical treatment decisions onbehalf of a person who lacks such decisional capacity, may execute acardiopulmonary resuscitation directive.

 

35-22-203. Cardiopulmonary resuscitation directive forms; duties ofdepartment of health.

 

 

(a) On or before January 1, 1994, the state department ofhealth shall promulgate rules and protocols for the implementation ofcardiopulmonary resuscitation directives by emergency medical personnel. Theprotocols adopted shall include uniform methods of identifying persons who haveexecuted a cardiopulmonary resuscitation directive. Protocols adopted by thedepartment of health shall include methods for rapid identification of personswho have executed a cardiopulmonary resuscitation directive, controlleddistribution of the methods of identifying persons who have executed acardiopulmonary resuscitation directive, and the information described insubsection (b) of this section. Nothing in this subsection shall be construedto restrict any other manner in which a person may make a cardiopulmonaryresuscitation directive.

 

(b) Cardiopulmonary resuscitation directive protocols to beadopted by the state department of health shall, at a minimum, require thefollowing information concerning the person who is the subject of thecardiopulmonary resuscitation directive:

 

(i) The person's name, date of birth and sex;

 

(ii) The person's eye and hair color;

 

(iii) The person's race or ethnic background;

 

(iv) If applicable, the name of a hospice program in which theperson is enrolled;

 

(v) The name, address and telephone number of the person'sattending physician;

 

(vi) The person's signature or mark or, if applicable, thesignature of a person authorized by this article to execute a cardiopulmonaryresuscitation directive;

 

(vii) The date on which the cardiopulmonary resuscitationdirective was signed;

 

(viii) The person's directive concerning the administration ofcardiopulmonary resuscitation, countersigned by the person's attendingphysician.

 

35-22-204. Duty to comply with cardiopulmonary resuscitation directive;immunity; effect on criminal charges against another person.

 

 

(a) Emergency medical service personnel, health care providersand health care facilities shall comply with a person's cardiopulmonaryresuscitation directive that is apparent and immediately available. Anyemergency medical service personnel, health care provider, health care facilityor any other person who, in good faith, complies with a cardiopulmonaryresuscitation directive which is perceived to be valid shall not be subject tocivil or criminal liability or regulatory sanction for such compliance.

 

(b) Compliance by emergency medical service personnel, healthcare providers or health care facilities with a cardiopulmonary resuscitationdirective shall not affect the criminal prosecution of any person otherwisecharged with the commission of a criminal act.

 

(c) In the absence of a cardiopulmonary resuscitationdirective, a person's consent to cardiopulmonary resuscitation shall bepresumed.

 

35-22-205. Effect of declaration after inpatient admission.

 

Acardiopulmonary resuscitation directive for any person who is admitted to ahealth care facility shall be implemented as a physician's order concerningresuscitation as directed by the person in the cardiopulmonary resuscitationdirective, pending further physicians' orders.

 

35-22-206. Effect of cardiopulmonary resuscitation directive; absence;on life or health insurance.

 

Neithera cardiopulmonary resuscitation directive nor the failure of a person toexecute one shall affect, impair or modify any contract of life or healthinsurance or annuity or be the basis for any delay in issuing or refusing toissue an annuity or policy of life or health insurance or any increase of apremium therefor.

 

35-22-207. Revocation of cardiopulmonary resuscitation directive.

 

Acardiopulmonary resuscitation directive may be revoked at any time by theperson who is the subject of the directive or by any other person who is,pursuant to the laws of this state or any other state, authorized to makemedical treatment decisions on behalf of the person who is the subject of thedirective.

 

35-22-208. Effect of article on euthanasia; mercy killing; constructionof statute.

 

Nothingis this article shall be construed as condoning, authorizing or approvingeuthanasia or mercy killing. In addition, the legislature does not intend thatthis article be construed as permitting any affirmative or deliberate act toend a person's life, except to permit natural death as provided by thisarticle.

 

ARTICLE 3 - PSYCHIATRIC ADVANCE DIRECTIVES

 

35-22-301. Definitions.

 

(a) As used in this act:

 

(i) "Adult" means a person eighteen (18) years of ageor older;

 

(ii) "Agent" means any person authorized in thepsychiatric advance directive to make decisions on behalf of the person whoexecuted the directive;

 

(iii) "Psychiatric advance directive" means an advancemedical directive pertaining to the administration or refusal of psychiatricrestabilization for the care and treatment of mental illness;

 

(iv) "Psychiatric personnel" means any licensed physicianwho specializes in psychiatric care;

 

(v) "Psychiatric restabilization" means measures torestore mental function or to support mental health in the event ofdestabilization of mental health due to lack of appropriate treatment. Psychiatric restabilization measures include administration of prescribedliquid medication by mouth or injection, administration of prescribedmedication orally, physical restraint, seclusion or crisis psychiatriccounseling;

 

(vi) "This act" means W.S. 35-22-301 through35-22-308.

