16 Del. Admin. Code § 4304-8.0
Current through Register Vol. 28, No. 7, January 1, 2025
Section 4304-8.0 - Conflicts8.1 In the event of a disagreement between the patient's authorized representative and the patient's health care practitioner concerning the patient's decision-making capacity or the appropriate interpretation and application of the terms of a completed DMOST form regarding the patient's course of treatment, the parties: 8.1.1 May seek to resolve the disagreement by means of procedures and practices established by the health care institution, including, but not limited to, consultation with an institutional ethics committee, or with an individual designated by the health care institution for this purpose; or8.1.2 May seek resolution by a court of competent jurisdiction.8.2 A health care provider involved in the patient's care or an administrator of a health care institution may seek to resolve a disagreement concerning the appropriate interpretation and application of the terms of a completed DMOST form to the patient's course of treatment in the same manner as set forth in 8.1.8.3 In the event of conflicting directives, the patient's scope of treatment shall be governed by the latest directive available. 8.3.1 If the treatment directives of a later Advance Health-Care Directive conflict with the patient's directives on a DMOST form, a health care practitioner shall be informed so that the DMOST form can be modified or voided in order to reflect that patient's later directive.8.3.2 If there is a conflict between the patient's expressed oral or written directives, the DMOST form, or the decisions of the patient's authorized representative, the patient's last expressed oral or written directives shall be followed and, if necessary, a new DMOST form shall be prepared and executed to reflect those directives.8.4 Any individual or entity may petition the Court of Chancery for appointment of a guardian of the person of a patient if that individual or entity has good reason to believe that the withdrawal or withholding of health care in a particular case: 8.4.1 Is contrary to the most recently expressed wishes of a patient;8.4.2 Is predicated on an incorrect assessment of the patient's decision-making capacity;8.4.3 Is being proposed pursuant to a DMOST form that has been falsified, forged, or coerced;8.4.4 Is being considered without knowledge of a voided completed DMOST form which has been unlawfully concealed, destroyed, altered, or cancelled; or8.4.5 Is based on a patient's status either as an individual with a pre-existing long-term mental or physical disability, or as an individual who is economically disadvantaged.8.5 A health care institution, health care practitioner, or health care provider acting in good faith and in accordance with generally accepted health care standards applicable to the health care institution, health care practitioner, or health care provider is not subject to civil or criminal liability or to discipline for unprofessional conduct for: 8.5.1 Complying with a DMOST form signed by a health care practitioner apparently having authority to make a DMOST for a patient, including a decision to withhold or withdraw health care;8.5.2 Declining to comply with a DMOST form based on a belief that the health care practitioner then lacked authority to sign a DMOST;8.5.3 Complying with a DMOST form and assuming that the DMOST form was valid when made and has not been modified or voided;8.5.4 Providing life-sustaining treatment in an emergency situation when the existence of a DMOST form is unknown; or8.5.5 Declining to comply with a DMOST form because the DMOST form is contrary to the conscience or good faith medical judgment of the health care practitioner or the written policies of the health care institution.16 Del. Admin. Code § 4304-8.0
19 DE Reg. 922( 4/1/2016) (Final)