Nebraska Health Care Declaration Law

Power of Attorney and Health Care – General – Nebraska

STATUTORY REFERENCE
ALL REFERENCES ARE TO     THE NEBRASKA STATUTES

POWER OF ATTORNEY FOR HEALTH CARE

Section 30-3408:

(1)  A power of attorney for health care executed on or after September 9, 1993, shall be in a form which complies  with sections 30-3401 to 30-3432 and may be in the form provided in this subsection.

(2) A power of attorney for health care may be included in a durable power of attorney drafted under the Uniform  Durable Power of Attorney Act or  in any  other form if the power of attorney for health care included  in such durable power  of attorney or any other form fully complies with the terms of section 30-3404.

(3) A power of attorney for health care executed prior to January 1, 1993, shall be effective if it fully complies with the terms of section 30-3404.

(4) A power of  attorney for health care which is executed  in another state and is valid under the laws of that state shall be valid according to its terms.

Section 30-3409: The power of attorney for health care, when its existence becomes known, shall be made a part of the principal’s medical record with any health care provider in or of which the principal is a patient or resides.

Section 30-3410: A  power of attorney for health care shall continue in effect until the  principal’s death, until revoked pursuant to section 30-3420, or until the attorney in fact and any successor attorney in fact withdraws pursuant to section 30-3407.

Section 30-3411:The authority of the attorney in fact shall commence upon a determination pursuant to  section  30-3412  that the principal is incapable of making health care decisions.

Section 30-3412:

(1)  A  determination  that a principal is incapable of making health care decisions shall be made in writing by the attending physician and any physician consulted with respect to the determination that the principal is incapable of making health care decisions, and they shall document the cause and nature of   the principal’s incapacity. The determination shall be included in the principal’s medical record with the attending physician and, when applicable, with the consulting physician and the health care facility in or of which the principal is a patient or resides.

(2) A physician who has been designated a  principal’s attorney in fact shall  not make the determination that the principal is incapable of making health care decisions.

Section 30-3413: Notice of a determination that a principal is incapable of making health care decisions shall be given by the attending physician

(1)  to the principal when  there  is  any indication  of the principal’s ability to comprehend such notice,

(2) to the attorney in fact, and

(3) to the health care provider.

Section 30-3414: Promptly upon being notified that a determination that the principal is incapable of making health care decisions has or is about to be made, the attorney in fact, if other than the principal’s most proximate next of kin and if the principal  has not directed otherwise, shall notify the most proximate next of kin and the court-appointed guardian of the principal, if any.   The order of notification shall be:

(1) The spouse;

(2) an adult child;

(3)  either  parent;

(4)  an  adult brother or sister; and

(5) the next closest kin.

Section 30-3415: If a dispute arises as to whether the principal is incapable, a petition may be filed with the county court in the county in which the principal resides or is located requesting the court’s determination as to whether the principal is incapable of making health care decisions.  If such a petition is  filed, the court shall appoint a guardian ad litem to represent the principal.  The court shall conduct a hearing on the petition within seven days after the court’s receipt of the petition.  Within seven days after the hearing, the court shall issue its determination.

If the court determines that the principal  is  incapable, the authority,  rights, and responsibilities of the principal’s attorney in fact shall become effective.   If the court determines that the principal is not incapable, the authority, rights, and responsibilities of the attorney in fact shall not become effective.

Section 30-3416: A determination that a principal is incapable of making health care decisions shall not be construed as a finding that the principal is incapable for any other purpose.

Section 30-3417:

(1) When the authority conferred by a power of attorney for health care has commenced, the attorney in  fact,subject  to  any  instructions  and limitations set forth in the power of attorney for health care or elsewhere, shall make health care  decisions  on  the  principal’s  behalf,  except  that  the attorney  in  fact shall not have authority

(a) to consent to any act or omission to which the principal could  not  consent  under law,

(b)  to make any decision when the principal is known to be pregnant that will result in the death of the principal’s  unborn child  and  it is probable that the unborn child will develop to the point of live birth with continued application of health care, or

(c)  to make decisions regarding withholding or withdrawing a  life-sustaining procedure or withholding or withdrawing  artificially administered nutrition  and hydration except as provided under section 30-3418.