 

35-22-302. Psychiatric advance directives; who may execute.

 

Any adult who has the decisional capacityto provide informed consent to or refusal of psychiatric restabilizationmeasures or any other person who is, pursuant to the laws of this state or anyother state, authorized to consent to or refuse psychiatric restabilizationmeasures on behalf of a person who lacks the decisional capacity, may execute apsychiatric advance directive.

 

35-22-303. Psychiatric advance directive forms; duties of department ofhealth.

 

(a) On or before January 1, 2000, the state department ofhealth shall promulgate rules, protocols and forms for the implementation ofpsychiatric advance directives by psychiatric personnel. The protocols adoptedshall include uniform methods for rapid identification of persons who haveexecuted a psychiatric advance directive, methods to protect theconfidentiality of persons who have executed a psychiatric advance directiveand the information described in subsection (b) of this section. Nothing inthis subsection shall be construed to restrict any other manner in which aperson may make a psychiatric advance directive. Forms which meet therequirements of law and are consistent with patient rights shall be developedand disseminated throughout the state as recommended forms.

 

(b) Psychiatric advance directive protocols to be adopted bythe state department of health shall, at a minimum, require the followinginformation concerning the person who is the subject of the psychiatric advancedirective:

 

(i) The person's name, date of birth and sex;

 

(ii) The person's eye and hair color;

 

(iii) The person's race or ethnic background;

 

(iv) The person's social security number;

 

(v) If applicable, the name of a treatment program and thesponsoring facility or institution in which the person is enrolled;

 

(vi) The name, address and telephone number of the person'sattending physician or psychiatric personnel;

 

(vii) The person's signature or mark or, if applicable, thesignature of a person authorized by this article to execute a psychiatricadvance directive;

 

(viii) The date on which the psychiatric advance directive wassigned;

 

(ix) The person's directive concerning the administration orrefusal of psychiatric restabilization measures, countersigned by the person'sattending physician or psychiatric personnel;

 

(x) The name, address and telephone number of the persondesignated as an agent, if applicable, to consent to or refuse psychiatricrestabilization measures for the person who has executed a psychiatric advancedirective and the signature of that person, indicating acceptance of thisappointment.

 

35-22-304. Duty to comply; immunity; effect on criminal charges againstanother person.

 

(a) Emergency medical service personnel in emergency situationsif they are aware of the person's psychiatric advance directive, psychiatricpersonnel, health care providers and health care facilities shall comply with aperson's psychiatric advance directive to the extent medically indicated.

 

(b) Any emergency medical service personnel, psychiatricpersonnel, health care provider, health care facility or any other person who,reasonably and in good faith, complies with a psychiatric advance directiveshall not be subject to civil or criminal liability or regulatory sanction forsuch compliance.

 

(c) Compliance by emergency medical service personnel,psychiatric personnel, health care providers or health care facilities with apsychiatric advance directive shall not affect the criminal prosecution of anyperson otherwise charged with the commission of a criminal act.

 

(d) In the absence of a psychiatric advance directive, aperson's consent to psychiatric restabilization measures shall not be presumed.

 

35-22-305. Effect of declaration after inpatient admission.

 

A psychiatric advance directive for anyperson who is admitted to a health care facility or mental health facilityshall be implemented as directed by the psychiatric advance directive, pendingfurther physician's orders. The psychiatric advance directive may be deviatedfrom only with the consent of the admitted person, his agent, the districtcourt or when adherence to the directive threatens permanent physical injury.

 

35-22-306. Effect of directive on life or health insurance.

 

Neither a psychiatric advance directive northe failure of a person to execute one shall affect, impair or modify anycontract of life or health insurance or annuity or be the basis for any delayin issuing or refusing to issue an annuity or policy of life or healthinsurance or any increase of a premium thereof.

 

35-22-307. Revocation of psychiatric advance directive.

 

A psychiatric advance directive may berevoked at any time by the person who is the subject of the directive unless heis mentally incompetent or at any time by any other person who is, pursuant tothe laws of this state or any other state, authorized to consent to or refusepsychiatric restabilization measures on behalf of the person who is the subjectof the directive.

