(a) Before implementing a health-care decision made for a patient, a supervising health-care provider, if possible, shall promptly communicate to the patient the decision made and the identity of the person making the decision.
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Terms Used In Hawaii Revised Statutes 327E-7

  • Advance health-care directive: means an individual instruction or a power of attorney for health care. See Hawaii Revised Statutes 327E-2
  • Agent: means an individual designated in a power of attorney for health care to make a health-care decision for the individual granting the power. See Hawaii Revised Statutes 327E-2
  • Capacity: means an individual's ability to understand the significant benefits, risks, and alternatives to proposed health care and to make and communicate a health-care decision. See Hawaii Revised Statutes 327E-2
  • Health care: means any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect an individual's physical or mental condition, including:

    (1) Selection and discharge of health-care providers and institutions;

    (2) Approval or disapproval of diagnostic tests, surgical procedures, programs of medication, and orders not to resuscitate; and

    (3) Direction to provide, withhold, or withdraw artificial nutrition and hydration; provided that withholding or withdrawing artificial nutrition or hydration is in accord with generally accepted health care standards applicable to health-care providers or institutions. See Hawaii Revised Statutes 327E-2

  • Health-care decision: means a decision made by an individual or the individual's agent, guardian, or surrogate, regarding the individual's health care. See Hawaii Revised Statutes 327E-2
  • Health-care institution: means an institution, facility, or agency licensed, certified, or otherwise authorized or permitted by law to provide health care in the ordinary course of business. See Hawaii Revised Statutes 327E-2
  • Health-care provider: means an individual licensed, certified, or otherwise authorized or permitted by law to provide health care in the ordinary course of business or practice of a profession. See Hawaii Revised Statutes 327E-2
  • Individual instruction: means an individual's direction concerning a health-care decision for the individual. See Hawaii Revised Statutes 327E-2
  • Person: means an individual, corporation, business trust, estate, trust, partnership, association, joint venture, government, governmental subdivision, agency, or instrumentality, or any other legal or commercial entity. See Hawaii Revised Statutes 327E-2
  • Supervising health-care provider: means the primary physician or the physician's designee, or the health-care provider or the provider's designee who has undertaken primary responsibility for an individual's health care. See Hawaii Revised Statutes 327E-2
  • Surrogate: means an individual, other than a patient's agent or guardian, authorized under this chapter to make a health-care decision or to act as a medicaid authorized representative for the patient. See Hawaii Revised Statutes 327E-2
(b) A supervising health-care provider who knows of the existence of an advance health-care directive, a revocation of an advance health-care directive, or a designation or disqualification of a surrogate, shall promptly record its existence in the patient’s health-care record and, if it is in writing, shall request a copy and if one is furnished shall arrange for its maintenance in the health-care record.
(c) A supervising health-care provider who makes or is informed of a determination that a patient lacks or has recovered capacity, or that another condition exists which affects an individual instruction or the authority of an agent, guardian, or surrogate, shall promptly record the determination in the patient’s health-care record and communicate the determination to the patient, if possible, and to any person then authorized to make health-care decisions for the patient.
(d) Except as provided in subsections (e) and (f), a health-care provider or institution providing care to a patient shall:

(1) Comply with an individual instruction of the patient and with a reasonable interpretation of that instruction made by a person then authorized to make health-care decisions for the patient; and
(2) Comply with a health-care decision for the patient made by a person then authorized to make health-care decisions for the patient to the same extent as if the decision had been made by the patient while having capacity.
(e) A health-care provider may decline to comply with an individual instruction or health-care decision for reasons of conscience. A health-care institution may decline to comply with an individual instruction or health-care decision if the instruction or decision is contrary to a policy of the institution which is expressly based on reasons of conscience and if the policy was timely communicated to the patient or to a person then authorized to make health-care decisions for the patient.
(f) A health-care provider or institution may decline to comply with an individual instruction or health-care decision that requires medically ineffective health care or health care contrary to generally accepted health-care standards applicable to the health-care provider or institution.
(g) A health-care provider or institution that declines to comply with an individual instruction or health-care decision shall:

(1) Promptly so inform the patient, if possible, and any person then authorized to make health-care decisions for the patient;
(2) Provide continuing care to the patient until a transfer can be effected; and
(3) Unless the patient or person then authorized to make health-care decisions for the patient refuses assistance, immediately make all reasonable efforts to assist in the transfer of the patient to another health-care provider or institution that is willing to comply with the instruction or decision.
(h) A health-care provider or institution may not require or prohibit the execution or revocation of [an] advance health-care directive as a condition for providing health care.

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