LIVING WILLS IN GEORGIA
CHAPTER 32
Sec.
31-32-1.
Legislative findings.
31-32-2.
Definitions.
31-32-3. Execution;
witnesses; form.
31-32-4. Patients
in hospitals or skilled nursing facilities.
31-32-5.
Revocation.
31-32-6. Period of
effectiveness.
31-32-7. Immunity
of participants from liability.
31-32-8. Conditions
precedent to withholding or withdrawal of life-sustaining procedures;
physician's failure or refusal to comply with living will.
31-32-9. Living
will as not constituting suicide; effect of living will on insurance;
restriction on health care facilities' preparing living wills.
31-32-10.
Concealment or damage of living will; coercion; criminal homicide.
31-32-11. Effect of
chapter on other legal rights and duties.
31-32-12.
Construction of chapter in relation to Title 53.
Cross references. -
Durable power of attorney for health care, Ch.
36, T.
31.
Cardiopulmonary
resuscitation, Ch.
39, T.
31.
31-32-1. Legislative findings.
(a) The General
Assembly finds that modern medical technology has made possible the
artificial prolongation of human life.
(b) The General
Assembly further finds that, in the interest of protecting individual
autonomy, such prolongation of life for persons with a terminal condition,
a coma, or a persistent vegetative state may cause loss of patient dignity
and unnecessary pain and suffering, while providing nothing medically
necessary or beneficial to the patient.
(c) The General
Assembly further finds that there exists considerable uncertainty in the
medical and legal professions as to the legality of terminating the use of
life-sustaining procedures in certain situations.
(d) In recognition of
the dignity and privacy which patients have a right to expect, the General
Assembly declares that the laws of the State of Georgia shall recognize
the right of a competent adult person to make a written directive, known
as a living will, instructing his physician to withhold or withdraw
life-sustaining procedures in the event of a terminal condition, a coma,
or a persistent vegetative state.
(Code 1981, § 31-32-1,
enacted by Ga. L. 1984, p. 1477, § 1; Ga. L. 1992, p. 1926, § 1.)
As used in this
chapter, the term:
(1) "Attending
physician" means the physician who has been selected by or assigned to the
patient and who has assumed primary responsibility for the treatment and
care of the patient; provided, however, that if the physician selected by
or assigned to the patient to provide such treatment and care directs
another physician to assume primary responsibility for such care and
treatment, the physician who has been so directed shall, upon his or her
assumption of such responsibility, be the "attending physician."
(2) "Coma" means a
profound state of unconsciousness caused by disease, injury, poison, or
other means and for which it has been determined that there exists no
reasonable expectation of regaining consciousness. The procedure for
establishing a coma is as follows: two physicians, one of whom must be the
attending physician, who, after personally examining the declarant, shall
certify in writing, based upon conditions found during the course of their
examination, that:
(A) The declarant has
been in a profound state of unconsciousness for a period of time
sufficient for the declarant's physicians to conclude that the unconscious
state will continue; and
(B) There exists no
reasonable expectation that the declarant will regain consciousness.
(3) "Competent adult"
means a person of sound mind who is 18 years of age or older.
(4) "Declarant" means
a person who has executed a living will authorized by this chapter.
(5) "Hospital" means a
facility which has a valid permit or provisional permit issued under
Chapter 7 of this title and which is primarily engaged in providing to
inpatients, by or under the supervision of physicians, diagnostic services
and therapeutic services for medical diagnosis, treatment, and care of
injured, disabled, or sick persons.
(6) "Life-sustaining
procedures" means any medical procedures or interventions, which, when
applied to a patient in a terminal condition or in a coma or persistent
vegetative state with no reasonable expectation of regaining consciousness
or significant cognitive function, would serve only to prolong the dying
process and where, in the judgment of the attending physician and a second
physician, death will occur without such procedures or interventions. The
term "life-sustaining procedures" may include, at the option of the
declarant, the provision of nourishment and hydration, but shall not
include the administration of medication to alleviate pain or the
performance of any medical procedure deemed necessary to alleviate pain.
(7) "Living will"
means a written document voluntarily executed by the declarant in
accordance with the requirements of Code
Section 31-32-3 or
31-32-4.
(8) "Patient" means a
person receiving care or treatment from a physician.
