Transmittal Notice 04-09
This chapter establishes the Indian Health Service (IHS) policy regarding a patient’s right to accept or refuse medical or surgical treatment. Every person recognized as competent to make medical decisions has the right to determine whether or not he/she will receive treatment. Whenever possible, the patient or his/her surrogate should have the opportunity to consider ahead of time if life-sustaining or life-prolonging treatment is desired. It is the responsibility of all health care providers to include their patients in the decisionmaking process and to adhere to Federal law governing patient self-determination.
/Charles W. Grim, DDS/
Charles W. Grim, D.D.S., M.H.S.A.
Assistant Surgeon General
Part 3, Chapter 26, “Patient Self-Determination and Advance Directives,” Indian Health Manual (IHM).
This chapter supersedes IHS Circular No. 92-2, “Patient Self-Determination and Advance Directives - Policy,” dated March 19, 1992.
File the attached table of contents and IHM chapter in their appropriate place.
Log and file this Transmittal Notice in sequential order.
Date" January 14, 2005
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