North Dakota § 23-12-13 - Individuals authorized to provide informed consent to health care for

§ 23-12-13. Individuals authorized to provide informed consent to health care for

incapacitated patients and minors - Priority. 1. For purposes of this section: a. "Incapacitated patient" means an adult unable to understand and appreciate the nature and consequence of a health care decision, including the benefits, harms, and reasonable alternatives to proposed health care, and unable to communicate a health care decision, as certified by the patient's attending physician, psychiatrist, or psychologist and filed in the patient's medical record. b. "Minor" means an individual under eighteen years of age. 2. Unless a court of competent jurisdiction determines otherwise, individuals in the following classes and in the following order of priority may provide informed consent to health care on behalf of an incapacitated patient: a. A health care agent appointed through a health care directive under chapter 23-06.5 or a similar instrument executed in another jurisdiction in accordance with the law in that jurisdiction; b. An appointed guardian or custodian of the patient under chapter 30.1-28 or a similar instrument executed in another jurisdiction in accordance with the law in that jurisdiction; c. A spouse of the patient who has maintained significant contact with the patient; d. A child of the patient who is at least eighteen years of age and who has maintained significant contact with the patient; e. A parent of the patient, including a stepparent who has maintained significant contact with the patient; f. An adult sibling of the patient who has maintained significant contact with the patient; g. A grandparent of the patient who has maintained significant contact with the patient; h. A grandchild of the patient who is at least eighteen years of age and who has maintained significant contact with the patient; i. A close relative or friend of the patient who is at least eighteen years of age and who has maintained significant contact with the patient; or j. An interdisciplinary team consisting of at least three health care professionals. (1) An interdisciplinary team may include an employee or agent of a health care provider treating an incapacitated patient, including a member of the ethics 3. 4. 5. 6. 7. committee, provided a member of the team is not directly involved with the treatment of the incapacitated patient. (2) If consent is provided under this subdivision, a health care provider shall continue good-faith efforts to identify and locate an individual in a preceding level of priority. Unless otherwise determined by court order, a parent may make health care decisions for the parent's minor child. Individuals in the following classes and in the following order of priority may provide informed consent to health care on behalf of a minor patient if a parent is unable to provide informed consent: a. A guardian acting under a court order specifically authorizing the guardian to make health care decisions for the minor; b. An appointed guardian or custodian of the minor; c. A noncustodial parent of the minor, including a stepparent who has maintained significant contact with the patient; d. An adult sibling of the minor who has maintained significant contact with the minor; e. A grandparent of the minor who has maintained significant contact with the minor; f. A close relative or friend of the minor who is at least eighteen years of age and who has maintained significant contact with the minor; or g. An interdisciplinary team consisting of at least three health care professionals. (1) An interdisciplinary team may include an employee or agent of a health care provider treating a minor, including a member of the ethics committee, provided a member of the team is not directly involved with the treatment of the minor. (2) If consent is provided under this subdivision, a health care provider shall continue good-faith efforts to identify and locate an individual in a preceding level of priority. A health care provider seeking informed consent for proposed health care for an incapacitated patient or a minor who is unable to consent must make reasonable efforts to locate and secure authorization for the health care from a competent individual in the first or succeeding class identified in subsection 2 for an incapacitated patient or subsection 3 for a minor. If the health care provider is unable to locate such individual, authorization may be given by any individual in the next class in the order of descending priority. An individual identified in subsection 2 for an incapacitated patient or subsection 3 for a minor may not provide informed consent to health care if an individual of higher priority has refused to give such authorization. Before any individual authorized to provide informed consent under this section exercises that authority, the individual must first determine in good faith that the patient, if not incapacitated, would consent to the proposed health care. If such a determination cannot be made, the decision to consent to the proposed health care may be made only after determining that the proposed health care is in the patient's best interests. An individual authorized to provide informed consent in accordance with this section may not provide consent for sterilization, abortion, or psychosurgery or for admission to a state mental health facility for a period of more than forty-five days without a mental health proceeding or other court order. If a patient who is determined by a physician, psychiatrist, or psychologist to be an incapacitated patient, or an individual interested in the patient's welfare, objects to a determination of incapacity made in accordance with this section, a court hearing pursuant to chapter 30.1-28 must be held to determine the issue of incapacity.