This is the preview version of the Wisconsin State Legislature site.
Please see http://docs.legis.wisconsin.gov for the production version.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB254,1 1Section 1 . 154.01 (1) of the statutes is renumbered 154.01 (1r) and amended
2to read:
SB254,2,53 154.01 (1r) “Attending physician health care professional" means a physician
4licensed under ch. 448
health care professional who has primary responsibility for
5the treatment and care of the patient.
SB254,2 6Section 2 . 154.01 (1g) of the statutes is created to read:
SB254,3,4
1154.01 (1g) “Advanced practice registered nurse” means a nurse licensed
2under ch. 441 who is currently certified by a national certifying body approved by the
3board of nursing as a nurse practitioner, certified nurse-midwife, certified registered
4nurse anesthetist, or clinical nurse specialist.
SB254,3 5Section 3. 154.01 (3) of the statutes is renumbered 154.01 (3) (intro.) and
6amended to read:
SB254,3,87 154.01 (3) (intro.) “Health care professional" means a person licensed, certified
8or registered under ch. 441, 448 or 455.
any of the following:
SB254,4 9Section 4. 154.01 (3) (a) of the statutes is created to read:
SB254,3,1010 154.01 (3) (a) A physician licensed under ch. 448.
SB254,5 11Section 5. 154.01 (3) (b) of the statutes is created to read:
SB254,3,1212 154.01 (3) (b) A physician assistant licensed under ch. 448.
SB254,6 13Section 6. 154.01 (3) (c) of the statutes is created to read:
SB254,3,1414 154.01 (3) (c) An advanced practice registered nurse.
SB254,7 15Section 7. 154.01 (5) (intro.) of the statutes is amended to read:
SB254,3,2116 154.01 (5) (intro.) “Life-sustaining procedure" means any medical procedure
17or intervention that, in the judgment of the attending physician health care
18professional
, would serve only to prolong the dying process but not avert death when
19applied to a qualified patient. “Life-sustaining procedure" includes assistance in
20respiration, artificial maintenance of blood pressure and heart rate, blood
21transfusion, kidney dialysis and other similar procedures, but does not include:
SB254,8 22Section 8. Subchapter II (title) of chapter 154 [precedes 154.02] of the statutes
23is amended to read:
SB254,3,2424 CHAPTER 154
SB254,4,3
1SUBCHAPTER II
2 DECLARATION TO PHYSICIANS
3health care professionals
SB254,9 4Section 9. 154.02 (3) of the statutes is amended to read:
SB254,4,95 154.02 (3) “Qualified patient" means a declarant who has been diagnosed and
6certified in writing to be afflicted with a terminal condition or to be in a persistent
7vegetative state by 2 physicians health care professionals, one of whom is the
8attending physician health care professional and one of whom is a physician, who
9have personally examined the declarant.
SB254,10 10Section 10. 154.03 (title) of the statutes is amended to read:
SB254,4,11 11154.03 (title) Declaration to physicians health care professionals .
