1.1                          A bill for an act 
  1.2             relating to health; modifying provisions governing 
  1.3             advance health care directives; combining laws 
  1.4             governing living wills and durable power of attorney 
  1.5             for health care; amending Minnesota Statutes 1996, 
  1.6             sections 14.03, subdivision 3; 14.386; 145B.13; 
  1.7             145C.01, subdivisions 2, 3, 4, 8, and by adding 
  1.8             subdivisions; 145C.02; 145C.03; 145C.04; 145C.05, 
  1.9             subdivision 2, and by adding a subdivision; 145C.06; 
  1.10            145C.07; 145C.08; 145C.09; 145C.10; 145C.11; 145C.12; 
  1.11            and 145C.13, subdivision 1; proposing coding for new 
  1.12            law in Minnesota Statutes, chapters 145B; and 145C; 
  1.13            repealing Minnesota Statutes 1996, sections 145C.05, 
  1.14            subdivision 1; and 145C.15. 
  1.15  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.16     Section 1.  Minnesota Statutes 1996, section 14.03, 
  1.17  subdivision 3, is amended to read: 
  1.18     Subd. 3.  [RULEMAKING PROCEDURES.] The definition of a rule 
  1.19  in section 14.02, subdivision 4, does not include: 
  1.20     (1) rules concerning only the internal management of the 
  1.21  agency or other agencies that do not directly affect the rights 
  1.22  of or procedures available to the public; 
  1.23     (2) rules of the commissioner of corrections relating to 
  1.24  the placement and supervision of inmates serving a supervised 
  1.25  release term, the internal management of institutions under the 
  1.26  commissioner's control, and rules adopted under section 609.105 
  1.27  governing the inmates of those institutions; 
  1.28     (3) rules relating to weight limitations on the use of 
  1.29  highways when the substance of the rules is indicated to the 
  1.30  public by means of signs; 
  2.1      (4) opinions of the attorney general; 
  2.2      (5) the systems architecture plan and long-range plan of 
  2.3   the state education management information system provided by 
  2.4   section 121.931; 
  2.5      (6) the data element dictionary and the annual data 
  2.6   acquisition calendar of the department of children, families, 
  2.7   and learning to the extent provided by section 121.932; 
  2.8      (7) the occupational safety and health standards provided 
  2.9   in section 182.655; 
  2.10     (8) revenue notices and tax information bulletins of the 
  2.11  commissioner of revenue; 
  2.12     (9) uniform conveyancing forms adopted by the commissioner 
  2.13  of commerce under section 507.09; or 
  2.14     (10) the interpretive guidelines developed by the 
  2.15  commissioner of human services to the extent provided in chapter 
  2.16  245A; or 
  2.17     (11) health care directive forms and instructions adopted 
  2.18  by the commissioner of health under section 145C.05, subdivision 
  2.19  1a. 
  2.20     Sec. 2.  Minnesota Statutes 1996, section 14.386, is 
  2.21  amended to read: 
  2.22     14.386 [PROCEDURE FOR ADOPTING EXEMPT RULES; DURATION.] 
  2.23     (a) A rule adopted, amended, or repealed by an agency, 
  2.24  under a statute authorizing or requiring rules to be adopted but 
  2.25  excluded from the rulemaking provisions of chapter 14 or from 
  2.26  the definition of a rule, has the force and effect of law only 
  2.27  if: 
  2.28     (1) the revisor of statutes approves the form of the rule 
  2.29  by certificate; 
  2.30     (2) the office of administrative hearings approves the rule 
  2.31  as to its legality within 14 days after the agency submits it 
  2.32  for approval and files two copies of the rule with the revisor's 
  2.33  certificate in the office of the secretary of state; and 
  2.34     (3) a copy is published by the agency in the State Register.
  2.35     (b) A rule adopted under this section is effective for a 
  2.36  period of two years from the date of publication of the rule in 
  3.1   the State Register.  The authority for the rule expires at the 
  3.2   end of this two-year period. 
  3.3      (c) The chief administrative law judge shall adopt rules 
  3.4   relating to the rule approval duties imposed by this section and 
  3.5   section 14.388, including rules establishing standards for 
  3.6   review. 
  3.7      (d) This section does not apply to rules adopted, amended, 
  3.8   or repealed under section 14.388. 
  3.9      This section also does not apply to: 
  3.10     (1) rules implementing emergency powers pursuant to 
  3.11  sections 12.31 to 12.37; 
  3.12     (2) rules of agencies directly in the legislative or 
  3.13  judicial branches; 
  3.14     (3) rules of the regents of the University of Minnesota; 
  3.15     (4) rules of the department of military affairs; 
  3.16     (5) rules of the comprehensive health association provided 
  3.17  in section 62E.10; 
  3.18     (6) rules of the tax court provided by section 271.06; 
  3.19     (7) rules concerning only the internal management of the 
  3.20  agency or other agencies, and which do not directly affect the 
  3.21  rights of or procedure available to the public; 
  3.22     (8) rules of the commissioner of corrections relating to 
  3.23  the placement and supervision of inmates serving a supervised 
  3.24  release term, the internal management of institutions under the 
  3.25  commissioner's control, and rules adopted under section 609.105 
  3.26  governing the inmates of those institutions; 
  3.27     (9) rules relating to weight limitations on the use of 
  3.28  highways when the substance of the rules is indicated to the 
  3.29  public by means of signs; 
  3.30     (10) opinions of the attorney general; 
  3.31     (11) the systems architecture plan and long-range plan of 
  3.32  the state education management information system provided by 
  3.33  section 121.931; 
  3.34     (12) the data element dictionary and the annual data 
  3.35  acquisition calendar of the department of children, families, 
  3.36  and learning to the extent provided by section 121.932; 
  4.1      (13) the occupational safety and health standards provided 
  4.2   in section 182.655; 
  4.3      (14) revenue notices and tax information bulletins of the 
  4.4   commissioner of revenue; 
  4.5      (15) uniform conveyancing forms adopted by the commissioner 
  4.6   of commerce under section 507.09; 
  4.7      (16) game and fish rules of the commissioner of natural 
  4.8   resources adopted under section 84.027, subdivision 13, or 
  4.9   sections 97A.0451 to 97A.0459; 
  4.10     (17) experimental and special management waters designated 
  4.11  by the commissioner of natural resources under sections 97C.001 
  4.12  and 97C.005; or 
  4.13     (18) game refuges designated by the commissioner of natural 
  4.14  resources under section 97A.085; or 
  4.15     (19) health care directive forms and instructions adopted 
  4.16  by the commissioner of health under section 145C.05, subdivision 
  4.17  1a. 
