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90_HB0725enr
745 ILCS 70/1 from Ch. 111 1/2, par. 5301
745 ILCS 70/2 from Ch. 111 1/2, par. 5302
745 ILCS 70/3 from Ch. 111 1/2, par. 5303
745 ILCS 70/4 from Ch. 111 1/2, par. 5304
745 ILCS 70/5 from Ch. 111 1/2, par. 5305
745 ILCS 70/6 from Ch. 111 1/2, par. 5306
745 ILCS 70/7 from Ch. 111 1/2, par. 5307
745 ILCS 70/8 from Ch. 111 1/2, par. 5308
745 ILCS 70/9 from Ch. 111 1/2, par. 5309
745 ILCS 70/10 from Ch. 111 1/2, par. 5310
745 ILCS 70/11 from Ch. 111 1/2, par. 5311
745 ILCS 70/11.2 new
745 ILCS 70/11.3 new
745 ILCS 70/11.4 new
745 ILCS 70/12 from Ch. 111 1/2, par. 5312
745 ILCS 70/13 from Ch. 111 1/2, par. 5313
745 ILCS 70/14 from Ch. 111 1/2, par. 5314
Amends the Right of Conscience Act. Changes the short
title of the Act to the Health Care Right of Conscience Act.
Changes defined terms "medical care", "medical personnel",
and "medical facility" to "health care", "health care
personnel", and "health care facility", respectively and
makes other changes in definitions, including changes in
definition of "physician". Adds definition of "health care
payer"; provides that a health care payer is not civilly or
criminally liable by reason of a refusal to pay or arrange
for payment of any particular form of health care services
that violate the payer's conscience as documented in its
ethical guidelines or other governing documents. Prohibits
discrimination against a health care payer in matters of
licensing and other privileges and prohibits denial of grants
or benefits to a health care payer for similar reasons.
Makes other changes.
LRB9001282DJcd
HB0725 Enrolled LRB9001282DJcd
1 AN ACT concerning health care, amending named Acts.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Right of Conscience Act is amended by
5 changing Sections 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13,
6 and 14 and adding Sections 11.2, 11.3, and 11.4 as follows:
7 (745 ILCS 70/1) (from Ch. 111 1/2, par. 5301)
8 Sec. 1. Short title. This Act shall be known and may be
9 cited as the Health Care "Right of Conscience Act".
10 (Source: P.A. 80-616.)
11 (745 ILCS 70/2) (from Ch. 111 1/2, par. 5302)
12 Sec. 2. Findings and policy. The General Assembly finds
13 and declares that people and organizations hold different
14 beliefs about whether certain health care services are
15 morally acceptable. It is the public policy of the State of
16 Illinois to respect and protect the right of conscience of
17 all persons who refuse to obtain, receive or accept, or who
18 are engaged in, the delivery of, arrangement for, or payment
19 of health care medical services and medical care whether
20 acting individually, corporately, or in association with
21 other persons; and to prohibit all forms of discrimination,
22 disqualification, coercion, disability or imposition of
23 liability upon such persons or entities by reason of their
24 refusing to act contrary to their conscience or conscientious
25 convictions in refusing to obtain, receive, accept, or
26 deliver, pay for, or arrange for the payment of health care
27 medical services and medical care.
28 (Source: P.A. 80-616.)
29 (745 ILCS 70/3) (from Ch. 111 1/2, par. 5303)
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1 Sec. 3. Definitions. As used in this Act, unless the
2 context clearly otherwise requires:
3 (a) "Health Medical care" means any phase of patient
4 care, including but not limited to, testing; diagnosis;
5 prognosis; ancillary research; instructions; family planning,
6 counselling, referrals, or any other advice in connection
7 with the use or procurement of contraceptives and
8 sterilization or abortion procedures; medication; or surgery
9 or other care or treatment rendered by a physician or
10 physicians, nurses, paraprofessionals or health care medical
11 facility, intended for the physical, emotional, and mental
12 well-being of persons;
13 (b) "Physician" means any person who is entitled to
14 provide medical services or medical care or is licensed by
15 the State of Illinois under the Medical Practice Act of 1987
16 to practice medicine in all its branches, whether as intern,
17 resident, medical trainee, or fully licensed practitioner of
18 medicine;
19 (c) "Health care Medical personnel" means any nurse,
20 nurses' aide aid, medical school student, professional,
21 paraprofessional or any other person who furnishes, or
22 assists in the furnishing of, health care medical care
23 services;
24 (d) "Health care Medical facility" means any public or
25 private hospital, clinic, center, medical school, medical
26 training institution, laboratory or diagnostic health care
27 facility, physician's office, infirmary, dispensary,
28 ambulatory surgical treatment center or other institution or
29 location wherein health care services are medical care is
30 provided to any person, including physician organizations and
31 associations, networks, joint ventures, and all other
32 combinations of those organizations; and
33 (e) "Conscience" means a sincerely held set of moral
34 convictions arising from belief in and relation to God, or
HB0725 Enrolled -3- LRB9001282DJcd
1 which, though not so derived, arises obtains from a place in
2 the life of its possessor parallel to that filled by God
3 among adherents to religious faiths; and.
