1.1                                        A bill for an act
1.2     relating to health; establishing the Minnesota Starvation and Dehydration of 
1.3     Persons with Disabilities Prevention Act; proposing coding for new law in 
1.4     Minnesota Statutes, chapter 144.
1.5     BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.6         Section 1. [144.995] STARVATION AND DEHYDRATION PREVENTION.
1.7         Subdivision 1. Citation. This act may be cited as the "Minnesota Starvation and 
1.8     Dehydration of Persons with Disabilities Prevention Act."
1.9         Subd. 2. Definitions. For purposes of this section, the following terms have the 
1.10    meanings given them.
1.11    (a) "Attending physician" means the physician who has primary responsibility for 
1.12    the overall medical treatment and care of a person.
1.13    (b) "Express and informed consent" means consent voluntarily given with 
1.14    sufficient knowledge of the subject matter involved, including a general understanding 
1.15    of the procedure, the medically acceptable alternative procedures or treatments, and 
1.16    the substantial risks and hazards inherent if the proposed treatment or procedures are 
1.17    carried out and if they are not carried out, to enable the person giving consent to make 
1.18    an understanding and enlightened decision without any element of force, fraud, deceit, 
1.19    duress, or other form of constraint or coercion.
1.20    (c) "Health care provider" means a person who is licensed, certified, or otherwise 
1.21    authorized by the law of this state to administer health care in the ordinary course of 
1.22    business or practice of a profession.
1.23    (d) "Hydration" means fluids administered by way of the gastrointestinal tract or 
1.24    intravenously.
2.1     (e) "Nutrition" means sustenance administered by way of the gastrointestinal tract or 
2.2     intravenously.
2.3     (f) "Person legally incapable of making health care decisions" means any person 
2.4     who:
2.5     (1) has been declared legally incompetent to make decisions affecting medical 
2.6     treatment or care; or 
2.7     (2) in the reasonable judgment of the attending physician, is unable to make 
2.8     decisions affecting medical treatment or other health care services; or
2.9     (3) is a minor.
2.10    (g) "Physician" means a physician licensed under section 147.02.
2.11    (h) "Reasonable medical judgment" means a medical judgment that would be made 
2.12    by a reasonably prudent physician, knowledgeable about the case and the treatment 
2.13    possibilities with respect to the medical conditions involved.
2.14        Subd. 3. Public information for completing an advanced directive. (a) The 
2.15    commissioner of health shall develop and carry out a statewide public campaign to:
2.16    (1) educate the public on the importance of making individual wishes known 
2.17    concerning the receipt of nutrition, hydration, and life-preserving medical treatment by 
2.18    completing a health care directive or health care living will; and 
2.19    (2) educate the public concerning the presumptions established by subdivision 
2.20    4 and the effective date.
2.21    The campaign shall be carried out for a minimum of two years following the enactment of 
2.22    this legislation, after which time subdivision 4 will become effective.
2.23    (b) The public information campaign under paragraph (a) may include the following, 
2.24    all of which materials shall be objective, nonjudgmental, and designed to convey only 
2.25    accurate scientific information, and which shall be designed to reach populations of 
2.26    different ages, languages, and different social and economic backgrounds:
2.27    (1) the preparation, publication, and dissemination of information, pamphlets, 
2.28    brochures, and other reports; and 
2.29    (2) the preparation and dissemination of a statewide media and public relations 
2.30    campaign, including public service advertising.
2.31    (c) The commissioner of health shall develop and maintain a stable Internet Web 
2.32    site, a link to which shall be featured on the home page of the Department of Health Web 
2.33    site, to provide information concerning advance directives. No information revealing the 
2.34    personal identity of individuals who use the Web site shall be collected or maintained. 
2.35    The commissioner of health shall monitor the Web site on a weekly basis to prevent 
2.36    and correct tampering. The Web site shall contain, in forms suitable for download and 
3.1     printing, the Health Care Living Will form established by section 145B.04, the suggested 
3.2     form of a health care directive established by section 145C.16, and all alternative forms 
3.3     for a health care directive that the commissioner determines would meet the requirements 
3.4     for legal sufficiency under section 145C.03 without containing any provision that would 