  4.18     Sec. 3.  [145B.011] [APPLICATION OF CHAPTER.] 
  4.19     This chapter applies only to living wills executed prior to 
  4.20  August 1, 1997.  If a document purporting to be a living will is 
  4.21  executed on or after August 1, 1997, its legal sufficiency, 
  4.22  interpretation, and enforcement shall be determined under the 
  4.23  provisions of chapter 145C in effect on the date of its 
  4.24  execution. 
  4.25     Sec. 4.  Minnesota Statutes 1996, section 145B.13, is 
  4.26  amended to read: 
  4.27     145B.13 [REASONABLE MEDICAL PRACTICE REQUIRED.] 
  4.28     In reliance on a patient's living will, a decision to 
  4.29  administer, withhold, or withdraw medical treatment after the 
  4.30  patient has been diagnosed by the attending physician to be in a 
  4.31  terminal condition must always be based on the legal rights of 
  4.32  the patient and reasonable medical practice, including: 
  4.33     (1) continuation of appropriate care to maintain the 
  4.34  patient's comfort, hygiene, and human dignity and to alleviate 
  4.35  pain; and 
  4.36     (2) oral administration of food or water to a patient who 
  5.1   accepts it, except for clearly documented medical reasons; and 
  5.2      (3) in the case of a living will of a patient that the 
  5.3   attending physician knows is pregnant, the living will must not 
  5.4   be given effect as long as it is possible that the fetus could 
  5.5   develop to the point of live birth with continued application of 
  5.6   life-sustaining treatment. 
  5.7      Sec. 5.  Minnesota Statutes 1996, section 145C.01, 
  5.8   subdivision 2, is amended to read: 
  5.9      Subd. 2.  [AGENT.] "Agent" means an individual age 18 or 
  5.10  older who is designated by a principal in a durable health care 
  5.11  power of attorney for health care to make health care decisions 
  5.12  on behalf of a principal and has consented to act in that 
  5.13  capacity.  An agent may also be referred to as "attorney in 
  5.14  fact." 
  5.15     Sec. 6.  Minnesota Statutes 1996, section 145C.01, 
  5.16  subdivision 3, is amended to read: 
  5.17     Subd. 3.  [DURABLE HEALTH CARE POWER OF ATTORNEY FOR HEALTH 
  5.18  CARE.] "Durable Health care power of attorney for health care" 
  5.19  means an instrument authorizing an agent to make health care 
  5.20  decisions for the principal if the principal is unable, in the 
  5.21  judgment of the attending physician, to make or communicate 
  5.22  health care decisions. 
  5.23     Sec. 7.  Minnesota Statutes 1996, section 145C.01, 
  5.24  subdivision 4, is amended to read: 
  5.25     Subd. 4.  [HEALTH CARE.] "Health care" means any care, 
  5.26  treatment, service, or procedure to maintain, diagnose, or treat 
  5.27  a person's physical or mental condition.  "Health care" includes 
  5.28  the provision of nutrition or hydration parenterally or through 
  5.29  intubation.  "Health care" does not include intrusive mental 
  5.30  health treatment as defined in section 253B.03, subdivision 6b, 
  5.31  unless the durable health care power of attorney for health care 
  5.32  specifically applies to authorizes the agent to make decisions 
  5.33  relating to intrusive mental health treatment.  
  5.34     Sec. 8.  Minnesota Statutes 1996, section 145C.01, is 
  5.35  amended by adding a subdivision to read: 
  5.36     Subd. 5a.  [HEALTH CARE DIRECTIVE.] "Health care directive" 
  6.1   means a written instrument that includes one or more health care 
  6.2   instructions or the designation of an agent under a health care 
  6.3   power of attorney, or both, or a durable power of attorney for 
  6.4   health care executed under this chapter prior to August 1, 
  6.5   1997.  A health care directive may also include a declaration 
  6.6   regarding intrusive mental health treatment executed on or after 
  6.7   August 1, 1997, as provided in section 253B.03, subdivision 6d. 
  6.8      Sec. 9.  Minnesota Statutes 1996, section 145C.01, is 
  6.9   amended by adding a subdivision to read: 
  6.10     Subd. 7a.  [HEALTH CARE INSTRUCTION.] "Health care 
  6.11  instruction" means a statement of the principal's values, 
  6.12  preferences, guidelines, or directions regarding health care. 
