TERMINAL CARE DOCUMENT - 18 V.S.A. CHAPTER 111
REPEALED - 2005
§ 5251. Purpose and policy
§ 5252. Definitions
§ 5253. Terminal care document
§ 5254. Execution and witnesses
§ 5255. [Reserved for future use.]
§ 5256. Action by physician
§ 5257. Revocation
§ 5258. Duty to deliver
§ 5259. Immunity
§ 5260. Suicide
§ 5261. Freedom from influence
§ 5262. Presumptions
The state of Vermont recognizes that a person as a matter of right may rationally make an election as to the extent of medical treatment he will receive in the event that his physical state reaches such a point of deterioration that he is in a terminal state and there is no reasonable expectation that life can be continued with dignity and without pain. A person has a fundamental right to determine whether or not life-sustaining procedures which would cause prolongation of life beyond natural limits, should be used or withdrawn. (Added 1981, No. 141 (Adj. Sess.), § 1, eff. April 8, 1982.)
The following definitions shall be applicable in the construction of this chapter:
(1) "Attending physician" means the physician selected by, or assigned to the patient, who has primary responsibility for the treatment and care of the patient.
(2) "Extraordinary measures" means any medical procedure or intervention which utilizes mechanical or other artificial means to sustain, restore, or supplant a vital function which, in the judgment of the attending physician, when applied to the patient, would serve only to artificially postpone the moment of death and where, in the judgment of the attending physician, the patient is in a terminal state.
(3) "Terminal care document" means a document which, when duly executed, contains the express direction that no extraordinary measures be taken when the person executing said document is in a terminal state, without hope of recovery from such state and is unable to actively participate in the decision-making process.
(4) "Physician" means a medical doctor licensed to practice in the state of Vermont.
(5) "Terminal state" means an incurable condition caused by injury, disease or illness which regardless of the application of life-saving procedures would, within reasonable medical judgment, produce death and where application of life-sustaining procedures would only postpone the moment of death. (Added 1981, No. 141 (Adj. Sess.), § 1, eff. April 8, 1982.)
A person of sound mind who is 18 years of age or older may execute at any time a document commonly known as a terminal care document, directing that no extraordinary measures be used to prolong his life when he is in a terminal state. The document shall only be effective in the event that the person is incapable of participating in decisions about his care and may, but need not, be in form and substance substantially as follows:
"To my family, my physician, my lawyer, my clergyman. To any medical facility in whose care I happen to be. To any individual who may become responsible for my health, welfare or affairs.
"Death is as much a reality as birth, growth, maturity and old age-it is the one certainty of life. If the time comes when I, , can no longer take part in decisions of my own future, let this statement stand as an expression of my wishes, while I am still of sound mind.
"If the situation should arise in which I am in a terminal state and there is no reasonable expectation of my recovery, I direct that I be allowed to die a natural death and that my life not be prolonged by extraordinary measures. I do, however, ask that medication be mercifully administered to me to alleviate suffering even though this may shorten my remaining life.
""This statement is made after careful consideration and is in accordance with my strong convictions and beliefs. I want the wishes and directions here expressed carried out to the extent permitted by law. Insofar as they are not legally enforceable, I hope that those to whom this will is addressed will regard themselves as morally bound by these provisions.
Copies of this request have been given to:
___________________________________________ ___________________________________________ ___________________________________________ "
(Added 1981, No. 141 (Adj. Sess.), § 1, eff. April 8, 1982.)
The document set forth in section 5253 of this title shall be executed by the person making the same in the presence of two or more subscribing witnesses, none of whom shall be the person's spouse, heir, reciprocal beneficiary, attending physician or person acting under the direction or control of the attending physician or any other person who has at the time of the witnessing thereof any claims against the estate of the person. (Added 1981, No. 141 (Adj. Sess.), § 1, eff. April 8, 1982; amended 1999, No. 91 (Adj. Sess.), § 34.)
An attending physician and any other physician under his direction or control, having in his possession his patient's terminal care document, or having knowledge that such a duly executed document is part of the patient's record in the institution in which he is receiving care, shall be bound to follow as closely as possible the dictates of said document. However, if because of moral conflict with the spirit of this act, a physician finds it impossible to follow his patient's directions, he shall forthwith have a duty to so inform his patient or actively assist in selecting another physician who is willing to honor the patient's directions, or both. (Added 1981, No. 141 (Adj. Sess.), § 1, eff. April 8, 1982.)
A person who has validly executed a document consistent with the provisions of sections 5253 and 5254 of this title may revoke the same orally in the presence of two or more witnesses, at least one of whom shall not be a spouse or a relative as specified in 15 V.S.A. §§ 1 or 2, or by burning, tearing or obliterating the same or by causing the same to be done by some other person at his direction and in his presence. A terminal care document may be revoked only as provided herein. (Added 1981, No. 141 (Adj. Sess.), § 1, eff. April 8, 1982.)
Any person having in his possession a duly executed terminal care document, if it becomes known to him that the person executing the same is in such circumstances that the terms of the terminal care document might become applicable, shall forthwith deliver the same to the physician attending the person executing said document or to the hospital in which said person is a patient. (Added 1981, No. 141 (Adj. Sess.), § 1, eff. April 8, 1982.)
An attending physician, other physician, nurse, health professional or any other person acting for him or under his control, or hospital within which the person may be, shall forever be immune from any civil or criminal liability for any act or intentional failure to act if said act or intentional failure to act is done pursuant to the terminal care document. (Added 1981, No. 141 (Adj. Sess.), § 1, eff. April 8, 1982.)
The withholding or withdrawal of life-sustaining procedures from a patient who has executed a document consistent with the purposes of section 5253 of this title shall at no time be construed as a suicide for any legal purpose. (Added 1981, No. 141 (Adj. Sess.), § 1, eff. April 8, 1982.)
No physician, health 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 terminal care document as a condition for being insured for, or receiving, health care services; nor can health care or services be refused except as is hereinbefore provided because a person is known to have executed a terminal care document. (Added 1981, No. 141 (Adj. Sess.), § 1, eff. April 8, 1982.)
This chapter shall not be construed to create a presumption that in the absence of a terminal care document, a person wants extraordinary measures to be taken. (Added 1981, No. 141 (Adj. Sess.), § 1, eff. April 8, 1982.)