145C.05 SUGGESTED FORM.
Subdivision 1. Content.
A health care directive executed pursuant to this chapter may, but
need not, be in the form contained in section
Subd. 2. Provisions that may be included.
(a) A health care directive may include
provisions consistent with this chapter, including, but not limited to:
(1) the designation of one or more alternate health care agents to act if the named health
care agent is not reasonably available to serve;
(2) directions to joint health care agents regarding the process or standards by which the
health care agents are to reach a health care decision for the principal, and a statement whether
joint health care agents may act independently of one another;
(3) limitations, if any, on the right of the health care agent or any alternate health care agents
to receive, review, obtain copies of, and consent to the disclosure of the principal's medical
(4) limitations, if any, on the nomination of the health care agent as guardian for purposes
(5) a document of gift for the purpose of making an anatomical gift, as set forth in sections
, or an amendment to, revocation of, or refusal to make an anatomical gift;
(6) a declaration regarding intrusive mental health treatment under section
, or a statement that the health care agent is authorized to give consent for the
principal under section
253B.04, subdivision 1a
(7) a funeral directive as provided in section
149A.80, subdivision 2
(8) limitations, if any, to the effect of dissolution or annulment of marriage or termination
of domestic partnership on the appointment of a health care agent under section
(9) specific reasons why a principal wants a health care provider or an employee of a health
care provider attending the principal to be eligible to act as the principal's health care agent;
(10) health care instructions by a woman of child bearing age regarding how she would like
her pregnancy, if any, to affect health care decisions made on her behalf; and
(11) health care instructions regarding artificially administered nutrition or hydration.
(b) A health care directive may include a statement of the circumstances under which the
directive becomes effective other than upon the judgment of the principal's attending physician
in the following situations:
(1) a principal who in good faith generally selects and depends upon spiritual means or
prayer for the treatment or care of disease or remedial care and does not have an attending
physician, may include a statement appointing an individual who may determine the principal's
decision-making capacity; and
(2) a principal who in good faith does not generally select a physician or a health care facility
for the principal's health care needs may include a statement appointing an individual who may
determine the principal's decision-making capacity, provided that if the need to determine the
principal's capacity arises when the principal is receiving care under the direction of an attending
physician in a health care facility, the determination must be made by an attending physician after
consultation with the appointed individual.
If a person appointed under clause (1) or (2) is not reasonably available and the principal is
receiving care under the direction of an attending physician in a health care facility, an attending
physician shall determine the principal's decision-making capacity.
(c) A health care directive may authorize a health care agent to make health care decisions
for a principal even though the principal retains decision-making capacity.
History: 1993 c 312 s 6; 1995 c 211 s 2; 1998 c 399 s 15,16; 2004 c 146 art 3 s 3