Montana Code 50-5-1304. Appointment of certain health care providers as medical proxy decisionmaker — limitations — termination
50-5-1304. Appointment of certain health care providers as medical proxy decisionmaker — limitations — termination. (1) An attending health care provider may designate another willing physician or advanced practice registered nurse to make health care treatment decisions as a patient’s proxy decisionmaker if:
Terms Used In Montana Code 50-5-1304
- Advanced practice registered nurse: means an individual who is licensed under Title 37, chapter 8, to practice professional nursing in this state and who has fulfilled the requirements of the board of nursing pursuant to 37-8-202 and 37-8-409. See Montana Code 50-5-1301
- Attending health care provider: means the physician, advanced practice registered nurse, or physician assistant, whether selected by or assigned to a patient, who has primary responsibility for the treatment and care of the patient. See Montana Code 50-5-1301
- Decisional capacity: means the ability to provide informed consent to or refuse medical treatment or the ability to make an informed health care decision as determined by a health care provider experienced in this type of assessment. See Montana Code 50-5-1301
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- Health care facility: means a hospital, critical access hospital, rural emergency hospital, or facility providing skilled nursing care as those terms are defined in 50-5-101. See Montana Code 50-5-1301
- Health care provider: means any individual licensed or certified by the state to provide health care. See Montana Code 50-5-1301
- Interested person: means a patient's:
(a)spouse;
(b)parent;
(c)adult child, sibling, or grandchild; or
(d)close friend. See Montana Code 50-5-1301
- Lay proxy decisionmaker: means an interested person selected pursuant to this part authorized to make medical decisions and discharge and transfer dispositions for a patient who lacks decisional capacity. See Montana Code 50-5-1301
- Medical proxy decisionmaker: means a physician or advanced practice registered nurse designated by the attending health care provider. See Montana Code 50-5-1301
- Person: includes a corporation or other entity as well as a natural person. See Montana Code 1-1-201
- Physician: means an individual licensed pursuant to Title 37, chapter 3. See Montana Code 50-5-1301
(a)after making reasonable efforts, the attending health care provider or the provider’s designee is unable to locate any persons with authority to make medical decisions for the patient or no interested person with authority to make medical decisions for the patient is willing and able to serve as lay proxy decisionmaker;
(b)the attending health care provider has determined, with the assistance of any relevant specialists or interpreters, the patient’s lack of decisional capacity;
(c)the attending health care provider’s assessment of lack of decisional capacity has been confirmed by another health care provider;
(d)the attending health care provider or the provider’s designee has consulted with and obtained a consensus on the proxy designation with the medical ethics committee of the health care facility where the patient is receiving care; and
(e)the identity of the physician or advanced practice registered nurse designated as proxy decisionmaker is documented in the medical record.
(2)For the purposes of subsection (1)(d), if the health care facility does not have a medical ethics committee, the facility may refer the attending health care provider or the provider’s designee to a medical ethics committee at another health care facility or obtain consensus with the health care facility’s chaplain.
(3)The authority of a physician or advanced practice registered nurse serving as a proxy decisionmaker terminates when:
(a)an interested person is willing to serve as a lay proxy decisionmaker;
(b)a family member is willing to serve as a decisionmaker;
(c)a guardian is appointed for the patient;
(d)the patient regains decisional capacity;
(e)the proxy decisionmaker decides to terminate the decisionmaker’s role; or
(f)the patient is transferred or discharged from the health care facility, if any, where the patient is receiving care unless the proxy decisionmaker expresses an intention to continue in the role.
(4)The attending health care provider shall document in the patient’s medical record the reason for termination of the authority of a physician or advanced practice registered nurse serving as a proxy decisionmaker.