SB254,11 12Section 11. 154.03 (1) (intro.) of the statutes is amended to read:
SB254,5,1013 154.03 (1) (intro.) Any person of sound mind and 18 years of age or older may
14at any time voluntarily execute a declaration, which shall take effect on the date of
15execution, authorizing the withholding or withdrawal of life-sustaining procedures
16or of feeding tubes when the person is in a terminal condition or is in a persistent
17vegetative state. A declarant may not authorize the withholding or withdrawal of
18any medication, life-sustaining procedure or feeding tube if the declarant's
19attending physician health care professional advises that, in his or her professional
20judgment, the withholding or withdrawal will cause the declarant pain or reduce the
21declarant's comfort and the pain or discomfort cannot be alleviated through pain
22relief measures. A declarant may not authorize the withholding or withdrawal of
23nutrition or hydration that is administered or otherwise received by the declarant
24through means other than a feeding tube unless the declarant's attending physician
25health care professional advises that, in his or her professional judgment, the

1administration is medically contraindicated. A declaration must be signed by the
2declarant in the presence of 2 witnesses. If the declarant is physically unable to sign
3a declaration, the declaration must be signed in the declarant's name by one of the
4witnesses or some other person at the declarant's express direction and in his or her
5presence; such a proxy signing shall either take place or be acknowledged by the
6declarant in the presence of 2 witnesses. The declarant is responsible for notifying
7his or her attending physician health care professional of the existence of the
8declaration. An attending physician health care professional who is so notified shall
9make the declaration a part of the declarant's medical records. No witness to the
10execution of the declaration may, at the time of the execution, be any of the following:
SB254,12 11Section 12. 154.03 (2) of the statutes is amended to read:
SB254,6,312 154.03 (2) The department shall prepare and provide copies of the declaration
13and accompanying information for distribution in quantities to health care
14professionals
persons licensed, certified, or registered under ch. 441, 448, or 455,
15hospitals, nursing homes, county clerks and local bar associations and individually
16to private persons. The department shall include, in information accompanying the
17declaration, at least the statutory definitions of terms used in the declaration,
18statutory restrictions on who may be witnesses to a valid declaration, a statement
19explaining that valid witnesses acting in good faith are statutorily immune from civil
20or criminal liability, an instruction to potential declarants to read and understand
21the information before completing the declaration and a statement explaining that
22an instrument may, but need not be, filed with the register in probate of the
23declarant's county of residence. The department may charge a reasonable fee for the
24cost of preparation and distribution. The declaration distributed by the department
25of health services shall be easy to read, the type size may be no smaller than 10 point,

1and the declaration shall be in the following form, setting forth on the first page the
2wording before the ATTENTION statement and setting forth on the 2nd page the
3ATTENTION statement and remaining wording:
SB254,6,4 4Declaration to physicians health care professionals
SB254,6,55 (WISCONSIN LIVING WILL)
SB254,6,126 I,...., being of sound mind, voluntarily state my desire that my dying not be
7prolonged under the circumstances specified in this document. Under those
8circumstances, I direct that I be permitted to die naturally. If I am unable to give
9directions regarding the use of life-sustaining procedures or feeding tubes, I intend
10that my family and physician, physician assistant, or advanced practice registered
11nurse
honor this document as the final expression of my legal right to refuse medical
12or surgical treatment.
SB254,6,1813 1. If I have a TERMINAL CONDITION, as determined by 2 physicians a
14physician, physician assistant, or advanced practice registered nurse
who have has
15personally examined me, and if a physician who has also personally examined me
16agrees with that determination,
I do not want my dying to be artificially prolonged
17and I do not want life-sustaining procedures to be used. In addition, the following
18are my directions regarding the use of feeding tubes:
SB254,6,1919 .... YES, I want feeding tubes used if I have a terminal condition.
SB254,6,2020 .... NO, I do not want feeding tubes used if I have a terminal condition.
SB254,6,2121 If you have not checked either box, feeding tubes will be used.
SB254,7,222 2. If I am in a PERSISTENT VEGETATIVE STATE, as determined by 2
23physicians
a physician, physician assistant, or advanced practice registered nurse
24who have has personally examined me, and if a physician who has also personally

1examined me agrees with that determination,
the following are my directions
2regarding the use of life-sustaining procedures:
SB254,7,43 .... YES, I want life-sustaining procedures used if I am in a persistent
4vegetative state.
SB254,7,65 .... NO, I do not want life-sustaining procedures used if I am in a persistent
6vegetative state.
SB254,7,77 If you have not checked either box, life-sustaining procedures will be used.
SB254,7,128 3. If I am in a PERSISTENT VEGETATIVE STATE, as determined by 2
9physicians
a physician, physician assistant, or advanced practice registered nurse
10who have has personally examined me, and if a physician who has also personally
11examined me agrees with that determination,
the following are my directions
12regarding the use of feeding tubes:
SB254,7,1313 .... YES, I want feeding tubes used if I am in a persistent vegetative state.