4 (f) "Health care payer" means a health maintenance
5 organization, insurance company, management services
6 organization, or any other entity that pays for or arranges
7 for the payment of any health care or medical care service,
8 procedure, or product.
9 The above definitions include not only the traditional
10 combinations and forms of these persons and organizations but
11 also all new and emerging forms and combinations of these
12 persons and organizations.
13 (Source: P.A. 80-616.)
14 (745 ILCS 70/4) (from Ch. 111 1/2, par. 5304)
15 Sec. 4. Liability. No physician or health care medical
16 personnel shall be civilly or criminally liable to any
17 person, estate, public or private entity or public official
18 by reason of his or her refusal to perform, assist, counsel,
19 suggest, recommend, refer or participate in any way in any
20 particular form of health medical care service which is
21 contrary to the conscience of such physician or health care
22 medical personnel.
23 (Source: P.A. 80-616.)
24 (745 ILCS 70/5) (from Ch. 111 1/2, par. 5305)
25 Sec. 5. Discrimination. It shall be unlawful for any
26 person, public or private institution, or public official to
27 discriminate against any person in any manner, including but
28 not limited to, licensing, hiring, promotion, transfer, staff
29 appointment, hospital, managed care entity, or any other
30 privileges, because of such person's conscientious refusal to
31 receive, obtain, accept, perform, assist, counsel, suggest,
32 recommend, refer or participate in any way in any particular
HB0725 Enrolled -4- LRB9001282DJcd
1 form of health care services medical care contrary to his or
2 her conscience.
3 (Source: P.A. 80-616.)
4 (745 ILCS 70/6) (from Ch. 111 1/2, par. 5306)
5 Sec. 6. Duty of physicians and other health care
6 personnel. Nothing in this Act shall relieve a physician
7 from any duty, which may exist under any laws concerning
8 current standards, of normal medical practices and
9 procedures, to inform his or her patient of the patient's
10 condition, prognosis and risks, provided, however, that such
11 physician shall be under no duty to perform, assist, counsel,
12 suggest, recommend, refer or participate in any way in any
13 form of medical practice or health medical care service that
14 is contrary to his or her conscience.
15 Nothing in this Act shall be construed so as to relieve a
16 physician or other health care medical personnel from
17 obligations under the law of providing emergency medical
18 care.
19 (Source: P.A. 80-616.)
20 (745 ILCS 70/7) (from Ch. 111 1/2, par. 5307)
21 Sec. 7. Discrimination by employers or institutions. It
22 shall be unlawful for any public or private employer, entity,
23 agency, institution, official or person, including but not
24 limited to, a medical, nursing or other medical training
25 institution, to deny admission because of, to place any
26 reference in its application form concerning, to orally
27 question about, to impose any burdens in terms or conditions
28 of employment on, or to otherwise discriminate against, any
29 applicant, in terms of employment, admission to or
30 participation in any programs for which the applicant is
31 eligible, or to discriminate in relation thereto, in any
32 other manner, on account of the applicant's refusal to
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1 receive, obtain, accept, perform, counsel, suggest,
2 recommend, refer, assist or participate in any way in any
3 forms of health medical care services contrary to his or her
4 conscience.
5 (Source: P.A. 80-616.)
6 (745 ILCS 70/8) (from Ch. 111 1/2, par. 5308)
7 Sec. 8. Denial of aid or benefits. It shall be unlawful
8 for any public official, guardian, agency, institution or
9 entity to deny any form of aid, assistance or benefits, or to
10 condition the reception in any way of any form of aid,
11 assistance or benefits, or in any other manner to coerce,
12 disqualify or discriminate against any person, otherwise
13 entitled to such aid, assistance or benefits, because that
14 person refuses to obtain, receive, accept, perform, assist,
15 counsel, suggest, recommend, refer or participate in any way
16 in any form of health medical care services contrary to his
17 or her conscience.
18 (Source: P.A. 80-616.)
