A.B. 471
Assembly Bill No. 471–Assemblywoman Freeman
March 19, 2001
____________
Referred to Committee on Judiciary
SUMMARY—Revises provisions governing declaration to withhold or withdraw life-sustaining treatment and durable power of attorney for health care. (BDR 40‑867)
FISCAL NOTE: Effect on Local Government: Yes.
~
EXPLANATION
– Matter in bolded italics is new; matter
between brackets [omitted material] is material to be omitted.
Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).
AN ACT relating to health care; revising the provisions governing a declaration to withhold or withdraw life-sustaining treatment; revising the provisions governing a durable power of attorney for health care and other powers of attorney concerning the withholding or withdrawal of life-sustaining treatment; providing penalties; and providing other matters properly relating thereto.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
1-1 Section 1. Chapter 449 of NRS is hereby amended by adding thereto
1-2 the provisions set forth as sections 2 and 3 of this act.
1-3 Sec. 2. “Facility for long-term care” has the meaning ascribed to it
1-4 in NRS 427A.028.
1-5 Sec. 3. “Incurable or terminal condition or illness” means a medical
1-6 condition or illness that cannot be cured by any known medical therapy
1-7 or treatment as determined by an attending physician.
1-8 Sec. 4. NRS 449.540 is hereby amended to read as follows:
1-9 449.540 As used in NRS 449.535 to 449.690, inclusive, and sections 2
1-10 and 3 of this act, unless the context otherwise requires, the words and
1-11 terms defined in NRS 449.550 to [449.590,] 449.585, inclusive, and
1-12 sections 2 and 3 of this act have the meanings ascribed to them in those
1-13 sections.
1-14 Sec. 5. NRS 449.585 is hereby amended to read as follows:
1-15 449.585 “Qualified patient” means a patient 18 or more years of age
1-16 who [has] :
1-17 1. Has executed a declaration or a durable power of attorney for
1-18 health care, or who has otherwise designated an attorney in fact to make
1-19 decisions regarding the withholding or withdrawal of life-sustaining
1-20 treatment; and [who has]
2-1 2. Has been determined by the attending physician to [be in a] have an
2-2 incurable or terminal condition[.] or illness.
2-3 Sec. 6. NRS 449.600 is hereby amended to read as follows:
2-4 449.600 1. A person of sound mind and 18 or more years of age may
2-5 execute at any time a declaration governing the withholding or withdrawal
2-6 of life-sustaining treatment. The declarant may designate another natural
2-7 person of sound mind and 18 or more years of age to make decisions
2-8 governing the withholding or withdrawal of life-sustaining treatment. The
2-9 declaration must be signed by the declarant, or another at the declarant’s
2-10 direction, and be attested by two witnesses[.] or acknowledged before a
2-11 notary public.
2-12 2. A physician or other provider of health care who is furnished a copy
2-13 of the declaration shall make it a part of the declarant’s medical record and,
2-14 if unwilling to comply with the declaration, promptly so advise the
2-15 declarant and any person designated to act for the declarant.
2-16 Sec. 7. NRS 449.610 is hereby amended to read as follows:
2-17 449.610 A declaration directing a physician to withhold or withdraw
2-18 life-sustaining treatment may, but need not, be in the following form:
2-19 DECLARATION
2-20 If I should have an incurable [and irreversible condition that, without the
2-21 administration of life-sustaining treatment, will, in the opinion of my
2-22 attending physician, cause my death within a relatively short time,] or
2-23 terminal condition or illness and I am no longer able to make decisions
2-24 regarding my medical treatment, I direct my attending physician, pursuant
2-25 to NRS 449.535 to 449.690, inclusive, and sections 2 and 3 of this act, to
2-26 withhold or withdraw treatment that only prolongs the process of dying and
2-27 is not necessary for my comfort or to alleviate pain.
2-28 If you wish to include [this statement] any of the following statements in
2-29 this declaration, you must INITIAL [the] each statement you wish to
2-30 include in the box provided:
2-31 1. Withholding or withdrawal of artificial
2-32 nutrition and hydration may result in death by
2-33 starvation or dehydration. [Initial this box if
2-34 you want] I desire to receive or continue
2-35 receiving artificial nutrition and hydration by
2-36 way of the gastro-intestinal tract after all other
2-37 treatment is withheld pursuant to this
2-38 declaration.
2-39 [............................... ]
3-1 2. I desire my attending physician to
3-2 administer such medication to me as will
3-3 alleviate any suffering I might experience,
3-4 regardless of whether the medication is
3-5 highly addictive or may shorten my
3-6 remaining life.
3-7 [............................... ]
3-8 3. If I am in a coma that my doctors have
3-9 reasonably concluded is irreversible, I desire
3-10 that life-sustaining or prolonging treatments
3-11 not be used, including cardiopulmonary
3-12 resuscitation and other resuscitative
3-13 procedures, and that my medical chart be
3-14 marked as “No Code” or “Do Not
3-15 Resuscitate.”
3-16 [............................... ]
3-17 4. If I have an incurable or terminal
3-18 condition or illness and no reasonable hope
3-19 of long-term recovery or survival, I desire
3-20 that life-sustaining or prolonging treatments
3-21 not be used, including cardiopulmonary
3-22 resuscitation and other resuscitative
3-23 procedures, and that my medical chart be
3-24 marked as “No Code” or “Do Not
3-25 Resuscitate.”
3-26 [............................... ]
3-27 5. If I am in a nursing home or facility
3-28 for long-term care with little or no chance of
3-29 recovery or returning to my home, I desire
3-30 that all resuscitative and preventive care be
3-31 discontinued, including the use of, or
3-32 treatment involving, antibiotics.
3-33 [............................... ]
3-34 Signed this ....................... day of ................, ......
3-35 Signature.........................
3-36 Address..........................
3-37 The declarant voluntarily signed this writing in my presence.
3-38 Witness...........................
3-39 Address..........................
3-40 Witness...........................
3-41 Address..........................
3-42 (You may use acknowledgment before a notary public instead of the
3-43 attestation of witnesses.)
3-44 State of Nevada }
3-45 }ss.
3-46 County of........... }
4-1 On this ................ day of ................, in the year ..., before me,
4-2 ................................ (here insert the name of the notary public) personally
4-3 appeared ................................ (here insert the name of the principal)
4-4 personally known to me (or proved to me on the basis of satisfactory
4-5 evidence) to be the person whose name is subscribed to this instrument,
4-6 and acknowledged that he or she executed it. I declare under penalty of
4-7 perjury that the person whose name is ascribed to this instrument
4-8 appears to be of sound mind and under no duress, fraud or undue
4-9 influence.
4-10 NOTARY SEAL
4-11 ....................................
