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An Act
ENROLLED HOUSE
BILL NO. 1687 By: Roe of the House
and
Rosino of the Senate
An Act relating to advance health care directives;
creating the Uniform Health Care Decisions Act of
2026; providing short title; defining terms;
establishing requirements to show capacity; providing
for presumption of capacity under certain
circumstances; providing for rebuttal of certain
presumption; requiring certain notice; establishing
procedures to object to certain finding; authorizing
judicial review of certain finding; authorizing
creation of health care instruction; establishing
requirements for health care instruction;
establishing requirements for creation of power of
attorney for health care; authorizing creation of
advance mental health care directive; establishing
requirements for advance mental health care
directive; establishing requirements for conflicting
health care directives; providing optional form for
advance health care directive; authorizing default
surrogate who is a member of certain classes;
establishing requirements for default surrogate;
establishing procedures for disagreement of default
surrogates; providing for disqualification of certain
persons for acting as default surrogate; authorizing
revocation of certain appointment, designation, or
instruction; establishing requirements for validity
of directives created out of state; directing
resolution of conflicts of law; establishing duties
of agent or default surrogate; providing for
commencement and ceasing of powers of agent or
default surrogate; prohibiting certain actions by
agent or default surrogate; authorizing appointment
of coagents and alternate agents; prohibiting
authorization of certain persons to serve as agent or
default surrogate; establishing certain duties for
ENR. H. B. NO. 1687 Page 2
health care professionals and health care
institutions; defining term; authorizing certain
decisions by guardians; providing immunity from civil
or criminal liability for certain health care
professionals or institutions; prohibiting certain
conduct; providing for award of damages; authorizing
issuance of certain court orders upon petition;
construing provisions; requiring court to consider
uniformity of law under certain circumstances;
providing for validity of certain advance directives;
clarifying applicability of act; requiring issuance
of court order upon certain motion; repealing 63 O.S.
2021, Sections 3101.1, 3101.2, 3101.3, 3101.4,
3101.5, 3101.6, 3101.7, 3101.8, 3101.9, 3101.10,
3101.11, as amended by Section 737, Chapter 486,
O.S.L. 2025, 3101.12, 3101.13, 3101.14, 3101.15,
3101.16, 3102.4, as amended by Section 15, Chapter
136, O.S.L. 2022, and 3102.5 (63 O.S. Supp. 2025,
Sections 3101.11 and 3102.4), which relate to the
Oklahoma Advance Directive Act; repealing Sections 1,
2, 3, as amended by Section 1, Chapter 154, O.S.L.
2023, 4, 5, as amended by Section 2, Chapter 154,
O.S.L. 2023, 6, 7, 8, 9, 10, 11, 12, and 13, Chapter
136, O.S.L. 2022 (63 O.S. Supp. 2025, Sections
3111.1, 3111.2, 3111.3, 3111.4, 3111.5, 3111.6,
3111.7, 3111.8, 3111.9, 3111.10, 3111.11, 3111.12,
and 3111.13), which relate to the Oklahoma Health
Care Agent Act; providing for codification; and
providing an effective date.
SUBJECT: Advance health care directives
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.1 of Title 63, unless there
is created a duplication in numbering, reads as follows:
This act shall be known and may be cited as the “Uniform Health
Care Decisions Act of 2026”.
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SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.2 of Title 63, unless there
is created a duplication in numbering, reads as follows:
As used in this act:
1. “Advance health care directive” means a power of attorney
for health care, health care instruction, or both. The term
includes an advance mental health care directive;
2. “Advance mental health care directive” means a power of
attorney for health care, health care instruction, or both, created
under Section 9 of this act;
3. “Agent” means an individual appointed under a power of
attorney for health care to make a health care decision for the
individual who made the appointment. The term includes a coagent or
alternate agent appointed under Section 20 of this act;
4. “Capacity” means having capacity under Section 3 of this
act;
5. “Cohabitant” means each of two individuals who have been
living together as a couple for at least one (1) year after each
became an adult or was emancipated and who are not married to one
another;
6. “Default surrogate” means an individual authorized under
Section 12 of this act to make a health care decision for another
individual;
7. “Electronic” means relating to technology having electrical,
digital, magnetic, wireless, optical, electromagnetic, or similar
capabilities;
8. “Family member” means a spouse, domestic partner, adult
child, parent, or grandparent, or an adult descendant of a spouse,
child, parent, or grandparent;
9. “Guardian” means a person appointed under law by a court to
make decisions regarding the personal affairs of an individual,
which may include health care decisions. The term does not include
a guardian ad litem;
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10. “Health care” means care or treatment or a service or
procedure to maintain, monitor, diagnose, or otherwise affect an
individual’s physical or mental illness, injury, or condition. The
term includes mental health care;
11. “Health care decision” means a decision made by an
individual or the individual’s surrogate regarding the individual’s
health care, including:
a. selection or discharge of a health care professional
or health care institution,
b. approval or disapproval of a diagnostic test, surgical
procedure, medication, therapeutic intervention, or
other health care,
c. direction to provide, withhold, or withdraw mechanical
ventilation or other health care, and
d. direction to provide, withhold, or withdraw
artificially administered hydration or nutrition,
subject to the limitations of the Hydration and
Nutrition for Incompetent Patients Act;
12. “Health care institution” means a facility or agency
licensed, certified, or otherwise authorized or permitted by other
law to provide health care in this state in the ordinary course of
business;
13. “Health care instruction” means a direction, whether or not
in a record, made by an individual that indicates the individual’s
goals, preferences, or wishes concerning the provision, withholding,
or withdrawal of health care. The term includes a direction
intended to be effective if a specified condition arises;
14. “Health care professional” means a physician or other
individual licensed, certified, or otherwise authorized or permitted
by other law of this state to provide health care in this state in
the ordinary course of business or the practice of the physician’s
or individual’s profession;
15. “Individual” means an adult or emancipated minor;
16. “Life-sustaining care” and “life-sustaining treatment” mean
health care that, in reasonable medical judgment, will be most
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likely to be effective in ameliorating an individual’s life-
threatening conditions;
17. “Mental health care” means care or treatment or a service
or procedure to maintain, monitor, diagnose, or otherwise affect an
individual’s mental illness or other psychiatric, psychological, or
psychosocial condition;
18. “Nursing home” means a nursing facility as defined in
Section 1919(a)(1) of the Social Security Act, 42 U.S.C., Section
1396r(a)(1), as amended, or skilled nursing facility as defined in
Section 1819(a)(1) of the Social Security Act, 42 U.S.C., Section
1395i–3(a)(1), as amended;
19. “Person” means an individual, estate, business or nonprofit
entity, government or governmental subdivision, agency, or
instrumentality, or other legal entity;
20. “Person interested in the welfare of the individual” means:
a. the individual’s surrogate,
b. a family member of the individual,
c. the cohabitant of the individual,
d. a public entity providing health care case management
or protective services to the individual,
e. a person appointed under other law to make decisions
for the individual under a power of attorney for
finances, or
f. a person that has an ongoing personal or professional
relationship with the individual, including a person
that has provided educational or health care services
or supported decision making to the individual;
21. “Physician” means an individual authorized to practice
medicine from the State Board of Medical Licensure and Supervision
or the State Board of Osteopathic Examiners;
22. “Power of attorney for health care” means a record in which
an individual appoints an agent to make health care decisions for
the individual;
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23. “Reasonable medical judgment” means a health care judgment
that would be made by a reasonably prudent physician knowledgeable
about the medical conditions involved and the treatment
possibilities with respect to such conditions;
24. “Reasonably available” means being able to be contacted
without undue effort and being willing and able to act in a timely
manner considering the urgency of an individual’s health care
situation. When used to refer to an agent or default surrogate, the
term includes being willing and able to comply with the duties under
Section 17 of this act in a timely manner considering the urgency of
an individual’s health care situation;
25. “Record” means information:
a. inscribed on a tangible medium, or