19 (745 ILCS 70/9) (from Ch. 111 1/2, par. 5309)
20 Sec. 9. Liability. No person, association, or
21 corporation, which owns, operates, supervises, or manages a
22 health care medical facility shall be civilly or criminally
23 liable to any person, estate, or public or private entity by
24 reason of refusal of the health care such medical facility to
25 permit or provide any particular form of health medical care
26 service which violates the facility's conscience as
27 documented in its ethical guidelines, mission statement,
28 constitution, bylaws, articles of incorporation, or
29 regulations, or other governing documents.
30 Nothing in this act shall be construed so as to relieve a
31 physician or other health care medical personnel from
32 obligations under the law of providing emergency medical
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1 care.
2 (Source: P.A. 80-616.)
3 (745 ILCS 70/10) (from Ch. 111 1/2, par. 5310)
4 Sec. 10. Discrimination against facility. It shall be
5 unlawful for any person, public or private institution or
6 public official to discriminate against any person,
7 association or corporation attempting to establish a new
8 health care medical facility or operating an existing health
9 care medical facility, in any manner, including but not
10 limited to, denial, deprivation or disqualification in
11 licensing, granting of authorizations, aids, assistance,
12 benefits, medical staff or any other privileges, and granting
13 authorization to expand, improve, or create any health care
14 medical facility, by reason of the refusal of such person,
15 association or corporation planning, proposing or operating a
16 health care medical facility, to permit or perform any
17 particular form of health medical care service which violates
18 the health care facility's conscience as documented in its
19 existing or proposed ethical guidelines, mission statement,
20 constitution, bylaws, articles of incorporation, or
21 regulations, or other governing documents.
22 (Source: P.A. 80-616.)
23 (745 ILCS 70/11) (from Ch. 111 1/2, par. 5311)
24 Sec. 11. Denial of aid or benefit to a facility. It
25 shall be unlawful for any public official, agency,
26 institution or entity to deny any form of aid, assistance,
27 grants or benefits; or in any other manner to coerce,
28 disqualify or discriminate against any person, association or
29 corporation attempting to establish a new health care medical
30 facility or operating an existing health care medical
31 facility which otherwise would be entitled to the aid,
32 assistance, grant or benefit because the existing or proposed
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1 health care medical facility refuses to perform, assist,
2 counsel, suggest, recommend, refer or participate in any way
3 in any form of health medical care services contrary to the
4 health care facility's conscience as documented in its
5 existing or proposed ethical guidelines, mission statement,
6 constitution, bylaws, articles of incorporation, or
7 regulations, or other governing documents.
8 (Source: P.A. 80-616.)
9 (745 ILCS 70/11.2 new)
10 Sec. 11.2. Liability of health care payer. No health
11 care payer and no person, association, or corporation that
12 owns, operates, supervises, or manages a health care payer
13 shall be civilly or criminally liable to any person, estate,
14 or public or private entity by reason of refusal of the
15 health care payer to pay for or arrange for the payment of
16 any particular form of health care services that violate the
17 health care payer's conscience as documented in its ethical
18 guidelines, mission statement, constitution, bylaws, articles
19 of incorporation, regulations, or other governing documents.
20 (745 ILCS 70/11.3 new)
21 Sec. 11.3. Discrimination against health care payer in
22 licensing. It shall be unlawful for any person, public or
23 private institution, or public official to discriminate
24 against any person, association, or corporation (i)
25 attempting to establish a new health care payer or (ii)
26 operating an existing health care payer, in any manner,
27 including but not limited to, denial, deprivation, or
28 disqualification in licensing; granting of authorizations,
29 aids, assistance, benefits, or any other privileges; and
30 granting authorization to expand, improve, or create any
31 health care payer, because the person, association, or
32 corporation planning, proposing, or operating a health care
HB0725 Enrolled -8- LRB9001282DJcd
1 payer refuses to pay for or arrange for the payment of any
2 particular form of health care services that violates the
3 health care payer's conscience as documented in the existing
4 or proposed ethical guidelines, mission statement,
5 constitution, bylaws, articles of incorporation, regulations
6 or other governing documents.
7 (745 ILCS 70/11.4 new)
8 Sec. 11.4. Denial of aid or benefits to health care
9 payer for refusal to participate in certain health care. It
10 shall be unlawful for any public official, agency,
11 institution, or entity to deny any form of aid, assistance,
12 grants, or benefits; or in any other manner to coerce,
13 disqualify, or discriminate against any person, association,
14 or corporation attempting to establish a new health care
15 payer or operating an existing health care payer that
16 otherwise would be entitled to the aid, assistance, grant, or
17 benefit because the existing or proposed health care payer
18 refuses to pay for, arrange for the payment of, or
19 participate in any way in any form of health care services
20 contrary to the health care payer's conscience as documented
21 in its existing or proposed ethical guidelines, mission
22 statement, constitution, bylaws, articles of incorporation,
23 regulations, or other governing documents.
