Montana Code 50-5-1305. Treatment guidelines when health care providers serve as proxy decisionmakers
50-5-1305. Treatment guidelines when health care providers serve as proxy decisionmakers. (1) The attending health care provider and a health care provider appointed pursuant to 50-5-1304 to serve as a medical proxy decisionmaker shall adhere to the following guidelines for proxy decisionmaking:
Terms Used In Montana Code 50-5-1305
- 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
- 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
- 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)for routine treatments and procedures that are low-risk and within broadly accepted standards of medical practice, the attending health care provider may make health care treatment decisions;
(b)for treatment involving anesthesia, invasive procedures, significant risk of complications, or otherwise requiring written, informed consent, the attending health care provider shall obtain the written consent of the medical proxy decisionmaker;
(c)for end-of-life treatment that is nonbeneficial and involves withholding or withdrawing specific medical treatments, the attending health care provider shall obtain:
(i)an independent concurring opinion from a physician or advanced practice registered nurse other than the medical proxy decisionmaker;
(ii)a consensus with the medical ethics committee, if available; and
(iii)a consensus with the health care facility‘s chaplain if a medical ethics committee is not available.
(2)Artificial nourishment and hydration may be withheld or withdrawn from a patient upon a decision of a physician or advanced practice registered nurse serving as a medical proxy decisionmaker only when the attending health care provider and an independent physician trained in neurology or neurosurgery certify in the patient’s medical record that the provision or continuation of artificial nourishment or hydration cannot reasonably be expected to prolong life, would be excessively burdensome for the patient, or would cause the patient significant physical discomfort, such as from complications from the procedures used.
(3)(a) Nothing in this part may be construed as condoning, authorizing, or approving euthanasia or mercy killing.
(b)Nothing in this part may be construed as permitting an affirmative or deliberate act to end a person‘s life except to permit natural death.
(4)When a lay or medical proxy decisionmaker has not been appointed and the attending health care provider determines that a patient requires end-of-life treatment that includes artificial nourishment and hydration, before a lay or medical proxy decisionmaker may be appointed the attending health care provider or health care facility shall petition the court to have a temporary guardian appointed as provided in 72-5-317. If the petition to have a temporary guardian appointed is not timely or successful considering the exigencies of the situation, a lay or medical proxy decisionmaker may be appointed.