4-12 (Signature of Notary Public)
4-13 Sec. 8. NRS 449.613 is hereby amended to read as follows:
4-14 449.613 1. A declaration that designates another person to make
4-15 decisions governing the withholding or withdrawal of life-sustaining
4-16 treatment may, but need not, be in the following form:
4-17 DECLARATION
4-18 If I should have an incurable [and irreversible condition that, without the
4-19 administration of life-sustaining treatment, will, in the opinion of my
4-20 attending physician, cause my death within a relatively short time,] or
4-21 terminal condition or illness and I am no longer able to make decisions
4-22 regarding my medical treatment, I appoint ............................... or, if he or
4-23 she is not reasonably available or is unwilling to serve, ..............................,
4-24 to make decisions on my behalf regarding withholding or withdrawal of
4-25 treatment that only prolongs the process of dying and is not necessary for
4-26 my comfort or to alleviate pain, pursuant to NRS 449.535 to 449.690,
4-27 inclusive[.] , and sections 2 and 3 of this act. (If the person or persons I
4-28 have so appointed are not reasonably available or are unwilling to serve, I
4-29 direct my attending physician, pursuant to those sections, to withhold or
4-30 withdraw treatment that only prolongs the process of dying and is not
4-31 necessary for my comfort or to alleviate pain.)
4-32 Strike language in parentheses if you do not desire it.
4-33 If you wish to include [this statement] any of the following statements in
4-34 this declaration, you must INITIAL [the] each statement you wish to
4-35 include in the box provided:
4-36 1. Withholding or withdrawal of artificial
4-37 nutrition and hydration may result in death by
4-38 starvation or dehydration. [Initial this box if
4-39 you want] I desire to receive or continue
4-40 receiving artificial nutrition and hydration by
4-41 way of the gastro-intestinal tract after all other
4-42 treatment is withheld pursuant to this
4-43 declaration.
4-44 [............................... ]
5-1 2. I desire my attending physician to
5-2 administer such medication to me as will
5-3 alleviate any suffering I might experience,
5-4 regardless of whether the medication is
5-5 highly addictive or may shorten my
5-6 remaining life.
5-7 [............................... ]
5-8 3. If I am in a coma that my doctors have
5-9 reasonably concluded is irreversible, I desire
5-10 that life-sustaining or prolonging treatments
5-11 not be used, including cardiopulmonary
5-12 resuscitation and other resuscitative
5-13 procedures, and that my medical chart be
5-14 marked as “No Code” or “Do Not
5-15 Resuscitate.”
5-16 [............................... ]
5-17 4. If I have an incurable or terminal
5-18 condition or illness and no reasonable hope
5-19 of long-term recovery or survival, I desire
5-20 that life-sustaining or prolonging treatments
5-21 not be used, including cardiopulmonary
5-22 resuscitation and other resuscitative
5-23 procedures, and that my medical chart be
5-24 marked as “No Code” or “Do Not
5-25 Resuscitate.”
5-26 [............................... ]
5-27 5. If I am in a nursing home or facility
5-28 for long-term care with little or no chance of
5-29 recovery or returning to my home, I desire
5-30 that all resuscitative and preventive care be
5-31 discontinued, including the use of, or
5-32 treatment involving, antibiotics.
5-33 [............................... ]
5-34 Signed this ....................... day of ................, ......
5-35 Signature.........................
5-36 Address..........................
5-37 The declarant voluntarily signed this writing in my presence.
5-38 Witness...........................
5-39 Address..........................
5-40 Witness...........................
5-41 Address..........................
5-42 (You may use acknowledgment before a notary public instead of the
5-43 attestation of witnesses.)
5-44 State of Nevada }
5-45 }ss.
5-46 County of........... }
6-1 On this ................ day of ................, in the year ..., before me,
6-2 ................................ (here insert the name of the notary public) personally
6-3 appeared ................................ (here insert the name of the principal)
6-4 personally known to me (or proved to me on the basis of satisfactory
6-5 evidence) to be the person whose name is subscribed to this instrument,
6-6 and acknowledged that he or she executed it. I declare under penalty of
6-7 perjury that the person whose name is ascribed to this instrument
6-8 appears to be of sound mind and under no duress, fraud or undue
6-9 influence.
6-10 NOTARY SEAL
6-11 ....................................
6-12 (Signature of Notary Public)
6-13 Name and address of each designee.
6-14 Name..............................
6-15 Address..........................
6-16 2. The designation of an attorney in fact pursuant to NRS 111.460 or
6-17 449.800 to 449.860, inclusive, or the judicial appointment of a guardian,
6-18 who is authorized to make decisions regarding the withholding or
6-19 withdrawal of life-sustaining treatment, constitutes for the purpose of NRS
6-20 449.535 to 449.690, inclusive, and sections 2 and 3 of this act a
6-21 declaration designating another person to act for the declarant pursuant to
6-22 subsection 1.
6-23 Sec. 9. NRS 449.617 is hereby amended to read as follows:
6-24 449.617 A declaration becomes operative when it is communicated to
6-25 the attending physician and the declarant is determined by the attending
6-26 physician to [be in a] have an incurable or terminal condition or illness
6-27 and no longer to be able to make decisions regarding administration of life-
6-28 sustaining treatment. When the declaration becomes operative, the
6-29 attending physician and other providers of health care shall act in
6-30 accordance with its provisions and with the instructions of a person
6-31 designated pursuant to NRS 449.600 or comply with the requirements of
6-32 NRS 449.628 to transfer care of the declarant.
6-33 Sec. 10. NRS 449.622 is hereby amended to read as follows:
6-34 449.622 [Upon determining that a declarant is in a] If the attending
6-35 physician of a patient determines that the patient has an incurable or
6-36 terminal condition[,] or illness and the attending physician [who knows
6-37 of] knows that the patient has executed a declaration or a durable power
6-38 of attorney for health care or other power of attorney designating an
6-39 attorney in fact to make decisions on behalf of the patient regarding the
6-40 withholding or withdrawal of life-sustaining treatment, the attending
6-41 physician shall record the determination, and the terms of the declaration
6-42 or power of attorney if not already a part of the record, in the [declarant’s]
6-43 patient’s medical record.
6-44 Sec. 11. NRS 449.626 is hereby amended to read as follows:
6-45 449.626 1. If written consent to the withholding or withdrawal of
6-46 [the] life-sustaining treatment, attested by two witnesses, is given to the
6-47 attending physician, the attending physician may withhold or withdraw
6-48 [life-sustaining] such treatment from a patient who:
7-1 (a) Has been determined by the attending physician to [be in a] have an
7-2 incurable or terminal condition or illness and no longer to be able to make
7-3 decisions regarding administration of life-sustaining treatment; and
7-4 (b) Has no effective declaration.