24 (745 ILCS 70/12) (from Ch. 111 1/2, par. 5312)
25 Sec. 12. Actions; damages. Any person, association,
26 corporation, entity or health care medical facility injured
27 by any public or private person, association, agency, entity
28 or corporation by reason of any action prohibited by this
29 Act, as now or hereafter amended, may commence a suit
30 therefor, and shall recover threefold the actual damages,
31 including pain and suffering, sustained by such person,
32 association, corporation, entity or health care medical
HB0725 Enrolled -9- LRB9001282DJcd
1 facility, the costs of the suit and reasonable attorney's
2 fees; but in no case shall recovery be less than $2,500 for
3 each violation in addition to costs of the suit and
4 reasonable attorney's fees. These damage remedies shall be
5 cumulative, and not exclusive of other remedies afforded
6 under any other state or federal law.
7 (Source: P.A. 80-616.)
8 (745 ILCS 70/13) (from Ch. 111 1/2, par. 5313)
9 Sec. 13. Liability for refusal to provide certain health
10 care. Nothing in this Act shall be construed as excusing any
11 person, public or private institution, or public official
12 from liability for refusal to permit or provide a particular
13 form of health medical care service if:
14 (a) the person, public or private institution or public
15 official has entered into a contract specifically to provide
16 that particular form of health medical care service; or
17 (b) the person, public or private institution or public
18 official has accepted federal or state funds for the sole
19 purpose of, and specifically conditioned upon, permitting or
20 providing that particular form of health medical care
21 service.
22 (Source: P.A. 80-616.)
23 (745 ILCS 70/14) (from Ch. 111 1/2, par. 5314)
24 Sec. 14. Supersedes other Acts. This Act shall
25 supersede all other Acts or parts of Acts to the extent that
26 any such prior Acts or parts of Acts are inconsistent with
27 the terms or operation of this Act.
28 (Source: P.A. 80-616.)
29 Section 10. The Health Care Surrogate Act is amended by
30 changing Sections 5, 10, 15, 20, and 25 as follows:
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1 (755 ILCS 40/5) (from Ch. 110 1/2, par. 851-5)
2 Sec. 5. Legislative findings and purposes.
3 (a) Findings.
4 The legislature recognizes that all persons have a
5 fundamental right to make decisions relating to their own
6 medical treatment, including the right to forgo
7 life-sustaining treatment.
8 Lack of decisional capacity, alone, should not prevent
9 decisions to forgo life-sustaining treatment from being made
10 on behalf of persons who lack decisional capacity and have no
11 known applicable living will or power of attorney for health
12 care.
13 Uncertainty and lack of clarity in the law concerning the
14 making of private decisions concerning medical treatment and
15 to forgo life-sustaining treatment, without judicial
16 involvement, causes unnecessary emotional distress to the
17 individuals involved and unduly impedes upon the individual
18 right to forgo life-sustaining treatment.
19 The enactment of statutory guidelines for private
20 decision making will bring improved clarity and certainty to
21 the process for implementing decisions concerning medical
22 treatment and to forgo life-sustaining treatment and will
23 substantially reduce the associated emotional distress for
24 involved parties.
25 (b) Purposes.
26 This Act is intended to define the circumstances under
27 which private decisions by patients with decisional capacity
28 and by surrogate decision makers on behalf of patients
29 lacking decisional capacity to make medical treatment
30 decisions or to terminate life-sustaining treatment may be
31 made without judicial involvement of any kind.
32 This Act is intended to establish a process for that
33 private decision making.
34 This Act is intended to clarify the rights and
HB0725 Enrolled -11- LRB9001282DJcd
1 obligations of those involved in these private decisions by
2 or on behalf of patients.
3 This Act is not intended to condone, authorize, or
4 approve mercy killing or assisted suicide.
5 (Source: P.A. 87-749)
6 (755 ILCS 40/10) (from Ch. 110 1/2, par. 851-10)
7 Sec. 10. Definitions.
8 "Adult" means a person who is (i) 18 years of age or
9 older or (ii) an emancipated minor under the Emancipation of
10 Mature Minors Act.
11 "Artificial nutrition and hydration" means supplying food
12 and water through a conduit, such as a tube or intravenous
13 line, where the recipient is not required to chew or swallow
14 voluntarily, including, but not limited to, nasogastric
15 tubes, gastrostomies, jejunostomies, and intravenous
16 infusions. Artificial nutrition and hydration does not
17 include assisted feeding, such as spoon or bottle feeding.
