Nevada Revised Statutes 449A.551 – Explanation of POLST form to patient; completion of form; validity of form; actions authorized for patient who regains capacity
1. A physician, physician assistant or advanced practice registered nurse shall take the actions described in subsection 2:
Terms Used In Nevada Revised Statutes 449A.551
- 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.
- person: means a natural person, any form of business or social organization and any other nongovernmental legal entity including, but not limited to, a corporation, partnership, association, trust or unincorporated organization. See Nevada Revised Statutes 0.039
- physician: means a person who engages in the practice of medicine, including osteopathy and homeopathy. See Nevada Revised Statutes 0.040
(a) If the physician, physician assistant or advanced practice registered nurse diagnoses a patient with a terminal condition;
(b) If the physician, physician assistant or advanced practice registered nurse determines, for any reason, that a patient has a life expectancy of less than 5 years; or
(c) At the request of a patient.
2. Upon the occurrence of any of the events specified in subsection 1, the physician, physician assistant or advanced practice registered nurse shall explain to the patient:
(a) The existence and availability of the Provider Order for Life-Sustaining Treatment form;
(b) The features of and procedures offered by way of the POLST form; and
(c) The differences between a POLST form and the other types of advance directives.
3. The physician, physician assistant or advanced practice registered nurse shall complete the POLST form based on the preferences and medical indications of the patient, upon the request of:
(a) If the patient is 18 years of age or older and the physician, physician assistant or advanced practice registered nurse determines that the patient has the capacity to make decisions regarding his or her wishes for the provision of life-resuscitating treatment and life-sustaining treatment, the patient.
(b) If the patient is 18 years of age or older and the physician, physician assistant or advanced practice registered nurse determines that the patient lacks the capacity to make decisions regarding his or her wishes for the provision of life-resuscitating treatment and life-sustaining treatment:
(1) The representative of the patient; or
(2) If no person is a representative of the patient and a valid POLST form has not been executed by the patient or the representative of the patient, a surrogate of the patient who has the capacity to make decisions regarding the provision of life-resuscitating treatment and life-sustaining treatment for the patient.
(c) If the patient is less than 18 years of age, the patient and a parent or legal guardian of the patient.
4. A POLST form is valid upon execution by a physician, physician assistant or advanced practice registered nurse and:
(a) If the patient is 18 years of age or older and the physician, physician assistant or advanced practice registered nurse determines that the patient has the capacity to make decisions regarding his or her wishes for the provision of life-resuscitating treatment and life-sustaining treatment, the patient.
(b) If the patient is 18 years of age or older and the physician, physician assistant or advanced practice registered nurse determines that the patient lacks the capacity to make decisions regarding his or her wishes for the provision of life-resuscitating treatment and life-sustaining treatment:
(1) The representative of the patient; or
(2) If no person is a representative of the patient and a valid POLST form has not been executed by the patient or the representative of the patient, a surrogate of the patient who has the capacity to make decisions regarding the provision of life-resuscitating treatment and life-sustaining treatment for the patient.
(c) If the patient is less than 18 years of age, a parent or legal guardian of the patient.
5. If, pursuant to subsection 3, a valid POLST form has been executed by a representative or surrogate of the patient and a provider of health care or the representative or surrogate of the patient believes that the patient has regained the capacity to make decisions regarding his or her wishes for the provision of life-resuscitating treatment and life-sustaining treatment, a physician, physician assistant or advanced practice registered nurse must examine the patient and inform the patient of the execution of the POLST form. If the physician, physician assistant or advanced practice registered nurse determines that the patient regained the capacity to make decisions regarding his or her wishes for the provision of life-resuscitating treatment and life-sustaining treatment, the patient may approve the execution of the POLST form or, pursuant to NRS 449A.554, revoke the POLST form executed for the patient by his or her representative or surrogate. If the patient approves the execution of the POLST form executed by his or her representative or surrogate, such approval must be made a part of the medical record of the patient and the POLST form is deemed to be valid. The physician, physician assistant or advanced practice registered nurse who examined the patient must notify the representative or surrogate of the patient who executed the POLST form of the decision of the patient to approve or revoke the POLST form.
6. For the purpose of determining whether a surrogate of the patient is authorized to request and execute a POLST form pursuant to subsections 3 and 4, respectively:
(a) If a class entitled to decide whether to request and execute a POLST form is not reasonably available for consultation and capable of deciding or declines to decide, the next class is authorized to decide, but an equal division in a class does not authorize the next class to decide.
(b) A decision to request and execute a POLST form must be made in good faith and is not valid if it conflicts with the expressed intention of the patient.
(c) A decision of the physician, physician assistant or advanced practice registered nurse acting in good faith that a decision to request and execute a POLST form is valid or invalid is conclusive.
7. As used in this section:
(a) ’Surrogate of the patient’ means the following persons, in order of priority:
(1) The spouse of the patient;
(2) An adult child of the patient or, if there is more than one adult child, a majority of the adult children who are reasonably available for consultation;
(3) The parents of the patient;
(4) An adult sibling of the patient or, if there is more than one adult sibling, a majority of the adult siblings who are reasonably available for consultation;
(5) The nearest other adult relative of the patient by blood or adoption who is reasonably available for consultation; or
(6) An adult who has exhibited special care or concern for the patient, is familiar with the values of the patient and willing and able to make health care decisions for the patient.
(b) ’Terminal condition’ has the meaning ascribed to it in NRS 449A.430.