1.1 	A bill for an act
1.2 	relating to health; creating a presumption directing
1.3 	nutrition and hydration sufficient to sustain life;
1.4 	proposing coding for new law in Minnesota Statutes,
1.5 	chapter 145.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. [145.99] PRESUMPTION OF NUTRITION AND
1.8 	HYDRATION SUFFICIENT TO SUSTAIN LIFE.
1.9 		Subdivision 1.Definitions. (a) For purposes of this
1.10 	section, the terms defined in this subdivision have the meanings
1.11 	given them.
1.12 	(b) "Attending physician" means the physician who has
1.13 	primary responsibility for the overall medical treatment and
1.14 	care of a person.
1.15 	(c) "Health care provider" means a person who is licensed,
1.16 	certified, or otherwise authorized by the laws of this state to
1.17 	administer health care in the ordinary course of business or
1.18 	practice of a profession.
1.19 	(d) "Express and informed consent" means consent
1.20 	voluntarily given with sufficient knowledge of the subject
1.21 	matter involved, including a general understanding of the
1.22 	procedure, the medically acceptable alternative procedures or
1.23 	treatments, and the substantial risks and hazards inherent in
1.24 	the proposed treatment or procedures, to enable the person
1.25 	giving consent to make an understanding and enlightened decision
2.1 	without any element of force, fraud, deceit, duress, or other
2.2 	form of constraint or coercion.
2.3 	(e) "Nutrition" means sustenance administered by way of the
2.4 	gastrointestinal tract.
2.5 	(f) "Person legally incapable of making health care
2.6 	decisions" means a person who:
2.7 	(1) has been declared legally incompetent to make decisions
2.8 	affecting medical treatment or care;
2.9 	(2) in the reasonable judgment of the attending physician,
2.10 	is unable to make decisions affecting medical treatment or other
2.11 	health care services; or 
2.12 	(3) is a minor.
2.13 	(g) "Physician" means a physician licensed by Minnesota.
2.14 	(h) "Reasonable medical judgment" means the medical
2.15 	judgment of two reasonably prudent physicians knowledgeable
2.16 	about the case and the treatment possibilities with respect to
2.17 	the medical conditions involved.
2.18 		Subd. 2.Presumption. (a) It shall be presumed that
2.19 	every person legally incapable of making health care decisions
2.20 	has directed the person's health care providers to provide the
2.21 	person with nutrition and hydration to a degree that is
2.22 	sufficient to sustain life.
2.23 	(b) No guardian, surrogate, public or private agency,
2.24 	court, or any other person has the authority to make a decision
2.25 	on behalf of a person legally incapable of making health care
2.26 	decisions to withhold or withdraw hydration or nutrition from
2.27 	the person except in the circumstances and under the conditions
2.28 	specifically provided for in subdivision 3.
2.29 		Subd. 3.Exceptions. The presumption under subdivision 2
2.30 	does not apply:
2.31 	(1) to the extent that, in reasonable medical judgment:
2.32 	(i) provision of nutrition and hydration is not medically
2.33 	possible;
2.34 	(ii) provision of nutrition and hydration would hasten
2.35 	death; or 
2.36 	(iii) because of the medical condition of the person
3.1 	legally incapable of making health care decisions, that person
3.2 	would be incapable of digesting or absorbing the nutrition and
3.3 	hydration so that its provision would not contribute to
3.4 	sustaining the person's life;
3.5 	(2) if the person executed a directive according to chapter
3.6 	145C specifically authorizing the withholding or withdrawal of
3.7 	nutrition or hydration, to the extent the authorization applies;
3.8 	or 
3.9 	(3) if there is clear and convincing evidence that the
3.10 	person, when legally capable of making health care decisions,
3.11 	gave express and informed consent to withdrawing or withholding
3.12 	hydration or nutrition in the applicable circumstances.
3.13 		Subd. 4.Civil remedies. (a) A cause of action for
3.14 	injunctive relief may be maintained against any person who is
3.15 	reasonably believed to be about to violate or who is in the
3.16 	course of violating this section, or to secure a court
3.17 	determination, notwithstanding the position of a guardian or
3.18 	surrogate, whether there is clear and convincing evidence that
3.19 	the person legally incapable of making health care decisions,
3.20 	when legally capable of making such decisions, gave express and
3.21 	informed consent to withdrawing or withholding hydration or
3.22 	nutrition in the applicable circumstances.
3.23 	(b) The action may be brought by any person who is:
3.24 	(1) the spouse, parent, child, or sibling of the person;
3.25 	(2) a current or former health care provider of the person;
3.26 	(3) a legally appointed guardian of the person;
3.27 	(4) the state protection and advocacy agency; or 
3.28 	(5) a public official with appropriate jurisdiction to
3.29 	prosecute or enforce the laws of this state.
3.30 	(c) Pending the final determination of the court, the court
3.31 	shall direct that nutrition and hydration be provided unless the
3.32 	court determines that subdivision 3, clause (1), applies.