SB254,7,1414 .... NO, I do not want feeding tubes used if I am in a persistent vegetative state.
SB254,7,1515 If you have not checked either box, feeding tubes will be used.
SB254,7,1816 If you are interested in more information about the significant terms used in
17this document, see section 154.01 of the Wisconsin Statutes or the information
18accompanying this document.
SB254,7,2019 ATTENTION: You and the 2 witnesses must sign the document at the same
20time.
SB254,7,21   21Signed ....   Date ....
SB254,7,22   22Address ....   Date of birth ....
SB254,8,4
1I believe that the person signing this document is of sound mind. I am an adult
2and am not related to the person signing this document by blood, marriage or
3adoption. I am not entitled to and do not have a claim on any portion of the person's
4estate and am not otherwise restricted by law from being a witness.
SB254,8,5   5Witness signature ....   Date signed ....
SB254,8,6   6Print name ....
SB254,8,8   8Witness signature ....   Date signed ....
SB254,8,9   9Print name ....
SB254,8,1110 DIRECTIVES TO ATTENDING PHYSICIAN, PHYSICIAN ASSISTANT, OR
11ADVANCED PRACTICE REGISTERED NURSE
SB254,8,1712 1. This document authorizes the withholding or withdrawal of life-sustaining
13procedures or of feeding tubes when 2 physicians a physician and another physician,
14physician assistant, or advanced practice registered nurse
, one of whom is the
15attending physician health care professional, have personally examined and
16certified in writing that the patient has a terminal condition or is in a persistent
17vegetative state.
SB254,8,2318 2. The choices in this document were made by a competent adult. Under the
19law, the patient's stated desires must be followed unless you believe that withholding
20or withdrawing life-sustaining procedures or feeding tubes would cause the patient
21pain or reduced comfort and that the pain or discomfort cannot be alleviated through
22pain relief measures. If the patient's stated desires are that life-sustaining
23procedures or feeding tubes be used, this directive must be followed.
SB254,9,4
13. If you feel that you cannot comply with this document, you must make a good
2faith attempt to transfer the patient to another physician, physician assistant, or
3advanced practice registered nurse
who will comply. Refusal or failure to make a
4good faith attempt to do so constitutes unprofessional conduct.
SB254,9,65 4. If you know that the patient is pregnant, this document has no effect during
6her pregnancy.
SB254,9,77 * * * * *
SB254,9,108 The person making this living will may use the following space to record the
9names of those individuals and health care providers to whom he or she has given
10copies of this document:
SB254,9,1111 .................................................................
SB254,9,1212 .................................................................
SB254,9,1313 .................................................................
SB254,13 14Section 13. 154.05 (1) (c) of the statutes is amended to read:
SB254,9,1815 154.05 (1) (c) By a verbal expression by the declarant of his or her intent to
16revoke the declaration. This revocation becomes effective only if the declarant or a
17person who is acting on behalf of the declarant notifies the attending physician
18health care professional of the revocation.
SB254,14 19Section 14. 154.05 (2) of the statutes is amended to read:
SB254,9,2320 154.05 (2) Recording the revocation. The attending physician health care
21professional
shall record in the patient's medical record the time, date and place of
22the revocation and the time, date and place, if different, that he or she was notified
23of the revocation.
SB254,15 24Section 15. 154.07 (1) (a) (intro.) of the statutes is amended to read:
SB254,10,5
1154.07 (1) (a) (intro.) No physician health care professional, inpatient health
2care facility or health care professional person licensed, certified, or registered under
3ch. 441, 448, or 455
acting under the direction of a physician health care professional
4may be held criminally or civilly liable, or charged with unprofessional conduct, for
5any of the following:
SB254,16 6Section 16. 154.07 (1) (a) 3. of the statutes is amended to read:
SB254,10,117 154.07 (1) (a) 3. Failing to comply with a declaration, except that failure by a
8physician health care professional to comply with a declaration of a qualified patient
9constitutes unprofessional conduct if the physician health care professional refuses
10or fails to make a good faith attempt to transfer the qualified patient to another
11physician health care professional who will comply with the declaration.