b. stored in an electronic or other medium and
retrievable in perceivable form;
26. “Responsible health care professional” means:
a. a health care professional designated by an individual
or the individual’s surrogate to have primary
responsibility for the individual’s health care or for
overseeing a course of treatment, or
b. in the absence of a designation under subparagraph a
of this paragraph, or if the professional designated
under subparagraph a of this paragraph is not
reasonably available, a health care professional who
has primary responsibility for overseeing the
individual’s health care or for overseeing a course of
treatment;
27. “Sign” means with present intent to authenticate or adopt a
record:
a. executing or adopting a tangible symbol, or
b. attaching to or logically associating with the record
an electronic symbol, sound, or process;
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28. “State” means a state of the United States, the District of
Columbia, the Commonwealth of Puerto Rico, the United States Virgin
Islands, or any other territory, or possession subject to the
jurisdiction of the United States. The term includes a federally
recognized Indian tribe;
29. “Supported decision making” means assistance, from one or
more persons of an individual’s choosing, that helps the individual
make or communicate a decision, including by helping the individual
understand the nature and consequences of the decision; and
30. “Surrogate” means:
a. an agent,
b. a default surrogate, or
c. a guardian authorized to make health care decisions.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.3 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. An individual has capacity for the purpose of this act if
the individual:
1. Is willing and able to communicate a decision independently
or with appropriate services, technological assistance, supported
decision making, or other reasonable accommodation; and
2. In making or revoking:
a. a health care decision, understands the nature and
consequences of the decision, including the primary
risks and benefits of the decision,
b. a health care instruction, understands the nature and
consequences of the instruction, including the primary
risks and benefits of the choices expressed in the
instruction, and
c. an appointment of an agent under a health care power
of attorney or identification of a default surrogate
under paragraph 1 of subsection B of Section 12 of
this act, recognizes the identity of the individual
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being appointed or identified and understands the
general nature of the relationship of the individual
making the appointment or identification with the
individual being appointed or identified.
B. The right of an individual who has capacity to make a
decision about the individual’s health care is not affected by
whether the individual creates or revokes an advance health care
directive.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.4 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. An individual is presumed to have capacity to make or revoke
a health care decision, health care instruction, and power of
attorney for health care unless:
1. A court has found the individual lacks capacity to do so; or
2. The presumption is rebutted under subsection B of this
section.
B. Subject to Sections 5 and 6 of this act, a presumption under
subsection A of this section may be rebutted by a finding that the
individual lacks capacity:
1. Subject to subsection C of this section, made on the basis
of a contemporaneous examination by any of the following:
a. a physician,
b. a psychologist licensed or otherwise authorized to
practice in this state,
c. an individual with training and expertise in the
finding of lack of capacity who is licensed or
otherwise authorized to practice in this state as an
Advanced Practice Registered Nurse, a physician
assistant, or a social worker, or
d. a responsible health care professional not described
in subparagraph a, b, or c of this paragraph if:
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(1) the individual about whom the finding is to be
made is experiencing a health condition requiring
a decision regarding health care treatment to be
made promptly to avoid loss of life or serious
harm to the health of the individual, and
(2) an individual listed in subparagraph a, b, or c
of this paragraph is not reasonably available;
2. Made in accordance with accepted standards of the profession
and the scope of practice of the individual making the finding and
to a reasonable degree of certainty; and
3. Documented in a record signed by the individual making the
finding that includes an opinion of the cause, nature, extent, and
probable duration of the lack of capacity.
C. The finding under subsection B of this section may not be
made by:
1. A family member of the individual presumed to have capacity;
2. The cohabitant of the individual or a descendant of the
cohabitant; or
3. The individual’s surrogate, a family member of the
surrogate, or a descendant of the surrogate.
D. If the finding under subsection B of this section was based
on a condition the individual no longer has or a responsible health
care professional subsequently has good cause to believe the
individual has capacity, the individual is presumed to have capacity
unless a court finds the individual lacks capacity or the
presumption is rebutted under subsection B of this section.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.5 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. As soon as reasonably feasible, an individual who makes a
finding under subsection B of Section 4 of this act shall inform the
individual about whom the finding was made or the individual’s
responsible health care professional of the finding.
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B. As soon as reasonably feasible, a responsible health care
professional who is informed of a finding under subsection B of
Section 4 of this act shall inform the individual about whom the
finding was made and the individual’s surrogate.
C. An individual found under subsection B of Section 4 of this
act to lack capacity may object to the finding:
1. By orally informing a responsible health care professional;
2. In a record provided to a responsible health care
professional or the health care institution in which the individual
resides or is receiving care; or
3. By another act that clearly indicates the individual’s
objection.
D. If the individual objects under subsection C of this
section, the finding under subsection B of Section 4 of this act is
not sufficient to rebut a presumption of capacity under subsection A
of Section 4 of this act and the individual shall be treated as
having capacity unless:
1. The individual withdraws the objection;
2. A court finds the individual lacks the presumed capacity;
3. The individual is experiencing a health condition requiring
a decision regarding health care treatment to be made promptly to
avoid imminent loss of life or serious harm to the health of the
individual; or
4. Subject to subsection B of this section, the finding is
confirmed by a second finding made by an individual authorized under
paragraph 1 of subsection B of Section 4 of this act who:
a. did not make the first finding,
b. is not a family member of the individual who made the
first finding, and
c. is not the cohabitant of the individual who made the
first finding or a descendant of the cohabitant.
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E. Neither a finding in the circumstances described in
paragraph 3 of subsection D of this section nor a second finding
that the individual lacks capacity under paragraph 4 of subsection D
of this section shall be sufficient to rebut the presumption of
capacity if the individual is requesting the provision or
continuation of life-sustaining treatment and the finding is being
used to make a decision to withhold or withdraw the treatment.
F. As soon as reasonably feasible, a health care professional
who is informed of an objection under subsection C of this section
shall:
1. Communicate the objection to a responsible health care
professional; and
2. Document the objection and the date of the objection in the
individual’s medical record or communicate the objection and the
date of the objection to an administrator with responsibility for
medical records of the health care institution providing health care
to the individual, who shall document the objection and the date of
the objection in the individual’s medical record.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.6 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. An individual found under subsection B of Section 4 of this
act to lack capacity, a responsible health care professional, the
health care institution providing health care to the individual, or
a person interested in the welfare of the individual may petition
the court in the respective county in which the individual resides
or is located to determine whether the individual lacks capacity.
B. The court in which a petition under subsection A of this
section is filed shall appoint legal counsel to represent the
individual if the individual does not have legal counsel. The court
shall hear the petition as soon as possible, but not later than
seven (7) days after the petition is filed. As soon as possible,
but not later than seven (7) days after the hearing, the court shall
determine whether the individual lacks capacity. The court may
determine that the individual lacks capacity only if the court finds
by clear and convincing evidence that the individual lacks capacity.
