2023 Indiana Code › Title 16. Health › Article 36. Medical Consent › Chapter 5. Out of Hospital Do Not Resuscitate Declarations › 16-36-5-11. Execution of Declaration

Sec. 11. (a) A person who is of sound mind and at least eighteen (18) years of age may execute an out of hospital DNR declaration.
(b) A person's representative may execute an out of hospital DNR declaration for the person under this chapter only if the person is:
(1) at least eighteen (18) years of age; and
(2) incapacitated or incompetent.
(c) If:
(1) a person is at least eighteen (18) years of age and is certified as a qualified person under section 10 of this chapter;
(2) the person is incapacitated or incompetent; and
(3) the person has no representative who is able and available to execute an out of hospital DNR declaration for the person;
then any individual who is the person's proxy under IC 16-36-7-42(c) and who is available to act and has priority to act may execute an out of hospital DNR declaration for the person.
(d) An out of hospital DNR declaration must meet the following conditions:
(1) Be voluntary.
(2) Be in writing.
(3) Be signed by the person making the declaration or by another person in the declarant's presence and at the declarant's express direction.
(4) Be dated.
(5) Be signed in the presence of at least two (2) competent witnesses.
(e) If the requirements concerning presence are met, a competent declarant and all necessary witnesses may complete and sign an out of hospital DNR declaration in two (2) or more tangible, paper counterparts with the declarant's signature placed on one (1) original counterpart and the signatures of the witnesses placed on one (1) or more different tangible, paper counterparts if the text of the out of hospital DNR declaration states that the declaration is being signed in separate counterparts. If an out of hospital DNR declaration is signed in counterparts under this subsection, one (1) or more of the following persons must combine each of the separately signed tangible, paper counterparts into a single composite document that contains all of the text of the out of hospital DNR declaration, the signature of the declarant, and the signature of each witness:
(1) The declarant.
(2) A health care representative who has been appointed by the declarant under subsection (b).
(3) A proxy acting for the declarant under subsection (c).
(4) A person who supervised the signing of the out of hospital DNR declaration in the person's presence.
(5) Any other person who was present during the signing of the out of hospital DNR declaration.
The person who combines the separately signed counterparts into a single composite document must do so not later than ten (10) business days after the person receives all of the separately signed tangible, paper counterparts. Any scanned, photocopied, or other accurate copy of the single, composite document shall be treated as validly signed under this subsection if the single, composite document contains the complete text of the out of hospital DNR declaration and all required signatures.
(f) If physical impairment, physical isolation, or other factors make it impossible or impractical for a declarant to use audiovisual technology to interact with witnesses or to otherwise comply with the requirements concerning presence as defined in section 7.7 of this chapter, the declarant and the witnesses may use telephonic interaction to witness and sign an out of hospital DNR declaration. A potential witness may not, however, be compelled to only use telephonic interaction when participating in the signing or witnessing of an out of hospital DNR declaration under this subsection. If an out of hospital DNR declaration is signed using telephonic interaction under this subsection:
(1) the:
(A) identity of the declarant must be personally known to the witness;
(B) witness must be able to view a government issued, photographic identification of the declarant; or
(C) witness must be able to ask any question of the declarant that:
(i) authenticates the identity of the declarant; and
(ii) establishes the capacity and sound mind of the declarant to the satisfaction of the witness;
(2) the text of the declaration must specify that the declarant and witnesses used telephonic interaction throughout the witnessing and signing process of the out of hospital DNR declaration; and
(3) the out of hospital DNR declaration is presumed valid if it specifies that the declarant and the witnesses witnessed and signed the declaration in compliance with Indiana law.
A health care provider or person who disputes the validity of an out of hospital DNR declaration described under this subsection has the burden of proving the invalidity of the declaration or noncompliance with this subsection, as applicable, by a preponderance of the evidence.
(g) An out of hospital DNR declaration must be issued on the form specified in section 15 of this chapter.
As added by P.L.148-1999, SEC.12. Amended by P.L.50-2021, SEC.49; P.L.9-2022, SEC.31; P.L.36-2022, SEC.4; P.L.86-2023, SEC.4.