Life Sustaining Statute, Hawaii
Declaration as Provided by Hawaii Revised Statutes Chapter 327D, Section 4
DECLARATIONA. Statement of Declarant
Declaration made this __________________ day of _____________, 20_______. I, _________________ being of sound mind, willfully and voluntarily make known my desire that my dying shall not be artificially prolonged under the circumstances set forth below, and do hereby declare:
If at any time I should have an incurable or irreversible condition certified to be terminal by two physicians who have personally examined me, one of whom shall be my attending physician, and the physicians have determined that I am unable to make decisions concerning my medical treatment, and that without administration of life-sustaining treatment my death will occur in a relatively short time, and where the application of life-sustaining procedures would serve only to prolong artificially the dying process, I direct that such procedures be withheld or withdrawn, and that I be permitted to die naturally with only the administration of medication, nourishment, or fluids or the performance of any medical procedure deemed necessary to provide me with comfort or to alleviate pain.
I understand the full import of this declaration and I am emotionally and mentally competent to make this declaration.
Signed:________________________________________________________________
STATE OF ____________________
COUNTY OF ___________________
B. Statement of WitnessesI am at least 18 years of age and not related to the Declarant by blood, marriage or adoption; and not the attending physician, an employee of the attending physician, or an employee of the medical care facility in which the Declarant is a patient.
The Declarant is personally known to me and I believe the Declarant to be of sound mind.
Witness:
_______________________________________________________________
Address:
Witness:_______________________________________________________________
Address:
C. Notarization
Subscribed, sworn to and acknowledged before me by _________________, the Declarant, and subscribed and sworn to before me by ___________________ and ___________________, witnesses, this ______________ day of ________________________, 20_______.
_____________________________________
Official Capacity: _________________
Declaration as Provided by Hawaii Revised Statutes Chapter 327D, Section 4
Review ListThis review list is provided to inform you about this document in question and assist you in its preparation. This simple Life Sustaining Declaration is valid in Hawaii. Check with a local hospital or doctor’s office, as well as with an experienced medical attorney, to assure yourself of its compliance with current statute (s) in your state.
1. Make multiple copies. Give one to your doctor (s), the local hospital, and have others available through your attorney and family. Remember, these kinds of documents are needed in emergency situations at worst and under stressful circumstances at best. So be sure they are available to the appropriate people easily, when needed.
Frequently Asked Questions
What is the Life Sustaining Statute in Hawaii?
The Life Sustaining Statute in Hawaii is part of the Hawaii Revised Statutes Chapter 327D, Section 4, which provides a declaration form for individuals to express their wishes regarding life-sustaining treatment. It allows a person to declare that their dying shall not be artificially prolonged under certain circumstances. The statute outlines the conditions under which life-sustaining procedures may be withheld or withdrawn.
Who can make a declaration under Hawaii's Life Sustaining Statute?
Any person who is of sound mind can make a declaration under Hawaii's Life Sustaining Statute. The declaration must be made willfully and voluntarily. The statute requires the declarant to be of sound mind at the time of making the declaration.
What conditions must be met for the declaration to take effect in Hawaii?
For the declaration to take effect, the declarant must have an incurable or irreversible condition certified to be terminal by two physicians, one of whom is the attending physician. The physicians must have personally examined the declarant and determined that the declarant is unable to make decisions concerning medical treatment. Additionally, without life-sustaining treatment, death must be expected to occur in a relatively short time, and the application of life-sustaining procedures would only prolong the dying process artificially.
What does the declaration direct regarding life-sustaining procedures?
The declaration directs that life-sustaining procedures be withheld or withdrawn under the specified circumstances. It also states that the declarant be permitted to die naturally. However, the declaration allows for the administration of medication, nourishment, or fluids, or any medical procedure deemed necessary to provide comfort or alleviate pain.
How many physicians must certify the terminal condition in Hawaii?
Two physicians must certify the terminal condition, and one of them must be the attending physician. Both physicians must have personally examined the declarant. This requirement is specified in the Hawaii Revised Statutes Chapter 327D, Section 4.
What is the role of the attending physician in the declaration process?
The attending physician is one of the two physicians who must certify the terminal condition and the declarant's inability to make medical decisions. The attending physician must have personally examined the declarant. This role is outlined in the statute.
Can nourishment and fluids be administered if the declaration is in effect?
Yes, the declaration permits the administration of medication, nourishment, or fluids. It also allows for any medical procedure deemed necessary to provide comfort or alleviate pain. The declaration only directs that life-sustaining procedures be withheld or withdrawn.
What is the purpose of the declaration in Hawaii's Life Sustaining Statute?
The purpose is to allow individuals to make known their desire that their dying not be artificially prolonged under certain circumstances. It provides a legal means to direct that life-sustaining procedures be withheld or withdrawn. The declaration ensures that the individual's wishes are respected when they are unable to make decisions.
Is the declaration in Hawaii's Life Sustaining Statute legally binding?
The declaration is provided by Hawaii Revised Statutes Chapter 327D, Section 4, which gives it legal standing. It is a formal statement made by the declarant. The statute outlines the conditions under which it applies, making it a legally recognized document.
What should be included in the declaration form according to Hawaii law?
The declaration form must include the date, the declarant's name, and a statement that the declarant is of sound mind and is making the declaration willfully and voluntarily. It must also specify the circumstances under which life-sustaining procedures should be withheld or withdrawn. The form should reflect the declarant's desire not to have dying artificially prolonged.