(9) "Persistent
vegetative state" means a state of severe mental impairment in which only
involuntary bodily functions are present and for which there exists no
reasonable expectation of regaining significant cognitive function. The
procedure for establishing a persistent vegetative state is as follows:
two physicians, one of whom must be the attending physician, who, after
personally examining the declarant, shall certify in writing, based upon
conditions found during the course of their examination, that:
(A) The declarant's
cognitive function has been substantially impaired; and
(B) There exists no
reasonable expectation that the declarant will regain significant
cognitive function.
(10) "Physician" means
a person lawfully licensed in this state to practice medicine and surgery
pursuant to Article 2 of
Chapter 34 of
Title 43.
(11) "Reasonable
expectation" means the result of prudent judgment made on the basis of the
medical judgment of a physician.
(12) "Skilled nursing
facility" means a facility having a valid permit or provisional permit
issued under Chapter 7 of this title and which provides skilled nursing
care and supportive care to patients whose primary need is for
availability of skilled nursing care on an extended basis.
(13) "Terminal
condition" means incurable condition caused by disease, illness, or injury
which, regardless of the application of life-sustaining procedures, would
produce death. The procedure for establishing a terminal condition is as
follows: two physicians, one of whom must be the attending physician,
who, after personally examining the declarant, shall certify in writing,
based upon conditions found during the course of their examination, that:
(A) There is no
reasonable expectation for improvement in the condition of the declarant;
and
(B) Death of the
declarant from these conditions will occur as a result of such disease,
illness, or injury.
(Code 1981, § 31-32-2,
enacted by Ga. L. 1984, p. 1477, § 1; Ga. L. 1992, p. 1926, § 2.)
31-32-3. Execution; witnesses; form.
Statute text
(a) Any competent adult may execute a document directing that, should the
declarant have a terminal condition, life-sustaining procedures be
withheld or withdrawn. Such living will shall be signed by the declarant
in the presence of at least two competent adults who, at the time of the
execution of the living will, to the best of their knowledge:
(1) Are not related to the declarant by blood or marriage;
(2) Would not be entitled to any portion of the estate of the declarant
upon the declarant's decease under any testamentary will of the declarant,
or codicil thereto, and would not be entitled to any such portion by
operation of law under the rules of descent and distribution of this state
at the time of the execution of the living will;
(3) Are neither the attending physician nor an employee of the attending
physician nor an employee of the hospital or skilled nursing facility in
which the declarant is a patient;
(4) Are not directly financially responsible for the declarant's medical
care; and
(5) Do not have a claim against any portion of the estate of the declarant.
(b) The declaration shall be a document, separate and self-contained.
Any declaration which constitutes an expression of the declarant's intent
shall be honored, regardless of the form used or when executed.
Declarations executed on or after March 28, 1986, shall be valid
indefinitely unless revoked. A declaration similar to the following form
or in substantially the form specified under prior law shall be presumed
on its face to be valid and effective:
LIVING WILL
(This Living Will Does Not Concern the Disposition of My Assets)
Living will made this ____________ day of ____________ (month, ________
year).
I, _______________________________________________, being of sound mind,
willfully and voluntarily make known my desire that my life shall not be
prolonged under the circumstances set forth below and do declare as
follows.
1. If at any time
I should (check each option desired)
(_____) have a terminal condition,
(_____) become in a coma with no reasonable expectation of regaining
consciousness, or
(_____) become in a persistent vegetative state with no reasonable
expectation of regaining significant cognitive function, as defined in and
established in accordance with the procedures set forth in paragraphs (2),
(9), and (13) of Code Section 31-32-2 of the Official Code of Georgia
Annotated,
I direct that the application of life-sustaining procedures to my body
(check the option desired):
(_____) including
nourishment and hydration,
(_____) including
nourishment but not hydration, or
(_____) excluding
nourishment and hydration,
be withheld or withdrawn and that I be permitted to die;
2. In the absence of my ability to give directions regarding the use of
such life-sustaining procedures, it is my intention that this living will
shall be honored by my family and physician(s) as the final expression of
my legal right to refuse medical or surgical treatment and accept the
consequences from such refusal;
3. I understand that I may revoke this living will at any time;
4. I understand the full import of this living will, and I am at least 18
years of age and am emotionally and mentally competent to make this living
will; and
5. If I am a female and I have been diagnosed as pregnant, this living
will shall have no force and effect unless the fetus is not viable and I
indicate by initialing after this sentence that I want this living will to
be carried out. (Initial______________)
Signed__________________________________________
____________ (City), ____________ (County), and ____________ (State of
Residence).