(2) The attorney in fact shall have priority over any person other than the principal to act for the principal in all health care decisions, except that the attorney in fact shall not have the authority to make any health care decision unless and until the principal has been determined to be incapable of making health care decisions pursuant to section 30-3412.

(3)  The  attorney in fact shall not be personally responsible for the cost  of health care provided to the principal.

(4)  Except to the extent that the right is limited by the power of attorney for health care, an attorney in fact shall have the same right as the principal to receive information regarding the proposed health care, to receive and review medical and clinical records, and to consent to the disclosures of such records, except that the right to access such records shall not be a waiver of any evidentiary privilege.

(5) Notwithstanding a determination pursuant to section 30-3412 that the principal is incapable of making health care decisions, when a principal objects to the determination or to a health care decision made by an attorney in fact, the principal’s objection or decision shall prevail unless the  principal is determined by a  county court to be incapable of making health care decisions.

(6) No health care provider shall be required to accept health care decisions from an attorney in fact until such health care provider has received a signed original or a photostatic copy of a signed original power of attorney for health care.

Section 30-3418:

(1) In exercising authority under the power of attorney for  health care, an attorney in fact shall have a duty to consult with medical personnel, including the  attending physician, and thereupon to make health care decisions

(a) in accordance with the principal’s wishes as expressed in the  power of attorney for health care or as otherwise made known to the attorney in fact  or

(b)  if the principal’s wishes are not reasonably known and  cannot with reasonable diligence be ascertained, in accordance with the principal’s  best interests, with due regard for the principal’s religious and moral beliefs if known.

(2) Notwithstanding subdivision (1)(b) of this section, the attorney in fact shall not have the authority to  consent to the  withholding or withdrawing of a life-sustaining procedure or artificially administered nutrition or hydration unless

(a) the principal  is suffering from a terminal condition or is in a persistent vegetative state and

(b) the power of  attorney for health care explicitly grants such authority to the attorney in fact or the intent of the  principal to have life-sustaining procedures  or  artificially administered nutrition or hydration withheld or withdrawn under such circumstances is established  by clear and convincing evidence.

(3)  In exercising any decision, the attorney in fact shall have no authority to withhold or withdraw consent to routine care necessary to maintain patient comfort or the usual and typical provision of nutrition and hydration.

Section 30-3419:

(1) Before acting upon a health care decision made by an attorney in fact, other than those decisions made at or about the time of the  initial  determination, the attending physician shall confirm that the principal continues to be incapable.  The confirmation shall be stated in writing and shall be included in the  principal’s medical records. The notice requirements set forth in sections 30-3413 and 30-3414 shall not apply to the confirmation required by this subsection.

(2) If the attending physician determines that the principal is no longer incapable, the authority of the attorney in fact shall cease unless otherwise directed by the principal, but it shall recommence if the principal subsequently becomes incapable as determined pursuant to section 30-3412.

Section 30-3420:

(1) A power of attorney for health care or a health care decision made by an attorney in fact may be revoked at any time by a principal who is competent and in any manner by which the principal is able to communicate his or her intent to revoke. Revocation shall be effective upon communication to the attending physician, the health care provider who shall  promptly inform the attending physician of the revocation, or the attorney in fact who shall promptly inform the attending physician of the revocation.

(2) The creation by the principal of written wishes or instructions  about health care or limitations upon the attorney in fact’s authority shall not revoke a power of attorney for health  care  unless  such  wishes,  instructions, or limitations expressly provide otherwise.

(3) Upon learning of the revocation of the power of attorney for health care, the attending physician shall cause the revocation to be made a part of the principal’s medical records.

(4)  Unless the power of attorney for health care provides otherwise, execution of a valid power of attorney for health care shall revoke any previously  executed power of attorney for health care.

