House File 2577 - Introduced HOUSE FILE 2577 BY COMMITTEE ON JUDICIARY (SUCCESSOR TO HSB 660) A BILL FOR An Act relating to end-of-life care under guardianships of 1 adults. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 6282HV (2) 90 cm/jh

H.F. 2577 Section 1. Section 633.635, subsection 2, paragraph a, Code 1 2024, is amended to read as follows: 2 a. Making decisions regarding the care, maintenance, health, 3 education, welfare, and safety of the protected person except 4 as otherwise limited by the court. Decisions regarding a 5 protected person’s health include all of the following: 6 (1) The ability to enter into hospice and palliative care. 7 (2) The power to execute, reaffirm, and revoke a 8 do-not-resuscitate or do-not-intubate order, or to enter the 9 protected person into hospice care, but only if all of the 10 following conditions are met: 11 (a) The guardian consulted with the protected person 12 about any proposed change not more than fourteen days before 13 executing the change and the protected person was in a 14 condition to engage in meaningful conversation about the 15 proposed change. If a meaningful conversation with the 16 protected person is not possible, the guardian may consult with 17 family members or significant others of the protected person 18 about any proposed change not more than fourteen days before 19 executing the change. 20 (b) The guardian consulted directly with the protected 21 person’s attending physician regarding the specific medical 22 indications that warrant the change. 23 (3) Except in cases in which the diagnosis is a terminal 24 illness with a life expectancy of six months or less, this 25 subsection shall not be construed to authorize a guardian to 26 withdraw life-sustaining procedures or authorize any medicine 27 or procedure that terminates the protected person’s life 28 without first obtaining a court order authorizing such action. 29 EXPLANATION 30 The inclusion of this explanation does not constitute agreement with 31 the explanation’s substance by the members of the general assembly. 32 This bill relates to end-of-life care decisions under 33 guardianships of adults. 34 Under current law, a court may grant a guardian the 35 -1- LSB 6282HV (2) 90 cm/jh 1/ 2

H.F. 2577 ability to make decisions regarding the care, maintenance, 1 health, education, welfare, and safety of the protected 2 person except as otherwise limited by the court, which 3 the guardian may exercise thereafter without prior court 4 approval. The bill provides that this includes end-of-life 5 care decisions (hospice, palliative care, and life-sustaining 6 interventions, and the power to execute, reaffirm, or revoke a 7 do-not-resuscitate or do-not-intubate order). A guardian is 8 only able to make an end-of-life care decision if the guardian 9 has consulted with the protected person not more than 14 days 10 before executing the end-of-life care decision and consulted 11 with the protected person’s attending physician. However, 12 if the protected person is not able to have a meaningful 13 conversation about end-of-life care decisions, a guardian may 14 instead consult with family members and other significant 15 others of the protected person not more than 14 days before 16 executing the end-of-life decision. The bill provides that 17 except for cases in which the protected person’s diagnosis is a 18 terminal illness with life expectancy of six months or less, a 19 guardian may not authorize the withdrawal of life-sustaining 20 procedures or authorize any medicine or procedure that 21 terminates the protected person’s life without first obtaining 22 a court order authorizing such action. 23 -2- LSB 6282HV (2) 90 cm/jh 2/ 2