Nebraska Living Will Requirements

This act creates Nebraska's health care power of attorney, an entirely separate document from the living will (declaration), which is governed instead by the Rights of the Terminally Ill Act (Section 20-401 to 20-416).

This act is the statutory authority for Nebraska's living will, legally called a declaration. It creates the declaration, the document letting a person direct the withholding or withdrawal of life-sustaining treatment if in a terminal condition or persistent vegetative state, as its own separate instrument with no agent-designation component.

The declaration must be signed by the declarant, or by another person at the declarant's direction, and either witnessed by two adults or acknowledged before a notary public, two independently sufficient routes. No more than one witness may be an administrator or employee of a health care provider caring for the declarant, and no witness may be an employee of the declarant's life or health insurance provider. Nebraska does not disqualify relatives from witnessing, unlike some other states.

A declarant may revoke a declaration at any time and in any manner, regardless of mental or physical condition. Revocation is effective once communicated to the attending physician or health care provider, by the declarant or by a witness to the revocation, who must then make it part of the medical record.

Life-sustaining treatment cannot be withheld or withdrawn under a declaration from a person known by the attending physician to be pregnant, so long as it is probable the fetus will develop to the point of live birth with continued treatment.

A physician or other health care provider who gives effect to a declaration in good faith, without knowledge of a revocation, or whose actions under the Act are in accord with reasonable medical standards, is not subject to civil or criminal liability or professional discipline for that action.

Death resulting from the withholding or withdrawal of life-sustaining treatment in accordance with a declaration does not constitute suicide or homicide for any purpose, and the Act does not condone, authorize, or approve homicide, suicide, or assisted suicide.

Federal law requires Medicare- and Medicaid-participating hospitals, nursing homes, and other facilities to inform patients in writing of their right under Nebraska law to make a declaration stating their own treatment wishes.

Federal HIPAA regulations govern how a designated decision-maker can be authorized to access a patient's protected health information. Because Nebraska's declaration names no agent, this authorization is relevant to the separate health care power of attorney document, not to the declaration's own treatment-wishes instructions.

Nebraska's Revised Uniform Anatomical Gift Act lets a declarant authorize organ and tissue donation.

The Advance Mental Health Care Directives Act lets a person state preferences about psychiatric medication, electroconvulsive therapy, and psychiatric hospitalization. It is a THIRD, separate advance-directive instrument from both the living-will declaration and the health care power of attorney, not a section within the declaration itself.

A declaration executed in another state, in compliance with that state's law or with Nebraska's law, is valid for purposes of the Rights of the Terminally Ill Act.

The Health Care Surrogacy Act establishes a hierarchy of decision-makers who may consent to health care on a patient's behalf when the patient lacks capacity and has neither a declaration addressing the situation nor a designated health care agent.

An attending physician or other health care provider unwilling to comply with a declaration, for any reason, must take reasonable steps to promptly transfer the declarant's care to a provider who is willing to comply.

Federal regulations require Medicare- and Medicaid-participating providers to comply with advance-directive requirements, including informing patients of their right under state law to accept or refuse medical treatment and to execute a declaration.

Addresses the relationship between a declaration and a subsequent guardianship proceeding; a guardian must comply with the ward's existing declaration.

Nebraska's Uniform Electronic Transactions Act applies generally to electronic records and signatures. The Rights of the Terminally Ill Act itself contains no declaration-specific electronic-signature rule of its own, unlike some states.

Nebraska's optional statutory declaration form only lets a person decline life-sustaining treatment under the two named conditions (terminal condition, persistent vegetative state). Unlike states whose optional forms offer a binary choice between prolonging life and not prolonging life, Nebraska's form has no built-in statutory line for affirmatively requesting maximum treatment. A person who wants that stated must add it in their own words.