  6.13     Sec. 10.  Minnesota Statutes 1996, section 145C.01, 
  6.14  subdivision 8, is amended to read: 
  6.15     Subd. 8.  [PRINCIPAL.] "Principal" means an individual age 
  6.16  18 or older who has executed a durable power of attorney for 
  6.17  health care directive. 
  6.18     Sec. 11.  Minnesota Statutes 1996, section 145C.01, is 
  6.19  amended by adding a subdivision to read: 
  6.20     Subd. 9.  [REASONABLY AVAILABLE.] "Reasonably available" 
  6.21  means readily able to be contacted without undue effort and 
  6.22  willing and able to act in a timely manner considering the 
  6.23  urgency of the principal's health care needs. 
  6.24     Sec. 12.  Minnesota Statutes 1996, section 145C.02, is 
  6.25  amended to read: 
  6.26     145C.02 [DURABLE POWER OF ATTORNEY FOR HEALTH CARE 
  6.27  DIRECTIVE.] 
  6.28     Subdivision 1.  [HEALTH CARE INSTRUCTION.] An adult with 
  6.29  the capacity to do so may provide one or more health care 
  6.30  instructions in a written instrument under this chapter to 
  6.31  direct health care providers, others assisting with health care, 
  6.32  family members, and an agent.  A health care instruction is 
  6.33  legally sufficient if it substantially complies with the 
  6.34  requirements of this chapter. 
  6.35     Subd. 2.  [HEALTH CARE POWER OF ATTORNEY.] A durable power 
  6.36  of attorney for health care under this chapter authorizes the An 
  7.1   adult with the capacity to do so may execute a health care power 
  7.2   of attorney to authorize an agent to make health care decisions 
  7.3   for the principal when the principal is unable, in the judgment 
  7.4   of the principal's attending physician, to make or communicate 
  7.5   health care decisions.  The durable A health care power of 
  7.6   attorney for health care must is legally sufficient if it 
  7.7   substantially comply complies with the requirements of this 
  7.8   chapter.  An instrument executed prior to August 1, 1993 1997, 
  7.9   purporting to create a durable power of attorney for health 
  7.10  care, is valid legally sufficient if the document instrument 
  7.11  specifically authorizes the agent to make health care decisions 
  7.12  and is executed in substantial compliance with section 145C.03. 
  7.13     Sec. 13.  Minnesota Statutes 1996, section 145C.03, is 
  7.14  amended to read: 
  7.15     145C.03 [REQUIREMENTS.] 
  7.16     Subdivision 1.  [EXECUTION.] A durable power of attorney 
  7.17  for health care directive must be signed by the principal or in 
  7.18  the principal's name by some other individual acting in the 
  7.19  principal's presence and by the principal's direction.  A 
  7.20  durable power of attorney for health care directive must contain 
  7.21  the date of its execution and must be witnessed or acknowledged 
  7.22  by one of the following methods: 
  7.23     (1) signed by at least two individuals age 18 or older each 
  7.24  of whom witnessed either the signing of the instrument by the 
  7.25  principal or the principal's acknowledgment of the signature; or 
  7.26     (2) acknowledged by the principal before a notary public 
  7.27  who is not the agent. 
  7.28     Subd. 2.  [INDIVIDUALS INELIGIBLE TO ACT AS AGENT.] The 
  7.29  following individuals are not eligible to act as the agent in a 
  7.30  durable health care power of attorney for health care, unless 
  7.31  the individual designated is related to the principal by blood, 
  7.32  marriage, registered domestic partnership, or adoption, or the 
  7.33  principal specifically describes the special reason for the 
  7.34  designation: 
  7.35     (1) a health care provider attending the principal; or 
  7.36     (2) an employee of a health care provider attending the 
  8.1   principal.  
  8.2      Subd. 3.  [INDIVIDUALS INELIGIBLE TO ACT AS WITNESSES.] The 
  8.3   agent designated in the durable power of attorney for health 
  8.4   care directive may not act as a witness for the execution of the 
  8.5   durable power of attorney for health care directive. 
  8.6      At least one witness to the execution of the durable power 
  8.7   of attorney for health care directive must not be a health care 
  8.8   provider providing direct care to the principal or an employee 
  8.9   of a health care provider providing direct care to the principal 
  8.10  on the date of execution. 
  8.11     Sec. 14.  Minnesota Statutes 1996, section 145C.04, is 
  8.12  amended to read: 
  8.13     145C.04 [EXECUTED IN ANOTHER STATE.] 
  8.14     A durable power of attorney for health care directive or 
  8.15  similar document executed in another state or jurisdiction in 
  8.16  compliance with the law of that state or jurisdiction is valid 
  8.17  legally sufficient and enforceable in this state, to the extent 
  8.18  the document is consistent with the laws of this state. 
  8.19     Sec. 15.  Minnesota Statutes 1996, section 145C.05, is 
  8.20  amended by adding a subdivision to read: 
  8.21     Subd. 1a.  [SUGGESTED FORMS; NEW FORMS; AMENDMENTS.] The 
  8.22  commissioner of health shall appoint an advisory task force on 
  8.23  health care directive forms to recommend to the commissioner of 
  8.24  health a suggested or recommended form or forms and supplemental 
  8.25  instructions for a health care directive.  The task force 
  8.26  membership must be representative of health care consumers, 
  8.27  health care providers, health care facilities, and their 
  8.28  respective legal representatives; individuals involved with 
  8.29  consumer education and advocacy in health; and other 
  8.30  representatives of the public chosen by the commissioner.  The 
  8.31  commissioner of health may adopt amended or new forms consistent 
  8.32  with the laws of this state by complying with the procedures in 
  8.33  section 14.38, subdivision 7. 