18 "Available" means that a person is not "unavailable". A
19 person is unavailable if (i) the person's existence is not
20 known, (ii) the person has not been able to be contacted by
21 telephone or mail, or (iii) the person lacks decisional
22 capacity, refuses to accept the office of surrogate, or is
23 unwilling to respond in a manner that indicates a choice
24 among the life-sustaining treatment matters at issue.
25 "Attending physician" means the physician selected by or
26 assigned to the patient who has primary responsibility for
27 treatment and care of the patient and who is a licensed
28 physician in Illinois. If more than one physician shares
29 that responsibility, any of those physicians may act as the
30 attending physician under this Act.
31 "Close friend" means any person 18 years of age or older
32 who has exhibited special care and concern for the patient
33 and who presents an affidavit to the attending physician
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1 stating that he or she (i) is a close friend of the patient,
2 (ii) is willing and able to become involved in the patient's
3 health care, and (iii) has maintained such regular contact
4 with the patient as to be familiar with the patient's
5 activities, health, and religious and moral beliefs. The
6 affidavit must also state facts and circumstances that
7 demonstrate that familiarity.
8 "Death" means when, according to accepted medical
9 standards, there is (i) an irreversible cessation of
10 circulatory and respiratory functions or (ii) an irreversible
11 cessation of all functions of the entire brain, including the
12 brain stem.
13 "Decisional capacity" means the ability to understand and
14 appreciate the nature and consequences of a decision
15 regarding medical treatment or forgoing life-sustaining
16 treatment and the ability to reach and communicate an
17 informed decision in the matter as determined by the
18 attending physician.
19 "Forgo life-sustaining treatment" means to withhold,
20 withdraw, or terminate all or any portion of life-sustaining
21 treatment with knowledge that the patient's death is likely
22 to result.
23 "Guardian" means a court appointed guardian of the person
24 who serves as a representative of a minor or as a
25 representative of a person under legal disability.
26 "Health care facility" means a type of health care
27 provider commonly known by a wide variety of titles,
28 including but not limited to, hospitals, medical centers,
29 nursing homes, rehabilitation centers, long term or tertiary
30 care facilities, and other facilities established to
31 administer health care and provide overnight stays in their
32 ordinary course of business or practice.
33 "Health care provider" means a person that is licensed,
34 certified, or otherwise authorized or permitted by the law of
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1 this State to administer health care in the ordinary course
2 of business or practice of a profession, including, but not
3 limited to, physicians, nurses, health care facilities, and
4 any employee, officer, director, agent, or person under
5 contract with such a person.
6 "Imminent" (as in "death is imminent") means a
7 determination made by the attending physician according to
8 accepted medical standards that death will occur in a
9 relatively short period of time, even if life-sustaining
10 treatment is initiated or continued.
11 "Life-sustaining treatment" means any medical treatment,
12 procedure, or intervention that, in the judgment of the
13 attending physician, when applied to a patient with a
14 qualifying condition, would not be effective to remove the
15 qualifying condition or would serve only to prolong the dying
16 process. Those procedures can include, but are not limited
17 to, assisted ventilation, renal dialysis, surgical
18 procedures, blood transfusions, and the administration of
19 drugs, antibiotics, and artificial nutrition and hydration.
20 "Minor" means an individual who is not an adult as
21 defined in this Act.
22 "Parent" means a person who is the natural or adoptive
23 mother or father of the child and whose parental rights have
24 not been terminated by a court of law.
25 "Patient" means an adult or minor individual, unless
26 otherwise specified, under the care or treatment of a
27 licensed physician or other health care provider.
28 "Person" means an individual, a corporation, a business
29 trust, a trust, a partnership, an association, a government,
30 a governmental subdivision or agency, or any other legal
31 entity.
32 "Qualifying condition" means the existence of one or more
33 of the following conditions in a patient certified in writing
34 in the patient's medical record by the attending physician
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1 and by at least one other qualified physician:
2 (1) "Terminal condition" means an illness or injury
3 for which there is no reasonable prospect of cure or
4 recovery, death is imminent, and the application of
5 life-sustaining treatment would only prolong the dying
6 process.
7 (2) "Permanent unconsciousness" means a condition
8 that, to a high degree of medical certainty, (i) will
9 last permanently, without improvement, (ii) in which
10 thought, sensation, purposeful action, social
11 interaction, and awareness of self and environment are
12 absent, and (iii) for which initiating or continuing
13 life-sustaining treatment, in light of the patient's
14 medical condition, provides only minimal medical benefit.
15 (3) "Incurable or irreversible condition" means an
16 illness or injury (i) for which there is no reasonable
17 prospect of cure or recovery, (ii) that ultimately will
18 cause the patient's death even if life-sustaining
19 treatment is initiated or continued, (iii) that imposes
20 severe pain or otherwise imposes an inhumane burden on
21 the patient, and (iv) for which initiating or continuing
22 life-sustaining treatment, in light of the patient's
23 medical condition, provides only minimal medical benefit.
