Introduced Version
HOUSE BILL No. 1336
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 16-21-2-17; IC 16-36-1-5.
Synopsis: Health care matters. Requires a hospital to inform a woman
in premature labor of the hospital's capabilities of treating the born
alive infant and managing a high risk pregnancy and, if the hospital's
capabilities interfere with the woman's care, the hospital must provide
this information before the woman is admitted to the hospital. Provides
that if a born alive infant is transported to a hospital with an
appropriate perinatal level of care, the woman must be offered an
opportunity to be transported to the same hospital. Provides that if the
local prosecuting attorney has probable cause to believe that a health
care provider may have knowingly or intentionally: (1) violated the
requirements concerning the treatment and care of a born alive infant
or mother or the professional standards of practice through the health
care provider's actions or inactions; and (2) caused harm or death to the
born alive infant or mother; the prosecuting attorney shall investigate
the health care provider for appropriate criminal prosecution.
Establishes a presumption that the continuation of life is in a minor's
best interests. Requires a health care provider to obtain the consent of
each parent or each legal guardian before issuing a do not resuscitate
order or otherwise withholding or withdrawing treatment to allow the
natural death of a minor. Prohibits a health care provider from
interfering with the transfer of a minor patient at the request of a parent
or guardian or otherwise preventing life saving measures before or
during the transfer. States that a court does not have jurisdiction to
withdraw life sustaining treatment for a minor.
Effective: July 1, 2025.
Sweet, Prescott, Cash, Patterson
January 13, 2025, read first time and referred to Committee on Public Health.
2025 IN 1336—LS 7533/DI 104 Introduced
First Regular Session of the 124th General Assembly (2025)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
Constitution) is being amended, the text of the existing provision will appear in this style type,
additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in this style type. Also, the
word NEW will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
between statutes enacted by the 2024 Regular Session of the General Assembly.
HOUSE BILL No. 1336
A BILL FOR AN ACT to amend the Indiana Code concerning
health.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 16-21-2-17, AS ADDED BY P.L.198-2021,
2 SECTION 11, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2025]: Sec. 17. (a) As used in this section, "born alive" means
4 the complete expulsion or extraction from the infant's mother, at any
5 stage of development or gestational age, of an infant who after the
6 expulsion or extraction:
7 (1) breathes;
8 (2) has a beating heart or pulsation of the umbilical cord; or
9 (3) has a definite movement of voluntary muscles;
10 regardless of whether the umbilical cord has been cut or whether the
11 expulsion or extraction occurs as a result of natural or induced labor,
12 cesarean section, or induced abortion.
13 (b) If a woman who is in premature labor presents to a hospital, the
14 hospital must inform the woman of the hospital's capabilities of treating
15 the born alive infant and managing a high risk pregnancy and, if the
16 hospital's capabilities interfere with the woman's care, the hospital
17 must provide this information before the woman is admitted to the
2025 IN 1336—LS 7533/DI 104 2
1 hospital. If the hospital does not have the capability to treat the
2 premature born alive infant or the ability to manage a high risk
3 pregnancy, the hospital must provide the woman options to get to a
4 hospital with the appropriate level of care under the perinatal level of
5 care designation established under IC 16-21-13.
6 (c) A hospital must provide:
7 (1) a medical screening examination; and
8 (2) any needed stabilizing treatment;
9 to an infant who is born alive, including born prematurely or with a
10 disability, or a woman who is in premature labor.
11 (d) After a hospital has provided a medical screening examination
12 under subsection (c)(1), the hospital must inform:
13 (1) a parent of the born alive infant of the:
14 (A) infant's treatment options; and
15 (B) hospital's determination of the appropriate level of care
16 under the perinatal level of care designation established under
17 IC 16-21-13; and
18 (2) the woman who is in premature labor of the:
19 (A) woman's treatment options; and
20 (B) hospital's determination of the appropriate level of care
21 under the perinatal level of care designation established under
22 IC 16-21-13.
23 (e) Subject to the requirements under the federal Emergency
24 Medical Treatment and Labor Act, a hospital shall determine what
25 perinatal level of care under IC 16-21-13 is appropriate for the born
26 alive infant and mother and arrange for transport consistent with
27 requirements adopted under IC 16-21-13-5. If a born alive infant is
28 transported to a hospital with the appropriate perinatal level of
29 care, the mother must be offered an opportunity to be transported
30 to the same hospital.
31 (f) A hospital that violates this section is subject to the penalties
32 under IC 16-21-3-1.
33 (g) A health care provider who is:
34 (1) licensed or certified under IC 25;
35 (2) employed or under contract with a hospital; and
36 (3) responsible for providing treatment or an examination to a
37 born alive infant or woman with a high risk pregnancy under this
38 chapter;
39 is subject to the standards of practice under IC 25-1-9. A health care
40 provider who violates the standards of practice is subject to disciplinary
41 sanctions under IC 25-1-9-9.
42 (h) If the local prosecuting attorney has probable cause to
2025 IN 1336—LS 7533/DI 104 3
1 believe that a health care provider may have knowingly or
2 intentionally:
3 (1) violated the requirements in this section or the standards
4 of practice under IC 25-1-9 through the health care provider's
5 actions or inactions; and
6 (2) caused harm or death to the born alive infant or mother;
7 the prosecuting attorney shall investigate the health care provider
8 for appropriate criminal prosecution.
