§ 2994-g. Health care decisions for adult patients without surrogates.\n1. Identifying adult patients without surrogates. Within a reasonable\ntime after admission as an inpatient to the hospital of each adult\npatient, the hospital shall make reasonable efforts to determine if the\npatient has appointed a health care agent or has a guardian, or if at\nleast one individual is available to serve as the patient's surrogate in\nthe event the patient lacks or loses decision-making capacity. With\nrespect to a patient who lacks capacity, if no such health care agent,\nguardian or potential surrogate is identified, the hospital shall\nidentify, to the extent reasonably possible, the patient's wishes and\npreferences, including the patient's religious and moral beliefs, about\npending health care decisions, and shall record its findings in the\npatient's medical record.\n 2. Decision-making standards and procedures. (a) The procedures\nspecified in this and the following subdivisions of this section apply\nto health care decisions for adult patients who would qualify for\nsurrogate decision-making under this article but for whom no surrogate\nis reasonably available, willing or competent to act.\n (b) Any health care decision made pursuant to this section shall be\nmade in accordance with the standards set forth in subdivision four of\nsection twenty-nine hundred ninety-four-d of this article and shall not\nbe based on the financial interests of the hospital or any other health\ncare provider. The specific procedures to be followed depend on whether\nthe decision involves routine medical treatment, major medical\ntreatment, or the withholding or withdrawal of life-sustaining\ntreatment, and the location where the treatment is provided.\n 3. Routine medical treatment. (a) For purposes of this subdivision,\n"routine medical treatment" means any treatment, service, or procedure\nto diagnose or treat an individual's physical or mental condition, such\nas the administration of medication, the extraction of bodily fluids for\nanalysis, or dental care performed with a local anesthetic, for which\nhealth care providers ordinarily do not seek specific consent from the\npatient or authorized representative. It shall not include the long-term\nprovision of treatment such as ventilator support or a nasogastric tube\nbut shall include such treatment when provided as part of post-operative\ncare or in response to an acute illness and recovery is reasonably\nexpected within one month or less.\n (b) An attending practitioner shall be authorized to decide about\nroutine medical treatment for an adult patient who has been determined\nto lack decision-making capacity pursuant to section twenty-nine hundred\nninety-four-c of this article. Nothing in this subdivision shall require\nhealth care providers to obtain specific consent for treatment where\nspecific consent is not otherwise required by law.\n 4. Major medical treatment. (a) For purposes of this subdivision,\n"major medical treatment" means any treatment, service or procedure to\ndiagnose or treat an individual's physical or mental condition: (i)\nwhere general anesthetic is used; or (ii) which involves any significant\nrisk; or (iii) which involves any significant invasion of bodily\nintegrity requiring an incision, producing substantial pain, discomfort,\ndebilitation or having a significant recovery period; or (iv) which\ninvolves the use of physical restraints, as specified in regulations\npromulgated by the commissioner, except in an emergency; or (v) which\ninvolves the use of psychoactive medications, except when provided as\npart of post-operative care or in response to an acute illness and\ntreatment is reasonably expected to be administered over a period of\nforty-eight hours or less, or when provided in an emergency.\n (b) A decision to provide major medical treatment, made in accordance\nwith the following requirements, shall be authorized for an adult\npatient who has been det
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