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SECTION 7. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.7 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. An individual may create a health care instruction that
expresses the individual’s preferences for future health care,
including preferences regarding:
1. Health care professionals or health care institutions;
2. How a health care decision will be made and communicated;
3. Persons that should or should not be consulted regarding a
health care decision;
4. A person to serve as guardian for the individual if one is
appointed; and
5. An individual to serve as a default surrogate.
B. A health care professional to whom an individual
communicates or provides an instruction under subsection A of this
section shall document the instruction and the date of the
instruction in the individual’s medical record or communicate the
instruction and date of the instruction to an administrator with
responsibility for medical records of the health care institution
providing health care to the individual, who shall document the
instruction and the date of the instruction in the individual’s
medical record.
C. A health care instruction made by an individual that
conflicts with an earlier health care instruction made by the
individual, including an instruction documented in a medical order,
revokes the earlier instruction to the extent of the conflict.
D. A health care instruction may be in the same record as a
power of attorney for health care.
SECTION 8. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.8 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. An individual may create a power of attorney for health care
to appoint an agent to make health care decisions for the
individual.
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B. An individual shall be disqualified from acting as agent for
an individual who lacks capacity to make health care decisions if:
1. A court finds that the potential agent poses a danger to the
individual’s well-being, even if the court does not issue a
restraining order against the potential agent; or
2. The potential agent is an owner, operator, employee, or
contractor of a nursing home, or other residential care facility, in
which the individual resides or is receiving care, unless the owner,
operator, employee, or contractor is a family member of the
individual, the cohabitant of the individual, or a descendant of the
cohabitant.
C. A health care decision made by an agent is effective without
judicial approval.
D. A power of attorney for health care shall be in a record,
signed by the individual creating the power, and signed by an adult
witness who:
1. Reasonably believes the act of the individual to create the
power of attorney is voluntary and knowing; and
2. Is not:
a. the agent appointed by the individual,
b. the agent’s spouse or cohabitant, or
c. if the individual resides or is receiving care in a
nursing home, or other residential care facility, the
owner, operator, employee, or contractor of the
nursing home or other residential care facility; and
3. Is present when the individual signs the power of attorney
or when the individual represents that the power of attorney
reflects the individual’s wishes.
E. A witness under subsection D of this section is considered
present if the witness and the individual are:
1. Physically present in the same location;
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2. Using electronic means that allow for real time audio and
visual transmission and communication in real time to the same
extent as if the witness and the individual were physically present
in the same location; or
3. Able to speak to and hear each other in real time through
audio connection if:
a. the identity of the individual is personally known to
the witness, or
b. the witness is able to authenticate the identity of
the individual by receiving accurate answers from the
individual that enables the authentication.
F. A power of attorney for health care may include a health
care instruction.
SECTION 9. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.9 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. An individual may create an advance health care directive
that addresses only mental health care for the individual. The
advance mental health care directive may include a health care
instruction, a power of attorney for health care, or both.
B. A health care instruction under this section may include the
individual’s:
1. General philosophy and objectives regarding mental health
care; and
2. Specific goals, preferences, and wishes regarding the
provision, withholding, or withdrawal of a form of mental health
care, including:
a. preferences regarding professionals, programs, and
facilities,
b. admission to a mental health facility, including
duration of admission,
c. preferences regarding medications,
ENR. H. B. NO. 1687 Page 15
d. refusal to accept a specific type of mental health
care, including a medication, and
e. preferences regarding crisis intervention.
C. A power of attorney for health care under this section may
appoint an agent to make decisions only for mental health care.
D. An individual may direct in an advance mental health care
directive that, if the individual is experiencing a psychiatric or
psychological event specified in the directive, the individual may
not revoke the directive or a part of the directive.
E. If an advance mental health care directive includes a
direction under subsection D of this section, the advance mental
health care directive shall be in a record that is separate from any
other advance health care directive created by the individual and
signed by the individual creating the advance mental health care
directive and at least two adult witnesses who:
1. Attest that to the best of their knowledge the individual:
a. understood the nature and consequences of the
direction, including its risks and benefits, and
b. made the direction voluntarily and without coercion or
undue influence;
2. Are not:
a. the agent appointed by the individual,
b. the agent’s spouse, or cohabitant, and
c. if the individual resides in a nursing home, or other
residential care facility, the owner, operator,
employee, or contractor of the nursing home or other
residential care facility; and
3. Are physically present in the same location as the
individual.
SECTION 10. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.10 of Title 63, unless
there is created a duplication in numbering, reads as follows:
ENR. H. B. NO. 1687 Page 16
A. If a direction in an advance mental health care directive of
an individual conflicts with a direction in another advance health
care directive of the individual, the later direction revokes the
earlier direction to the extent of the conflict.
B. An appointment of an agent to make decisions only for mental
health care for an individual does not revoke an earlier appointment
of an agent to make other health care decisions for the individual.
A later appointment revokes the authority of an agent under the
earlier appointment to make decisions about mental health care
unless otherwise specified in the power of attorney making the later
appointment.
C. An appointment of an agent to make health care decisions for
an individual other than decisions about mental health care made
after appointment of an agent authorized to make only mental health
care decisions does not revoke the appointment of the agent
authorized to make only mental health care decisions.
SECTION 11. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.11 of Title 63, unless
there is created a duplication in numbering, reads as follows:
The following form may be used to create an advance health care
directive:
ADVANCE HEALTH CARE DIRECTIVE
HOW YOU CAN USE THIS FORM
You can use this form if you wish to name someone to make health
care decisions for you in case you cannot make decisions for
yourself. This is called giving the person a power of attorney for
health care. This person is called your agent.
You can also use this form to state your wishes, preferences,
and goals for health care, and to say if you want to be an organ
donor after you die.
YOUR NAME AND DATE OF BIRTH
Name:
Date of birth:
ENR. H. B. NO. 1687 Page 17
PART A: NAMING AN AGENT
This part lets you name someone else to make health care
decisions for you. You may leave any item blank.
1. NAMING AN AGENT
I want the following person to make health care decisions for me
if I cannot make decisions for myself:
Name:
Optional contact information (it is helpful to include
information such as address, phone, and email):
2. NAMING AN ALTERNATE AGENT
I want the following person to make health care decisions for me
if I cannot and my agent is not able or available to make them for
me:
Name:
Optional contact information (it is helpful to include
information such as address, phone, and email):
3. LIMITING YOUR AGENT’S AUTHORITY
I give my agent the power to make all health care decisions for
me if I cannot make those decisions for myself, except the
following:
(If you do not add a limitation here, your agent will be able to
make all health care decisions that an agent is permitted to make
under state law. State law does not permit your agent to withhold
or withdraw food and liquids needed for you to stay alive except as
you specify in this document or by any other means the law
provides.)
PART B: HEALTH CARE INSTRUCTIONS
This part lets you state your priorities for health care and to
state types of health care you do and do not want.
ENR. H. B. NO. 1687 Page 18
1. INSTRUCTIONS ABOUT LIFE-SUSTAINING TREATMENT
This section gives you the opportunity to say how you want your
agent to act while making decisions for you. You may mark or
initial each choice. You also may leave any choice blank.
