WILLIAM DONALD SCHAEFER, Governor                           S.B. 664

(D) NO ADVANCE DIRECTIVE PRESUMPTION OF INTENT:--------THE ABSENCE

OF AN ADVANCE DIRECTIVE BY AN ADULT PATIENT CREATES NO PRESUMPTION AS
TO THE PATIENT'S INTENT TO CONSENT TO OR REFUSE LIFE PROLONGING
LIFE SUSTAINING PROCEDURES.

(E) EXCLUSIONS. ---- (1) THE PROVISIONS OF THIS SUBTITLE SECTION DO

NOT APPLY TO THE AUTHORIZATION OF THE FOLLOWING TREATMENTS OR
ACTION'S:

(I) NONTHERAPEUTIC STERILIZATION; OR

(II) PSYCHOSURGERY; OR

(III) ADMISSION TO A MENTAL RETARDATION FACILITY OR
PSYCHIATRIC HOSPITAL RECEIPT OF HEALTH CARE FOR A MENTAL DISORDER.

(2) THE PROVISIONS OF THIS SUBTITLE DO NOT AUTHORIZE ANY
ACTION WITH RESPECT TO MEDICAL TREATMENT THAT IS:

(I) PROTESTED BY THE PATIENT; OR

(II)  CONTRARY TO THE RELIGIOUS BELIEFS OR BASIC VALUES OF
THE PATIENT. IF THE HEALTH CARE PROVIDER IS AWARE THAT THE PATIENT FOR
WHOM THE HEALTH CARE IS PROVIDED HAS EXPRESSED DISAGREEMENT WITH THE
ACTION. A SURROGATE MAY NOT AUTHORIZE:

(1) STERILIZATION; OR

(2) TREATMENT FOR A MENTAL DISORDER.

5-606. CERTIFICATION BY PHYSICIANS.

(F) (A) CERTIFICATION OF INCAPACITY. — (1) PRIOR TO PROVIDING,
WITHHOLDING, OR WITHDRAWING TREATMENT FOR WHICH AUTHORIZATION HAS
BEEN OBTAINED OR WILL BE SOUGHT UNDER THIS SUBTITLE, THE ATTENDING
PHYSICIAN AND A SECOND PHYSICIAN, ONE OF WHOM SHALL HAVE EXAMINED THE
PATIENT WITHIN 2 HOURS BEFORE MAKING THE CERTIFICATION, SHALL CERTIFY IN
WRITING THAT THE PATIENT IS INCAPABLE OF MAKING AN INFORMED DECISION
REGARDING THE TREATMENT. THE CERTIFICATION SHALL BE BASED ON A
PERSONAL EXAMINATION OF THE PATIENT.

(2)      IF A PATIENT IS UNCONSCIOUS, OR UNABLE TO COMMUNICATE BY
ANY MEANS, THE CERTIFICATION OF A SECOND PHYSICIAN IS NOT REQUIRED
UNDER PARAGRAPH (1) OF THIS SUBSECTION.

(3)      WHEN AUTHORIZATION IS SOUGHT FOR TREATMENT OF A MENTAL
ILLNESS, THE SECOND PHYSICIAN MAY NOT BE OTHERWISE CURRENTLY INVOLVED
IN THE TREATMENT OF THE PERSON ASSESSED.

(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.

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