  8.34     Sec. 16.  Minnesota Statutes 1996, section 145C.05, 
  8.35  subdivision 2, is amended to read: 
  8.36     Subd. 2.  [ADDITIONAL PROVISIONS.] The durable power of 
  9.1   attorney for A health care directive may include additional 
  9.2   provisions as may be consistent with this chapter, including, 
  9.3   but not limited to: 
  9.4      (1) the designation of one or more alternative alternate 
  9.5   agents to act if the named agent is unable, unavailable, or 
  9.6   unwilling not reasonably available to serve; 
  9.7      (2) specific instructions to the agent or any alternative 
  9.8   agents directions to joint agents regarding the process or 
  9.9   standards by which the agents are to reach a health care 
  9.10  decision for the principal, and a statement as to whether joint 
  9.11  agents may or may not act independently of one another; 
  9.12     (3) limitations, if any, on the right of the agent or any 
  9.13  alternative alternate agents to receive, review, obtain copies 
  9.14  of, and consent to the disclosure of the principal's medical 
  9.15  records; 
  9.16     (4) limitations, if any, on the nomination of the agent as 
  9.17  guardian or conservator for purposes of section 525.544; and 
  9.18     (5) a document of gift for the purpose of making an 
  9.19  anatomical gift, as set forth in sections 525.921 to 525.9224, 
  9.20  or an amendment to, revocation of, or refusal to make an 
  9.21  anatomical gift. 
  9.22     Sec. 17.  Minnesota Statutes 1996, section 145C.06, is 
  9.23  amended to read: 
  9.24     145C.06 [WHEN EFFECTIVE.] 
  9.25     (a) Except as provided in paragraph (b), a durable power of 
  9.26  attorney for health care directive is effective for a health 
  9.27  care decision when: 
  9.28     (1) it has been executed in accordance with section 
  9.29  145C.03; and 
  9.30     (2) the principal is unable, in the determination of the 
  9.31  attending physician of the principal, to make or communicate 
  9.32  that health care decision and the agent consents to make or 
  9.33  communicate the decision. 
  9.34     (b) If the principal states in the durable power of 
  9.35  attorney health care directive that the principal does not have 
  9.36  an attending physician because the principal in good faith 
 10.1   generally selects and depends upon spiritual means or prayer for 
 10.2   the treatment or care of disease or remedial care, the principal 
 10.3   may designate an individual in the durable power of attorney for 
 10.4   health care directive who may certify in a writing acknowledged 
 10.5   before a notary public that the principal is unable to make or 
 10.6   communicate a health care decision.  The requirements of section 
 10.7   145C.03, subdivisions 2 and 3, relating to the eligibility of a 
 10.8   health care provider attending the principal or the provider's 
 10.9   employee to act as an agent or witness apply to an individual 
 10.10  designated under this paragraph. 
 10.11     Sec. 18.  Minnesota Statutes 1996, section 145C.07, is 
 10.12  amended to read: 
 10.13     145C.07 [AUTHORITY AND DUTIES OF AGENT.] 
 10.14     Subdivision 1.  [AUTHORITY.] The agent has authority to 
 10.15  make any particular health care decision only if the principal 
 10.16  is unable, in the determination of the attending physician, to 
 10.17  make or communicate that health care decision.  The agent does 
 10.18  not have authority to consent to a voluntary commitment under 
 10.19  chapter 253B.  The physician or other health care provider shall 
 10.20  continue to obtain the principal's informed consent to all 
 10.21  health care decisions for which the principal is capable of 
 10.22  informed consent.  An alternate agent has authority to act if 
 10.23  the primary agent is not reasonably available to act. 
 10.24     Subd. 2.  [AGENT AS GUARDIAN.] Except as otherwise provided 
 10.25  in the durable power of attorney for health care Unless the 
 10.26  principal has otherwise specified, appointment of the agent in a 
 10.27  durable power of attorney for health care directive is 
 10.28  considered a nomination of a guardian or conservator of the 
 10.29  person for purposes of section 525.544. 
 10.30     Subd. 3.  [DUTIES.] In exercising the authority under the 
 10.31  durable power of attorney for a health care directive, the an 
 10.32  agent has a duty to act in accordance with the desires health 
 10.33  care instructions of the principal as expressed in the a health 
 10.34  care directive, a durable power of attorney for health 
 10.35  care executed under this chapter prior to August 1, 1997, as 
 10.36  expressed in a living will executed under chapter 145B, or in a 
 11.1   declaration regarding intrusive mental health treatment executed 
 11.2   under section 253B.03, subdivision 6d, or as otherwise made 
 11.3   known by the principal to the agent at any time.  If the 
 11.4   principal's desires are not known or cannot be determined from 
 11.5   information known to the agent, the agent has a duty to act in 
 11.6   the best interests of the principal taking into account the 
 11.7   principal's overall medical condition and prognosis.  In 
 11.8   determining the principal's best interests, the agent shall 
 11.9   consider the principal's general health condition and prognosis 
 11.10  and the principal's personal values to the extent known to the 
 11.11  agent.  An agent or any alternative alternate agent has a 
 11.12  personal obligation to the principal to make health care 
 11.13  decisions authorized by the durable health care power of 
 11.14  attorney for health care but this obligation does not constitute 
 11.15  a legal duty to act. 
