Power of Attorney and Health Care – General – Indiana
Related Indiana Legal Forms
ALL REFERENCES ARE TO THE INDIANA CODE
OUT OF HOSPITAL DO NOT RESUSCITATE DECLARATION
(Indiana Code 16-36-5-1 through 16-36-5-28)
A “competent witness” to a DNR declaration is a person at least eighteen years of age and who is not:
the person who signed an out of hospital DNR declaration on behalf of and at the direction of the declarant;
a parent, spouse, or child of the declarant;
entitled to any part of the declarant’s estate; or
directly financially responsible for the declarant’s medical care.
A “declarant” is a person:
who has executed an out of hospital DNR declaration; or
for whom a representative has executed an out of hospital DNR declaration.
An “out of hospital DNR declaration and order” is a document executed under §16-36-5-11 and §16-36-5-12.
A “qualified person” is an individual certified as a qualified person under §16-36-5-10.
A “representative” is a person’s legal guardian or other court appointed representative responsible for making health care decisions for the person, a health care representative under §16-36-1; or an attorney in fact for health care appointed under §30-5-5-16.
An attending physician may certify that a patient is a qualified person if the attending physician determines, in accordance with reasonable medical standards, that one (1) of the following conditions is met:
The person has a terminal condition as defined in §16-36-4-5.
The person has a medical condition such that, if the person were to suffer cardiac or pulmonary failure, resuscitation would be unsuccessful or within a short period the person would experience repeated cardiac or pulmonary failure resulting in death.
A person who is of sound mind and at least eighteen years of age may execute an out of hospital DNR declaration. A person’s representative may execute an out of hospital DNR declaration for the person only if the person is at least eighteen years of age and incompetent.
An out of hospital DNR declaration must meet the following conditions:
Be in writing.
Be signed by the person making the declaration or by another person in the declarant’s presence and at the declarant’s express direction.
Be signed in the presence of at least two competent witnesses.
An out of hospital DNR declaration MUST be issued on the form specified in §16-35-5-15.
An out of hospital DNR declaration and order of a declarant known to be pregnant has no effect during the declarant’s pregnancy.
A declarant may at any time revoke an out of hospital DNR declaration and order by any of the following:
A signed, dated writing.
Physical cancellation or destruction of the declaration and order by the declarant or another in the declarant’s presence and at the declarant’s direction.
An oral expression by the declarant of intent to revoke.
A declarant’s representative may revoke an out of hospital DNR declaration and order under this chapter only if the declarant is incompetent.
A revocation is effective upon communication to a health care provider.
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