7-5 2. The authority to consent or to withhold consent under subsection 1
7-6 may be exercised by the following persons, in order of priority:
7-7 (a) The spouse of the patient;
7-8 (b) An adult child of the patient or, if there is more than one adult child,
7-9 a majority of the adult children who are reasonably available for
7-10 consultation;
7-11 (c) The parents of the patient;
7-12 (d) An adult sibling of the patient or, if there is more than one adult
7-13 sibling, a majority of the adult siblings who are reasonably available for
7-14 consultation; [or]
7-15 (e) The nearest other adult relative of the patient by blood or adoption
7-16 who is reasonably available for consultation[.] ; or
7-17 (f) A guardian of the patient who has been appointed by a court of
7-18 competent jurisdiction.
7-19 3. If a class entitled to decide whether to consent is not reasonably
7-20 available for consultation and competent to decide, or declines to decide,
7-21 the next class is authorized to decide, but an equal division in a class does
7-22 not authorize the next class to decide.
7-23 4. A decision to grant or withhold consent must be made in good faith.
7-24 A consent is not valid if it conflicts with the expressed intention of the
7-25 patient.
7-26 5. A decision of the attending physician acting in good faith that a
7-27 consent is valid or invalid is conclusive.
7-28 6. Life-sustaining treatment must not be withheld or withdrawn
7-29 pursuant to this section from a patient known to the attending physician to
7-30 be pregnant so long as it is probable that the fetus will develop to the point
7-31 of live birth with continued application of life-sustaining treatment.
7-32 Sec. 12. NRS 449.628 is hereby amended to read as follows:
7-33 449.628 An attending physician or other provider of health care who is
7-34 unwilling to comply with the provisions of NRS 449.535 to 449.690,
7-35 inclusive, and sections 2 and 3 of this act, or with an authorized decision
7-36 of an attorney in fact who has been so designated in a durable power of
7-37 attorney for health care or who has been otherwise designated an
7-38 attorney in fact to make decisions on behalf of a principal regarding the
7-39 withholding or withdrawal of life-sustaining treatment, shall [take all
7-40 reasonable steps as promptly as practicable to] transfer care of the
7-41 declarant or principal to another physician or provider of health care.
7-42 Sec. 13. NRS 449.630 is hereby amended to read as follows:
7-43 449.630 1. A physician or other provider of health care is not subject
7-44 to civil or criminal liability, or discipline for unprofessional conduct, for
7-45 giving effect to [a] :
7-46 (a) A declaration or the direction of a person designated pursuant to
7-47 NRS 449.600 , in the absence of knowledge of the revocation of [a
7-48 declaration, or for giving effect to a] the declaration;
7-49 (b) A written consent under NRS 449.626[.] ; or
8-1 (c) A durable power of attorney for health care or an authorized
8-2 decision of an attorney in fact who has been so designated in a durable
8-3 power of attorney for health care or who has been otherwise designated
8-4 an attorney in fact to make decisions on behalf of a principal regarding
8-5 the withholding or withdrawal of life-sustaining treatment, in the
8-6 absence of knowledge of the revocation of the durable power of attorney
8-7 for health care or other power of attorney.
8-8 2. A physician or other provider of health care, whose action pursuant
8-9 to NRS 449.535 to 449.690, inclusive, and sections 2 and 3 of this act, or
8-10 pursuant to an authorized decision of an attorney in fact who has been so
8-11 designated in a durable power of attorney for health care or who has
8-12 been otherwise designated an attorney in fact to make decisions on
8-13 behalf of a principal regarding the withholding or withdrawal of life-
8-14 sustaining treatment, is in accord with reasonable medical standards, is not
8-15 subject to civil or criminal liability, or discipline for unprofessional
8-16 conduct, with respect to that action.
8-17 3. A physician or other provider of health care[, whose decision
8-18 about] who makes a decision in good faith concerning the validity of
8-19 consent under NRS 449.626 [is made in good faith,] , or concerning the
8-20 validity of a decision of an attorney in fact who has been so designated in
8-21 a durable power of attorney for health care or who has been otherwise
8-22 designated an attorney in fact to make decisions on behalf of a principal
8-23 regarding the withholding or withdrawal of life-sustaining treatment, is
8-24 not subject to civil or criminal liability, or discipline for unprofessional
8-25 conduct, with respect to that decision.
8-26 4. A person designated pursuant to NRS 449.600 , [or] a person
8-27 authorized to consent pursuant to NRS 449.626, or an attorney in fact who
8-28 has been so designated in a durable power of attorney for health care or
8-29 who has been otherwise designated an attorney in fact to make decisions
8-30 on behalf of a principal regarding the withholding or withdrawal of life-
8-31 sustaining treatment, whose decision is made or consent is given in good
8-32 faith pursuant to NRS 449.535 to 449.690, inclusive, and sections 2 and 3
8-33 of this act, or 449.800 to 449.860, inclusive, or pursuant to the terms of
8-34 the durable power of attorney for health care or other power of attorney,
8-35 is not subject to civil or criminal liability, or discipline for unprofessional
8-36 conduct, with respect to that decision.
8-37 Sec. 14. NRS 449.640 is hereby amended to read as follows:
8-38 449.640 1. If a patient [in a] who has an incurable or terminal
8-39 condition or illness has a declaration , a durable power of attorney for
8-40 health care or other power of attorney designating an attorney in fact to
8-41 make decisions on behalf of the patient regarding the withholding or
8-42 withdrawal of life-sustaining treatment in effect and becomes comatose or
8-43 is otherwise rendered incapable of communicating with his attending
8-44 physician, the physician [must] shall give weight to the declaration or
8-45 power of attorney as evidence of the patient’s directions regarding the
8-46 application of life-sustaining treatments, but the attending physician may
8-47 also consider other factors in determining whether the circumstances
8-48 warrant following the directions.
9-1 2. No hospital or other medical facility, physician or person working
9-2 under the direction of a physician is subject to criminal or civil liability for
9-3 failure to follow the directions of the patient to withhold or withdraw life-
9-4 sustaining treatments.
9-5 Sec. 15. NRS 449.645 is hereby amended to read as follows:
9-6 449.645 1. Unless he has knowledge to the contrary, a physician or
9-7 other provider of health care may assume that a declaration complies with
9-8 the provisions of NRS 449.535 to 449.690, inclusive, and sections 2 and 3
9-9 of this act, a durable power of attorney for health care complies with the
9-10 provisions of NRS 449.800 to 449.860, inclusive, and any other power of
9-11 attorney designating an attorney in fact to make decisions on behalf of a
9-12 patient regarding the withholding or withdrawal of life-sustaining
9-13 treatment complies with all applicable law, and is valid.
9-14 2. The provisions of NRS 449.535 to 449.690, inclusive, and sections
9-15 2 and 3 of this act, and 449.800 to 449.860, inclusive, create no
9-16 presumption concerning the intention of a person who has revoked or has
9-17 not executed a declaration or durable power of attorney for health care
9-18 with respect to the use, withholding or withdrawal of life-sustaining
9-19 treatment in the event of [a] an incurable or terminal condition[.] or
9-20 illness.
