Transmittal Notice 04-09

BACKGROUND:

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.

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.