I hereby witness this living will and attest that:
(1) The declarant is personally known to me and I believe the declarant to
be at least 18 years of age and of sound mind;
(2) I am at least 18 years of age;
(3) To the best of my knowledge, at the time of the execution of this
living will, I:
(A) Am not related to the declarant by blood or marriage;
(B) Would not be entitled to any portion of the declarant's estate by any
will or by operation of law under the rules of descent and distribution of
this state;
(C) Am not the attending physician of declarant or an employee of the
attending physician or an employee of the hospital or skilled nursing
facility in which declarant is a patient;
(D) Am not directly financially responsible for the declarant's medical
care; and
(E) Have no present claim against any portion of the estate of the
declarant;
(4) Declarant has signed this document in my presence as above instructed,
on the date above first shown.
_________________________________________________________ Witness
_________________________________________________________ Address of
Witness
_________________________________________________________ Witness
_________________________________________________________ Address of
Witness
Additional witness required when living will is signed in a hospital or
skilled nursing facility.
I hereby witness this living will and attest that I believe the declarant
to be of sound mind and to have made this living will willingly and
voluntarily.
_________________________________________________________ Witness
The witness is not Medical director
of skilled nursing facility or staff physician not participating in care
of the patient or chief of the hospital medical staff or staff
physician or hospital designee not participating in care of the
patient."
(Code 1981, § 31-32-3, enacted by Ga. L. 1984, p. 1477, § 1; Ga. L. 1986,
p. 445, § 2; Ga. L. 1989, p. 1182, § 1; Ga. L. 1992, p. 1926, § 3; Ga. L.
1993, p. 91, § 31.)
31-32-4. Patients in hospitals or skilled
nursing facilities.
Statute text
A living will shall
have no force or effect if the declarant is a patient in a hospital or
skilled nursing facility at the time the living will is executed unless
the living will is signed in the presence of the two witnesses as provided
in Code
Section 31-32-3 and, additionally, is signed in the presence of either
the chief of the hospital medical staff, any physician on the medical
staff who is not participating in the care of the patient, or a person on
the hospital staff who is not participating in the care of the patient
designated by the chief of staff and the hospital administrator, if
witnessed in a hospital, or the medical director or any physician on the
medical staff who is not participating in the care of the patient, if
witnessed in a skilled nursing facility.
History
(Code 1981, § 31-32-4,
enacted by Ga. L. 1984, p. 1477, § 1; Ga. L. 1989, p. 1182, § 2; Ga. L.
1992, p. 1926, § 4.)
31-32-5. Revocation.
Statute text
(a) A living will may
be revoked at any time by the declarant, without regard to his mental
state or competency, by any of the following methods:
(1) By being canceled,
defaced, obliterated, burnt, torn, or otherwise destroyed by the declarant
or by some person in his presence and by his direction;
(2) By the declarant
or a person acting at the direction of the declarant signing and dating a
written revocation expressing the intent of the declarant to revoke. In
order to be effective, such a written revocation must clearly express an
intention to revoke a living will as opposed to a will or wills relating
to the disposition of property after death; and without limiting the
generality of the foregoing, it is specifically provided that the
revocation clause which is customarily included in a will relating to the
disposition of property and which provides for the revocation of "all
other wills" of the testator shall not operate to revoke a living will
without further evidence of a specific intent to revoke the living will.
Such revocation shall become effective only upon communication to the
attending physician by the declarant or by a person acting at the
direction of the declarant. The attending physician shall record in the
patient's medical record the time and date when he received notification
of the written revocation; or
(3) By any verbal or
nonverbal expression by the declarant of his intent to revoke the living
will. In order to be effective, such an oral revocation must clearly
express an intention to revoke a living will as opposed to a will relating
to the disposition of property after death. Such revocation shall become
effective only upon communication to the attending physician by the
declarant or by a person acting at the direction of the declarant. The
attending physician shall record in the patient's medical record the time,
date, and place of the revocation and the time, date, and place, if
different, when he received notification of the revocation.
(b) Any person who
participates in the withholding or withdrawal of life-sustaining
procedures pursuant to a living will, as authorized by this chapter, which
person has actual knowledge that such living will has been properly
revoked, shall not have any civil or criminal immunity otherwise granted
under this chapter for such conduct.