 

35-22-308. Duration of psychiatric advance directive.

 

A psychiatric advance directive shall bevalid for a period not to exceed two (2) years from the date of executionunless reaffirmed by the person who executed the directive, in which case itshall be valid for two (2) years from the date of reaffirmation.

 

ARTICLE 4 - WYOMING HEALTH CARE DECISIONS ACT

 

35-22-401. Short title.

 

This act may be cited as the "WyomingHealth Care Decisions Act."

 

35-22-402. Definitions.

 

(a) As used in this act:

 

(i) "Advance health care directive" means an individualinstruction or a power of attorney for health care, or both;

 

(ii) "Agent" means an individual designated in a powerof attorney for health care to make a health care decision for the individualgranting the power;

 

(iii) "Artificial nutrition and hydration" meanssupplying food and water through a conduit, such as a tube or an intravenousline where the recipient is not required to chew or swallow voluntarily,including, but not limited to, nasogastric tubes, gastrostomies, jejunostomiesand intravenous infusions. Artificial nutrition and hydration does not includeassisted feeding, such as spoon or bottle feeding;

 

(iv) "Capacity" means an individual's ability tounderstand the significant benefits, risks and alternatives to proposed healthcare and to make and communicate a health care decision;

 

(v) "Community care facility" means a public orprivate facility responsible for the day-to-day care of persons withdisabilities;

 

(vi) "Emancipated minor" means a minor who has becomeemancipated as provided in W.S. 14-1-201 through 14-1-206;

 

(vii) "Guardian" means a judicially appointed guardianor conservator having authority to make a health care decision for anindividual;

 

(viii) "Health care" means any care, treatment, serviceor procedure to maintain, diagnose or otherwise affect an individual's physicalor mental condition;

 

(ix) "Health care decision" means a decision made byan individual or the individual's agent, guardian, or surrogate, regarding theindividual's health care, including:

 

(A) Selection and discharge of health care providers andinstitutions;

 

(B) Approval or disapproval of diagnostic tests, surgicalprocedures, programs of medication and orders not to resuscitate; and

 

(C) Directions to provide, withhold or withdraw artificialnutrition and hydration and all other forms of health care.

 

(x) "Health care institution" means an institution,facility or agency licensed, certified or otherwise authorized or permitted bylaw to provide health care in the ordinary course of business;

 

(xi) "Individual instruction" means an individual'sdirection concerning a health care decision for the individual;

 

(xii) "Physician" means an individual authorized topractice medicine under the Wyoming Medical Practice Act;

 

(xiii) "Power of attorney for health care" means thedesignation of an agent to make health care decisions for the individualgranting the power;

 

(xiv) "Primary health care provider" means any personlicensed under the Wyoming statutes practicing within the scope of that licenseas a licensed physician, licensed physician's assistant or licensed advancedpractice registered nurse and who is designated by an individual or theindividual's agent, guardian or surrogate to have primary responsibility forthe individual's health care or, in the absence of a designation or if thedesignated provider is not reasonably available, a provider who undertakes theresponsibility;

 

(xv) "Primary physician" means a physician designatedby an individual or the individual's agent, guardian or surrogate, to haveprimary responsibility for the individual's health care or, in the absence of adesignation or if the designated physician is not reasonably available, aphysician who undertakes the responsibility;

 

(xvi) "Reasonably available" means able to be contactedwith a level of diligence appropriate to the seriousness and urgency of apatient's health care needs and willing and able to act in a timely mannerconsidering the urgency of the patient's health care needs;

 

(xvii) "Residential care facility" means a public orprivate facility providing for the residential and health care needs of theelderly or persons with disabilities or chronic mental illness;

 

(xviii) "State" means a state of the United States, theDistrict of Columbia, the Commonwealth of Puerto Rico or a territory or insularpossession subject to the jurisdiction of the United States;

 

(xix) Repealed By Laws 2007, Ch. 61, 2.

 

(xx) "Surrogate" means an adult individual or individualswho:

 

(A) Have capacity;

 

(B) Are reasonably available;

 

(C) Are willing to make health care decisions, includingdecisions to initiate, refuse to initiate, continue or discontinue the use of alife sustaining procedure on behalf of a patient who lacks capacity; and

 

(D) Are identified by the primary health care provider inaccordance with this act as the person or persons who are to make thosedecisions in accordance with this act.

 

(xxi) "This act" means W.S. 35-22-401 through35-22-416.

 

35-22-403. Advance health care directives.

