LRB-0271/2
DAK:kmg:kaf
1995 - 1996 LEGISLATURE
May 24, 1995 - Introduced by Representatives Huber, Klusman, Meyer, Zukowski,
Kunicki, Goetsch, Olsen, Wasserman, Cullen, Notestein, Schneiders,
Carpenter, La Fave, Robson, Krug, Ainsworth, Gronemus, R. Young, Hanson,
Springer, Ryba, Albers, Wirch, Bock, Boyle and Murat, cosponsored by
Senators Rosenzweig, Rude, Huelsman, Moen, Plewa, Burke, Breske,
Decker, Darling, Chvala, Shibilski and Panzer. Referred to Committee on
Health.
AB399,1,5
1An Act to repeal 154.01 (7);
to amend chapter 154 (title), 154.03 (1) (intro.),
2154.03 (2), 154.15 (1) and 154.15 (2);
to create 154.05 (1) (d), 154.07 (1m),
3154.11 (7) (d) and 154.11 (8) and (9) of the statutes; and
to affect 1991
4Wisconsin Act 84, section
19 (title),
1991 Wisconsin Act 84, section
19 and
1991 5Wisconsin Act
84, section
19 (2);
relating to: declarations to physicians.
Analysis by the Legislative Reference Bureau
Under current law, an adult of sound mind may voluntarily execute, under
specified procedures, a declaration to physicians (commonly known as a living will),
authorizing physicians to withhold or withdraw medication, life-sustaining
procedures or feeding tubes if the person is in a terminal condition or a persistent
vegetative state. The living will laws prohibit this withholding or withdrawal if
doing so will cause the person executing the living will (the declarant) pain or reduce
his or her comfort. Health care providers lawfully participating in actions authorized
under a living will are immune from civil or criminal liability or from being charged
with unprofessional conduct, except that a physician who refuses to comply with a
living will and refuses or fails to make a good faith attempt to transfer the declarant
to another physician who will comply may be charged with unprofessional conduct.
A form model of a living will is statutorily set forth. The department of health and
social services (DHSS) must prepare and provide copies of the statutory form model
and certain other information to health care professionals, hospitals, nursing homes,
county clerks, local bar associations and private persons.
This bill makes numerous changes to the living will statutes, including the
following:
1. The bill changes the standard under which withholding or withdrawal of
medications, life-sustaining procedures or feeding tubes is prohibited. Under the
bill, the withholding or withdrawal may not be made if the declarant's attending
physician advises that doing so will cause the declarant pain or reduce his or her
comfort, despite the administration of pain relief medication.
2. The bill creates an affirmative duty for a physician who refuses to comply
with a living will to make a good faith attempt to transfer the declarant to the care
of another physician who will comply.
3. The bill authorizes the validity and enforceability of a valid living will from
another state or jurisdiction, to the extent that the living will is consistent with
Wisconsin law.
4. The bill requires a health care facility or provider that receives a copy of a
living will to include the copy in the declarant's medical record.
5. The bill permits a person to revoke his or her living will by executing a
subsequent living will.
6. The bill shortens and revises the statutory living will form.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB399, s. 1
1Section
1. Chapter 154 (title) of the statutes is amended to read:
AB399,2,42
Chapter 154
3NATURAL DEATH
4DECLARATIONS TO PHYSICIANS
AB399, s. 2
5Section
2. 154.01 (7) of the statutes is repealed.
AB399, s. 3
6Section
3. 154.03 (1) (intro.) of the statutes is amended to read:
AB399,3,147
154.03
(1) (intro.) Any person of sound mind and 18 years of age or older may
8at any time voluntarily execute a declaration, which shall take effect on the date of
9execution, authorizing the withholding or withdrawal of life-sustaining procedures
10or of feeding tubes when the person is in a terminal condition or is in a persistent
11vegetative state. A declarant may not authorize the withholding or withdrawal of
12any medication, life-sustaining procedure or feeding tube if the declarant's
13attending physician advises that, in his or her professional judgment, the
14withholding or withdrawal will cause the declarant pain or reduce the declarant's
1comfort
, despite the administration of pain relief medication. A declarant may not
2authorize the withholding or withdrawal of nutrition or hydration that is
3administered or otherwise received by the declarant through means other than a
4feeding tube unless the declarant's attending physician advises that, in his or her
5professional judgment, the administration is medically contraindicated. A
6declaration must be signed by the declarant in the presence of 2 witnesses. If the
7declarant is physically unable to sign a declaration, the declaration must be signed
8in the declarant's name by one of the witnesses or some other person at the
9declarant's express direction and in his or her presence; such a proxy signing shall
10either take place or be acknowledged by the declarant in the presence of 2 witnesses.
