WILLIAM DONALD SCHAEFER, Governor                            Ch. 372

(4) THE COST OF AN ASSESSMENT TO CERTIFY INCAPACITY UNDER THIS
SUBSECTION SHALL BE CONSIDERED FOR ALL PURPOSES A COST OF THE PATIENT'S
TREATMENT.

(B) CERTIFICATION OF CONDITION. - A HEALTH CARE PROVIDER MAY NOT
WITHHOLD OR WITHDRAW LIFE-SUSTAINING PROCEDURES ON THE BASIS OF AN
ADVANCE DIRECTIVE WHERE NO AGENT HAS BEEN APPOINTED OR ON THE BASIS
OF THE AUTHORIZATION OF A SURROGATE, UNLESS:

(1)      THE PATIENT'S ATTENDING PHYSICIAN AND A SECOND PHYSICIAN
HAVE CERTIFIED THAT THE PATIENT IS TERMINALLY ILL IN A TERMINAL CONDITION
OR HAS AN END-STAGE CONDITION; OR

(2)      TWO PHYSICIANS, ONE OF WHOM IS A NEUROLOGIST,
NEUROSURGEON, OR OTHER PHYSICIAN WHO HAS SPECIAL EXPERTISE IN THE
EVALUATION OF COGNITIVE FUNCTIONING, CERTIFY THAT THE PATIENT IS IN A
PERSISTENT VEGETATIVE STATE.

5-607. TREATMENT WITHOUT CONSENT.

A HEALTH CARE PROVIDER MAY TREAT A PATIENT WHO IS INCAPABLE OF
MAKING AN INFORMED DECISION, WITHOUT CONSENT, IF:

(1)      THE TREATMENT IS OF AN EMERGENCY MEDICAL NATURE:

(2)      A PERSON WHO IS AUTHORIZED TO GIVE THE CONSENT IS NOT
AVAILABLE IMMEDIATELY; AND

(3) THE ATTENDING PHYSICIAN DETERMINES THAT:

(I)      THERE IS A SUBSTANTIAL RISK OF DEATH OR IMMEDIATE AND
SERIOUS HARM TO THE PATIENT; AND

(II)     WITH A REASONABLE DEGREE OF MEDICAL PROBABILITY
CERTAINTY, THE LIFE OR HEALTH OF THE PATIENT WOULD BE AFFECTED
ADVERSELY BY DELAYING TREATMENT TO OBTAIN CONSENT.

5-608. AUTHORIZATION TO FOLLOW EMERGENCY MEDICAL SERVICES "DO NOT
RESUSCITATE ORDER" IN THE OUTPATIENT SETTING.

(A) CERTIFIED EMERGENCY MEDICAL SERVICES PERSONNEL SHALL BE
DIRECTED BY PROTOCOL TO FOLLOW EMERGENCY MEDICAL SERVICES "DO NOT
RESUSCITATE ORDERS" PERTAINING TO ADULT PATIENTS IN THE OUTPATIENT
SETTING IN ACCORDANCE WITH PROTOCOLS ESTABLISHED BY THE MARYLAND
INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS IN CONJUNCTION WITH
THE STATE BOARD OF PHYSICIAN QUALITY ASSURANCE. EMERGENCY MEDICAL
SERVICES "DO NOT RESUSCITATE ORDERS" MAY NOT AUTHORIZE THE
WITHHOLDING OF MEDICAL INTERVENTIONS, OR THERAPIES DEEMED NECESSARY
TO PROVIDE COMFORT CARE OR TO ALLEVIATE PAIN.

- 2053 -