 

(a) An adult or emancipated minor may give an individualinstruction. The instruction may be oral or written. The instruction may belimited to take effect only if a specified condition arises.

 

(b) An adult or emancipated minor may execute a power ofattorney for health care, which may authorize the agent to make any health caredecision the principal could have made while having capacity. The power must bein writing and signed by the principal or by another person in the principal'spresence and at the principal's expressed direction. The power remains ineffect notwithstanding the principal's later incapacity and may includeindividual instructions. Unless related to the principal by blood, marriage oradoption, an agent may not be an owner, operator or employee of a residentialor community care facility at which the principal is receiving care. Thedurable power of attorney must be acknowledged before a notarial officer ormust be signed by at least two (2) witnesses, each of whom witnessed either thesigning of the instrument by the principal or the principal's acknowledgementof the signature or of the instrument, each witness making the followingdeclaration in substance:

 

I declare underpenalty of perjury under the laws of Wyoming that the person who signed oracknowledged this document is known to me to be the principal, and theprincipal signed or acknowledged this document in my presence.

 

(c) None of the following shall be used as a witness for apower of attorney for health care:

 

(i) A treating health care provider or employee of theprovider;

 

(ii) The attorney-in-fact nominated in the writing;

 

(iii) The operator of a community care facility or employee ofthe operator or facility;

 

(iv) The operator of a residential care facility or employee ofthe operator or facility.

 

(d) Unless otherwise specified in a power of attorney forhealth care, the authority of an agent becomes effective only upon adetermination that the principal lacks capacity, and ceases to be effectiveupon a determination that the principal has recovered capacity.

 

(e) Unless otherwise specified in a written advance health caredirective, a determination that an individual lacks or has recovered capacity,or that another condition exists that affects an individual instruction or theauthority of an agent, shall be made by the primary physician, but the treatingprimary health care provider may make the decision if the primary physician isunavailable.

 

(f) An agent shall make a health care decision in accordancewith the principal's advance health care directive and other wishes to theextent known to the agent. Otherwise, the agent shall make the decision inaccordance with the agent's determination of the principal's best interest. Indetermining the principal's best interest, the agent shall consider theprincipal's personal values to the extent known to the agent.

 

(g) A health care decision made by an agent for a principal iseffective without judicial approval.

 

(h) A written advance health care directive may include theindividual's nomination of a guardian of the person.

 

(j) An advance health care directive is valid for purposes ofthis act if it complied with the applicable law at the time of execution orcommunication.

 

35-22-404. Revocation of advance health care directive.

 

(a) An individual with capacity may revoke the designation ofan agent only by a signed writing.

 

(b) An individual with capacity may revoke all or part of anadvance health care directive, other than the designation of an agent, at anytime and in any manner that communicates an intention to revoke. Any oralrevocation shall, as soon as possible after the revocation, be documented in awriting signed and dated by the individual or a witness to the revocation.

 

(c) A health care provider, agent, guardian or surrogate who isinformed of a revocation shall promptly communicate the fact of the revocationto the primary health care provider and to any health care institution at whichthe patient is receiving care.

 

(d) A decree of annulment, divorce, dissolution of marriage orlegal separation revokes a previous designation of a spouse as agent unlessotherwise specified in the decree or in a power of attorney for health care.

 

(e) An advance health care directive that conflicts with anearlier advance health care directive revokes the earlier directive to theextent of the conflict.

 

35-22-405. Repealed By Laws 2007, Ch. 61, 2.

 

 

35-22-406. Decisions by surrogate.

 

(a) If a valid advance health care directive does not exist, asurrogate may make a health care decision for a patient who is an adult oremancipated minor if the patient has been determined by the primary physicianor the primary health care provider to lack capacity and no agent or guardianhas been appointed or the agent or guardian is not reasonably available.

 

(b) An adult or emancipated minor may designate any individualto act as surrogate by personally informing the primary health care provider.In the absence of a designation, or if the designee is not reasonablyavailable, it is suggested that any member of the following classes of thepatient's family who is reasonably available, in descending order of priority,may act as surrogate:

 

(i) The spouse, unless legally separated;

 

(ii) An adult child;

 

(iii) A parent;

 

(iv) A grandparent;

 

(v) An adult brother or sister;

 

(vi) An adult grandchild.

 

(c) If none of the individuals eligible to act as surrogateunder subsection (b) of this section is reasonably available, an adult who hasexhibited special care and concern for the patient, who is familiar with thepatient's personal values, and who is reasonably available may act assurrogate.