9-21 Sec. 16. NRS 449.650 is hereby amended to read as follows:
9-22 449.650 1. Death resulting from the withholding or withdrawal of
9-23 life-sustaining treatment in accordance with NRS 449.535 to 449.690,
9-24 inclusive, and sections 2 and 3 of this act, a durable power of attorney for
9-25 health care or other power of attorney designating an attorney in fact to
9-26 make decisions on behalf of a patient regarding the withholding or
9-27 withdrawal of life-sustaining treatment does not constitute, for any
9-28 purpose, a suicide or homicide.
9-29 2. The making of a declaration pursuant to NRS 449.600 , a durable
9-30 power of attorney for health care or other power of attorney designating
9-31 an attorney in fact to make decisions on behalf of a patient regarding the
9-32 withholding or withdrawal of life-sustaining treatment does not affect the
9-33 sale, procurement or issuance of a policy of life insurance or annuity, nor
9-34 does it affect, impair or modify the terms of an existing policy of life
9-35 insurance or annuity. A policy of life insurance or annuity is not legally
9-36 impaired or invalidated by the withholding or withdrawal of life-sustaining
9-37 treatment from an insured, notwithstanding any term to the contrary.
9-38 3. A person [may] shall not prohibit or require the execution of a
9-39 declaration , a durable power of attorney for health care or other power
9-40 of attorney designating an attorney in fact to make decisions on behalf of
9-41 a patient regarding the withholding or withdrawal of life-sustaining
9-42 treatment as a condition for being insured for, or receiving, health care.
9-43 Sec. 17. NRS 449.660 is hereby amended to read as follows:
9-44 449.660 1. A physician or other provider of health care who willfully
9-45 fails to transfer the care of a patient in accordance with NRS 449.628 is
9-46 guilty of a gross misdemeanor.
9-47 2. A physician who willfully fails to record a determination of an
9-48 incurable or terminal condition or illness, the terms of a declaration , or
9-49 the terms of a durable power of attorney for health care or other power
10-1 of attorney designating an attorney in fact to make decisions on behalf of
10-2 a patient regarding the withholding or withdrawal of life-sustaining
10-3 treatment in accordance with NRS 449.622 is guilty of a misdemeanor.
10-4 3. A person who [willfully] :
10-5 (a) Willfully conceals, cancels, defaces or obliterates the declaration of
10-6 another without the declarant’s consent or [who falsifies] a durable power
10-7 of attorney for health care or other power of attorney designating an
10-8 attorney in fact to make decisions on behalf of a principal regarding the
10-9 withholding or withdrawal of life-sustaining treatment without the
10-10 principal’s consent; or
10-11 (b) Falsifies or forges a revocation of [the declaration of another] such
10-12 a declaration or power of attorney,
10-13 is guilty of a misdemeanor.
10-14 4. A person who falsifies or forges the declaration of another[,] or a
10-15 durable power of attorney for health care or other power of attorney
10-16 designating an attorney in fact to make decisions on behalf of a principal
10-17 regarding the withholding or withdrawal of life-sustaining treatment, or
10-18 willfully conceals or withholds personal knowledge of [a revocation,] the
10-19 revocation of such a document, with the intent to cause a withholding or
10-20 withdrawal of life-sustaining treatment contrary to the wishes of the
10-21 declarant or principal, and thereby directly causes life-sustaining treatment
10-22 to be withheld or withdrawn and death to be hastened , is guilty of murder.
10-23 5. A person who requires or prohibits the execution of a declaration or
10-24 a durable power of attorney for health care or other power of attorney
10-25 designating an attorney in fact to make decisions on behalf of a principal
10-26 regarding the withholding or withdrawal of life-sustaining treatment as a
10-27 condition of being insured for, or receiving, health care is guilty of a
10-28 misdemeanor.
10-29 6. A person who coerces or fraudulently induces another to execute a
10-30 declaration[,] or a durable power of attorney for health care or other
10-31 power of attorney designating an attorney in fact to make decisions on
10-32 behalf of a principal regarding the withholding or withdrawal of life-
10-33 sustaining treatment, or who falsifies or forges the declaration of another
10-34 or a durable power of attorney for health care or other power of attorney
10-35 designating an attorney in fact to make decisions on behalf of a principal
10-36 regarding the withholding or withdrawal of life-sustaining treatment,
10-37 except as otherwise provided in subsection 4, is guilty of a gross
10-38 misdemeanor.
10-39 7. The penalties provided in this section do not displace any sanction
10-40 applicable under other law.
10-41 Sec. 18. NRS 449.680 is hereby amended to read as follows:
10-42 449.680 The provisions of NRS 449.535 to 449.690, inclusive, and
10-43 sections 2 and 3 of this act, and 449.800 to 449.860, inclusive, do not
10-44 affect the right of a patient to make decisions regarding the use of life-
10-45 sustaining treatment, so long as he is able to do so, or impair or supersede a
10-46 right or responsibility that any person has to effect the withholding or
10-47 withdrawal of medical care.
11-1 Sec. 19. NRS 449.690 is hereby amended to read as follows:
11-2 449.690 1. A declaration executed in another state in compliance
11-3 with the law of that state or of this state is valid for the purposes of NRS
11-4 449.535 to 449.690, inclusive[.] , and sections 2 and 3 of this act.
11-5 2. An instrument executed anywhere before July 1, 1977, which
11-6 clearly expresses the intent of the declarant to direct the withholding or
11-7 withdrawal of life-sustaining treatment from him when he [is in a] has an
11-8 incurable or terminal condition or illness and becomes comatose or is
11-9 otherwise rendered incapable of communicating with his attending
11-10 physician, if executed in a manner which attests voluntary execution, or
11-11 executed anywhere before October 1, 1991, which substantially complies
11-12 with NRS 449.600, and has not been subsequently revoked, is effective
11-13 under NRS 449.535 to 449.690, inclusive[.] , and sections 2 and 3 of this
11-14 act.
11-15 3. As used in this section, “state” includes the District of Columbia,
11-16 the Commonwealth of Puerto Rico, and a territory or insular possession
11-17 subject to the jurisdiction of the United States.
11-18 Sec. 20. NRS 449.800 is hereby amended to read as follows:
11-19 449.800 As used in NRS 449.800 to 449.860, inclusive, unless the
11-20 context otherwise requires:
11-21 1. “Facility for long-term care” has the meaning ascribed to it in
11-22 NRS 427A.028.
11-23 2. “Health care facility” includes:
11-24 (a) Any medical facility; and
11-25 (b) Any facility for the dependent.
11-26 [2.] 3. “Incurable or terminal condition or illness” means a medical
11-27 condition or illness that cannot be cured by any known medical therapy
11-28 or treatment as determined by an attending physician.
11-29 4. “Mentally ill person” has the meaning ascribed to it in NRS
11-30 433A.115.
11-31 5. “Power of attorney” means a power of attorney for a disabled
11-32 principal.
