Sec. 13. (a) An attending physician, advanced practice registered nurse, or physician assistant who does not issue an out of hospital DNR order for a patient who is a qualified person may transfer the patient to another physician, who may issue an out of hospital DNR order, unless:

(1) the attending physician, advanced practice registered nurse, or physician assistant has reason to believe the patient’s declaration was not validly executed, or there is evidence the patient no longer intends the declaration to be enforced; and

Terms Used In Indiana Code 16-36-5-13

  • attending: means the physician, advanced practice registered nurse, or physician assistant who has the primary responsibility for the treatment and care of the patient. See Indiana Code 16-36-5-1.1
  • DNR: means do not resuscitate. See Indiana Code 16-36-5-4
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • 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.
  • in writing: include printing, lithographing, or other mode of representing words and letters. See Indiana Code 1-1-4-5
  • out of hospital: refers to a location other than an acute care hospital licensed under IC 16-21-2. See Indiana Code 16-36-5-5
  • qualified person: means an individual certified as a qualified person under section 10 of this chapter. See Indiana Code 16-36-5-8
(2) the patient is unable to validate the declaration.

     (b) Notwithstanding section 10 of this chapter, if an attending physician, advanced practice registered nurse, or physician assistant, after reasonable investigation, does not find any other physician willing to honor the patient’s out of hospital DNR declaration and issue an out of hospital DNR order, the attending physician, advanced practice registered nurse, or physician assistant may refuse to issue an out of hospital DNR order.

     (c) If the attending physician, advanced practice registered nurse, or physician assistant does not transfer a patient under subsection (a), the attending physician, advanced practice registered nurse, or physician assistant may attempt to ascertain the patient’s intent and attempt to determine the validity of the declaration by consulting with any of the following individuals who are reasonably available, willing, and competent to act:

(1) A court appointed guardian of the patient, if one has been appointed. This subdivision does not require the appointment of a guardian so that a treatment decision may be made under this section.

(2) A person designated by the patient in writing to make a treatment decision.

(3) The patient’s spouse.

(4) An adult child of the patient or a majority of any adult children of the patient who are reasonably available for consultation.

(5) An adult sibling of the patient or a majority of any adult siblings of the patient who are reasonably available for consultation.

(6) The patient’s clergy.

(7) Another person who has firsthand knowledge of the patient’s intent.

     (d) The individuals described in subsection (c)(1) through (c)(7) shall act in the best interest of the patient and shall follow the patient’s express or implied intent, if known.

     (e) The attending physician, advanced practice registered nurse, or physician assistant acting under subsection (c) shall list the names of the individuals described in subsection (c) who were consulted and include the information received in the patient’s medical file.

     (f) If the attending physician, advanced practice registered nurse, or physician assistant determines from the information received under subsection (c) that the patient intended to execute a valid out of hospital DNR declaration, the attending physician, advanced practice registered nurse, or physician assistant may:

(1) issue an out of hospital DNR order, with the concurrence of at least one (1) physician documented in the patient’s medical file; or

(2) request a court to appoint a guardian for the patient to make the consent decision on behalf of the patient.

     (g) An out of hospital DNR order must be issued on the form specified in section 15 of this chapter.

As added by P.L.148-1999, SEC.12. Amended by P.L.50-2021, SEC.51.