SB254,17 12Section 17. 154.07 (2) of the statutes is amended to read:
SB254,10,2213 154.07 (2) Effect of declaration. The desires of a qualified patient who is
14competent supersede the effect of the declaration at all times. If a qualified patient
15is adjudicated incompetent at the time of the decision to withhold or withdraw
16life-sustaining procedures or feeding tubes, a declaration executed under this
17subchapter is presumed to be valid. The declaration of a qualified patient who is
18diagnosed as pregnant by the attending physician health care professional has no
19effect during the course of the qualified patient's pregnancy. For the purposes of this
20subchapter, a physician health care professional or inpatient health care facility may
21presume in the absence of actual notice to the contrary that a person who executed
22a declaration was of sound mind at the time.
SB254,18 23Section 18. 154.19 (1) (intro.) of the statutes is amended to read:
SB254,11,224 154.19 (1) (intro.) No person except an attending physician health care
25professional
may issue a do-not-resuscitate order. An attending physician health

1care professional
may issue a do-not-resuscitate order to a patient only if all of the
2following apply:
SB254,19 3Section 19. 154.19 (1) (e) of the statutes is amended to read:
SB254,11,54 154.19 (1) (e) The physician health care professional does not know the patient
5to be pregnant.
SB254,20 6Section 20. 154.19 (2) (a) of the statutes is amended to read:
SB254,11,117 154.19 (2) (a) The attending physician health care professional, or a person
8directed by the attending physician health care professional, shall provide the
9patient with written information about the resuscitation procedures that the patient
10has chosen to forego and the methods by which the patient may revoke the
11do-not-resuscitate order.
SB254,21 12Section 21. 154.19 (2) (b) (intro.) of the statutes is amended to read:
SB254,11,1813 154.19 (2) (b) (intro.) After providing the information under par. (a), the
14attending physician health care professional, or the person directed by the attending
15physician health care professional, shall document in the patient's medical record
16the medical condition that qualifies the patient for the do-not-resuscitate order,
17shall make the order in writing and shall do one of the following, as requested by the
18qualified patient:
SB254,22 19Section 22. 154.21 (2) of the statutes is amended to read:
SB254,11,2520 154.21 (2) Recording the revocation. The attending physician health care
21professional
shall be notified as soon as practicable of the patient's revocation and
22shall record in the patient's medical record the time, date and place of the revocation,
23if known, and the time, date and place, if different, that he or she was notified of the
24revocation. A revocation under sub. (1) is effective regardless of when the attending
25physician health care professional has been notified of that revocation.
SB254,23
1Section 23. 154.23 (intro.) of the statutes is amended to read:
SB254,12,5 2154.23 Liability. (intro.) No physician, emergency medical services
3practitioner, emergency medical responder, health care professional provider, as
4defined in s. 146.81 (1)
, or emergency health care facility may be held criminally or
5civilly liable, or charged with unprofessional conduct, for any of the following:
SB254,24 6Section 24. 154.27 (1) of the statutes is amended to read:
SB254,12,127 154.27 (1) The department shall establish by rule a uniform standard for the
8size, color, and design of all do-not-resuscitate bracelets. Except as provided in sub.
9(2), the rules shall require that the do-not-resuscitate bracelets include the
10inscription “Do Not Resuscitate"; the name, address, date of birth and gender of the
11patient; and the name, business telephone number and signature of the attending
12physician health care professional issuing the order.
SB254,25 13Section 25. 155.01 (1) of the statutes is renumbered 155.01 (1r).
SB254,26 14Section 26. 155.01 (1g) of the statutes is created to read:
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