HOUSE BILL No. 4743

 

May 5, 2005, Introduced by Reps. Stahl, Palmer, Garfield, Gosselin, Stakoe, Vander Veen, Sheen, Taub, Hummel, Pastor and Moolenaar and referred to the Committee on Judiciary.

 

     A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

(MCL 333.1101 to 333.25211) by adding part 56B.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

PART 56B

 

WITHHOLDING OR WITHDRAWAL OF NUTRITION OR HYDRATION

 

     Sec. 5675. (1) As used in this part:

 

     (a) "Patient" means an individual who is under the care of a

 

physician.

 

     (b) "Patient advocate" means that term as defined in section

 

1106 of the estates and protected individuals code, 1998 PA 386,

 


MCL 700.1106.

 

     (c) "Patient surrogate" means the parent or legal guardian of

 

a patient who is a minor or a member of the immediate family, the

 

next of kin, or the legal guardian of a patient who has a condition

 

other than minority that prevents the patient from giving consent

 

to medical treatment.

 

     (d) "Persistent vegetative state" means a permanent and

 

irreversible condition of unconsciousness in which there is no

 

voluntary action or cognitive behavior of any kind and no ability

 

to communicate or interact purposefully with the environment.

 

     (e) "Physician" means that term as defined in section 17001 or

 

17501.

 

     (2) Article 1 contains general definitions and principles of

 

construction applicable to all articles in this code.

 

     Sec. 5677. If a patient is diagnosed as being in a persistent

 

vegetative state and the patient has not designated a patient

 

advocate, has designated a patient advocate but the designation

 

does not specifically authorize the patient advocate to withhold or

 

withdraw nutrition or hydration in the event that the patient is

 

diagnosed as being in a persistent vegetative state, or the

 

patient's immediate family disagrees on the issue of withholding or

 

withdrawing nutrition or hydration, a physician shall not withhold

 

or withdraw nutrition or hydration from that patient unless any of

 

the following conditions apply:

 

     (a) In the physician's reasonable medical judgment and in

 

compliance with the applicable standard of practice and care, any

 

of the following apply:

 


     (i) The provision of nutrition or hydration is not medically

 

possible.

 

     (ii) The provision of nutrition or hydration would hasten

 

death.

 

     (iii) The patient's condition is such that the provision of

 

nutrition or hydration would not contribute to sustaining the

 

patient's life or provide comfort to the patient.

 

     (b) The patient has executed a written advanced directive or a

 

living will in accordance with the provisions of another state that

 

specifically authorizes the withholding or withdrawal of nutrition

 

or hydration if he or she is diagnosed as being in a persistent

 

vegetative state.

 

     (c) The patient has expressed in a clear and convincing manner

 

that if diagnosed as being in a persistent vegetative state he or

 

she would consent to the withholding or withdrawal of nutrition or

 

hydration that would allow him or her to die.

 

     Sec. 5679. A life insurer, a health insurer, or a health care

 

payment or benefits plan shall not do any of the following because

 

a patient is diagnosed as being in a persistent vegetative state

 

and the patient, the patient's patient surrogate, or the patient

 

advocate has authorized the withholding or withdrawal of nutrition

 

or hydration:

 

     (a) Refuse to provide or continue coverage or benefits to the

 

patient within the scope and level of coverage or benefits of an

 

existing policy, certificate, or contract.

 

     (b) Limit the amount of coverage or benefits available to the

 

patient within the scope and level of coverage or benefits of an

 


existing policy, certificate, or contract.

 

     (c) Charge the patient a different rate for coverage or

 

benefits under an existing policy, certificate, or contract.

 

     (d) Consider the terms of an existing policy, certificate, or

 

contract to have been breached or modified.

 

     (e) Invoke a suicide or intentional death exemption or

 

exclusion in a policy, certificate, or contract covering the

 

patient.

 

     Sec. 5681. This part does not do the following:

 

     (a) Impair or supersede a legal right a parent, patient,

 

patient advocate, legal guardian, or other individual may have to

 

authorize or deny the withholding or withdrawing of nutrition or

 

hydration on behalf of a patient who is diagnosed as being in a

 

persistent vegetative state.

 

     (b) Create a presumption about the desire of a patient who is

 

diagnosed as being in a persistent vegetative state to withhold or

 

withdraw nutrition or hydration.

 

     (c) Limit the ability of a court making a determination about

 

a decision of a patient who is diagnosed as being in a persistent

 

vegetative state to take into consideration all of the following

 

state interests:

 

     (i) The preservation of life.

 

     (ii) The prevention of suicide.

 

     (iii) The protection of innocent third parties.

 

     (iv) The preservation of the integrity of the medical

 

profession.

 

     (d) Condone, authorize, or approve suicide, assisted suicide,

 


mercy killing, or euthanasia.