HF 2577 (LSB 6282HV (2) 90)

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 adults.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 633.635, subsection 2, paragraph a, Code 2024, is amended to read as follows:
   a.  Making decisions regarding the care, maintenance, health, education, welfare, and safety of the protected person except as otherwise limited by the court.  Decisions regarding a protected person’s health include all of the following:
   (1)  The ability to enter into hospice and palliative care.
   (2)  The power to execute, reaffirm, and revoke a do-not-resuscitate or do-not-intubate order, or to enter the protected person into hospice care, but only if all of the following conditions are met:
   (a)  The guardian consulted with the protected person about any proposed change not more than fourteen days before executing the change and the protected person was in a condition to engage in meaningful conversation about the proposed change. If a meaningful conversation with the protected person is not possible, the guardian may consult with family members or significant others of the protected person about any proposed change not more than fourteen days before executing the change.
   (b)  The guardian consulted directly with the protected person’s attending physician regarding the specific medical indications that warrant the change.
   (3)  Except in cases in which the diagnosis is a terminal illness with a life expectancy of six months or less, this subsection shall not be construed to authorize a guardian to withdraw life-sustaining procedures or authorize any medicine or procedure that terminates the protected person’s life without first obtaining a court order authorizing such action.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to end-of-life care decisions under guardianships of adults.
   Under current law, a court may grant a guardian the ability to make decisions regarding the care, maintenance, health, education, welfare, and safety of the protected person except as otherwise limited by the court, which the guardian may exercise thereafter without prior court approval. The bill provides that this includes end-of-life care decisions (hospice, palliative care, and life-sustaining interventions, and the power to execute, reaffirm, or revoke a do-not-resuscitate or do-not-intubate order). A guardian is only able to make an end-of-life care decision if the guardian has consulted with the protected person not more than 14 days before executing the end-of-life care decision and consulted with the protected person’s attending physician. However, if the protected person is not able to have a meaningful conversation about end-of-life care decisions, a guardian may instead consult with family members and other significant others of the protected person not more than 14 days before executing the end-of-life decision. The bill provides that except for cases in which the protected person’s diagnosis is a terminal illness with life expectancy of six months or less, a guardian may not authorize the withdrawal of life-sustaining procedures or authorize any medicine or procedure that terminates the protected person’s life without first obtaining a court order authorizing such action.