incapacity – Conflicting instructions – Transfer when unable to comply with directive. A. The attending physician or psychologist shall continue to obtain the declarant’s informed consent to all mental health treatment decisions when the declarant is capable of providing informed consent or refusal. B. A declarant appearing to require mental health treatment shall be examined by two persons, who shall be physicians or psychologists. If after the examination the declarant is determined to be incapable and is in need of mental health treatment, a written certification, substantially in the form provided by subsection E of this section, of the declarant’s condition shall be made a part of the declarant’s medical record. C. The attending physician or psychologist is authorized to act in accordance with an operative advance directive for mental health treatment when the declarant has been determined to be incapable and mental health treatment is necessary. Except as otherwise provided by this act with regard to conflicting instructions in an advance directive for mental health treatment: 1. An attending physician or psychologist and any other physician or psychologist under the attending physician’s or psychologist’s direction or control, having possession of the declaration of the consumer or having knowledge that the declaration is part of the medical record of the consumer, shall follow as closely as possible the terms of the declaration. 2. An attending physician or psychologist and any other physician or psychologist under the attending physician’s direction or control, having possession of the appointment of the consumer of an attorney-in-fact or having knowledge of the appointment of an attorney-in-fact, shall follow as closely as possible the instruction of the attorney-in-fact. D. An attending physician or psychologist who is unable to comply with the terms of the declaration of the consumer shall make the necessary arrangements to transfer the patient and the appropriate medical records without delay to another physician or psychologist. 1. A physician or psychologist who transfers the consumer without unreasonable delay, or who makes a good faith attempt to do so, shall not be subject to criminal prosecution or civil liability, and shall not be found to have committed an act of unprofessional conduct for refusal to comply with the terms of the declaration. Transfer under these circumstances shall not constitute abandonment. 2. The failure of an attending physician or psychologist to transfer in accordance with this subsection shall constitute professional misconduct. E. The following certification of the examination of a declarant determining whether the declarant is in need of mental health treatment and whether the declarant is or is not incapable may be utilized by examiners: EXAMINER’S CERTIFICATION We, the undersigned, have made an examination of _______________, and do hereby certify that we made a careful personal examination of the actual condition of the person and on such examination we find that _____________________: 1. (Is) (Is not) in need of mental health treatment; and 2. (Is) (Is not) incapable to participate in decisions about (her) (his) mental health treatment. The facts and circumstances on which we base our opinions are stated in the following report of symptoms and history of case, which is hereby made a part hereof. According to the advance directive for mental health treatment, (name of consumer)_________________________________________, wishes to receive mental health treatment in accordance with the preferences and instructions stated in the advance directive for mental health treatment. We are duly licensed to practice in the State of Oklahoma, are not related to _______________ by blood or marriage, and have no interest in her/his estate. Witness our hands this ____________ day of _____________, 20__ ___________________, M.D., D.O., Ph.D., Other ___________________, M.D., D.O., Ph.D., Other Subscribed and sworn to before me this _______________________ day of ________________, 20__ __________________________________________ Notary Public REPORT OF SYMPTOMS AND HISTORY OF CASE BY EXAMINERS 1. GENERAL Complete name ________________________________________________ Place of residence ___________________________________________ Sex _______________ Color ________________ Age _______________ Date of Birth ________________________________________________ 2. STATEMENT OF FACTS AND CIRCUMSTANCES Our determination that the declarant (is) (is not) in need for mental health treatment is based on the following: ________________________________________________________ __________________________________________________________________ Our determination that the declarant (is) (is not) incapable of participating in mental health treatment decisions is based on the following:________________________________________________________ __________________________________________________________________ 3. NAME AND RELATIONSHIPS OF FAMILY MEMBERS/OTHERS TO BE NOTIFIED Other data ___________________________________________________ Dated at _____________, Oklahoma, this __________ day of ___________________, 20__ _____________, M.D., D.O., Ph.D., Other _______________________________________ Address _____________, M.D., D.O., Ph.D., Other _______________________________________ Address
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