24 The determination that a patient has a qualifying
25 condition creates no presumption regarding the application or
26 non-application of life-sustaining treatment. It is only
27 after a determination by the attending physician that the
28 patient has a qualifying condition that the surrogate
29 decision maker may consider whether or not to forgo
30 life-sustaining treatment. In making this decision, the
31 surrogate shall weigh the burdens on the patient of
32 initiating or continuing life-sustaining treatment against
33 the benefits of that treatment.
34 "Qualified physician" means a physician licensed to
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1 practice medicine in all of its branches in Illinois who has
2 personally examined the patient.
3 "Surrogate decision maker" means an adult individual or
4 individuals who (i) have decisional capacity, (ii) are
5 available upon reasonable inquiry, (iii) are willing to make
6 medical treatment decisions regarding the forgoing of
7 life-sustaining treatment on behalf of a patient who lacks
8 decisional capacity and is diagnosed as suffering from a
9 qualifying condition, and (iv) are identified by the
10 attending physician in accordance with the provisions of this
11 Act as the person or persons who are to make those decisions
12 in accordance with the provisions of this Act.
13 (Source: P.A. 87-749; 88-670, eff. 12-2-94.)
14 (755 ILCS 40/15) (from Ch. 110 1/2, par. 851-15)
15 Sec. 15. Applicability. This Act applies to patients
16 who lack decisional capacity or who and have a qualifying
17 condition. This Act does not apply to instances in which the
18 patient has an operative and unrevoked living will under the
19 Illinois Living Will Act, an operative and unrevoked
20 declaration for mental health treatment under the Mental
21 Health Treatment Preferences Declaration Act, or an
22 authorized agent under a power of attorney for health care
23 under the Illinois Power of Attorney Act and the patient's
24 condition falls within the coverage of the living will, the
25 declaration for mental health treatment, or the power of
26 attorney for health care. In those instances, the living
27 will, declaration for mental health treatment, or power of
28 attorney for health care, as the case may be, shall be given
29 effect according to its terms. This Act does apply in
30 circumstances in which a patient has a qualifying condition
31 but the patient's condition does not fall within the coverage
32 of the living will, the declaration for mental health
33 treatment, or the power of attorney for health care.
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1 Each health care facility shall maintain any advance
2 directives proffered by the patient or other authorized
3 person, including a do not resuscitate order, a living will,
4 a declaration for mental health treatment, or a power of
5 attorney for health care, in the patient's medical records
6 for the duration of the patient's stay. This Act does not
7 apply to patients without a qualifying condition. If a,
8 unless the patient is an adult with decisional capacity, then
9 in which case the right to refuse medical treatment or
10 life-sustaining treatment does not require the presence of a
11 qualifying condition.
12 (Source: P.A. 87-749.)
13 (755 ILCS 40/20) (from Ch. 110 1/2, par. 851-20)
14 Sec. 20. Private decision making process.
15 (a) Decisions whether to forgo life-sustaining or any
16 other form of medical treatment involving an adult patient
17 with decisional capacity may be made by that adult patient.
18 (b) Decisions whether to forgo life-sustaining treatment
19 on behalf of a patient without decisional capacity are
20 lawful, without resort to the courts or legal process, if the
21 patient has a qualifying condition and if the decisions are
22 made in accordance with one of the following paragraphs in
23 this subsection and otherwise meet the requirements of this
24 Act:
25 (1) Decisions whether to forgo life-sustaining
26 treatment on behalf of a minor or an adult patient who
27 lacks decisional capacity may be made by a surrogate
28 decision maker or makers in consultation with the
29 attending physician, in the order or priority provided in
30 Section 25. A surrogate decision maker shall make
31 decisions for the adult patient conforming as closely as
32 possible to what the patient would have done or intended
33 under the circumstances, taking into account evidence
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1 that includes, but is not limited to, the patient's
2 personal, philosophical, religious and moral beliefs and
3 ethical values relative to the purpose of life, sickness,
4 medical procedures, suffering, and death. Where
5 possible, the surrogate shall determine how the patient
6 would have weighed the burdens and benefits of initiating
7 or continuing life-sustaining treatment against the
8 burdens and benefits of that treatment. In the event an
9 unrevoked advance directive, such as a living will, a
10 declaration for mental health treatment, or a power of
11 attorney for health care, is no longer valid due to a
12 technical deficiency or is not applicable to the
13 patient's condition, that document may be used as
14 evidence of a patient's wishes. The absence of a living
15 will, declaration for mental health treatment, or power
16 of attorney for health care shall not give rise to any
17 presumption as to the patient's preferences regarding the
18 initiation or continuation of life-sustaining procedures.