(5) Unless the power of attorney for health care provides otherwise, a  power of attorney for health care shall supersede:

(a) Any conflicting preexisting directive;

(b) Any guardianship proceedings under the Nebraska Probate  Code to the extent the proceedings involve the right to make health care decisions for the protected person; and

(c) Any conservatorship proceedings under the Nebraska Probate Code  to the extent the proceedings involve the right to make health care decisions for the protected person.

(6) A decree of divorce or legal separation entered into pursuant to sections 42-347 to 42-380 may specify whether the choice of the principal’s spouse as attorney in fact under a power of attorney for health care shall be revoked or remain effective.  If the decree does not specify whether the choice of the spouse as the principal’s attorney in fact for health care is revoked or remains effective, the  choice of the principal’s spouse as attorney in fact for health care shall be deemed revoked upon entry of the decree.

(7)  The revocation of a power of attorney for health care shall not revoke or terminate the authority as to the attorney in fact or other person who acts in good faith under the power of attorney for health care and without actual knowledge of the  revocation.  An action taken without knowledge of the revocation, unless the action   is otherwise invalid or unenforceable, shall bind the principal and his or her heirs, devisees, and personal representatives.

Section 30-3421:

(1)  A petition may be filed for any one or more of the following purposes:

(a) To determine whether the power of attorney for health care is in effect or has been revoked or terminated;

(b)  To determine whether the acts or proposed acts of the attorney in fact are consistent with the wishes of the principal as expressed in the power of attorney for health care or otherwise established by clear and convincing evidence or, when the wishes of the principal are unknown, whether the acts or proposed acts of the attorney in fact are clearly contrary to the best interests of the principal;

(c)  To declare that the power of attorney for health care is revoked upon a determination that the attorney in fact made or proposed to make a health care decision for the principal that authorized an illegal act or omission;or

(d)  To declare that the power of attorney for health care is revoked upon a determination by the court of both of  the following:

(i) That the attorney in fact has violated, failed to perform,  or  is unable  to  perform the duty to act in a manner consistent with the wishes of the principal or, when the desires of  the  principal are unknown, to act in a manner that is in the best interests of the principal; and

(ii) that at the time of the determination by the court, the principal lacks the  capacity to revoke the power of attorney for health care.

(2) A petition under this section shall be filed with the county court of the county in which the principal resides or is located.

Section 30-3422: A petition under section 30-3415 or 30-3421 may be filed by any of the following:

(1) The principal;

(2) The attorney in fact;

(3) The spouse, parent, sibling, or adult child of the principal;

(4) A close adult friend of the principal;

(5) The guardian of the principal;

(6) The attending physician or other health care provider; or

(7) Any other interested party.

Section 30-3423:

(1) An attorney in fact shall not be guilty of  any criminal offense, subject to any civil liability, or in violation of any professional oath or code of ethics or conduct for any action taken in good faith pursuant to a power of attorney for health care.

(2) No attending  physician or health care provider acting or declining to act in reliance upon the decision made by a person whom the attending physician or health care provider in good faith believes is the attorney in fact for health care shall be  subject to criminal prosecution, civil  liability, or professional disciplinary action.  Nothing in sections 30-3401 to 30-3432, however, shall  limit  the  liability  of  an  attending physician or health care provider for a negligent act or omission in  connection  with the medical diagnosis, treatment, or care of the principal.

Section 30-3424: Subject to subsection (5) of section 30-3417 and subsection (7) of section 30-3420, in the absence of an effective  designation of power of attorney for health care nothing in sections 30-3401 to 30-3432 shall affect any right a person may otherwise have to make health care decisions on behalf of another.

Section 30-3425: Health  care providers shall be entitled to assume the validity of a power of attorney for health care executed in this state until given actual notice to the contrary.

Section 30-3426: By executing a power of attorney for health care, a principal shall not waive his or her right to routine hygiene, nursing, and comfort  care and the usual and typical provision of nutrition and hydration.