History
(Code 1981, § 31-32-5,
enacted by Ga. L. 1984, p. 1477, § 1; Ga. L. 1987, p. 322, § 1.)
31-32-6. Period of effectiveness.
Statute text
(a) A living will
executed on or after March 28, 1986, shall be effective from the date of
execution thereof unless revoked in a manner prescribed in Code
Section 31-32-5.
(b) A living will
executed prior to March 28, 1986, in the form specified by prior law shall
be effective for a period of seven years from the date of execution
thereof, except that, if the declarant crosses through or otherwise marks
over the paragraph of such a living will relating to the seven-year period
of effectiveness of the living will so as to indicate an intention to
defeat the operation of such paragraph, and if the declarant signs or
initials the living will in the area of the stricken paragraph, then the
living will shall continue in effect until and unless revoked in a manner
prescribed in Code
Section 31-32-5.
History
(Code 1981, § 31-32-6,
enacted by Ga. L. 1984, p. 1477, § 1; Ga. L. 1986, p. 445, § 1; Ga. L.
1991, p. 94, § 31.)
31-32-7. Immunity of participants from
liability.
Statute text
(a) No physician nor
any person acting under his direction and no hospital, skilled nursing
facility, nor any agent or employee thereof who acting in good faith in
accordance with the requirements of this chapter causes the withholding or
withdrawal of life-sustaining procedures from a patient or who otherwise
participates in good faith therein shall be subject to any civil liability
therefor. No physician nor any person acting under his direction and no
hospital, skilled nursing facility, nor any agent or employee thereof who
acting in good faith in accordance with the requirements of this chapter
causes the withholding or withdrawal of life-sustaining procedures from a
patient or who otherwise participates in good faith therein shall be
guilty of any criminal act therefor, nor shall any such person be guilty
of unprofessional conduct therefor.
(b) No person who
witnesses and attests a living will in good faith and in accordance with
Code
Section 31-32-3 shall be civilly or criminally liable or guilty of
unprofessional conduct for such action.
History
(Code 1981, § 31-32-7,
enacted by Ga. L. 1984, p. 1477, § 1.)
31-32-8. Conditions precedent to
withholding or withdrawal of life-sustaining procedures; physician's
failure or refusal to comply with living will.
Statute text
(a) Prior to
effecting a withholding or withdrawal of life-sustaining procedures from a
patient pursuant to a living will, the attending physician:
(1) Shall determine
that, to the best of his knowledge, the declarant patient is not pregnant,
or if she is, that the fetus is not viable and that the declarant's living
will specifically indicates that the living will is to be carried out;
(2) Shall, without
delay after the diagnosis of a terminal condition of the declarant, take
the necessary steps to provide for the written certification required by
Code
Section 31-32-2 of the declarant's terminal condition, coma, or
persistent vegetative state;
(3) Shall make a
reasonable effort to determine that the living will complies with
subsection (b) of Code
Section 31-32-3; and
(4) Shall make the
living will and the written certification of the terminal condition, coma,
or persistent vegetative state a part of the declarant patient's medical
records.
(b) The living will
shall be presumed, unless revoked, to be the directions of the declarant
regarding the withholding or withdrawal of life-sustaining procedures. No
person shall be civilly liable for failing or refusing in good faith to
effectuate the living will of the declarant patient. The attending
physician who fails or refuses to comply with the declaration of a patient
pursuant to this chapter shall endeavor to advise promptly the next of kin
or legal guardian of the declarant that such physician is unwilling to
effectuate the living will of the declarant patient. The attending
physician shall thereafter at the election of the next of kin or the legal
guardian of the declarant:
(1) Make a good faith
attempt to effect the transfer of the qualified patient to another
physician who will effectuate the declaration of the patient; or
(2) Permit the next of
kin or legal guardian to obtain another physician who will effectuate the
declaration of the patient.
History
(Code 1981, § 31-32-8,
enacted by Ga. L. 1984, p. 1477, § 1; Ga. L. 1992, p. 1926, § 5.)
31-32-9. Living will as not constituting
suicide; effect of living will on insurance; restriction on health care
facilities' preparing living wills.
Statute text
(a) The making of a
living will pursuant to this chapter shall not, for any purpose,
constitute a suicide.