19 If the adult patient's wishes are unknown and remain
20 unknown after reasonable efforts to discern them or if
21 the patient is a minor, the decision shall be made on the
22 basis of the patient's best interests as determined by
23 the surrogate decision maker. In determining the
24 patient's best interests, the surrogate shall weigh the
25 burdens on and benefits to the patient of initiating or
26 continuing life-sustaining treatment against the burdens
27 and benefits of that treatment and shall take into
28 account any other information, including the views of
29 family and friends, that the surrogate decision maker
30 believes the patient would have considered if able to act
31 for herself or himself.
32 (2) Decisions whether to forgo life-sustaining
33 treatment on behalf of a minor or an adult patient who
34 lacks decisional capacity, but without any surrogate
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1 decision maker or guardian being available determined
2 after reasonable inquiry by the health care provider, may
3 be made by a court appointed guardian. A court appointed
4 guardian shall be treated as a surrogate for the purposes
5 of this Act.
6 (b-5) Decisions concerning medical treatment on behalf
7 of a patient without decisional capacity are lawful, without
8 resort to the courts or legal process, if the patient does
9 not have a qualifying condition and if decisions are made in
10 accordance with one of the following paragraphs in this
11 subsection and otherwise meet the requirements of this Act:
12 (1) Decisions concerning medical treatment on
13 behalf of a minor or adult patient who lacks decisional
14 capacity may be made by a surrogate decision maker or
15 makers in consultation with the attending physician, in
16 the order of priority provided in Section 25 with the
17 exception that decisions to forgo life-sustaining
18 treatment may be made only when a patient has a
19 qualifying condition. A surrogate decision maker shall
20 make decisions for the patient conforming as closely as
21 possible to what the patient would have done or intended
22 under the circumstances, taking into account evidence
23 that includes, but is not limited to, the patient's
24 personal, philosophical, religious, and moral beliefs and
25 ethical values relative to the purpose of life, sickness,
26 medical procedures, suffering, and death. In the event
27 an unrevoked advance directive, such as a living will, a
28 declaration for mental health treatment, or a power of
29 attorney for health care, is no longer valid due to a
30 technical deficiency or is not applicable to the
31 patient's condition, that document may be used as
32 evidence of a patient's wishes. The absence of a living
33 will, declaration for mental health treatment, or power
34 of attorney for health care shall not give rise to any
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1 presumption as to the patient's preferences regarding any
2 process. If the adult patient's wishes are unknown and
3 remain unknown after reasonable efforts to discern them
4 or if the patient is a minor, the decision shall be made
5 on the basis of the patient's best interests as
6 determined by the surrogate decision maker. In
7 determining the patient's best interests, the surrogate
8 shall weigh the burdens on and benefits to the patient of
9 the treatment against the burdens and benefits of that
10 treatment and shall take into account any other
11 information, including the views of family and friends,
12 that the surrogate decision maker believes the patient
13 would have considered if able to act for herself or
14 himself.
15 (2) Decisions concerning medical treatment on
16 behalf of a minor or adult patient who lacks decisional
17 capacity, but without any surrogate decision maker or
18 guardian being available as determined after reasonable
19 inquiry by the health care provider, may be made by a
20 court appointed guardian. A court appointed guardian
21 shall be treated as a surrogate for the purposes of this
22 Act.
23 (c) For the purposes of this Act, a patient or surrogate
24 decision maker is presumed to have decisional capacity in the
25 absence of actual notice to the contrary without regard to
26 advanced age. With respect to a patient, a diagnosis of
27 mental illness or mental retardation, of itself, is not a bar
28 to a determination of decisional capacity. A determination
29 that an adult patient lacks decisional capacity shall be made
30 by the attending physician to a reasonable degree of medical
31 certainty. The determination shall be in writing in the
32 patient's medical record and shall set forth the attending
33 physician's opinion regarding the cause, nature, and duration
34 of the patient's lack of decisional capacity. Before
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1 implementation of a decision by a surrogate decision maker to
2 forgo life-sustaining treatment, at least one other qualified
3 physician must concur in the determination that an adult
4 patient lacks decisional capacity. The concurring
5 determination shall be made in writing in the patient's
6 medical record after personal examination of the patient.
7 The attending physician shall inform the patient that it has
8 been determined that the patient lacks decisional capacity
9 and that a surrogate decision maker will be making
10 life-sustaining treatment decisions on behalf of the patient.