Treatment. Medical treatment needed to keep me alive but not
needed for comfort or any other purpose should (mark or initial all
that apply):
(____) Always be given to me. (If you mark or initial this
choice, you should not mark or initial other choices in this
“treatment” section.)
(____) Not be given to me if I have a condition that is not
curable and is expected to cause me to die within two weeks, even if
treated.
(____) Not be given to me if I am unconscious and I am not
expected to be conscious again.
(____) Not be given to me if I have a medical condition from
which I am not expected to recover that prevents me from
communicating with people I care about, caring for myself, and
recognizing family and friends.
(____) Other (write what you want or do not want):
Food and liquids. If I can’t swallow and staying alive requires
me to get food or liquids through a tube or other means for the rest
of my life, then food or liquids should (mark or initial all that
apply):
(____) Always be given to me. (If you mark or initial this
choice, you should not mark or initial other choices in this “food
and liquids” section.)
(____) Not be given to me if I have a condition that is not
curable and is expected to cause me to die within two weeks, even if
treated.
(____) Not be given to me if I am unconscious and am not
expected to be conscious again.
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(____) Not be given to me if I have a medical condition from
which I am not expected to recover that prevents me from
communicating with people I care about, caring for myself, and
recognizing family and friends.
(____) Other (write what you want or do not want):
Pain relief. If I am in significant pain, care that will keep
me comfortable but is likely to shorten my life should (mark or
initial all that apply):
(____) Always be given to me. (If you mark or initial this
choice, you should not mark or initial other choices in this “pain
relief” section.)
(____) Never be given to me. (If you mark or initial this
choice, you should not mark or initial other choices in this “pain
relief” section.)
(____) Be given to me if I have a condition that is not curable
and is expected to cause me to die soon, even if treated.
(____) Be given to me if I am unconscious and am not expected
to be conscious again.
(____) Be given to me if I have a medical condition from which
I am not expected to recover that prevents me from communicating
with people I care about, caring for myself, and recognizing family
and friends.
(____) Other (write what you want or do not want):
2. MY PRIORITIES
You can use this section to indicate what is important to you,
and what is not important to you. This information can help your
agent make decisions for you if you cannot. It also helps others
understand your preferences.
You may leave any choice blank.
My priorities:
____________________________________________________________________
____________________________________________________________________
ENR. H. B. NO. 1687 Page 20
____________________________________________________________________
____________________________________________________________________
Having my agent talk with my family before making decisions
about my care is:
(____) Very important
(____) Somewhat important
(____) Not important
Having my agent talk with my friends before making decisions
about my care is:
(____) Very important
(____) Somewhat important
(____) Not important
3. OTHER INSTRUCTIONS
You can write in this section more information about your goals,
values, and preferences for treatment, including care you want or do
not want. You can also use this section to name anyone who you do
not want to make decisions for you under any conditions.
PART C: OPTIONAL SPECIAL POWERS AND GUIDANCE
This part lets you give your agent additional powers, and to
provide more guidance about your wishes. You may mark or initial
each choice. You also may leave any choice blank.
1. OPTIONAL SPECIAL POWERS
My agent can do the following things ONLY if I have marked or
initialed them below:
(____) Consent to withholding of food or liquid provided
through a tube or by other means and required to keep me alive. (If
I do not mark or initial this choice, my agent MAY NOT prevent me
from receiving such food or liquid.)
ENR. H. B. NO. 1687 Page 21
(____) Admit me as a voluntary patient to a facility for mental
health treatment for up to _____ days (write in the number of days
you want like 7, 14, 30, or another number). (If I do not mark or
initial this choice, my agent MAY NOT admit me as a voluntary
patient to this type of facility.)
(____) Place me in a nursing home, other than a short-term
placement for rehabilitation following hospitalization, even if my
needs can be met somewhere else. (If I do not mark or initial this
choice, my agent MAY NOT do this.)
2. ACCESS TO MY HEALTH INFORMATION
My agent may obtain, examine, and share information about my
health needs and health care if I am not able to make decisions for
myself. If I mark or initial below, my agent may also do that at
any time my agent thinks it will help me.
(____) I give my agent permission to obtain, examine, and share
information about my health needs and health care whenever my agent
thinks it will help me.
3. FLEXIBILITY FOR MY AGENT
Mark or initial below if you want to give your agent flexibility
in following instructions you provide in this form. If you do not,
your agent must follow the instructions even if your agent thinks
something else would be better for you.
(____) I give my agent permission to be flexible in applying
these instructions if my agent thinks it would be in my best
interest based on what my agent knows about me.
4. NOMINATION OF GUARDIAN
You can say who you would want as your guardian if you needed
one. A guardian is a person appointed by a court to make decisions
for someone who cannot make decisions. Filling this out does NOT
mean you want or need a guardian.
If a court appoints a guardian to make personal decisions for
me, I want the court to choose:
(____) My agent named in this form. If my agent cannot be a
guardian, I want the alternate agent named in this form.
ENR. H. B. NO. 1687 Page 22
(____) Other (write who you would want and their contact
information):
PART D: ORGAN DONATION
This part lets you donate your organs after you die. You may
leave any item blank. If you leave both choices under “DONATION”
blank, your health care agent may decide whether your organs will be
donated.
1. DONATION
You may mark or initial only one choice.
(____) I donate my organs, tissues, and other body parts after
I die, even if it requires maintaining treatments that conflict with
other instructions I have put in this form, EXCEPT for those I list
below (list any body parts you do NOT want to donate):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
(____) I do not want my organs, tissues, or body parts donated
to anybody for any reason. (If you mark or initial this choice, you
should skip the “PURPOSE OF DONATION” section.)
2. PURPOSE OF DONATION
You may mark or initial all that apply. (If you do not mark or
initial any of the purposes below, your donation can be used for all
of them.)
(____) Transplant
(____) Therapy
(____) Research
(____) Education
(____) All of the above
ENR. H. B. NO. 1687 Page 23
PART E: SIGNATURES
YOUR SIGNATURE
Sign your name:
Today’s date:
City/Town/Village and State (optional):
SIGNATURE OF A WITNESS
You need a witness if you are using this form to name an agent.
The witness must be an adult and cannot be the person you are naming
as agent or the agent’s spouse, or someone the agent lives with as a
couple. If you live or are receiving care in a nursing home, the
witness cannot be an employee or contractor of the home or someone
who owns or runs the home.
Name of Witness:
Signature of Witness:
(Only sign as a witness if you think the person signing above is
doing it voluntarily.)
Date witness signed:
PART F: INFORMATION FOR AGENTS
1. If this form names you as an agent, you can make decisions
about health care for the person who named you when the person
cannot make their own.
2. If you make a decision for the person, follow any
instructions the person gave, including any in this form.
3. If you do not know what the person would want, make the
decision that you think is in the person’s best interest. To figure
out what is in the person’s best interest, consider the person’s
values, preferences, and goals if you know them or can learn them.
Some of these preferences may be in this form. You should also
consider any behavior or communication from the person that
indicates what the person currently wants.
ENR. H. B. NO. 1687 Page 24
4. If this form names you as an agent, you can also get and
share the person’s health information. Unless the person has said
so in this form, you can get or share this information only when the
person cannot make decisions about the person’s health care.