 

(d) A surrogate shall communicate his assumption of authorityas promptly as practicable to the members of the patient's family specified insubsection (b) of this section who can be readily contacted.

 

(e) If more than one (1) member of a class assumes authority toact as surrogate, and the other members of the class do not agree on a healthcare decision and the primary health care provider is so informed, the primaryhealth care provider shall comply with the decision of a majority of themembers of that class who have communicated their views to the provider.

 

(f) A surrogate shall make a health care decision in accordancewith the patient's individual instructions, if any, and other wishes to theextent known to the surrogate. Otherwise, the surrogate shall make the decisionin accordance with the surrogate's determination of the patient's bestinterest. In determining the patient's best interest, the surrogate shallconsider the patient's personal, philosophical, religious and ethical values tothe extent known to the surrogate and reliable oral or written statementspreviously made by the patient, including, but not limited to, statements madeto family members, friends, health care providers or religious leaders.

 

(g) A health care decision made by a surrogate for a patient iseffective without judicial approval.

 

(h) The patient at any time may disqualify another, including amember of the individual's family, from acting as the individual's surrogate bya signed writing or by personally informing the primary health care provider ofthe disqualification.

 

(j) Unless related to the patient by blood, marriage oradoption, a surrogate may not be an owner, operator or employee of aresidential or community care facility at which the patient is receiving care.

 

(k) A primary health care provider may require an individual claimingthe right to act as surrogate for a patient to provide a written declarationunder penalty of perjury stating facts and circumstances reasonably sufficientto establish the claimed authority.

 

35-22-407. Decisions by guardian.

 

(a) Repealed By Laws 2007, Ch. 61, 2.

 

(b) Absent a court order to the contrary, a health caredecision of an agent takes precedence over that of a guardian.

 

(c) Repealed By Laws 2007, Ch. 61, 2.

 

(d) Repealed By Laws 2007, Ch. 61, 2.

 

(e) A guardian's authority to make health care decisions forthe ward shall be as provided in W.S. 3-2-201(a)(iii), subject to therestrictions in W.S. 3-2-202 and 35-22-407(b).

 

35-22-408. Obligations of health care provider.

 

(a) Before implementing a health care decision made for apatient who is able to comprehend, a primary health care provider shallpromptly communicate to the patient the decision made and may communicate theidentity of the person making the decision.

 

(b) A primary health care provider who knows of the existenceof an advance health care directive, a revocation of an advance health caredirective, or a designation or disqualification of a surrogate, shall promptlyrecord its existence in the patient's health care record and, if it is inwriting, shall request a copy and if one is furnished shall arrange for itsmaintenance in the health care record.

 

(c) The primary physician who makes or is informed of adetermination that a patient lacks or has recovered capacity, or that anothercondition exists which affects an individual instruction or the authority of anagent, guardian or surrogate, shall promptly record the determination in thepatient's health care record and communicate the determination to the patient,if possible, and to any person then authorized to make health care decisionsfor the patient.

 

(d) Except as provided in subsections (e) and (f) of thissection, a health care provider or institution providing care to a patientshall:

 

(i) Comply with an individual instruction of the patient andwith a reasonable interpretation of that instruction made by a person thenauthorized to make health care decisions for the patient; and

 

(ii) Comply with a health care decision for the patient made bya person then authorized to make health care decisions for the patient to thesame extent as if the decision had been made by the patient while havingcapacity.

 

(e) A health care provider may decline to comply with anindividual instruction or health care decision for reasons of conscience. Ahealth care institution may decline to comply with an individual instruction orhealth care decision if the instruction or decision is contrary to a writtenpolicy of the institution which is expressly based on reasons of conscience andif the policy was timely communicated to the patient or to a person thenauthorized to make health care decisions for the patient. The institutionshall deliver the written policy upon receipt of the patient's advancedirective that may conflict with the policy or upon notice from the primaryhealth care provider that the patient's instruction or decision may be inconflict with the health care institution's policy.

 

(f) A health care provider or institution may decline to complywith an individual instruction or health care decision that requires medicallyineffective health care or health care contrary to generally accepted healthcare standards applicable to the health care provider or institution.

 

(g) A health care provider or institution that declines tocomply with an individual instruction or health care decision shall:

 

(i) Promptly so inform the patient, if possible, and any personthen authorized to make health care decisions for the patient;

 

(ii) Provide continuing care, including continuing life sustainingcare, to the patient until a transfer can be effected; and

 

(iii) Unless the patient or person then authorized to make healthcare decisions for the patient refuses assistance, immediately make allreasonable efforts to assist in the transfer of the patient to another healthcare provider or institution that is willing to comply with the instruction ordecision.