Section 30-3427: In following the decision of an attorney in fact, a health care provider shall exercise the same independent medical judgment that the health care provider would exercise in following the decision of the principal if the principal were not incapable.

Section 30-3428:

(1) Nothing in sections  30-3401 to  30-3432 shall  obligate a health care provider organization to honor a health care decision by an attorney in fact that the health care provider organization would not honor if the decision had been made by the principal because the decision is contrary to a formally adopted policy of the health care provider organization that is expressly based on religious beliefs  or  sincerely held ethical or moral convictions central to the operating principles of the health care  provider organization.  The health care provider organization may refuse to honor the decision whether made by the principal or by the attorney in fact if the  health care provider organization has informed the principal or the attorney in fact of such policy, if reasonably possible.  If the attorney in fact is unable or unwilling to arrange a transfer to another health care facility, the health care provider organization may intervene to facilitate such a transfer.

(2)  Nothing in sections  30-3401 to 30-3432 shall obligate an individual as a health care provider to honor or cooperate with a health care decision by an attorney in fact that the individual would not honor or cooperate with if the decision had been made by the principal because the decision is contrary to the individual’s religious beliefs or sincerely held moral or ethical convictions.

The individual health care provider shall promptly inform the attorney in fact and the health care provider organization of his or her refusal to honor or cooperate with the decision of the attorney in fact.  In such event, the health care provider  organization shall promptly assist in the transfer of responsibility for the principal to  another  individual  health care provider who is willing to honor the decision of the attorney in fact.

Section 30-3429:

(1) No person shall be required to execute or to refrain from executing a power of attorney for health care as a criterion for insurance or as a condition for receiving health care.

(2)  No  person authorized to engage in the business of insurance in this state, medical care corporation, health care corporation,  health  maintenance organization, other health care plan, or legal entity that is self-insured and provides benefits to its employees or members shall do any of the following because of  the  execution  or  implementation of a power of attorney for health care or because of the failure or refusal  to execute or implement a power of attorney for health care:

(a) Refuse to provide or continue coverage to any person;

(b) limit or increase the amount of coverage available to  any  person;

(c) charge a person a different rate;

(d) consider the terms of an existing policy of life or health insurance  to  have been breached or modified; or

(e) invoke a suicide or intentional death exemption or exclusion in a policy covering the person.

(3) Nothing in sections 30-3401  to  30-3432  shall be intended to impair or supersede any federal statute.

(4)  Except as provided in subsections (2) and (3) of section 30-3408 and subsection (4) of section 30-3420, nothing in sections 30-3401 to 30-3432 shall impair or supersede any durable power of attorney in effect prior to January 1, 1993.

Section 30-3430: The fact that a person has not appointed an attorney in fact or has not provided the attorney in fact with specific  health  care  instructions shall create no presumptions regarding the person’s wishes about health care.

Section 30-3431: For purposes of making health care decisions, an attempted  suicide by the principal shall not be construed as any indication of the principal’s wishes with regard to health care.

Section 30-3432:

(1) It shall be a Class II felony for a person to willfully sign or  alter without authority or to otherwise  alter, forge, conceal, or destroy a power of attorney for health care or to willfully conceal or destroy a revocation with the   intent and effect of causing a withholding or withdrawing of life-sustaining procedures   or artificially administered nutrition or hydration which hastens the death of the principal.

(2) It shall be a Class I misdemeanor for a person without the authorization  of the principal to willfully alter, forge, conceal, or destroy a power of attorney for health care or a revocation of a power of attorney for health care.

(3) A physician or other health care provider who willfully prevents the transfer of a principal in accordance with section  30-3428 with the intention of avoiding the provisions of sections 30-3401 to 30-3432 shall be guilty of a Class I misdemeanor.

Note: All Information and Previews are subject to the Disclaimer located on the main forms page, and also linked at the bottom of all search results.


Inside Nebraska Health Care Declaration Law