16 Del. Admin. Code § 4304-1.0
"Advance Health-Care Directive (AHCD)" means an Advance Health-Care Directive under 16 Del.C. Ch. 25, a durable power of attorney for health care decisions, or any individual instruction or power of attorney for health care valid under Delaware law because it is valid in the state where such document was executed or where the individual executing such document was a resident at the time that such document appointing an agent was executed. Said document must have been executed by the individual authorizing the appointed agent to make decisions about the individual's health care when such individual no longer has decision-making capacity.
"Decision-making capacity" means a patient's ability to understand and appreciate the nature and consequences of a particular health care decision, including the benefits and risks of that decision and alternatives to any proposed health care treatment, and to reach an informed health care decision.
"Delaware Medical Orders for Scope of Treatment (DMOST)" means a clinical process to facilitate communication between health care professionals and a patient living with serious illness or frailty whose health care practitioner would not be surprised if the patient died within the next year or, if the patient lacks decision-making capacity, the patient's authorized representative. The process encourages shared, informed medical decision-making. The decisions are memorialized on a completed DMOST form, which contains portable medical orders that respect the patient's goals for care with respect to the use of CPR and other life-sustaining treatments and medical interventions. The DMOST form is applicable across health care settings, is reviewable, andthe patient controls if it can be voided.
"Department" means the Department of Health and Social Services.
"DMOST form" means the standardized document created by the Department that is identified as an Attachment to these regulations, which:
| * | Is used on a voluntary basis by a patient living with serious illness or frailty whose health care practitioner would not be surprised if the patient died within the next year; |
| * | Is not an advance health-care directive; |
| * | Is not valid unless it meets the requirements for a completed DMOST form as set forth in 16 Del.C. Ch. 25A; |
| * | Is intended to provide direction to emergency care personnel regarding the use of emergency care and to health care providers regarding the use of life-sustaining treatment by indicating the patient's preferences concerning the scope of treatment, the use of specified interventions, and the intensity of treatment for each intervention; |
| * | Is intended to accompany the patient, and to be honored by all personnel attending the patient, across the full range of possible health care settings, including but not limited to the patient's home, a health care institution, at the scene of a medical emergency, or during transport; |
| * | May be reviewed or voided at any time by a patient with decision-making capacity or, if the patient lacks decision-making capacity, the patient's authorized representative in accordance with the provisions of 16 Del.C. § 2511A; and |
| * | Must be signed by a health care practitioner as defined below. |
"Emergency-care provider" means an emergency medical technician, paramedic, or first responder authorized under 16 Del.C.Ch 97.
"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.
"Health care practitioner" means a physician or an individual licensed and authorized to write medical orders pursuant to 24 Del.C. Ch. 17 and Ch. 19 who is providing care for the patient or overseeing the health care provided to the patient and has completed all training required by the Department for individuals participating in the completion of a DMOST form. Over time, a patient's health care practitioner may change.
"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. A health care practitioner is also a health care provider.
"Life-sustaining treatment" includes any medical intervention, including procedures, administration of medication, or use of a medical device, that maintains life by sustaining, restoring, or supplanting a vital function. It does not include care provided for the purpose of keeping a patient comfortable.
"Patient" means an individual who is under the care of the health care practitioner or health care provider.
"Patient's authorized representative" or "authorized representative" means the individual signing a DMOST form on behalf of a patient without decision-making capacity, who has the highest priority to act for the patient under law, and who has the authority to make decisions with respect to the patient's health care preferences being made on the DMOST form. The health care practitioner shall determine the individual who is the patient's authorized representative by referencing the documentation giving such individual the required authority under law. Based on the documentation provided by such individual as evidence of his or her authority, the patient's authorized representative could be an individual designated by a patient under an advance health-care directive, an agent under a medical durable power of attorney for health care decisions, a guardian of the person appointed pursuant to 12 Del.C. Ch. 39 or Ch. 39A, in accordance with the authority granted by the appointing court, a surrogate appointed under 16 Del.C. Ch. 25, or an individual who is otherwise authorized under applicable law to make the health care decisions being made by execution of the DMOST form on the patient's behalf, if the patient lacks decision-making capacity.
"Scope of treatment" means those medical interventions, procedures, medications, and treatments that a patient, in consultation with a health care practitioner, has determined are appropriate, necessary, and desired by and for the patient and will always include the provision of comfort measures. A patient may decline life-sustaining treatment.
"Serious illness or frailty" means a condition for which a health care practitioner would not be surprised if a patient died within the next year.
16 Del. Admin. Code § 4304-1.0