SECTION 12. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.12 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. A default surrogate may make a health care decision for an
individual who lacks capacity to make health care decisions and for
whom an agent, or guardian authorized to make health care decisions,
has not been appointed or is not reasonably available.
B. Unless the individual has an advance health care directive
that indicates otherwise, a member of the following classes, in
descending order of priority, who is reasonably available and not
disqualified under Section 14 of this act, may act as a default
surrogate for the individual:
1. An adult the individual has identified, other than in a
power of attorney for health care, to make a health care decision
for the individual if the individual cannot make the decision;
2. The individual’s spouse, unless:
a. a petition for annulment, divorce, dissolution of
marriage, legal separation, or termination has been
filed and not dismissed or withdrawn,
b. a decree of annulment, divorce, dissolution of
marriage, legal separation, or termination has been
issued,
c. the individual and the spouse have agreed in a record
to a legal separation, or
d. the spouse has abandoned the individual for more than
one (1) year;
3. The individual’s adult child or parent;
4. The individual’s cohabitant;
5. The individual’s adult sibling;
ENR. H. B. NO. 1687 Page 25
6. The individual’s adult grandchild or grandparent;
7. An adult not listed in paragraphs 1 through 6 of this
subsection who has assisted the individual with supported decision
making routinely during the preceding six (6) months;
8. The individual’s adult stepchild not listed in paragraphs 1
through 7 of this subsection whom the individual actively parented
during the stepchild’s minor years and with whom the individual has
an ongoing relationship; or
9. An adult not listed in paragraphs 1 through 8 of this
subsection who has exhibited special care and concern for the
individual and is familiar with the individual’s personal values.
C. A responsible health care professional may require an
individual who assumes authority to act as a default surrogate to
provide a declaration in a record under penalty of perjury stating
facts and circumstances reasonably sufficient to establish the
authority.
D. If a responsible health care professional reasonably
determines that an individual who assumed authority to act as a
default surrogate is not willing or able to comply with a duty under
Section 17 of this act or fails to comply with the duty in a timely
manner, the professional may recognize the individual next in
priority under subsection B of this section as the default
surrogate.
E. A health care decision made by a default surrogate is
effective without judicial approval.
F. Prior to making a health care decision for an individual
pursuant to subsection A of this section, a responsible health care
professional may require a default surrogate to provide to the
responsible health care professional a signed copy of the following
statement to be entered into the patient’s medical record:
“I hereby certify that:
I have not been convicted of, pleaded guilty to, or pleaded no
contest to the crimes of abuse, verbal abuse, neglect, or financial
exploitation by a caregiver; exploitation of an elderly person or
ENR. H. B. NO. 1687 Page 26
disabled adult; or abuse, neglect, exploitation, or sexual abuse of
a child;
I have not been found to have committed abuse, verbal abuse, or
exploitation by a final investigative finding of the State
Department of Health or the Department of Human Services or by a
finding of an administrative law judge, unless it was overturned on
appeal; and I have not been criminally charged as a person
responsible for the care of a vulnerable adult with a crime
resulting in the death or near death of a vulnerable adult.”
SECTION 13. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.13 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. A default surrogate who assumes authority under Section 12
of this act shall inform a responsible health care professional if
two or more members of a class under subsection B of Section 12 of
this act have assumed authority to act as default surrogates and the
members do not agree on a health care decision.
B. A responsible health care professional shall comply with the
decision of a majority of the members of the class with highest
priority under subsection B of Section 12 of this act who have
communicated their views to the professional and who the
professional reasonably believes are acting consistently with their
duties under Section 17 of this act.
C. If a responsible health care professional is informed that
the members of the class who have communicated their views to the
professional are evenly divided concerning the health care decision,
the professional shall make a reasonable effort to solicit the views
of members of the class who are reasonably available but have not
yet communicated their views to the professional. The professional,
after the solicitation, shall comply with the decision of a majority
of the members who have communicated their views to the professional
and who the professional reasonably believes are acting consistently
with their duties under Section 17 of this act.
D. If the class remains evenly divided after the effort is made
under subsection C of this section, the health care decision shall
be made as provided by other laws of this state regarding the
treatment of an individual who is found to lack capacity.
ENR. H. B. NO. 1687 Page 27
E. Nothing in this section shall be construed to supersede or
limit the remedies available under Section 27 of this act.
SECTION 14. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.14 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. An individual for whom a health care decision would be made
may disqualify another individual from acting as default surrogate
for the first individual. The disqualification shall be in a record
signed by the first individual or communicated verbally or
nonverbally to the individual being disqualified, another
individual, or a responsible health care professional.
Disqualification under this subsection shall be effective even if
made by an individual who lacks capacity to make an advance
directive if the individual clearly communicates a desire that the
individual being disqualified cannot make health care decisions for
the individual.
B. An individual is disqualified from acting as a default
surrogate for an individual who lacks capacity to make health care
decisions if:
1. A court finds that the potential default surrogate poses a
danger to the individual’s well-being, even if the court does not
issue a restraining order against the potential surrogate;
2. The potential default surrogate is an owner, operator,
employee, or contractor of a nursing home, or other residential care
facility, in which the individual is residing or receiving care
unless the owner, operator, employee, or contractor is a family
member of the individual, the cohabitant of the individual, or a
descendant of the cohabitant; or
3. The potential default surrogate refuses to provide a timely
declaration under subsection C or F of Section 12 of this act.
SECTION 15. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.15 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. An individual may revoke the appointment of an agent, the
designation of a default surrogate, or a health care instruction in
whole or in part, unless:
ENR. H. B. NO. 1687 Page 28
1. A court finds the individual lacks capacity to do so;
2. The individual is found under subsection B of Section 4 of
this act to lack capacity to do so, and if the individual objects to
the finding, the finding is confirmed under paragraph 4 of
subsection D of Section 5 of this act and is not revoked under
Section 6 of this act; or
3. The individual created an advance mental health care
directive that includes the provision under subsection D of Section
9 of this act, and the individual is experiencing the psychiatric or
psychological event specified in the directive.
B. Revocation under subsection A of this section may be by any
act of the individual that clearly indicates that the individual
intends to revoke the appointment, designation, or instruction,
including an oral statement to a health care professional.
C. Except as provided in Section 10 of this act, an advance
health care directive of an individual that conflicts with another
advance health care directive of the individual revokes the earlier
directive to the extent of the conflict.
D. Unless otherwise provided in an individual’s advance health
care directive appointing an agent, the appointment of a spouse of
an individual as agent for the individual is revoked if:
1. A petition for annulment, divorce, dissolution of marriage,
legal separation, or termination has been filed and not dismissed or
withdrawn;
2. A decree of annulment, divorce, dissolution of marriage,
legal separation, or termination has been issued;
3. The individual and the spouse have agreed in a record to a
legal separation; or
4. The spouse has abandoned the individual for more than one
(1) year.
SECTION 16. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.16 of Title 63, unless
there is created a duplication in numbering, reads as follows:
ENR. H. B. NO. 1687 Page 29
A. Subject to subsection C of Section 19 of this act, an
advance health care directive created outside this state is valid if
it complies with:
1. The law of the state specified in the directive or, if a
state is not specified, the state in which the individual created
the directive; or
2. The provisions of this act.
B. A person may assume without inquiry that an advance health
care directive is genuine, valid, and still in effect, and may
implement and rely on it, unless the person has good cause to
believe the directive is invalid or has been revoked.