11-33 [3.] 6. “Principal” means a natural person who has executed a power of
11-34 attorney for a disabled principal.
11-35 [4.] 7. “Provider of health care” has the meaning ascribed to it in NRS
11-36 629.031.
11-37 Sec. 21. NRS 449.830 is hereby amended to read as follows:
11-38 449.830 The form of a power of attorney for a disabled principal must
11-39 be substantially as follows:
11-40 DURABLE POWER OF ATTORNEY
11-41 FOR HEALTH CARE DECISIONS
11-42 WARNING TO PERSON EXECUTING THIS DOCUMENT
11-43 THIS IS AN IMPORTANT LEGAL DOCUMENT. IT CREATES A
11-44 DURABLE POWER OF ATTORNEY FOR HEALTH CARE. BEFORE
11-45 EXECUTING THIS DOCUMENT, YOU SHOULD KNOW THESE
11-46 IMPORTANT FACTS:
12-1 1. THIS DOCUMENT GIVES THE PERSON YOU DESIGNATE AS
12-2 YOUR ATTORNEY-IN-FACT THE POWER TO MAKE HEALTH
12-3 CARE DECISIONS FOR YOU. THIS POWER IS SUBJECT TO ANY
12-4 LIMITATIONS OR STATEMENT OF YOUR DESIRES THAT YOU
12-5 INCLUDE IN THIS DOCUMENT. THE POWER TO MAKE HEALTH
12-6 CARE DECISIONS FOR YOU MAY INCLUDE CONSENT, REFUSAL
12-7 OF CONSENT, OR WITHDRAWAL OF CONSENT TO ANY CARE,
12-8 TREATMENT, SERVICE[,] OR PROCEDURE TO MAINTAIN,
12-9 DIAGNOSE[,] OR TREAT A PHYSICAL OR MENTAL CONDITION.
12-10 YOU MAY STATE IN THIS DOCUMENT ANY TYPES OF
12-11 TREATMENT OR PLACEMENTS THAT YOU DO NOT DESIRE.
12-12 2. THE PERSON YOU DESIGNATE IN THIS DOCUMENT HAS A
12-13 DUTY TO ACT CONSISTENT WITH YOUR DESIRES AS STATED IN
12-14 THIS DOCUMENT OR OTHERWISE MADE KNOWN OR, IF YOUR
12-15 DESIRES ARE UNKNOWN, TO ACT IN YOUR BEST INTERESTS.
12-16 3. EXCEPT AS YOU OTHERWISE SPECIFY IN THIS
12-17 DOCUMENT, THE POWER OF THE PERSON YOU DESIGNATE TO
12-18 MAKE HEALTH CARE DECISIONS FOR YOU MAY INCLUDE THE
12-19 POWER TO CONSENT TO YOUR DOCTOR NOT GIVING
12-20 TREATMENT OR STOPPING TREATMENT WHICH WOULD KEEP
12-21 YOU ALIVE.
12-22 4. UNLESS YOU SPECIFY A SHORTER PERIOD IN THIS
12-23 DOCUMENT, THIS POWER WILL EXIST INDEFINITELY FROM
12-24 THE DATE YOU EXECUTE THIS DOCUMENT AND, IF YOU ARE
12-25 UNABLE TO MAKE HEALTH CARE DECISIONS FOR YOURSELF,
12-26 THIS POWER WILL CONTINUE TO EXIST UNTIL THE TIME WHEN
12-27 YOU BECOME ABLE TO MAKE HEALTH CARE DECISIONS FOR
12-28 YOURSELF.
12-29 5. NOTWITHSTANDING THIS DOCUMENT, YOU HAVE THE
12-30 RIGHT TO MAKE MEDICAL AND OTHER HEALTH CARE
12-31 DECISIONS FOR YOURSELF SO LONG AS YOU CAN GIVE
12-32 INFORMED CONSENT WITH RESPECT TO THE PARTICULAR
12-33 DECISION. IN ADDITION, NO TREATMENT MAY BE GIVEN TO
12-34 YOU OVER YOUR OBJECTION, AND HEALTH CARE NECESSARY
12-35 TO KEEP YOU ALIVE MAY NOT BE STOPPED IF YOU OBJECT.
12-36 6. YOU HAVE THE RIGHT TO REVOKE THE APPOINTMENT
12-37 OF THE PERSON DESIGNATED IN THIS DOCUMENT TO MAKE
12-38 HEALTH CARE DECISIONS FOR YOU BY NOTIFYING THAT
12-39 PERSON OF THE REVOCATION ORALLY OR IN WRITING.
12-40 7. YOU HAVE THE RIGHT TO REVOKE THE AUTHORITY
12-41 GRANTED TO THE PERSON DESIGNATED IN THIS DOCUMENT
12-42 TO MAKE HEALTH CARE DECISIONS FOR YOU BY NOTIFYING
12-43 THE TREATING PHYSICIAN, HOSPITAL[,] OR OTHER PROVIDER
12-44 OF HEALTH CARE ORALLY OR IN WRITING.
12-45 8. THE PERSON DESIGNATED IN THIS DOCUMENT TO MAKE
12-46 HEALTH CARE DECISIONS FOR YOU HAS THE RIGHT TO
12-47 EXAMINE YOUR MEDICAL RECORDS AND TO CONSENT TO
12-48 THEIR DISCLOSURE UNLESS YOU LIMIT THIS RIGHT IN THIS
12-49 DOCUMENT.
13-1 9. THIS DOCUMENT REVOKES ANY PRIOR DURABLE POWER
13-2 OF ATTORNEY FOR HEALTH CARE.
13-3 10. IF THERE IS ANYTHING IN THIS DOCUMENT THAT YOU
13-4 DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER TO
13-5 EXPLAIN IT TO YOU.
13-6 1. DESIGNATION OF HEALTH CARE AGENT.
13-7 I,.....................................................................
13-8 (insert your name) do hereby designate and appoint:
13-9 Name: ............................................................
13-10 Address: ........................................................
13-11 Telephone Number: ........................................
13-12 as my attorney-in-fact to make health care decisions for me as authorized
13-13 in this document.
13-14 (Insert the name and address of the person you wish to designate as your
13-15 attorney-in-fact to make health care decisions for you. Unless the person is
13-16 also your spouse, legal guardian or the person most closely related to you
13-17 by blood, none of the following may be designated as your attorney-in-fact:
13-18 (1) your treating provider of health care, (2) an employee of your treating
13-19 provider of health care, (3) an operator of a health care facility, or (4) an
13-20 employee of an operator of a health care facility.)
13-21 2. CREATION OF DURABLE POWER OF ATTORNEY FOR
13-22 HEALTH CARE.
13-23 By this document I intend to create a durable power of attorney by
13-24 appointing the person designated above to make health care decisions for
13-25 me. This power of attorney [shall not be] is not affected by my subsequent
13-26 incapacity.
13-27 3. GENERAL STATEMENT OF AUTHORITY GRANTED.