3.5     direct or authorize conduct prohibited under section 609.215, together with explanatory 
3.6     material, that are submitted to the commissioner with a request that they be included on 
3.7     the Web site. Forms or material containing obscene or libelous matter may be excluded by 
3.8     the commissioner. The section of the Web site containing these alternative forms shall 
3.9     include the following prominently displayed statement: "This section of the Department 
3.10    of Health Web site is a limited public forum containing advance directive forms and 
3.11    explanatory material which have been submitted by private groups and individuals, and 
3.12    represents different perspectives on treatment issues you may wish to review to see how 
3.13    closely they would reflect your own choices. Although the department has determined that 
3.14    each of the forms complies with Minnesota law, neither the Department of Health nor the 
3.15    state of Minnesota endorses or assumes any responsibility for their content."
3.16        Subd. 4. Presumption of nutrition and hydration sufficient to sustain life. (a) 
3.17    It shall be presumed that every person legally incapable of making health care decisions 
3.18    has directed the person's health care providers to provide the person with nutrition and 
3.19    hydration to a degree that is sufficient to sustain life.
3.20    (b) No guardian, surrogate, public or private agency, court, or any other person shall 
3.21    have the authority to make a decision on behalf of a person legally incapable of making 
3.22    health care decisions to withhold or withdraw hydration or nutrition from the person except 
3.23    in the circumstances and under the conditions specifically provided for in subdivision 5.
3.24        Subd. 5. Presumption of nutrition and hydration, when inapplicable. The 
3.25    presumption in subdivision 4 shall not apply:
3.26    (1) to the extent that, in reasonable medical judgment, the medical condition of the 
3.27    person legally incapable of making health care decisions is such that the provision of 
3.28    nutrition or hydration would not contribute to sustaining that person's life or to providing 
3.29    comfort to that person;
3.30    (2) if the person executed a directive according to chapter 145B or 145C specifically 
3.31    authorizing the withholding or withdrawal of nutrition or hydration or both, to the extent 
3.32    the authorization applies; or 
3.33    (3) if there is clear and convincing evidence that the person, when legally capable 
3.34    of making health care decisions, gave express and informed consent to withdrawing or 
3.35    withholding hydration or nutrition in the applicable circumstances.
4.1         Subd. 6. Civil remedies. (a) A cause of action for injunctive relief may be 
4.2     maintained against any person who is reasonably believed to be about to violate or who is 
4.3     in the course of violating this section, or to secure a court determination, notwithstanding 
4.4     the position of a guardian or surrogate, whether there is clear and convincing evidence 
4.5     that the person legally incapable of making health care decisions, when legally capable of 
4.6     making such decisions, gave express and informed consent to withdrawing or withholding 
4.7     hydration or nutrition in the applicable circumstances.
4.8     (b) The action may be brought by any person who is:
4.9     (1) the spouse, parent, child, or sibling of the person;
4.10    (2) a current or former health care provider of the person;
4.11    (3) a legally appointed guardian of the person;
4.12    (4) the state protection and advocacy agency; or 
4.13    (5) a public official with appropriate jurisdiction to prosecute or enforce the laws of 
4.14    this state.
4.15    (c) Pending the final determination of the court, the court shall direct that nutrition 
4.16    and hydration be provided unless the court determines that subdivision 5, clause (1), 
4.17    is applicable.
4.18        Subd. 7. Severability. If any provision, word, phrase, or clause of this section or the 
4.19    application to any person or circumstance is held invalid, the invalidity shall not affect 
4.20    the provisions, words, phrases, clauses, or applications of this section which can be given 
4.21    effect without the invalid provision, word, phrase, clause, or application, and to this end, 
4.22    the provisions, words, phrases, and clauses of this section are severable.

Please direct all comments concerning issues or legislation
to your House Member or State Senator.

For Legislative Staff or for directions to the Capitol, visit the Contact Us page.

General questions or comments.

The views and opinions expressed in this page are strictly those of the page author.
The contents of this page have not been reviewed or approved by the University of Minnesota.