 11.16     Subd. 4.  [INCONSISTENCIES AMONG DOCUMENTS.] In the event 
 11.17  of inconsistency between the designation of a proxy under 
 11.18  chapter 145B or section 253B.03, subdivision 6d, or of an agent 
 11.19  under this chapter, the most recent designation takes 
 11.20  precedence.  In the event of other inconsistencies among 
 11.21  documents executed under this chapter, under chapter 145B, or 
 11.22  under section 253B.03, subdivision 6d, or 525.544, or other 
 11.23  legally sufficient documents, the provisions of the most 
 11.24  recently executed document take precedence only to the extent of 
 11.25  the inconsistency. 
 11.26     Sec. 19.  [145C.075] [COMPLIANCE WITH HEALTH CARE 
 11.27  DIRECTIVE.] 
 11.28     Subdivision 1.  [DUTY TO COMPLY; INFORMED CONSENT.] A 
 11.29  health care provider or health care facility must comply with a 
 11.30  health care directive to the fullest extent practicable, 
 11.31  consistent with the principal's legal rights, reasonable medical 
 11.32  practice, and other applicable law.  The physician or other 
 11.33  health care provider shall continue to obtain the principal's 
 11.34  informed consent to all health care decisions for which the 
 11.35  principal is capable of giving informed consent. 
 11.36     Subd. 2.  [NOTICE OF UNWILLINGNESS TO COMPLY.] If the 
 12.1   health care provider or health care facility is unwilling at any 
 12.2   time to comply with the health care directive, the health care 
 12.3   provider or health care facility shall promptly notify the 
 12.4   principal and document the notification in the principal's 
 12.5   medical record.  After notification, if a principal with the 
 12.6   capacity to do so fails to transfer to a different health care 
 12.7   provider or health care facility, the health care provider or 
 12.8   health care facility has no duty to transfer the principal. 
 12.9      Subd. 3.  [DUTY TO TRANSFER CARE.] If the health care 
 12.10  provider or health care facility receives a health care 
 12.11  directive and does not advise the principal of the health care 
 12.12  provider's or health care facility's unwillingness to comply, 
 12.13  and if the principal subsequently lacks the capacity to make and 
 12.14  communicate health care decisions, the health care provider or 
 12.15  health care facility who is unwilling to comply with the health 
 12.16  care directive shall promptly take reasonable steps to transfer 
 12.17  care of the principal to a health care provider or health care 
 12.18  facility that is willing to comply with the health care 
 12.19  directive. 
 12.20     Subd. 4.  [OTHER OBLIGATIONS NOT AFFECTED.] Nothing in this 
 12.21  section alters any legal obligation or lack of legal obligation 
 12.22  of a health care provider or health care facility to provide 
 12.23  health care to a principal who refuses, has refused, or is 
 12.24  unable to pay for the health care. 
 12.25     Sec. 20.  Minnesota Statutes 1996, section 145C.08, is 
 12.26  amended to read: 
 12.27     145C.08 [AUTHORITY TO REVIEW MEDICAL RECORDS.] 
 12.28     An agent acting pursuant to a durable power of attorney for 
 12.29  health care directive has the same right as the principal to 
 12.30  receive, review, and obtain copies of medical records of the 
 12.31  principal, and to consent to the disclosure of medical records 
 12.32  of the principal, unless the durable power of attorney for 
 12.33  health care expressly provides otherwise principal has otherwise 
 12.34  specified. 
 12.35     Sec. 21.  Minnesota Statutes 1996, section 145C.09, is 
 12.36  amended to read: 
 13.1      145C.09 [REVOCATION OF DURABLE POWER OF ATTORNEY HEALTH 
 13.2   CARE DIRECTIVE.] 
 13.3      Subdivision 1.  [REVOCATION.] The A principal with the 
 13.4   capacity to do so may revoke a durable power of attorney for 
 13.5   health care directive in whole or in part at any time by doing 
 13.6   any of the following: 
 13.7      (1) canceling, defacing, obliterating, burning, tearing, or 
 13.8   otherwise destroying the durable power of attorney for health 
 13.9   care directive instrument or directing another in the presence 
 13.10  of the principal to destroy the durable power of attorney for 
 13.11  health care directive instrument, with the intent to revoke the 
 13.12  health care directive in whole or in part; 
 13.13     (2) executing a statement, in writing and dated, expressing 
 13.14  the principal's intent to revoke the durable power of attorney 
 13.15  for health care directive in whole or in part; 
 13.16     (3) verbally expressing the principal's intent to revoke 
 13.17  the durable power of attorney for health care directive in whole 
 13.18  or in part in the presence of two witnesses who do not have to 
 13.19  be present at the same time; or 
 13.20     (4) executing a subsequent durable power of attorney for 
 13.21  health care instrument directive, to the extent the subsequent 
 13.22  instrument is inconsistent with any prior instrument. 
 13.23     Subd. 2.  [EFFECT OF DISSOLUTION OR ANNULMENT OF MARRIAGE 
 13.24  OR TERMINATION OF DOMESTIC PARTNERSHIP ON APPOINTMENT OF AGENT.] 
 13.25  Unless the durable power of attorney for health care expressly 
 13.26  provides otherwise principal has otherwise specified, the 
 13.27  appointment by the principal of the principal's spouse or 
 13.28  domestic partner as agent under a durable health care power of 
 13.29  attorney for health care is revoked by the commencement of 
 13.30  proceedings for dissolution, annulment, or termination of the 
 13.31  principal's marriage or commencement of proceedings for 
 13.32  termination of the principal's registered domestic partnership. 
