411-390-0200 Limits on Authority (1) A health care advocate may not make a health care decision related to any of the following: (a) Convulsive treatment. (b) Psychosurgery. (c) Sterilization. (d) Abortion. (e) Withholding or withdrawing of a life-sustaining treatment. (f) Withholding or withdrawing artificially administered nutrition and hydration other than hyperalimentation. (g) Testing for HIV, unless testing is necessary for obtaining treatment or care for an individual. (h) A request for medication for the purpose of ending an individual’s life according to ORS 127.805 or other form of assisted suicide. (i) An experimental procedure, unless the procedure has been approved by an institutional review board and is determined by the attending physician to be in the best interest of an individual. (j) An experimental drug that has not been approved for use by the United States Food and Drug Administration, unless the drug is part of an approved clinical trial and an individual’s attending physician has determined that it is in the best interest of the individual. (k) The use of seclusion or physical or chemical restraints, unless an imminent risk of harm to the individual or others exists but only for as long as the imminent risk continues except in the case of an emergency. (2) If an individual objects to any health care decision made by a health care advocate: (a) The health care decision is revoked; (b) The health care advocate’s authority is withdrawn with respect to the health care decision that is revoked; and (c) A member of the individualized written service plan team or the health care advocate must notify the health care provider whose recommendation is the subject of the health care decision that the decision has been revoked. (3) SIGNIFICANT MEDICAL PROCEDURES OR TREATMENTS. (a) If a health care decision involves a significant medical procedure or treatment, an individual's individualized written service plan team must approve by a majority with the recommended health care decision of the individual's health care advocate prior to administration of the significant medical procedure or treatment. (A) The approval must be reached through an in-person meeting of the individualized written service plan team identified under OAR 411-390-0220. (B) An in-person meeting must allow for real time, verbal communication between all members of the individualized written service plan team. (b) The health care decision by the individualized written service plan team to approve or disapprove the recommended health care decision must involve consideration and documentation of all of the following: (A) The alternatives to the proposed significant medical procedure or treatment. (B) The risks and benefits of the proposed significant medical procedure or treatment. (C) The risks and benefits of not receiving the proposed significant medical procedure or treatment. (D) The impact of the proposed significant medical procedure or treatment on the individual's wellbeing. (E) Any preferences indicated by any verbal or nonverbal communication by the individual. (F) Any additional information that may need to be obtained that may affect the decision, such as a second opinion. (c) If a majority of the individualized written service plan team disapproves of the health care advocate’s recommended health care decision, the health care advocate does not have the authority to make the health care decision. Statutory/Other Authority: ORS 127.765 & 409.050 Statutes/Other Implemented: ORS 127.765 History: APD 5-2020, adopt filed 02/25/2020, effective 03/01/2020