 

(h) A health care provider or institution may not require orprohibit the execution or revocation of an advance health care directive as acondition for providing health care.

 

35-22-409. Health care information.

 

Unless otherwise specified in an advancehealth care directive, a person then authorized to make health care decisions fora patient has the same rights as the patient to request, receive, examine, copyand consent to the disclosure of medical or any other health care information.

 

35-22-410. Immunities.

 

(a) A health care provider or institution acting in good faithand in accordance with generally accepted health care standards applicable tothe health care provider or institution is not subject to civil or criminalliability or to discipline for:

 

(i) Complying with a health care decision of a personapparently having authority to make a health care decision for a patient,including a decision to withhold or withdraw health care;

 

(ii) Declining to comply with a health care decision of a personbased on a belief that the person then lacked authority;

 

(iii) Complying with an advance health care directive andassuming that the directive was valid when made and has not been revoked orterminated;

 

(iv) Providing life-sustaining treatment in an emergencysituation when the existence of a health care directive is unknown; or

 

(v) Declining to comply with a health care decision or advancehealth care directive because the instruction is contrary to the conscience orgood faith medical judgment of the health care provider, or the writtenpolicies of the institution.

 

(b) An individual acting in good faith as agent or surrogateunder this act is not subject to civil liability or criminal prosecution or todiscipline by a licensing board for unprofessional conduct for health caredecisions made in good faith.

 

35-22-411. Statutory damages.

 

(a) A health care provider or institution that violates thisact willfully or with reckless disregard of the patient's instruction or healthcare decision is subject to liability to the aggrieved individual for damagesof five hundred dollars ($500.00) or actual damages resulting from theviolation, whichever is greater, plus reasonable attorney's fees.

 

(b) A person who intentionally falsifies, forges, conceals,defaces or obliterates an individual's advance health care directive or arevocation of an advance health care directive without the individual'sconsent, or who coerces or fraudulently induces an individual to give, revokeor not to give an advance health care directive, is subject to liability tothat individual for damages of two thousand five hundred dollars ($2,500.00) oractual damages resulting from the action, whichever is greater, plus reasonableattorney's fees.

 

35-22-412. Capacity.

 

(a) This act does not affect the right of an individual to makehealth care decisions while having capacity to do so.

 

(b) An individual is presumed to have capacity to make a healthcare decision, to give or revoke an advance health care directive, and todesignate or disqualify a surrogate unless the primary physician has certifiedin writing that the patient lacks such capacity.

 

35-22-413. Effect of copy.

 

A copy of a written advance health caredirective, revocation of an advance health care directive, or designation ordisqualification of a surrogate has the same effect as the original.

 

35-22-414. Effect of act.

 

(a) This act does not create a presumption concerning theintention of an individual who has not made or who has revoked an advancehealth care directive.

 

(b) Death resulting from the withholding or withdrawal ofhealth care in accordance with this act does not for any purpose constitute asuicide or homicide or legally impair or invalidate a policy of insurance or anannuity providing a death benefit, notwithstanding any term of the policy orannuity to the contrary.

 

(c) This act does not authorize mercy killing, assistedsuicide, euthanasia or the provision, withholding or withdrawal of health care,to the extent prohibited by other statutes of this state.

 

(d) This act does not authorize or require a health careprovider or institution to provide health care contrary to generally acceptedhealth care standards applicable to the health care provider or institution.

 

(e) This act does not affect other statutes of this stategoverning treatment for mental illness of an individual involuntarily committedto a mental health care institution pursuant to law or a psychiatric advancedirective executed in accordance with W.S. 35-22-301 through 35-22-308.

 

(f) Any cardiopulmonary resuscitation directives developedunder W.S. 35-22-201 through 35-22-208 shall remain in effect unlessspecifically revoked by the advance health care directive.

 

35-22-415. Judicial relief.

 

On petition of a patient, the patient'sagent, guardian or surrogate, a health care provider or institution involvedwith the patient's care, or an individual described in W.S. 35-22-406(b) or (c)the district court may enjoin or direct a health care decision or order otherequitable relief. A proceeding under this section is governed by the WyomingRules of Civil Procedure.

 

35-22-416. Uniformity of application and construction.

 

This act shall be applied and construed toeffectuate its general purpose to make uniform the law with respect to thesubject matter of this act among states enacting it.

 

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