13-28 In the event that I am incapable of giving informed consent with respect
13-29 to health care decisions, I hereby grant to the attorney-in-fact named above
13-30 full power and authority to make health care decisions for me before[,] or
13-31 after my death, including[:] consent, refusal of consent, or withdrawal of
13-32 consent to any care, treatment, service[,] or procedure to maintain,
13-33 diagnose[,] or treat a physical or mental condition, including placement in
13-34 a facility for long-term care, and short-term placement in a mental
13-35 health facility for not more than 14 consecutive days for the purpose of
13-36 determining the need for placement or the need for minimal impact drug
13-37 therapy or other therapy necessary to control aggressive or other
13-38 behavior resulting from Alzheimer’s disease, senile dementia, age-related
13-39 dementia or complications from stroke, subject only to the limitations and
13-40 special provisions, if any, set forth in paragraph 4 or 6.
13-41 4. SPECIAL PROVISIONS AND LIMITATIONS.
13-42 (Your attorney-in-fact is not permitted to consent to [any of the
13-43 following:] your commitment to or placement in a mental health [treatment
13-44 facility,] facility as a mentally ill person pursuant to NRS 433A.115 to
13-45 433A.330, inclusive, or to convulsive treatment, psychosurgery,
13-46 sterilization[,] or abortion. If there are any other types of treatment or
14-1 placement that you do not want to authorize your [attorney-in-fact’s
14-2 authority] attorney-in-fact to give consent for or other restrictions you
14-3 wish to place on [his or her attorney-in-fact’s authority, you should] the
14-4 authority of your attorney-in-fact, list them in the space below. If you do
14-5 not [write any limitations,] list any restrictions, your attorney-in-fact will
14-6 have the broad powers to make health care decisions on your behalf which
14-7 are set forth in paragraph 3, except to the extent that there are limits
14-8 provided by law.)
14-9 In exercising the authority under this durable power of attorney for
14-10 health care, the authority of my attorney-in-fact is subject to the following
14-11 special provisions and limitations:
14-12 ...........................................................................
14-13 ...........................................................................
14-14 ...........................................................................
14-15 ...........................................................................
14-16 5. DURATION.
14-17 I understand that this power of attorney will exist indefinitely from the
14-18 date I execute this document unless I establish a shorter time. If I am
14-19 unable to make health care decisions for myself when this power of
14-20 attorney expires, the authority I have granted my attorney-in-fact will
14-21 continue to exist until the time when I become able to make health care
14-22 decisions for myself.
14-23 (IF APPLICABLE)
14-24 I wish to have this power of attorney end on the
14-25 following
14-26 date:
14-27 6. STATEMENT OF DESIRES.
14-28 (With respect to decisions to withhold or withdraw life-sustaining
14-29 treatment, your attorney-in-fact must make health care decisions that are
14-30 consistent with your known desires. You can, but are not required to,
14-31 indicate your desires below. If your desires are unknown, your attorney-in-
14-32 fact has the duty to act in your best interests[;] and, under some
14-33 circumstances, a judicial proceeding may be necessary so that a court can
14-34 determine the health care decision that is in your best interests. If you wish
14-35 to indicate your desires, you may INITIAL the statement or statements that
14-36 reflect your desires [and/or] and you may write your own statements in the
14-37 space below.)
14-38 (If the statement
14-39 reflects your desires,
14-40 initial the box next to
14-41 the statement.)
14-42 1. I desire that my life be prolonged to the
14-43 greatest extent possible, without regard to my
14-44 condition, the chances I have for recovery or
14-45 long-term survival, or the cost of the
14-46 procedures. [.. ]
15-1 2. If I am in a coma [which] that my
15-2 doctors have reasonably concluded is
15-3 irreversible, I desire that life-sustaining or
15-4 prolonging treatments not be used[.] ,
15-5 including cardiopulmonary resuscitation and
15-6 other resuscitative procedures, and that my
15-7 medical chart be marked as “No Code” or
15-8 “Do Not Resuscitate.” [(Also] You should
15-9 also utilize the provisions of NRS 449.535 to
15-10 449.690, inclusive, and sections 2 and 3 of
15-11 this act, if this subparagraph is initialed.) [.. ]
15-12 3. If I have an incurable or terminal
15-13 condition or illness and no reasonable hope of
15-14 long-term recovery or survival, I desire that
15-15 life-sustaining or prolonging treatments not be
15-16 used[.(Also] , including cardiopulmonary
15-17 resuscitation and other resuscitative
15-18 procedures, and that my medical chart be
15-19 marked as “No Code” or “Do Not
15-20 Resuscitate.” (You should also utilize the
15-21 provisions of NRS 449.535 to 449.690,
15-22 inclusive, and sections 2 and 3 of this act, if
15-23 this subparagraph is initialed.)[ ]
15-24 4. Withholding or withdrawal of artificial
15-25 nutrition and hydration may result in death by
15-26 starvation or dehydration. I [want] desire to
15-27 receive or continue receiving artificial
15-28 nutrition and hydration by way of the gastro-
15-29 intestinal tract after all other treatment is
15-30 withheld. [.. ]
15-31 5. I do not desire treatment to be provided
15-32 [and/or] or continued if the burdens of the
15-33 treatment outweigh the expected benefits. My
15-34 attorney-in-fact is to consider the relief of
15-35 suffering, the preservation or restoration of
15-36 functioning, and the quality as well as the
15-37 extent of the possible extension of my life. [.. ]
15-38 6. I desire my attending physician to
15-39 administer such medication to me as will
15-40 alleviate any suffering I might experience,
15-41 regardless of whether the medication is
15-42 highly addictive or may shorten my
15-43 remaining life. [.. ]
15-44 7. If I am in a nursing home or facility
15-45 for long-term care with little or no chance of
15-46 recovery or returning to my home, I desire
15-47 that all resuscitative and preventive care be
15-48 discontinued, including the use of, or
15-49 treatment involving, antibiotics. [.. ]
16-1 (If you wish to change your answer, you may do so by drawing an “X”
16-2 through the answer you do not want, and circling the answer you prefer.)
16-3 Other or Additional Statements of Desires:
16-4 ............................................................................
16-5 ............................................................................
16-6 ............................................................................
16-7 ............................................................................
16-8 ............................................................................
16-9 7. DESIGNATION OF [ALTERNATE] ALTERNATIVE
16-10 ATTORNEY-IN-FACT.
16-11 (You are not required to designate any alternative attorney-in-fact , but
16-12 you may do so. Any alternative attorney-in-fact you designate will be able
16-13 to make the same health care decisions as [the attorney-in-fact designated
16-14 in paragraph 1, page 2, in the event that] your designated attorney-in-fact
16-15 if he or she is unable or unwilling to act as your attorney-in-fact. Also, if
16-16 [the attorney-in-fact designated in paragraph 1] your designated attorney-
16-17 in-fact is your spouse, his or her designation as your attorney-in-fact is
16-18 automatically revoked by law if your marriage is dissolved.)