(b) The making of a
living will pursuant to this chapter shall not restrict, inhibit, or
impair in any manner the sale, procurement, issuance, or enforceability of
any policy of life insurance, nor shall it be deemed to modify the terms
of an existing policy of life insurance. No policy of life insurance shall
be legally impaired or invalidated in any manner by the making of a living
will pursuant to this chapter or by the withholding or withdrawal of
life-sustaining procedures from an insured patient, nor shall the making
of such a living will or the withholding or withdrawal of such
life-sustaining procedures operate to deny any additional insurance
benefits for accidental death of the patient in any case in which the
terminal condition of the patient is the result of accident,
notwithstanding any term of the policy to the contrary.
(c) No physician,
hospital, skilled nursing facility, or other health provider and no health
care service plan, insurer issuing disability insurance, self-insured
employee welfare benefit plan, or nonprofit hospital service plan shall
require any person to execute a living will as a condition for being
insured for, or receiving, health care services.
(d) No hospital,
skilled nursing facility, or other medical or health care facility shall
prepare or offer to prepare living wills unless specifically requested to
do so by a person desiring to execute a living will. For purposes of this
article, a person in the custody of the Department of Corrections shall
not be deemed to be a patient within the meaning of this article, nor
shall a correctional facility be deemed to be a hospital, skilled nursing
facility, nor any other medical or health care facility.
History
(Code 1981, § 31-32-9,
enacted by Ga. L. 1984, p. 1477, § 1; Ga. L. 1985, p. 455, § 1; Ga. L.
1992, p. 1926, § 6.)
31-32-10. Concealment or damage of living
will; coercion; criminal homicide.
Statute text
Any person who
willfully conceals, cancels, defaces, obliterates, alters, or damages the
living will of another without such declarant's consent or who witnesses a
living will knowing at the time he is not eligible to witness such living
will under Code
Section 31-32-3 or who coerces or attempts to coerce a person into
making a living will shall be guilty of a misdemeanor. Any person who
falsifies or forges the living will of another or willfully conceals or
withholds personal knowledge of a revocation as provided in Code
Section 31-32-5 with the intent to cause a withholding or withdrawal
of life-sustaining procedures contrary to the wishes of the declarant and,
thereby, because of any such act, directly causes life-sustaining
procedures to be withheld or withdrawn and death thereby to be hastened
shall be subject to prosecution for criminal homicide as provided in
Chapter 5 of
Title 16.
History
(Code 1981, §
31-32-10, enacted by Ga. L. 1984, p. 1477, § 1.)
31-32-11. Effect of chapter on other legal
rights and duties.
Statute text
(a) Nothing in this
chapter shall impair or supersede any legal right or legal responsibility
which any person may have to effect the withholding or withdrawal of
life-sustaining procedures in any lawful manner. In such respect the
provisions of this chapter are cumulative.
(b) Nothing in this
chapter shall be construed to condone, authorize, or approve mercy killing
or to permit any affirmative or deliberate act or omission to end life
other than to permit the process of dying as provided in this chapter.
Furthermore, nothing in this chapter shall be construed to condone,
authorize, or approve abortion.
(c) This chapter
shall create no presumption concerning the intention of an individual who
has not executed a declaration to consent to the use or withholding of
life-sustaining procedures in the event of a terminal condition, a coma,
or a persistent vegetative state.
(d) Unless otherwise
specifically provided in a durable power of attorney for health care, a
declaration under this chapter is ineffective and inoperative as long as
there is an agent available to serve pursuant to a durable power of
attorney executed in accordance with the provisions of Chapter 36 of this
title, the "Durable Power of Attorney for Health Care Act," which grants
the agent authority with respect to the withdrawal or withholding of
life-sustaining or death-delaying treatment under the same circumstances
as those covered by a declaration under this chapter.
History
(Code 1981, §
31-32-11, enacted by Ga. L. 1984, p. 1477, § 1; Ga. L. 1992, p. 1926, §
7.)
31-32-12. Construction of chapter in
relation to Title 53.
Statute text
This chapter is wholly
independent of the provisions of
Title 53, relating to wills, trusts, and the administration of
estates, and nothing in this chapter shall be construed to affect in any
way the provisions of said
Title 53.
History
(Code 1981, §
31-32-12, enacted by Ga. L. 1984, p. 1477, § 1.)
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