2018 Alaska Statutes
Title 13. Decedents' Estates, Guardianships, Transfers, Trusts, and Health Care Decisions
Chapter 52. Health Care Decisions Act
Sec. 13.52.390. Definitions.

In this chapter, unless the context otherwise requires,

(1) “advance health care directive” means an individual instruction or a durable power of attorney for health care;

(2) “agent” means an individual designated in a durable power of attorney for health care to make a health care decision for the individual granting the power;

(3) “anatomical gift” means a donation of all or a part of a human body to take effect after the donor's death for the purpose of transplantation, therapy, research, or education;

(4) “artificial nutrition and hydration” means medically appropriate nutrition and hydration delivered

(A) through an intravenous needle placed directly in a vein; or

(B) by a tube that is inserted into a functioning gastrointestinal tract;

(5) “available” means, when referring to a person, that the

(A) person's existence is known;

(B) person can be contacted;

(C) person does not lack capacity;

(D) person does not refuse to accept the position; and

(E) person is willing to make a health care decision;

(6) “best interest” means that the benefits to the individual resulting from a treatment outweigh the burdens to the individual resulting from that treatment after assessing

(A) the effect of the treatment on the physical, emotional, and cognitive functions of the patient;

(B) the degree of physical pain or discomfort caused to the individual by the treatment or the withholding or withdrawal of the treatment;

(C) the degree to which the individual's medical condition, the treatment, or the withholding or withdrawal of treatment results in a severe and continuing impairment;

(D) the effect of the treatment on the life expectancy of the patient;

(E) the prognosis of the patient for recovery, with and without the treatment;

(F) the risks, side effects, and benefits of the treatment or the withholding of treatment; and

(G) the religious beliefs and basic values of the individual receiving treatment, to the extent that these may assist the decision-maker to determine benefits and burdens;

(7) “capacity,” except in (9) of this section, means an individual's ability to receive and evaluate information effectively and to make and effectively communicate health care decisions;

(8) “cardiopulmonary resuscitation” means an attempt to restore spontaneous circulation;

(9) “competent” means that an individual has the capacity

(A) to assimilate relevant facts and to appreciate and understand the individual's situation with regard to those facts; and

(B) to participate in treatment decisions by means of a rational thought process;

(10) “department” means the Department of Health and Social Services;

(11) “do not resuscitate identification” means an identification card, form, necklace, or bracelet that carries the standardized design or symbol developed by the department under AS 13.52.065 to signify, when carried or worn, that the carrier or wearer is an individual for whom a physician has issued a do not resuscitate order;

(12) “do not resuscitate order” means a directive from a licensed physician that emergency cardiopulmonary resuscitation should not be administered to a qualified patient;

(13) “durable power of attorney for health care” means a power of attorney that remains in effect when the principal lacks capacity; in this paragraph, “power of attorney” means the designation of an agent to make health care decisions for the individual granting the power;

(14) “generally accepted health care standards” includes the protocol for do not resuscitate orders that is adopted under AS 13.52.065;

(15) “guardian” means a judicially appointed person having authority to make a health care decision for an individual;

(16) “health care” means any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect an individual's physical or mental condition;

(17) “health care decision” means a decision made by an individual or the individual's agent, guardian, or surrogate regarding the individual's health care, including

(A) selection and discharge of health care providers and institutions;

(B) approval or disapproval of proposed diagnostic tests, surgical procedures, and programs of medication;

(C) direction to provide, withhold, or withdraw artificial nutrition and hydration if providing, withholding, or withdrawing artificial nutrition, artificial hydration, or artificial nutrition and hydration is in accord with generally accepted health care standards applicable to health care providers or institutions;

(D) the administration or withdrawal of psychotropic medications, the use of electroconvulsive treatment, and the admission to a mental health facility; and

(E) making an anatomical gift at death;

(18) “health care facility” means a nursing home, a rehabilitation center, a long-term care facility, and any other health care institution that administers health care and that provides overnight stays in the ordinary course of the facility's business;

(19) “health care institution” means an institution, facility, or agency licensed, certified, or otherwise authorized or permitted by law to provide health care in the ordinary course of business;

(20) “health care provider” means an individual licensed, certified, or otherwise authorized or permitted by law to provide health care in the ordinary course of business or practice of a profession;

(21) “hospital” means a facility

(A) licensed, accredited, or approved as a hospital under the laws of this state; or

(B) operated as a hospital by the United States government, this state, or a subdivision of this state;

(22) “individual instruction” means an individual's direction concerning a health care decision for the individual;

(23) “life-sustaining procedures” means any medical treatment, procedure, or intervention that, in the judgment of the primary physician, when applied to a patient with a qualifying condition, would not be effective to remove the qualifying condition, would serve only to prolong the dying process, or, when administered to a patient with a condition of permanent unconsciousness, may keep the patient alive but is not expected to restore consciousness; in this paragraph, “medical treatment, procedure, or intervention” includes assisted ventilation, renal dialysis, surgical procedures, blood transfusions, and the administration of drugs, including antibiotics, or artificial nutrition and hydration;

(24) “mental health facility” has the meaning given to “designated treatment facility” in AS 47.30.915;

(25) “mental health treatment” means electroconvulsive treatment, treatment with psychotropic medication, or admission to and retention in a health care institution for mental health treatment;

(26) “part” means an organ, tissue, or an eye of a human being, except fetal tissue; the term does not include the whole body;

(27) “permanent unconsciousness” means a condition

(A) that, to a high degree of medical certainty, will last permanently without improvement;

(B) in which, to a high degree of medical certainty, thought, sensation, purposeful action, social interaction, and awareness of self and the environment are absent; and

(C) for which, to a high degree of medical certainty, initiating or continuing life-sustaining procedures, in light of the patient's medical outcome, provides only minimal medical benefit;

(28) “person” means an individual, corporation, business trust, estate, trust, partnership, joint venture, association, government, governmental subdivision, governmental agency, or another legal or commercial entity;

(29) “physician” or “surgeon” means an individual licensed or otherwise authorized to practice medicine and surgery or osteopathy and surgery under the laws of any state;

(30) “primary physician” means a physician designated by an individual, or by the individual's agent, guardian, or surrogate, to have primary responsibility for the individual's health care or, in the absence of a designation or if the designated physician is not reasonably available, a physician who undertakes the responsibility;

(31) “qualified patient” means a patient with a qualifying condition who is eligible for do not resuscitate identification;

(32) “qualifying condition” means a terminal condition or permanent unconsciousness in a patient;

(33) “reasonably available” means available using a level of diligence appropriate to the seriousness and urgency of an individual's health care needs;

(34) “state” means a state, territory, or possession of the United States, the District of Columbia, or the Commonwealth of Puerto Rico;

(35) “supervising health care provider” means the primary physician or the physician's designee, or the health care provider or the provider's designee who has undertaken primary responsibility for an individual's health care;

(36) “surrogate” means an individual, other than a patient's agent or guardian, authorized under this chapter to make a health care decision for the patient;

(37) “terminal condition” means an incurable or irreversible illness or injury

(A) that without administration of life-sustaining procedures will result in death in a short period of time;

(B) for which there is no reasonable prospect of cure or recovery;

(C) that imposes severe pain or otherwise imposes an inhumane burden on the patient; and

(D) for which, in light of the patient's medical condition, initiating or continuing life-sustaining procedures will provide only minimal medical benefit.