11 Moreover, the patient shall be informed of the identity of
12 the surrogate decision maker and any decisions made by that
13 surrogate. If the person identified as the surrogate
14 decision maker is not a court appointed guardian and the
15 patient objects to the statutory surrogate decision maker or
16 any decision made by that surrogate decision maker, then the
17 provisions of this Act shall not apply.
18 (d) A surrogate decision maker acting on behalf of the
19 patient shall express decisions to forgo life-sustaining
20 treatment to the attending physician and one adult witness
21 who is at least 18 years of age. This decision and the
22 substance of any known discussion before making the decision
23 shall be documented by the attending physician in the
24 patient's medical record and signed by the witness.
25 (e) The existence of a qualifying condition shall be
26 documented in writing in the patient's medical record by the
27 attending physician and shall include its cause and nature,
28 if known. The written concurrence of another qualified
29 physician is also required.
30 (f) Once the provisions of this Act are complied with,
31 the attending physician shall thereafter promptly implement
32 the decision to forgo life-sustaining treatment on behalf of
33 the patient unless he or she believes that the surrogate
34 decision maker is not acting in accordance with his or her
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1 responsibilities under this Act, or is unable to do so for
2 reasons of conscience or other personal views or beliefs.
3 (g) In the event of a patient's death as determined by a
4 physician, all life-sustaining treatment and other medical
5 care is to be terminated, unless the patient is an organ
6 donor, in which case appropriate organ donation treatment may
7 be continued temporarily.
8 (Source: P.A. 87-749.)
9 (755 ILCS 40/25) (from Ch. 110 1/2, par. 851-25)
10 Sec. 25. Surrogate decision making.
11 (a) When a patient has a qualifying condition and lacks
12 decisional capacity, the health care provider must make a
13 reasonable inquiry as to the availability and authority of a
14 health care agent under the Powers of Attorney for Health
15 Care Law. When no health care agent is authorized and
16 available, the health care provider must make a reasonable
17 inquiry as to the availability of possible surrogates listed
18 in items (1) through (4) of this subsection. The surrogate
19 decision makers, as identified by the attending physician,
20 are then authorized to make decisions as follows: (i) for
21 patients who lack decisional capacity and do not have a
22 qualifying condition, medical treatment decisions may be made
23 in accordance with subsection (b-5) of Section 20; and (ii)
24 for patients who lack decisional capacity and have a
25 qualifying condition, medical treatment decisions including
26 whether to forgo life-sustaining treatment on behalf of the
27 patient may be made without court order or judicial
28 involvement in the following order of priority:
29 (1) the patient's guardian of the person;
30 (2) the patient's spouse;
31 (3) any adult son or daughter of the patient;
32 (4) either parent of the patient;
33 (5) any adult brother or sister of the patient;
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1 (6) any adult grandchild of the patient;
2 (7) a close friend of the patient;
3 (8) the patient's guardian of the estate.
4 The health care provider shall have the right to rely on
5 any of the above surrogates if the provider believes after
6 reasonable inquiry that neither a health care agent under the
7 Powers of Attorney for Health Care Law nor a surrogate of
8 higher priority is available.
9 Where there are multiple surrogate decision makers at the
10 same priority level in the hierarchy, it shall be the
11 responsibility of those surrogates to make reasonable efforts
12 to reach a consensus as to their decision on behalf of the
13 patient regarding the forgoing of life-sustaining treatment.
14 If 2 or more surrogates who are in the same category and have
15 equal priority indicate to the attending physician that they
16 disagree about the health care matter at issue, a majority of
17 the available persons in that category (or the parent with
18 custodial rights) shall control, unless the minority (or the
19 parent without custodial rights) initiates guardianship
20 proceedings in accordance with the Probate Act of 1975. No
21 health care provider or other person is required to seek
22 appointment of a guardian.
23 (b) After a surrogate has been identified, the name,
24 address, telephone number, and relationship of that person to
25 the patient shall be recorded in the patient's medical
26 record.
27 (c) Any surrogate who becomes unavailable for any reason
28 may be replaced by applying the provisions of Section 25 in
29 the same manner as for the initial choice of surrogate.
30 (d) In the event an individual of a higher priority to
31 an identified surrogate becomes available and willing to be
32 the surrogate, the individual with higher priority may be
33 identified as the surrogate. In the event an individual in a
34 higher, a lower, or the same priority level or a health care
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1 provider seeks to challenge the priority of or the
2 life-sustaining treatment decision of the recognized
3 surrogate decision maker, the challenging party may initiate
4 guardianship proceedings in accordance with the Probate Act
5 of 1975.
6 (e) The surrogate decision maker shall have the same
7 right as the patient to receive medical information and
8 medical records and to consent to disclosure.
9 (Source: P.A. 87-749.)".