C. An advance health care directive, revocation of a directive,
or a signature on a directive or revocation may not be denied legal
effect or enforceability solely because it is in electronic form.
D. Evidence relating to an advance health care directive,
revocation of a directive, or a signature on a directive or
revocation may not be excluded in a proceeding solely because the
evidence is in electronic form.
E. This act shall not affect the validity of an electronic
record or signature that is valid under Section 15-101 et seq. of
Title 12A of the Oklahoma Statutes.
F. Except as provided in subsections D and E of Section 19,
Section 21, subsection H of Section 22, and subsections A and D of
Section 28 of this act, if this act conflicts with any other law of
this state relating to the creation, execution, implementation, or
revocation of an advance health care directive, the provisions of
this act shall prevail.
SECTION 17. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.17 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. An agent or default surrogate has a fiduciary duty to the
individual for whom the agent or default surrogate is acting when
exercising or purporting to exercise a power under Section 18 of
this act.
ENR. H. B. NO. 1687 Page 30
B. An agent or default surrogate shall make a health care
decision in accordance with the direction of the individual in an
advance health care directive and other goals, preferences, and
wishes of the individual to the extent known or reasonably
ascertainable by the agent or default surrogate.
C. If there is not a direction in an advance health care
directive and the goals, preferences, and wishes of the individual
regarding a health care decision are not known or reasonably
ascertainable by the agent or default surrogate, the agent or
default surrogate shall make the decision in accordance with the
agent’s or default surrogate’s reasonable determination of the
individual’s best interest.
D. In determining the individual’s best interest under
subsection C of this section, the agent or default surrogate shall:
1. Give primary consideration to the individual’s
contemporaneous communications, including verbal and nonverbal
expressions;
2. Consider the individual’s values to the extent known or
reasonably ascertainable by the agent or default surrogate; and
3. Consider the risks and benefits of the potential health care
decision.
E. As soon as reasonably feasible, an agent or default
surrogate who is informed of a revocation of an advance health care
directive or disqualification of the agent or default surrogate
shall communicate the revocation or disqualification to a
responsible health care professional.
SECTION 18. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.18 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. Except as provided in subsection C of this section, the
power of an agent or default surrogate commences when the individual
is found under subsection B of Section 4 of this act or by a court
to lack capacity to make a health care decision. The power shall
cease if the individual later is found to have capacity to make a
health care decision, or the individual objects under subsection C
of Section 5 of this act to the finding of lack of capacity under
ENR. H. B. NO. 1687 Page 31
subsection B of Section 4 of this act. Subject to subsection E of
Section 5 of this act, the power shall resume if:
1. The power ceased because the individual objected under
subsection C of Section 5 of this act; and
2. The finding of lack of capacity is confirmed under paragraph
4 of subsection D of Section 5 of this act, or a court finds that
the individual lacks capacity to make a health care decision.
B. An agent or default surrogate may request, receive, examine,
copy, and consent to the disclosure of medical and other health care
information about the individual if the individual would have the
right to request, receive, examine, copy, or consent to the
disclosure of the information.
C. A power of attorney for health care may provide that the
power of an agent under subsection B of this section commences on
appointment.
D. If no other person is authorized to do so, an agent or
default surrogate may apply for public or private health insurance
and benefits on behalf of the individual. An agent or default
surrogate who may apply for insurance and benefits does not, solely
by reason of the power, have a duty to apply for the insurance or
benefits.
E. An agent or default surrogate may not consent to voluntary
admission of the individual to a facility for mental health
treatment unless:
1. Voluntary admission is specifically authorized by the
individual in an advance health care directive in a record; and
2. The admission is for no more than the maximum of the number
of days specified in the directive.
F. Except as provided in subsection G of this section, an agent
or default surrogate may not consent to placement of the individual
in a nursing home, other than for short-term rehabilitation services
following hospitalization, if the individual objects to the
placement and a reasonable alternative living arrangement is
feasible.
ENR. H. B. NO. 1687 Page 32
G. If specifically authorized by the individual in an advance
health care directive in a record, an agent or default surrogate may
consent to placement of the individual in a nursing home even if a
reasonable alternative living arrangement is feasible.
SECTION 19. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.19 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. If an individual has a long-term disability requiring
routine treatment by mechanical ventilation and a history of using
the treatment without objection, an agent or default surrogate may
not consent to withhold or withdraw the treatment unless:
1. The treatment is both not necessary to sustain the
individual’s life and not necessary to maintain the individual’s
health or well-being;
2. The individual has expressly authorized the withholding or
withdrawal in a health care instruction that has not been revoked;
or
3. The individual has experienced a life-threatening condition
that is not curable and is expected to cause the individual to die
within two (2) weeks, even if treated, and the individual has not:
a. given a direction inconsistent with withholding or
withdrawal, or
b. communicated by verbal or nonverbal expression a
desire for mechanical ventilation.
B. An advance directive that is executed in this state shall
not be deemed to authorize the withholding or withdrawal of
artificially administered nutrition or hydration unless it
specifically authorizes the withholding or withdrawal of
artificially administered nutrition or hydration in the declarant’s
own words or by a separate section, separate paragraph, or other
separate subdivision that deals only with nutrition or hydration and
which section, paragraph, or other subdivision is separately
initialed, separately signed, or otherwise separately marked by the
declarant.
C. Execution of an advance directive by an individual that
provides for the provision, withholding, or withdrawal of life-
ENR. H. B. NO. 1687 Page 33
sustaining treatment for the individual or for the appointment of
another to give directions to provide, withhold, or withdraw life-
sustaining treatment, executed in another state in compliance with
the laws of that state or of this state, shall be valid for purposes
of the this act to the extent the advance directive does not exceed
authorizations allowed under the laws of this state. No such
advance directive shall be deemed to authorize the withholding or
withdrawal of artificially administered nutrition or hydration
unless it specifically authorizes such withholding or withdrawal,
and the advance directive either:
1. Was executed by a person who was not a resident of this
state at the time of execution; or
2. Specifically authorizes the withholding or withdrawal of
artificially administered nutrition or hydration in the declarant’s
own words or by a separate section, separate paragraph, or other
separate subdivision that deals only with nutrition or hydration,
and such section, paragraph, or other subdivision is separately
initialed, separately signed, or otherwise separately marked by the
person executing the advance directive.
D. Decisions by a default surrogate or agent to consent to
withholding or withdrawal of nutrition or hydration are subject to
the provisions of the Hydration and Nutrition for Incompetent
Patients Act.
E. A default surrogate may not make a health care decision if,
under other laws of this state, the decision:
1. May not be made by a guardian; or
2. May be made by a guardian only if the court appointing the
guardian specifically authorizes the guardian to make the decision.
SECTION 20. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.20 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. An individual in a power of attorney for health care may
appoint multiple individuals as coagents. Unless the power of
attorney provides otherwise, each coagent may exercise independent
authority.
ENR. H. B. NO. 1687 Page 34
B. An individual in a power of attorney for health care may
appoint one or more individuals to act as alternate agents if a
predecessor agent resigns, dies, becomes disqualified, is not
reasonably available, or otherwise is unwilling or unable to act as
agent.