16-19 If [the person designated in paragraph 1 as] my designated attorney-in-
16-20 fact is unable to make health care decisions for me, then I designate the
16-21 following persons to serve as my alternative attorney-in-fact to make
16-22 health care decisions for me as authorized in this document, such persons
16-23 to serve in the order listed below:
16-24 A. First Alternative Attorney-in-fact
16-25 Name:..............................................
16-26 Address:..........................................
16-27 ..............................................
16-28 Telephone Number:..........................
16-29 B. Second Alternative Attorney-in-fact
16-30 Name:..............................................
16-31 Address:..........................................
16-32 ..............................................
16-33 Telephone Number:..........................
16-34 8. WAIVER OF CONFLICT OF INTEREST. If my designated
16-35 attorney-in-fact is my spouse or one of my children, I hereby waive any
16-36 conflict of interest in carrying out the provisions of this durable power of
16-37 attorney that my spouse or child may have by being a beneficiary of my
16-38 estate.
16-39 9. CHALLENGES. If the legality of any provision of this durable
16-40 power of attorney is questioned by my physician, my attorney-in-fact or
16-41 any other interested person, I hereby authorize my attorney-in-fact to
16-42 commence an action for a declaratory judgment as to the legality of the
16-43 provision, with the costs of the action to be paid from my estate. This
16-44 durable power of attorney must be construed and interpreted in
16-45 accordance with the laws of the State of Nevada.
17-1 10. INCIDENTAL NECESSITIES. I hereby authorize my attorney-
17-2 in-fact to make all decisions concerning the provision of food, clothing,
17-3 shelter and all incidental necessities relating to my physical or mental
17-4 health care and treatment.
17-5 11. PRIOR DESIGNATIONS REVOKED. I revoke any prior durable
17-6 power of attorney for health care.
17-7 (YOU MUST DATE AND SIGN THIS POWER OF ATTORNEY)
17-8 I sign my name to this Durable Power of Attorney for Health [care] Care on
17-9 .............................. (date) at ........................ (city),
17-10 .................. (state)
17-11 ...........................
17-12 (Signature)
17-13 (THIS POWER OF ATTORNEY WILL NOT BE VALID FOR
17-14 MAKING HEALTH CARE DECISIONS UNLESS IT IS EITHER (1)
17-15 SIGNED BY AT LEAST TWO QUALIFIED WITNESSES WHO ARE
17-16 PERSONALLY KNOWN TO YOU AND WHO ARE PRESENT WHEN
17-17 YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE OR (2)
17-18 ACKNOWLEDGED BEFORE A NOTARY PUBLIC.)
17-19 CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC
17-20 (You may use acknowledgment before a notary public instead of the
17-21 statement of witnesses.)
17-22 State of Nevada}
17-23 }ss.
17-24 County of........ }
17-25 On this ................ day of ................, in the year ..., before me,
17-26 ................................ (here insert the name of the notary public) personally
17-27 appeared ................................ (here insert the name of the principal)
17-28 personally known to me (or proved to me on the basis of satisfactory
17-29 evidence) to be the person whose name is subscribed to this instrument,
17-30 and acknowledged that he or she executed it. I declare under penalty of
17-31 perjury that the person whose name is ascribed to this instrument appears
17-32 to be of sound mind and under no duress, fraud[,] or undue influence.
17-33 NOTARY SEAL ....................................
17-34 (Signature of Notary Public)
17-35 STATEMENT OF WITNESSES
17-36 (You should carefully read and follow this witnessing procedure. This
17-37 document will not be valid unless you comply with the witnessing
17-38 procedure. If you elect to use witnesses instead of having this document
17-39 notarized , you must use two qualified adult witnesses. None of the
17-40 following may be used as a witness: (1) a person you designate as the
18-1 attorney-in-fact, (2) a provider of health care, (3) an employee of a
18-2 provider of health care, (4) the operator of a health care facility, or (5) an
18-3 employee of an operator of a health care facility. At least one of the
18-4 witnesses must make the additional declaration set out following the place
18-5 where the witnesses sign.)
18-6 I declare under penalty of perjury that the principal is personally known
18-7 to me, that the principal signed or acknowledged this durable power of
18-8 attorney in my presence, that the principal appears to be of sound mind and
18-9 under no duress, fraud[,] or undue influence, that I am not the person
18-10 appointed as attorney-in-fact by this document, and that I am not a provider
18-11 of health care, an employee of a provider of health care, the operator of a
18-12 [community] health care facility, [nor] or an employee of an operator of a
18-13 health care facility.
18-14 Signature:..................... Residence Address:.........
18-15 Print Name:.................. .......................................
18-16 Date:............................ .......................................
18-17 Signature:..................... Residence Address:.........
18-18 Print Name:.................. .......................................
18-19 Date:............................ .......................................
18-20 (AT LEAST ONE OF THE ABOVE WITNESSES MUST ALSO SIGN
18-21 THE FOLLOWING DECLARATION.)
18-22 I declare under penalty of perjury that I am not related to the principal
18-23 by blood, marriage[,] or adoption, and to the best of my knowledge , I am
18-24 not entitled to any part of the estate of the principal upon the death of the
18-25 principal under a will now existing or by operation of law.
18-26 Signature:.................................
18-27 Signature:.................................
18-28 --------------------------------------------------------------
18-29 Names:........................ Address:.........................
18-30 Print Name:.................. .......................................
18-31 Date:............................ .......................................
18-32 COPIES: You should retain an executed copy of this document and give
18-33 one to your attorney-in-fact. The power of attorney should be available so a
18-34 copy may be given to your providers of health care.
18-35 Sec. 22. NRS 449.850 is hereby amended to read as follows:
18-36 449.850 1. The attorney in fact may not consent to:
18-37 (a) Commitment or placement of the principal in a [facility for
18-38 treatment of mental illness;] mental health facility as a mentally ill person
18-39 pursuant to NRS 433A.115 to 433A.330, inclusive;
18-40 (b) Convulsive treatment;
18-41 (c) Psychosurgery;
18-42 (d) Sterilization;
19-1 (e) Abortion;
19-2 (f) Aversive intervention, as that term is defined in NRS 449.766; or
19-3 (g) Any other treatment to which the principal, in the power of attorney,
19-4 states that the attorney in fact may not consent.
19-5 2. The attorney in fact [must] shall make decisions concerning the use
19-6 or nonuse of [life sustaining treatment which] life-sustaining treatment
19-7 that conform to the known desires of the principal. The principal may
19-8 make [these] those desires known in the power of attorney.