 13.33     Sec. 22.  Minnesota Statutes 1996, section 145C.10, is 
 13.34  amended to read: 
 13.35     145C.10 [PRESUMPTIONS.] 
 13.36     (a) The principal is presumed to have the capacity to 
 14.1   appoint an agent to make execute a health care decisions 
 14.2   directive and to revoke a durable power of attorney for health 
 14.3   care directive.  A health care provider or agent may presume 
 14.4   that a durable power of attorney for health care directive is 
 14.5   valid legally sufficient absent actual knowledge to the contrary.
 14.6      (b) It is presumed that an agent, and a health care 
 14.7   provider acting pursuant to the direction of an agent, are 
 14.8   acting in good faith and in the best interests of the principal, 
 14.9   absent clear and convincing evidence to the contrary. 
 14.10     (c) It is presumed that a health care directive remains in 
 14.11  effect until the principal modifies or revokes it. 
 14.12     (d) An instrument or a copy of the instrument purporting to 
 14.13  be a health care directive executed in another state is presumed 
 14.14  legally sufficient and enforceable in this state if it is dated 
 14.15  and bears the signature of the principal and the signatures of 
 14.16  two witnesses or a notary, absent actual knowledge to the 
 14.17  contrary. 
 14.18     (e) This chapter does not create a presumption concerning 
 14.19  the intention of an individual who has not executed a durable 
 14.20  power of attorney for health care directive and does not impair 
 14.21  or supersede any right or responsibility of an individual to 
 14.22  consent, refuse to consent, or withdraw consent to health care 
 14.23  on behalf of another in the absence of a durable power of 
 14.24  attorney for health care directive. 
 14.25     (f) For purposes of this chapter, acting in good faith 
 14.26  means acting consistently with the desires health care 
 14.27  instructions of the principal as expressed in the a health care 
 14.28  directive under this chapter, a durable power of attorney for 
 14.29  health care executed under this chapter prior to August 1, 1997, 
 14.30  as expressed in a living will executed under chapter 145B, or in 
 14.31  a declaration regarding intrusive mental health 
 14.32  treatment executed under section 253B.03, subdivision 6d, or as 
 14.33  otherwise made known by the principal to the agent.  If the 
 14.34  principal's desires are not known or cannot be determined from 
 14.35  information known to the agent health care instructions provide 
 14.36  inadequate guidance to the agent, acting in good faith means 
 15.1   acting in the best interests of the principal, taking into 
 15.2   account the principal's overall medical condition and 
 15.3   prognosis.  In determining the principal's best interests, the 
 15.4   agent shall consider the principal's overall general health 
 15.5   condition and prognosis and the principal's personal values to 
 15.6   the extent known to the agent. 
 15.7      Sec. 23.  Minnesota Statutes 1996, section 145C.11, is 
 15.8   amended to read: 
 15.9      145C.11 [IMMUNITIES.] 
 15.10     Subdivision 1.  [AGENT.] An agent is not subject to 
 15.11  criminal prosecution or civil liability for any health care 
 15.12  decision made in good faith pursuant to a durable power of 
 15.13  attorney for health care directive, unless the agent has actual 
 15.14  knowledge of the revocation of the durable power of attorney for 
 15.15  health care directive. 
 15.16     Subd. 2.  [HEALTH CARE PROVIDER.] (a) A health care 
 15.17  provider is not subject to criminal prosecution, civil 
 15.18  liability, or professional disciplinary action if the health 
 15.19  care provider relies in good faith on health care instructions 
 15.20  unless the health care provider has actual knowledge of the 
 15.21  revocation of the health care directive. 
 15.22     (b) A health care provider is not subject to criminal 
 15.23  prosecution, civil liability, or professional disciplinary 
 15.24  action if the health care provider relies on a health care 
 15.25  decision made by the agent and the following requirements are 
 15.26  satisfied: 
 15.27     (1) the health care provider believes in good faith that 
 15.28  the decision was made by an agent authorized to make the 
 15.29  decision and has no actual knowledge that the durable power of 
 15.30  attorney for health care directive has been revoked; and 
 15.31     (2) the health care provider believes in good faith that 
 15.32  the decision is consistent with the desires of the principal as 
 15.33  expressed in the durable power of attorney for health care 
 15.34  directive or otherwise made known by the principal to the agent. 
 15.35     (b) (c) A health care provider who administers health care 
 15.36  necessary to keep the principal alive, despite a health care 
 16.1   decision of the agent to withhold or withdraw that treatment, is 
 16.2   not subject to criminal prosecution, civil liability, or 
 16.3   professional disciplinary action if that health care provider 
 16.4   promptly took all reasonable steps to transfer care of the 
 16.5   principal to another health care provider willing to comply with 
 16.6   the decision of the agent. 
 16.7      Sec. 24.  Minnesota Statutes 1996, section 145C.12, is 
 16.8   amended to read: 
 16.9      145C.12 [PROHIBITED PRACTICES.] 
 16.10     Subdivision 1.  [HEALTH CARE PROVIDER.] A health care 
 16.11  provider, health care service plan, insurer, self-insured 
 16.12  employee welfare benefit plan, or nonprofit hospital plan may 
 16.13  not condition admission to a facility, or the providing of 
 16.14  treatment or insurance, on the requirement that an individual 
 16.15  execute a durable power of attorney for health care directive. 