C. Unless the power of attorney provides otherwise, an
alternate agent has the same authority as the original agent:
1. At any time the original agent is not reasonably available
or is otherwise unwilling or unable to act, for the duration of the
unavailability, unwillingness, or inability to act; or
2. If the original agent and all other predecessor agents have
resigned or died or are disqualified from acting as agent.
SECTION 21. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.21 of Title 63, unless
there is created a duplication in numbering, reads as follows:
No person shall be authorized as a default surrogate to make
health care decisions for a patient if that person:
1. Has been convicted of, pled guilty to, or pled no contest to
any violation of Section 843.1, 843.2, 843.4, or 843.5 of Title 21
of the Oklahoma Statutes;
2. Has been found to have committed abuse, verbal abuse, or
exploitation, as defined in Section 10-103 of Title 43A of the
Oklahoma Statutes, by a final State Department of Health or
Department of Human Services investigative finding, or by an
administrative law judge finding, unless that finding has been
overturned through judicial review; or
3. Has been criminally charged as described in subsection B of
Section 10-110.1 of Title 43A of the Oklahoma Statutes, unless the
person has been acquitted or those charges have been finally
dismissed.
SECTION 22. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.22 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. A responsible health care professional who is aware that an
individual has been found to lack capacity to make a decision shall
ENR. H. B. NO. 1687 Page 35
make a reasonable effort to determine if the individual has a
surrogate.
B. If possible before implementing a health care decision made
by a surrogate, a responsible health care professional, as soon as
reasonably feasible, shall communicate to the individual the
decision made and the identity of the surrogate.
C. A responsible health care professional who makes or is
informed of a finding that an individual lacks capacity to make a
health care decision or no longer lacks capacity, or that other
circumstances exist that affect a health care instruction or the
authority of a surrogate, as soon as reasonably feasible, shall:
1. Document the finding or circumstance in the individual’s
medical record; and
2. If possible, communicate to the individual and the
individual’s surrogate the finding or circumstance and that the
individual may object under subsection C of Section 5 of this act to
the finding under subsection B of Section 4 of this act.
D. A responsible health care professional who is informed that
an individual has created or revoked an advance health care
directive, or that a surrogate for an individual has been appointed,
designated, or disqualified, shall:
1. Document the information as soon as reasonably feasible in
the individual’s medical record; and
2. If evidence of the directive, revocation, appointment,
designation, or disqualification is in a record, request a copy and,
upon receipt, cause the copy to be included in the individual’s
medical record.
E. Except as provided in subsections F and G of this section, a
health care professional or health care institution providing health
care to an individual shall comply with:
1. A health care instruction given by the individual regarding
the individual’s health care;
2. A reasonable interpretation by the individual’s surrogate of
an instruction given by the individual; and
ENR. H. B. NO. 1687 Page 36
3. A health care decision for the individual made by the
individual’s surrogate in accordance with Sections 17 and 18 of this
act to the same extent as if the decision had been made by the
individual at a time when the individual had capacity.
F. A health care professional or a health care institution may
refuse to provide health care consistent with a health care
instruction or health care decision if:
1. The instruction or decision is contrary to a policy of the
health care institution providing care to the individual that is
based expressly on reasons of conscience, and the policy was timely
communicated to the individual or to the individual’s surrogate;
2. The care would require health care that is not available to
the professional or institution; or
3. Compliance with the instruction or decision would:
a. require the professional to provide care that is
contrary to the professional’s religious belief or
moral conviction if other law permits the professional
to refuse to provide care for that reason,
b. require the professional or institution to provide
care that is contrary to generally accepted health
care standards applicable to the professional or
institution, or
c. violate a court order or other law.
G. A health care professional or health care institution that
refuses to provide care under subsection F of this section shall:
1. As soon as reasonably feasible, inform the individual, if
possible, and the individual’s surrogate of the refusal;
2. Immediately make a reasonable effort to transfer the
individual to another health care professional or health care
institution that is willing to comply with the instruction or
decision; and
3. Either:
ENR. H. B. NO. 1687 Page 37
a. if care is refused under paragraph 1 or 2 of
subsection F of this section, provide life-sustaining
care and care needed to keep or make the individual
comfortable, consistent with accepted medical
standards to the extent feasible, until a transfer is
made, or
b. if care is refused under paragraph 3 of subsection F
of this section, provide life-sustaining care and care
needed to keep or make the individual comfortable,
consistent with accepted medical standards, until a
transfer is made.
H. As used in this section, “generally accepted health care
standards” and “accepted medical standards” shall not be interpreted
to supersede, or to authorize any violation of, the
Nondiscrimination in Treatment Act.
SECTION 23. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.23 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. A guardian may refuse to comply with or revoke the
individual’s advance health care directive only if the court
appointing the guardian expressly orders the noncompliance or
revocation.
B. Unless a court orders otherwise, a health care decision made
by an agent appointed by an individual subject to guardianship
prevails over a decision of the guardian appointed for the
individual.
SECTION 24. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.24 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. A health care professional or health care institution acting
in good faith shall not be subject to civil or criminal liability or
to discipline for unprofessional conduct for:
1. Complying with a health care decision made for an individual
by another person if compliance is based on a reasonable belief that
the person has authority to make the decision, including a decision
to withhold or withdraw health care;
ENR. H. B. NO. 1687 Page 38
2. Refusing to comply with a health care decision made for an
individual by another person if the refusal is based on a reasonable
belief that the person lacked authority or capacity to make the
decision;
3. Complying with an advance health care directive based on a
reasonable belief that the directive is valid;
4. Refusing to comply with an advance health care directive
based on a reasonable belief that the directive is not valid,
including a reasonable belief that the directive was not made by the
individual or, after its creation, was substantively altered by a
person other than the individual who created it;
5. Determining that an individual who otherwise might be
authorized to act as an agent or default surrogate is not reasonably
available; or
6. Complying with an individual’s direction under subsection D
of Section 9 of this act.
B. An agent, default surrogate, or individual with a reasonable
belief that the individual is an agent or a default surrogate shall
not be subject to civil or criminal liability or to discipline for
unprofessional conduct for a health care decision made in a good
faith effort to comply with Section 17 of this act.
SECTION 25. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.25 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. A person shall not:
1. Intentionally falsify, in whole or in part, an advance
health care directive;
2. For the purpose of frustrating the intent of the individual
who created an advance health care directive or with knowledge that
doing so is likely to frustrate the intent:
a. intentionally conceal, deface, obliterate, or delete
the directive or a revocation of the directive without
consent of the individual who created or revoked the
directive, or
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b. intentionally withhold knowledge of the existence or
revocation of the directive from a responsible health
care professional or health care institution providing
health care to the individual who created or revoked
the directive;
3. Coerce or fraudulently induce an individual to create,
revoke, or refrain from creating or revoking an advance health care
directive or a part of a directive; or
4. Require or prohibit the creation or revocation of an advance
health care directive as a condition for providing health care.
B. An individual who is the subject of conduct prohibited under
subsection A of this section, or the individual’s estate, shall have
a cause of action against a person who violates subsection A of this
section for statutory damages of Twenty-five Thousand Dollars
($25,000.00) or actual damages resulting from the violation,
whichever is greater.
C. Subject to subsection D of this section, an individual who
makes a health care instruction, or the individual’s estate, shall
have a cause of action against a health care professional or health
care institution that intentionally violates Section 22 of this act
for statutory damages of Fifty Thousand Dollars ($50,000.00) or
actual damages resulting from the violation, whichever is greater.