9 SECTION 2. IC 16-36-1-5, AS AMENDED BY P.L.67-2018,
10 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
11 JULY 1, 2025]: Sec. 5. (a) If an adult incapable of consenting under
12 section 4 of this chapter has not appointed a health care representative
13 under section 7 of this chapter or the health care representative
14 appointed under section 7 of this chapter is not reasonably available or
15 declines to act, except as provided in sections 9 and 9.5 of this chapter,
16 consent to health care may be given in the following order of priority:
17 (1) A judicially appointed guardian of the person or a
18 representative appointed under section 8 of this chapter.
19 (2) A spouse.
20 (3) An adult child.
21 (4) A parent.
22 (5) An adult sibling.
23 (6) A grandparent.
24 (7) An adult grandchild.
25 (8) The nearest other adult relative in the next degree of kinship
26 who is not listed in subdivisions (2) through (7).
27 (9) A friend who:
28 (A) is an adult;
29 (B) has maintained regular contact with the individual; and
30 (C) is familiar with the individual's activities, health, and
31 religious or moral beliefs.
32 (10) The individual's religious superior, if the individual is a
33 member of a religious order.
34 (b) Except as provided in subsection (f), consent to health care for
35 a minor not authorized to consent under section 3 of this chapter may
36 be given by any of the following:
37 (1) A judicially appointed guardian of the person or a
38 representative appointed under section 8 of this chapter.
39 (2) A parent or an individual in loco parentis if:
40 (A) there is no guardian or other representative described in
41 subdivision (1);
42 (B) the guardian or other representative is not reasonably
2025 IN 1336—LS 7533/DI 104 4
1 available or declines to act; or
2 (C) the existence of the guardian or other representative is
3 unknown to the health care provider.
4 (3) An adult sibling of the minor if:
5 (A) there is no guardian or other representative described in
6 subdivision (1);
7 (B) a parent or an individual in loco parentis is not reasonably
8 available or declines to act; or
9 (C) the existence of the parent or individual in loco parentis is
10 unknown to the health care provider after reasonable efforts
11 are made by the health care provider to determine whether the
12 minor has a parent or an individual in loco parentis who is able
13 to consent to the treatment of the minor.
14 (4) A grandparent of the minor if:
15 (A) there is no guardian or other representative described in
16 subdivision (1);
17 (B) a parent, an individual in loco parentis, or an adult sibling
18 is not reasonably available or declines to act; or
19 (C) the existence of the parent, individual in loco parentis, or
20 adult sibling is unknown to the health care provider after
21 reasonable efforts are made by the health care provider to
22 determine whether the minor has a parent, an individual in
23 loco parentis, or an adult sibling who is able to consent to the
24 treatment of the minor.
25 (c) A representative delegated authority to consent under section 6
26 of this chapter has the same authority and responsibility as the
27 individual delegating the authority.
28 (d) An individual authorized to consent for another under this
29 section shall act in good faith and in the best interest of the individual
30 incapable of consenting.
31 (e) If there are multiple individuals at the same priority level under
32 this section, those individuals shall make a reasonable effort to reach
33 a consensus as to the health care decisions on behalf of the individual
34 who is unable to provide health care consent. If the individuals at the
35 same priority level disagree as to the health care decisions on behalf of
36 the individual who is unable to provide health care consent, a majority
37 of the available individuals at the same priority level controls.
38 (f) This subsection does not apply to a minor described in
39 section 3(a)(2) of this chapter. It is hereby established that there is
40 a presumption that the continuation of life is in a minor's best
41 interests. A health care provider may not issue a do not resuscitate
42 order or otherwise withhold or withdraw treatment that would
2025 IN 1336—LS 7533/DI 104 5
1 allow the natural death of a minor unless the health care provider
2 has received the consent of each parent or each legal guardian of
3 the minor. Consent by each parent or each legal guardian must be
4 given orally and in writing to the health care provider. The health
5 care provider must have at least two (2) witnesses attest that the
6 consent was given by each parent or each legal guardian. The
7 health care provider shall document the consent in the minor's
8 medical record, specifying each parent or legal guardian who gave
9 consent. A parent or legal guardian may revoke the consent at any
10 time either orally or in writing.
11 (g) This subsection does not apply to a minor described in
12 section 3(a)(2) of this chapter. A health care provider may not
13 interfere with the efforts of a parent or legal guardian to obtain
14 other medical opinions or transfer the minor's care to another
15 health care provider. A health care provider may not hinder or
16 delay necessary medical measures for a minor, including a
17 tracheostomy or gastronomy tube required to transfer a minor
18 patient's care to another health care provider. If the parent or legal
19 guardian of a minor requests a transfer for the minor patient's
20 care, the health care provider must continue to provide
21 life-sustaining procedures, including nutrition and hydration, until
22 the transfer is made.
23 (h) This subsection does not apply to a minor described in
24 section 3(a)(2) of this chapter. A court does not have jurisdiction to
25 withdraw life sustaining procedures from a minor over the
26 objection of a parent or legal guardian.
2025 IN 1336—LS 7533/DI 104