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Bill > HF708
IA HF708
IA HF708A bill for an act relating to health care decisions related to palliative care, hospice programs, life-sustaining procedures, and out-of-hospital do-not-resuscitate orders.(See HF 2305.)
summary
Introduced
03/03/2025
03/03/2025
In Committee
03/03/2025
03/03/2025
Crossed Over
Passed
Dead
Introduced Session
91st General Assembly
Bill Summary
This bill relates to health care decisions related to palliative care, hospice programs, life-sustaining procedures, and out-of-hospital do-not-resuscitate orders. Current law requires a hospice program to provide palliative care in order to be eligible for a license. The bill removes this requirement and requires a hospice program to provide care directed at symptom management to be eligible to receive a license. Under the bill, if a patient who has a terminal condition, and is comatose, incompetent, or incapable of communication, and has not expressed their desire regarding palliative care or a hospice program, certain individuals in order of priority have the authority to make the decision to place the patient in a hospice program. The individuals who have the authority to make such a decision include an attorney in fact, a guardian, the patient’s spouse, an adult child or stepchild, a parent or stepparent, adult sibling or adult stepsibling, a relative of the patient, and a close adult friend. The bill defines close adult friend. An individual making a decision for such a patient shall be guided by the express or implied intention of the patient in making the decision. Current law provides that certain individuals in order of priority, including an attorney in fact, a guardian, the patient’s spouse, an adult child, a parent, and an adult sibling, have the authority to withhold or withdraw life-sustaining procedures from a patient who has a terminal condition, and who is comatose, incompetent, or incapable of communication, and who has not made a declaration for life-sustaining procedures. The bill broadens these categories to include stepchildren, stepparents, and stepsiblings, relatives of the patient, and a close adult friend of the patient. The bill provides restrictions on who may act as a witness to the consultation when the decision is made with the patient’s attending physician. The bill provides that resuscitation may be withheld or withdrawn from a patient who has a terminal condition, and who is comatose, incompetent, or incapable of communication, and who has not executed an out-of-hospital do-not-resuscitate order if there is consultation and written agreement between the patient’s attending physician and certain individuals, in order of priority, making the decision. The individuals who are authorized to make such a decision include an attorney in fact, a guardian, the patient’s spouse, an adult child or stepchild, a parent or stepparent, adult sibling or adult stepsibling, a relative of the patient, and a close adult friend. An individual making a health care decision for such a patient shall be guided by the express or implied intention of the patient in making the decision. A witness, as specified in the bill, shall be present at the time of consultation with the patient’s attending physician when a decision is made to withdraw or withhold resuscitation. Current law requires a guardian to obtain court approval before the guardian may consent to the withholding or withdrawal of life-sustaining procedures for a protected person. The bill makes an exception to this requirement and allows a guardian to make a decision for the protected person relating to hospice care, life-sustaining procedures, and resuscitation without court approval in circumstances detailed in the bill.
AI Summary
This bill updates Iowa's health care decision-making laws related to palliative care, hospice programs, and end-of-life medical procedures, expanding the categories of people who can make critical medical decisions for patients who are unable to communicate. The bill modifies existing definitions, introduces new terms like "close adult friend" (defined as an adult who has shown special care and concern for the patient, maintains regular contact, and is willing to be involved in their care), and establishes a clear hierarchy of decision-makers for patients with terminal conditions who cannot express their own medical preferences. The bill allows for decisions regarding hospice placement, withholding or withdrawing life-sustaining procedures, and resuscitation to be made by a progressively broader group of individuals, starting with an attorney in fact or guardian and extending to spouse, children, parents, siblings, relatives, and even a close adult friend. Importantly, the bill requires that these decision-makers be guided by the patient's express or implied intentions and mandates the presence of an independent witness during consultations with the attending physician. The legislation also provides guardians more flexibility by allowing them to make certain medical decisions without prior court approval, and it redefines palliative care to emphasize symptom management and support for patients with serious illnesses at any stage of their medical journey.
Committee Categories
Health and Social Services
Sponsors (1)
Last Action
Committee report approving bill, renumbered as HF 2305. (on 02/06/2026)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.legis.iowa.gov/legislation/BillBook?ga=91&ba=HF708 |
| BillText | https://www.legis.iowa.gov/docs/publications/LGI/91/attachments/HF708.html |
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