 16.16     Subd. 2.  [INSURANCE.] A policy of life insurance is not 
 16.17  legally impaired or invalidated in any manner by the withholding 
 16.18  or withdrawing of health care pursuant to the direction of an 
 16.19  agent appointed pursuant to this chapter, or pursuant to the 
 16.20  implementation of health care instructions under this chapter. 
 16.21     Sec. 25.  Minnesota Statutes 1996, section 145C.13, 
 16.22  subdivision 1, is amended to read: 
 16.23     Subdivision 1.  [GROSS MISDEMEANOR OFFENSES.] Whoever 
 16.24  commits any of the following acts is guilty of a gross 
 16.25  misdemeanor: 
 16.26     (1) willfully conceals, cancels, defaces, or obliterates a 
 16.27  durable power of attorney for health care directive of a 
 16.28  principal without the consent of the principal; 
 16.29     (2) willfully conceals or withholds personal knowledge of a 
 16.30  revocation of a durable power of attorney for health care 
 16.31  directive; 
 16.32     (3) falsifies or forges a durable power of attorney for 
 16.33  health care directive or a revocation of the instrument; 
 16.34     (4) coerces or fraudulently induces another to execute a 
 16.35  durable power of attorney for health care directive; or 
 16.36     (5) requires or prohibits the execution of a durable power 
 17.1   of attorney for health care directive as a condition for being 
 17.2   insured for or receiving all or some health care services. 
 17.3      Sec. 26.  [145C.16] [INTERIM SUGGESTED FORM OF HEALTH CARE 
 17.4   DIRECTIVE.] 
 17.5      The following form may be used for health care directives 
 17.6   until the commissioner of health adopts forms under section 
 17.7   145C.05, subdivision 1a. 
 17.8                       "Health Care Directive
 17.9      Purpose of Document:  This document allows you to do ONE OR 
 17.10  BOTH of the following: 
 17.11     (1) Name another person (called an agent) to make health 
 17.12  care decisions for you (the principal) if a doctor decides that 
 17.13  you are unable to make decisions for yourself.  Your agent must 
 17.14  make health care decisions for you based on the instructions you 
 17.15  provide in this document (see #2 below) and the wishes you have 
 17.16  made known to them, or must act in your best interest if you 
 17.17  have not made your health care wishes known. 
 17.18     (2) Leave instructions to guide any part of your health 
 17.19  care decisions.  These instructions are for your health care 
 17.20  providers, others assisting with your health care, and your 
 17.21  family in the event you cannot make health care decisions for 
 17.22  yourself.  If you have named another person to make health care 
 17.23  decisions for you (an agent), these instructions are to be used 
 17.24  by the agent. 
 17.25     
 17.26     Personal Information:  In the following pages, I or MY 
 17.27  refers to me (the person appointing the agent and/or leaving 
 17.28  instructions, also called the principal). 
 17.29     
 17.30  Name .......................................... 
 17.31  Address ....................................... 
 17.32  Date of Birth: ................................ 
 17.33  Telephones:  Home ................... 
 17.34          Work ................... 
 17.35     
 17.36     Part I:  Appointing Health Care Power of Attorney 
 18.1      
 18.2      A.  Who I Want as Agent 
 18.3      
 18.4      I appoint the following person as my agent:  
 18.5   .................... 
 18.6      
 18.7      I want my agent to make any health care decisions for me 
 18.8   whenever the physician caring for me decides I am unable to make 
 18.9   or communicate the decision for myself. 
 18.10  Agent's Address ................................. 
 18.11  Telephones:  Home ....................... 
 18.12               Work ....................... 
 18.13  Relationship to me (if any) ..................... 
 18.14     
 18.15     B.  Who I Want as Alternate Agents 
 18.16     
 18.17     If the agent named above is unable, unwilling, or not 
 18.18  reasonably available to serve, I appoint the following person(s) 
 18.19  as alternate agents.  An alternate agent has all the powers and 
 18.20  responsibilities of my agent. 
 18.21  First alternate agent's name 
 18.22  .............................. 
 18.23  Address....................... 
 18.24  Telephones:  Home ............ 
 18.25               Work ............ 
 18.26  Relationship to me (if any) ............................ 
 18.27  Second alternate agent's name 
 18.28  ................................... 
 18.29  Address ....................... 
 18.30  Telephones:  Home ............. 
 18.31               Work ............. 
 18.32  Relationship to me (if any) ............................ 
 18.33     
 18.34     C.  Powers of the Agent 
 18.35     
 18.36     My agent has the power to make any health care decision for 
 19.1   me.  This includes the power to give, refuse, or withdraw 
 19.2   consent to any care, treatment, service, or procedures to 
 19.3   maintain, diagnose, or treat my physical or mental condition.  
 19.4   This includes giving me food or water by artificial means.  My 
 19.5   agent has the power, where legal, to make a decision to withhold 
 19.6   or stop health care necessary to keep me alive.  My agent has 
 19.7   the power to make decisions about intrusive mental health 
 19.8   treatment (as provided in Minnesota Statutes, section 253B.03, 
 19.9   subdivision 6b). 
 19.10     
 19.11     D.  Agreement and Duties of the Agent 
 19.12     
 19.13     My agent has agreed to act for me if it becomes necessary.  
 19.14  However, I understand that my agent has the right to refuse to 
 19.15  act for me if the agent becomes unwilling or unable to serve. 
 19.16     I understand that my agent has a personal obligation to 
 19.17  make health care decisions for me based on the instructions I 
 19.18  provide in this document, and any instructions I made known to 
 19.19  the agent, or to act in my best interests if I have not made my 
 19.20  health care wishes known. 