19-9 Sec. 23. NRS 450B.520 is hereby amended to read as follows:
19-10 450B.520 1. A qualified patient may apply to the health authority for
19-11 a do-not-resuscitate identification by submitting an application on a form
19-12 provided by the health authority. To obtain a do-not-resuscitate
19-13 identification, the patient must comply with the requirements prescribed by
19-14 the board and sign a form which states that he has informed each member
19-15 of his family within the first degree of consanguinity or affinity, whose
19-16 whereabouts are known to him, or if no such members are living, his legal
19-17 guardian, if any, or if he has no such members living and has no legal
19-18 guardian, his caretaker, if any, of his decision to apply for an identification.
19-19 2. An application must include, without limitation:
19-20 (a) Certification by the patient’s attending physician that the patient
19-21 suffers from [a] an incurable or terminal condition[;] or illness;
19-22 (b) Certification by the patient’s attending physician that the patient:
19-23 (1) Is capable of making an informed decision; or
19-24 (2) When he was capable of making an informed decision, executed:
19-25 (I) A written directive that life-resuscitating treatment be withheld
19-26 under certain circumstances; or
19-27 (II) A durable power of attorney for health care pursuant to NRS
19-28 449.800 to 449.860, inclusive;
19-29 (c) A statement that the patient does not wish that life-resuscitating
19-30 treatment be undertaken in the event of a cardiac or respiratory arrest;
19-31 (d) The name, signature and telephone number of the patient’s attending
19-32 physician; and
19-33 (e) The name and signature of the patient or the attorney in fact who is
19-34 authorized to make health care decisions on the patient’s behalf pursuant to
19-35 a durable power of attorney for health care.
19-36 Sec. 24. NRS 159.079 is hereby amended to read as follows:
19-37 159.079 1. Except as otherwise ordered by the court, a guardian of
19-38 the person has the care, custody and control of the person of the ward, and
19-39 has the authority and, subject to subsection 2, shall perform the duties
19-40 necessary for the proper care, maintenance, education and support of the
19-41 ward, including the following:
19-42 (a) Supplying the ward with food, clothing, shelter and all incidental
19-43 necessaries.
19-44 (b) Authorizing medical, surgical, dental, psychiatric, psychological,
19-45 hygienic or other remedial care and treatment for the ward.
19-46 (c) Seeing that the ward is properly trained and educated and that he has
19-47 the opportunity to learn a trade, occupation or profession.
19-48 2. In the performance of the duties enumerated in subsection 1 by a
19-49 guardian of the person, due regard must be given to the extent of the estate
20-1 of the ward. A guardian of the person is not required to incur expenses on
20-2 behalf of the ward except to the extent that the estate of the ward is
20-3 sufficient to reimburse the guardian. This section does not relieve a parent
20-4 or other person of any duty required by law to provide for the care, support
20-5 and maintenance of any dependent.
20-6 3. If the ward is determined to have an incurable or terminal
20-7 condition or illness, the guardian may authorize the withholding or
20-8 withdrawal of medical treatment that only prolongs the death of the ward
20-9 and is not necessary for the comfort of the ward or to alleviate the pain of
20-10 the ward. The guardian may consult with the spouse, parents, adult
20-11 children or adult siblings of the ward before authorizing the withholding
20-12 or withdrawal of treatment.
20-13 4. As used in this section “incurable or terminal condition or illness”
20-14 has the meaning ascribed to it in section 3 of this act.
20-15 Sec. 25. NRS 433A.115 is hereby amended to read as follows:
20-16 433A.115 1. As used in NRS [433A.120] 433A.115 to 433A.330,
20-17 inclusive, unless the context otherwise requires, “mentally ill person”
20-18 means any person whose capacity to exercise self-control, judgment and
20-19 discretion in the conduct of his affairs and social relations or to care for his
20-20 personal needs is diminished, as a result of a mental illness, to the extent
20-21 that he presents a clear and present danger of harm to himself or others, but
20-22 does not include any person in whom that capacity is diminished by
20-23 epilepsy, mental retardation, Alzheimer’s disease, senile dementia, age-
20-24 related dementia, complications from stroke, brief periods of intoxication
20-25 caused by alcohol or drugs, or dependence upon or addiction to alcohol or
20-26 drugs, unless a mental illness that can be diagnosed is also present which
20-27 contributes to the diminished capacity of the person.
20-28 2. A person presents a clear and present danger of harm to himself if,
20-29 within the next preceding 30 days, he has, as a result of a mental illness:
20-30 (a) Acted in a manner from which it may reasonably be inferred that,
20-31 without the care, supervision or continued assistance of others, he will be
20-32 unable to satisfy his need for nourishment, personal or medical care,
20-33 shelter, self-protection or safety, and if there exists a reasonable probability
20-34 that his death, serious bodily injury or physical debilitation will occur
20-35 within the next following 30 days unless he is admitted to a mental health
20-36 facility pursuant to the provisions of NRS [433A.120] 433A.115 to
20-37 433A.330, inclusive, and adequate treatment is provided to him;
20-38 (b) Attempted or threatened to commit suicide or committed acts in
20-39 furtherance of a threat to commit suicide, and if there exists a reasonable
20-40 probability that he will commit suicide unless he is admitted to a mental
20-41 health facility pursuant to the provisions of NRS [433A.120] 433A.115 to
20-42 433A.330, inclusive, and adequate treatment is provided to him; or
20-43 (c) Mutilated himself, attempted or threatened to mutilate himself or
20-44 committed acts in furtherance of a threat to mutilate himself, and if there
20-45 exists a reasonable probability that he will mutilate himself unless he is
20-46 admitted to a mental health facility pursuant to the provisions of NRS
20-47 [433A.120] 433A.115 to 433A.330, inclusive, and adequate treatment is
20-48 provided to him.
21-1 3. A person presents a clear and present danger of harm to others if,
21-2 within the next preceding 30 days, he has, as a result of a mental illness,
21-3 inflicted or attempted to inflict serious bodily harm on any other person, or
21-4 made threats to inflict harm and committed acts in furtherance of those
21-5 threats, and if there exists a reasonable probability that he will do so again
21-6 unless he is admitted to a mental health facility pursuant to the provisions
21-7 of NRS [433A.120] 433A.115 to 433A.330, inclusive, and adequate
21-8 treatment is provided to him.
21-9 Sec. 26. NRS 449.590 is hereby repealed.
21-10 Sec. 27. The provisions of this act do not affect the validity of any
21-11 declaration executed in accordance with the requirements of NRS 449.560,
21-12 durable power of attorney for health care or other power of attorney
21-13 designating an attorney in fact to make decisions on behalf of a principal
21-14 regarding the withholding or withdrawal of life-sustaining treatment that
21-15 was executed on or before June 30, 2001.
21-16 Sec. 28. This act becomes effective on July 1, 2001.
21-17 TEXT OF REPEALED SECTION
21-18 449.590 “Terminal condition” defined. “Terminal condition”
21-19 means an incurable and irreversible condition that, without the
21-20 administration of life-sustaining treatment, will, in the opinion of the
21-21 attending physician, result in death within a relatively short time.
21-22 H