2983 - Determination of lack of capacity to make health care decisions for the purpose of empowering agent.

§  2983.  Determination  of  lack  of  capacity  to  make  health care  decisions for the purpose of empowering  agent.  1.    Determination  by  attending physician. (a) A determination that a principal lacks capacity  to  make  health care decisions shall be made by the attending physician  to a reasonable degree of medical certainty. The determination shall  be  made  in  writing  and  shall contain such attending physician's opinion  regarding the cause and nature of the principal's incapacity as well  as  its extent and probable duration. The determination shall be included in  the  patient's  medical  record.  For a decision to withdraw or withhold  life-sustaining  treatment,  the  attending  physician  who  makes   the  determination  that  a  principal  lacks  capacity  to  make health care  decisions  must  consult  with  another  physician   to   confirm   such  determination.  Such  consultation  shall  also  be  included within the  patient's medical record.    (b) If an attending physician of a patient in a  general  hospital  or  mental hygiene facility determines that a patient lacks capacity because  of  mental  illness, the attending physician who makes the determination  must  be,  or  must  consult,  for  the  purpose   of   confirming   the  determination,   with   a  qualified  psychiatrist.  A  record  of  such  consultation shall be included in the patient's medical record.    (c) If  the  attending  physician  determines  that  a  patient  lacks  capacity  because of a developmental disability, the attending physician  who makes the determination must be, or must consult, for the purpose of  confirming the determination, with a physician or clinical  psychologist  who  either is employed by a school named in section 13.17 of the mental  hygiene law, or who has been employed for a  minimum  of  two  years  to  render care and service in a facility operated or licensed by the office  of  mental  retardation  and developmental disabilities, or who has been  approved by the commissioner of  mental  retardation  and  developmental  disabilities   in   accordance  with  regulations  promulgated  by  such  commissioner.  Such  regulations  shall  require  that  a  physician  or  clinical  psychologist  possess  specialized  training  or  three  years  experience in treating developmental  disabilities.  A  record  of  such  consultation shall be included in the patient's medical record.    (d)  A physician who has been appointed as a patient's agent shall not  make the determination of the patient's capacity  to  make  health  care  decisions.    2.  Request  for  a  determination.  If  requested  by  the  agent, an  attending physician shall make a determination regarding the principal's  capacity to make health care decisions for the purposes of this article.    3. Notice of determination. Notice of a determination that a principal  lacks capacity to make health care decisions shall  promptly  be  given:  (a)  to  the  principal,  orally  and  in  writing,  where  there is any  indication of the principal's ability to comprehend such notice; (b)  to  the  agent;  (c)  if the principal is in or is transferred from a mental  hygiene facility, to the facility director; and (d) to  the  conservator  for, or committee of, the principal.    4.  Limited purpose of determination. A determination made pursuant to  this section that  a  principal  lacks  capacity  to  make  health  care  decisions  shall  not  be  construed as a finding that the patient lacks  capacity for any other purpose.    5. Priority of principal's decision. Notwithstanding  a  determination  pursuant  to  this  section  that  the  principal lacks capacity to make  health care decisions, where a principal objects to the determination of  incapacity  or  to  a  health  care  decision  made  by  an  agent,  the  principal's  objection or decision shall prevail unless the principal is  determined by a court of competent jurisdiction to lack capacity to make  health care decisions.6. Confirmation of lack of capacity. (a) The attending physician shall  confirm the principal's continued incapacity before  complying  with  an  agent's  health  care  decisions,  other than those decisions made at or  about the time of the initial determination made pursuant to subdivision  one  of  this  section.  The confirmation shall be stated in writing and  shall be included in the principal's medical record.    (b) The notice requirements set forth in  subdivision  three  of  this  section   shall   not   apply  to  the  confirmation  required  by  this  subdivision.    7. Effect  of  recovery  of  capacity.  In  the  event  the  attending  physician  determines  that  the  principal  has  regained capacity, the  authority of  the  agent  shall  cease,  but  shall  recommence  if  the  principal  subsequently  loses  capacity  as determined pursuant to this  section.