D. A health care professional who is an emergency medical
responder shall not be liable under subsection C of this section for
a violation of subsection E of Section 22 of this act if:
1. The violation occurs in the course of providing care to an
individual experiencing a health condition for which the
professional reasonably believes the care was appropriate to avoid
imminent loss of life or serious harm to the individual;
2. The failure to comply is consistent with accepted standards
of the profession of the professional; and
3. The provision of care does not begin in a health care
institution in which the individual resides or was receiving care.
E. In an action under this section, a prevailing plaintiff may
recover reasonable attorney fees, court costs, and other reasonable
litigation expenses.
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F. A cause of action or remedy under this section shall be in
addition to any cause of action or remedy under any other law.
SECTION 26. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.26 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. A physical or electronic copy of an advance health care
directive, revocation of an advance health care directive, or
appointment, designation, or disqualification of a surrogate has the
same effect as the original.
B. An individual may create a certified physical copy of an
advance health care directive or revocation of an advance health
care directive that is in electronic form by affirming under penalty
of perjury that the physical copy is a complete and accurate copy of
the directive or revocation.
SECTION 27. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.27 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. On petition of an individual, the individual’s surrogate, a
health care professional or health care institution providing health
care to the individual, or a person interested in the welfare of the
individual, the court may:
1. Enjoin implementation of a health care decision made by an
agent or default surrogate on behalf of the individual, on a finding
that the decision is inconsistent with Section 17 or 18 of this act;
2. Enjoin an agent from making a health care decision for the
individual, on a finding that the individual’s appointment of the
agent has been revoked or the agent:
a. is disqualified under subsection B of Section 8 or
under Section 21 of this act,
b. is unwilling or unable to comply with Section 17 of
this act, or
c. poses a danger to the individual’s well-being;
ENR. H. B. NO. 1687 Page 41
3. Enjoin another individual from acting as a default
surrogate, on a finding that the other individual acting as a
default surrogate did not comply with Section 12 of this act or the
other individual:
a. is disqualified under Section 14 or 21 of this act,
b. is unwilling or unable to comply with Section 17 of
this act, or
c. poses a danger to the first individual’s well-being,
and authorize another member of the classes identified in subsection
B of Section 12 of this act who is able and willing to comply with
the provisions of this act to serve as the individual’s default
surrogate in place of the enjoined surrogate; or
4. Order implementation of a health care decision made:
a. by and for the individual, or
b. by an agent or default surrogate who is acting in
compliance with the powers and duties of the agent or
default surrogate.
B. In this act, advocacy for the provision, withholding, or
withdrawal of health care or mental health care to or from an
individual is not itself evidence that an agent or default
surrogate, or a potential agent or default surrogate, poses a danger
to the individual’s well-being.
C. A proceeding under this section shall be governed by
Sections 2-101 et seq. and 3-101 et seq. of Title 30 of the Oklahoma
Statutes.
SECTION 28. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.28 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. This act shall not authorize mercy killing, assisted
suicide, or euthanasia, and is subject to the provisions of the
Assisted Suicide Prevention Act.
B. This act shall not affect other laws of this state governing
treatment for mental illness of an individual involuntarily
ENR. H. B. NO. 1687 Page 42
committed to a mental health care institution under Section 5-410 et
seq. of Title 43A of the Oklahoma Statutes.
C. Death of an individual caused by withholding or withdrawing
health care in accordance with this act shall not constitute a
suicide or homicide or legally impair or invalidate a policy of
insurance or an annuity providing a death benefit, notwithstanding
any term of the policy or annuity.
D. This act shall not create a presumption concerning the
intention of an individual who has not created an advance health
care directive, except as provided in the Hydration and Nutrition
for Incompetent Patients Act.
E. An advance health care directive created before, on, or
after the effective date of this act shall be interpreted in
accordance with the laws of this state, excluding the state’s choice
of law rules, at the time the directive is implemented.
SECTION 29. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.29 of Title 63, unless
there is created a duplication in numbering, reads as follows:
In applying and construing this uniform act, a court shall
consider the promotion of uniformity of the law among jurisdictions
that enact it, except with regard to provisions of this act that
substantively differ from provisions in the act as proposed by the
Uniform Law Commission.
SECTION 30. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.30 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. Subject to Section 19 of this act, an advance health care
directive created before the effective date of this act shall be
valid if it complies with this act or complied at the time of
creation with the laws of the state in which it was created.
B. Except as provided in subsection E of Section 28 of this
act, this act shall not affect the validity or effect of an act done
before the effective date of this act.
C. An individual who assumed authority to act as default
surrogate before the effective date of this act may continue to act
as default surrogate until the individual for whom the default
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surrogate is acting has capacity or the default surrogate is
disqualified, whichever occurs first.
SECTION 31. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.31 of Title 63, unless
there is created a duplication in numbering, reads as follows:
This act applies to an advance health care directive created
before, on, or after the effective date of this act.
SECTION 32. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3100.32 of Title 63, unless
there is created a duplication in numbering, reads as follows:
Upon motion by any party to enjoin the implementation of a
health care decision by a surrogate to provide, withhold, or
withdraw life-sustaining care, the court shall issue an order
requiring that, pending a final decision on the merits and the
resolution of any appeal, the individual be provided with health
care which, in reasonable medical judgment, is necessary to prevent
the individual’s death. The court shall not order the provision of
such care if doing so would require the denial of the same health
care to another individual.
SECTION 33. REPEALER 63 O.S. 2021, Sections 3101.1,
3101.2, 3101.3, 3101.4, 3101.5, 3101.6, 3101.7, 3101.8, 3101.9,
3101.10, 3101.11, as amended by Section 737, Chapter 486, O.S.L.
2025, 3101.12, 3101.13, 3101.14, 3101.15, 3101.16, 3102.4, as
amended by Section 15, Chapter 136, O.S.L. 2022, and 3102.5 (63 O.S.
Supp. 2025, Sections 3101.11 and 3102.4), are hereby repealed.
SECTION 34. REPEALER Sections 1, 2, 3, as amended by
Section 1, Chapter 154, O.S.L. 2023, 4, 5, as amended by Section 2,
Chapter 154, O.S.L. 2023, 6, 7, 8, 9, 10, 11, 12, and 13, Chapter
136, O.S.L. 2022 (63 O.S. Supp. 2025, Sections 3111.1, 3111.2,
3111.3, 3111.4, 3111.5, 3111.6, 3111.7, 3111.8, 3111.9, 3111.10,
3111.11, 3111.12, and 3111.13), are hereby repealed.
SECTION 35. This act shall become effective July 1, 2027.
ENR. H. B. NO. 1687 Page 44
Passed the House of Representatives the 6th day of May, 2026.
Presiding Officer of the House
of Representatives
Passed the Senate the 5th day of May, 2026.
Presiding Officer of the Senate
OFFICE OF THE GOVERNOR
Received by the Office of the Governor this ____________________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________
Approved by the Governor of the State of Oklahoma this _________
day of ___________________, 20_______, at _______ o'clock _______ M.
_________________________________
Governor of the State of Oklahoma
OFFICE OF THE SECRETARY OF STATE
Received by the Office of the Secretary of State this __________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________
ENR. H. B. NO. 1687 Page 45