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<section article="ghg" article_name="Health - General" number="5-605" title_number="5" title_name="Death" subtitle_number="6" subtitle_name="Health Care Decisions Act">
  <level label="a">
    <level label="1">
      <level label="i">
        <text>In this subsection the following words have the meanings indicated.</text>
      </level>
      <level label="ii">
        <text>“Person eligible for relief” has the meaning stated in § 4–501 of the Family Law Article.</text>
      </level>
      <level label="iii">
        <text>“Unavailable” means:</text>
        <level label="1">
          <text>After reasonable inquiry, a health care provider is unaware of the existence of a health care agent or surrogate decision maker;</text>
        </level>
        <level label="2">
          <text>After reasonable inquiry, a health care provider cannot ascertain the whereabouts of a health care agent or surrogate decision maker;</text>
        </level>
        <level label="3">
          <text>A health care agent or surrogate decision maker has not responded in a timely manner, taking into account the health care needs of the individual, to a written or oral message from a health care provider;</text>
        </level>
        <level label="4">
          <text>A health care agent or surrogate decision maker is incapacitated; or</text>
        </level>
        <level label="5">
          <text>A health care agent or surrogate decision maker is unwilling to make decisions concerning health care for the individual.</text>
        </level>
      </level>
    </level>
    <level label="2">
      <text>Subject to paragraph (4) of this subsection, the following individuals or groups, in the specified order of priority, may make decisions about health care for a person who has been certified to be incapable of making an informed decision and who has not appointed a health care agent in accordance with this subtitle or whose health care agent is unavailable. Individuals in a particular class may be consulted to make a decision only if all individuals in the next higher class are unavailable:</text>
      <level label="i">
        <text>A guardian for the patient, if one has been appointed;</text>
      </level>
      <level label="ii">
        <text>The patient’s spouse or domestic partner;</text>
      </level>
      <level label="iii">
        <text>An adult child of the patient;</text>
      </level>
      <level label="iv">
        <text>A parent of the patient;</text>
      </level>
      <level label="v">
        <text>An adult brother or sister of the patient; or</text>
      </level>
      <level label="vi">
        <text>A friend or other relative of the patient who meets the requirements of paragraph (3) of this subsection.</text>
      </level>
    </level>
    <level label="3">
      <text>A friend or other relative may make decisions about health care for a patient under paragraph (2) of this subsection if the person:</text>
      <level label="i">
        <text>Is a competent individual; and</text>
      </level>
      <level label="ii">
        <text>Presents an affidavit to the attending physician stating:</text>
        <level label="1">
          <text>That the person is a relative or close friend of the patient; and</text>
        </level>
        <level label="2">
          <text>Specific facts and circumstances demonstrating that the person has maintained regular contact with the patient sufficient to be familiar with the patient’s activities, health, and personal beliefs.</text>
        </level>
      </level>
    </level>
    <level label="4">
      <text>An individual may not make decisions about health care for a patient under paragraph (2) of this subsection if:</text>
      <level label="i">
        <text>The individual is the subject of an interim, temporary, or final protective order and the patient is a person eligible for relief under the order; or</text>
      </level>
      <level label="ii">
        <text>The individual is the spouse of the patient and:</text>
        <level label="1">
          <text>The individual and patient have executed a separation agreement; or</text>
        </level>
        <level label="2">
          <text>The individual or patient has filed an application for divorce.</text>
        </level>
      </level>
    </level>
    <level label="5">
      <text>The attending physician shall include the affidavit presented under paragraph (3) of this subsection in the patient’s medical record.</text>
    </level>
    <level label="6">
      <text>A person who obtains new information that would prohibit an individual from making health care decisions for a patient under paragraph (4) of this subsection shall provide the information to any health care provider or health care facility providing services to the patient.</text>
    </level>
  </level>
  <level label="b">
    <level label="1">
      <text>If persons with equal decision making priority under subsection (a) of this section disagree about a health care decision, and a person who is incapable of making an informed decision is receiving care in a hospital or related institution, the attending physician or an individual specified in subsection (a) of this section shall refer the case to the institution’s patient care advisory committee, and may act in accordance with the recommendation of the committee or transfer the patient in accordance with the provisions of § 5–613 of this subtitle. A physician who acts in accordance with the recommendation of the committee is not subject to liability for any claim based on lack of consent or authorization for the action.</text>
    </level>
    <level label="2">
      <text>If a person who is incapable of making an informed decision is not in a hospital or related institution, a physician may not withhold or withdraw life–sustaining procedures if there is not agreement among all the persons in the same class.</text>
    </level>
  </level>
  <level label="c">
    <level label="1">
      <text>Any person authorized to make health care decisions for another under this section shall base those decisions on the wishes of the patient and, if the wishes of the patient are unknown or unclear, on the patient’s best interest.</text>
    </level>
    <level label="2">
      <text>In determining the wishes of the patient, a surrogate shall consider the patient’s:</text>
      <level label="i">
        <text>Current diagnosis and prognosis with and without the treatment at issue;</text>
      </level>
      <level label="ii">
        <text>Expressed preferences regarding the provision of, or the withholding or withdrawal of, the specific treatment at issue or of similar treatments;</text>
      </level>
      <level label="iii">
        <text>Relevant religious and moral beliefs and personal values;</text>
      </level>
      <level label="iv">
        <text>Behavior, attitudes, and past conduct with respect to the treatment at issue and medical treatment generally;</text>
      </level>
      <level label="v">
        <text>Reactions to the provision of, or the withholding or withdrawal of, a similar treatment for another individual; and</text>
      </level>
      <level label="vi">
        <text>Expressed concerns about the effect on the family or intimate friends of the patient if a treatment were provided, withheld, or withdrawn.</text>
      </level>
    </level>
    <level label="3">
      <text>The decision of a surrogate regarding whether life–sustaining procedures should be provided, withheld, or withdrawn shall not be based, in whole or in part, on either a patient’s preexisting, long–term mental or physical disability, or a patient’s economic disadvantage.</text>
    </level>
    <level label="4">
      <text>A surrogate shall inform the patient, to the extent possible, of the proposed procedure and the fact that someone else is authorized to make a decision regarding that procedure.</text>
    </level>
  </level>
  <level label="d">
    <text>A surrogate may not authorize:</text>
    <level label="1">
      <text>Sterilization; or</text>
    </level>
    <level label="2">
      <text>Treatment for a mental disorder.</text>
    </level>
  </level>
</section>