 19.21     My agent has the same right as I have to get copies of my 
 19.22  medical records and to let others see the records. 
 19.23     
 19.24     E.  Nominating a Guardian or Conservator 
 19.25     
 19.26     I have notified or will notify my agent that the agent is 
 19.27  nominated as my guardian or conservator if appointing one 
 19.28  becomes necessary. 
 19.29     
 19.30     F.  Changes in Domestic Arrangements and Agent 
 19.31     
 19.32     I understand that if I have appointed my spouse or 
 19.33  registered domestic partner as my agent, any proceedings for 
 19.34  dissolution, annulment, or termination of my marriage or 
 19.35  registered domestic partnership will automatically revoke the 
 19.36  appointment. 
 20.1      
 20.2            Part II.  Providing Health Care Instructions
 20.3      
 20.4      If I am no longer able to make health care decisions for 
 20.5   myself, these are my health care instructions to be followed by 
 20.6   my agent (if I appointed one in Part I), my health care 
 20.7   providers, my family, and others assisting with my health care. 
 20.8      Instructions about these health care issues can help my 
 20.9   health care decision-makers understand my values and preferences 
 20.10  and what I do and do not want, provide guidelines for making 
 20.11  choices, and describe any preferences or wishes regarding my 
 20.12  health care. 
 20.13     When making decisions about the benefits and costs of 
 20.14  health care options or procedures, I want my decision-makers to 
 20.15  consider what is most important to me (examples include relief 
 20.16  from pain, respecting my religious beliefs, being able to 
 20.17  communicate, trying treatments for a time to see if there are 
 20.18  benefits, refusing or withdrawing treatment if there is no hope 
 20.19  of recovery, not being a financial burden to my family, or 
 20.20  preserving my life no matter what its quality): 
 20.21     My feelings and preferences regarding certain medical 
 20.22  procedures. 
 20.23     How my concerns and wishes differ depending upon the health 
 20.24  care situation (permanent coma, terminal condition, or 
 20.25  irreversible chronic illness). 
 20.26     My beliefs about when my quality of life would no longer be 
 20.27  worth living. 
 20.28     My spiritual or religious beliefs and traditions. 
 20.29     My preferences regarding location of care and care while 
 20.30  dying. 
 20.31     My preferences about donating organs or tissues from my 
 20.32  body. 
 20.33     My preferences about disposing of my remains (cremation or 
 20.34  burial). 
 20.35     
 20.36                 Part III:  Making Document Legal
 21.1      
 21.2      This document must be signed by me.  It must be witnessed 
 21.3   or acknowledged by either a notary public (Option 1) OR two 
 21.4   eligible individuals (Option 2).  It must be dated when it is 
 21.5   witnessed or acknowledged. 
 21.6      My Signature or mark: ........................ 
 21.7      If I am unable to sign my own name, I can ask someone to 
 21.8   sign for me. 
 21.9      Signature of person directed to sign on my behalf: 
 21.10     .................................................. 
 21.11     Printed name of person directed to sign on my behalf: 
 21.12     ..................................................... 
 21.13     
 21.14                            Witnessing
 21.15     
 21.16     Option 1:  Notary Public 
 21.17     The principal acknowledged his/her signature on this 
 21.18  document in my presence on .............................. (date).
 21.19     I am not named as an agent or alternate agent in this 
 21.20  document. 
 21.21     Signature of Notary Public ............................ 
 21.22     State of Minnesota, County of ......................... 
 21.23     My Commission Expires ................................. 
 21.24     [Notary stamp or seal] 
 21.25     
 21.26     Option 2:  Two Witnesses (both must sign) 
 21.27     Witness One: 
 21.28     I certify that I am at least 18 years of age. 
 21.29     I am not named as an agent or alternate agent in this 
 21.30  document. 
 21.31     I am ..... am not ..... a health care provider giving 
 21.32  direct care to the principal or an employee of the provider. 
 21.33     The principal signed or acknowledged his/her signature on 
 21.34  this document in my presence on ............... (date). 
 21.35     Signature of witness .......................... 
 21.36     Address ....................................... 
 22.1      
 22.2      Witness Two: 
 22.3      I certify that I am at least 18 years of age. 
 22.4      I am not named as an agent or alternate agent in this 
 22.5   document. 
 22.6      I am ..... am not ..... a health care provider giving 
 22.7   direct care to the principal or an employee of the provider. 
 22.8      The principal signed or acknowledged his/her signature on 
 22.9   this document in my presence on ............. (date). 
 22.10     Signature of witness ....................... 
 22.11     Address .................................... 
 22.12     
 22.13     NOTE: 
 22.14     Only one witness can be a health care provider giving 
 22.15  direct care or an employee of a provider. 
 22.16     A principal's signature may be made by a mark." 
 22.17     Sec. 27.  [REPEALER.] 
 22.18     Minnesota Statutes 1996, sections 145C.05, subdivision 1; 
 22.19  and 145C.15, are repealed. 
 22.20     Sec. 28.  [EFFECTIVE DATE.] 
 22.21     Sections 1 to 27 are effective August 1, 1997.  Nothing in 
 22.22  sections 1 to 27 impairs the legal sufficiency, validity, 
 22.23  effectiveness or enforceability of a living will, durable power 
 22.24  of attorney, declaration regarding intrusive mental health 
 22.25  treatment, or other advance directive for health care which is 
 22.26  legally sufficient and enforceable under law.