11The declarant is responsible for notifying his or her attending physician of the
12existence of the declaration. An attending physician who is so notified shall make
13the declaration a part of the declarant's medical records. No witness to the execution
14of the declaration may, at the time of the execution, be any of the following:
AB399, s. 4
15Section
4. 154.03 (2) of the statutes is amended to read:
AB399,4,616
154.03
(2) The department shall prepare and provide copies of the declaration
17and accompanying information for distribution in quantities to health care
18professionals, hospitals, nursing homes, county clerks and local bar associations and
19individually to private persons. The department shall include, in information
20accompanying the declaration, at least the statutory definitions of terms used in the
21declaration, statutory restrictions on who may be witnesses to a valid declaration,
22a statement explaining that valid witnesses acting in good faith are statutorily
23immune from civil or criminal liability, an instruction to potential declarants to read
24and understand the information before completing the declaration and a statement
25explaining that an instrument may, but need not be, filed with the register in probate
1of the declarant's county of residence. The department may charge a reasonable fee
2for the cost of preparation and distribution. The declaration distributed by the
3department of health and social services shall be
easy to read, the type size may be
4no smaller than 10 point, and the declaration shall be in the following form
, setting
5forth on the first page the wording before the ATTENTION statement and setting
6forth on the 2nd page the ATTENTION statement and remaining wording:
AB399,4,8
7Declaration to physicians
8(WISCONSIN LIVING WILL)
AB399,4,15
91. I,...., being of sound mind, voluntarily state my desire that my dying
may not
10be prolonged under the circumstances specified in this document. Under those
11circumstances, I direct that I be permitted to die naturally. If I am unable to give
12directions regarding the use of life-sustaining procedures or feeding tubes, I intend
13that my family and physician honor this document as the final expression of my legal
14right to refuse medical or surgical treatment
and to accept the consequences from
15this refusal.
AB399,4,20
162. 1. If I have a TERMINAL CONDITION,
as determined by 2 physicians who
17have personally examined me, I do not want my dying to be artificially prolonged and
18I do not want life-sustaining procedures to be used. In addition,
if I have such a
19terminal condition, the following are my directions regarding the use of feeding tubes
20(check only one):
AB399,4,21
21a. Use .... YES, I want feeding tubes
used if I have a terminal condition
.....
AB399,4,23
22b. Do not use .... NO, I do not want feeding tubes
used if I have a terminal
23condition
.....
AB399,4,24
24c. If
I you have not checked either box, feeding tubes will be used.
AB399,5,3
13. 2. If I am in a PERSISTENT VEGETATIVE STATE,
as determined by 2
2physicians who have personally examined me, the following are my directions
3regarding the use of life-sustaining procedures
and feeding tubes:
AB399,5,4
4a. Check only one:
AB399,5,6
5Use .... YES, I want life-sustaining procedures
used if I am in a persistent
6vegetative state
.....
AB399,5,8
7Do not use .... NO, I do not want life-sustaining procedures
used if I am in a
8persistent vegetative state
.....
AB399,5,99
If
I you have not checked either box, life-sustaining procedures will be used.
AB399,5,10
10b. Check only one:
AB399,5,11
11Use feeding tubes if I am in a persistent vegetative state....
AB399,5,13
12Do not use 3. If I am in a PERSISTENT VEGETATIVE STATE, the following
13are my directions regarding the use of feeding tubes:
AB399,5,14
14.... YES, I want feeding tubes used if I am in a persistent vegetative state.
AB399,5,16
15.... NO, I do not want feeding tubes
used if I am in a persistent vegetative
16state
.....
AB399,5,1717
If
I you have not checked either box, feeding tubes will be used.
AB399,5,22
184. By law, this document cannot be used to authorize: a) withholding or
19withdrawal of any medication, procedure or feeding tube if to do so would cause me
20pain or reduce my comfort; and b) withholding or withdrawal of nutrition or
21hydration that is administered to me through means other than a feeding tube
22unless, in my physician's opinion, this administration is medically contraindicated.
AB399,5,24
235. If I have been diagnosed as pregnant and my physician knows of this
24diagnosis, this document has no effect during the course of my pregnancy.
AB399,6,5
3If you are interested in more information about the significant terms used in
4this document, see section 154.01 of the Wisconsin Statutes or the information
5accompanying this document.
AB399,6,7
6ATTENTION: You and the 2 witnesses must sign the document at the same
7time.
AB399,6,8
8Signed .... Date ....
