§ 20-6-304. Physician order for life-sustaining treatment form

(a) The State Board of Health shall prescribe a standardized physician order for life-sustaining treatment form that:

1. (1) Is signed and dated by:

   1. (A) The patient or the legal representative of the patient; and

   2. (B) The physician of the patient;

2. (2) Includes:

   1. (A) The name and date of birth of the patient; and

   2. (B) The intentions of the patient regarding care, including without limitation the administration of cardiopulmonary resuscitation and the level of medical interventions in the event of a medical emergency; and

3. (3) Is easily distinguishable to facilitate recognition by healthcare providers and healthcare facilities.

(b) A legal representative may sign a physician order for life-sustaining treatment form on behalf of a patient who lacks capacity to do so, guided by:

1. (1) The express or implied intentions of the patient; or

2. (2) If the intentions of the patient are unknown and cannot be reasonably determined, the best interest of the patient given the overall medical condition and prognosis of the patient.

(c)

1. (1) The physician order for life-sustaining treatment form shall be completed by a physician based upon patient intentions and medical indications.

2. (2) During the process of completing the physician order for life-sustaining treatment form, the physician may:

   1. (A) Explain:

      1. (i) The physician order for life-sustaining treatment form; and

      2. (ii) The medical interventions and procedures offered by the life-sustaining treatment form; and

   2. (B) Inform the patient or the legal representative of the patient about the difference between an advance directive and the physician order for life-sustaining treatment form.

(d) This subchapter does not authorize a physician to unilaterally create a physician order for life-sustaining treatment on behalf of an individual.