All Roll Calls
Yes: 267 • No: 11
North DakotaSB 22972025 Regular SessionSenateWALLET
AN ACT to amend and reenact subsection 3 of section 23-06.5-03 and section 23-12-13 of the North Dakota Century Code, relating to the determination of incapacity and informed consent of incapacitated patients and minors.
Sponsored By: Kristin Roers (Republican)
Became Law
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 4 benefits, 0 costs, 0 mixed.
Rules for surrogate consent and limits
When a patient cannot consent, providers must make reasonable efforts to find and get consent from the highest‑priority person. If they cannot find someone, they may move down the list. A lower‑priority person cannot consent if a higher‑priority person said no. Anyone giving consent must first try to follow what the patient would have wanted. If they cannot tell, they must choose what is in the patient’s best interests. A surrogate cannot consent to sterilization, abortion, or psychosurgery. A surrogate also cannot admit someone to a state mental health facility for more than 45 days without a court order or mental health proceeding.
When your health directive applies
A health care directive and your agent’s power start only after your attending physician, psychiatrist, or psychologist signs a written incapacity certification and files it in your medical record. They stop when you regain capacity. You are incapacitated if you cannot understand the choice, its risks and benefits, or reasonable options, and you cannot communicate a decision; a clinician must certify this in writing and file it in your record. If you or someone interested in your welfare objects to the incapacity finding, a court must hold a hearing to decide.
Who can consent for a minor
A parent may make health care decisions for their child unless a court says otherwise. A minor is anyone under 18. If a parent cannot consent, the order is: a guardian with court authorization; an appointed guardian or custodian; a noncustodial parent (including a stepparent with significant contact); an adult sibling with significant contact; a grandparent with significant contact; or a close relative or friend age 18+ with significant contact. If none can serve, a team of at least three health professionals, with at least one not directly involved in treatment, may consent. Providers must keep trying to find someone higher on the list.
Who decides care for incapacitated adults
When an adult is certified as incapacitated and this is in the medical record, North Dakota sets a consent order. It starts with any health care power of attorney or health care agent named in a directive (unless a court gave a guardian that role), then a guardian or custodian. Next are the spouse, adult children, parents (including stepparents), adult siblings, grandparents, and adult grandchildren—each with significant contact. If no one is available, a close relative or friend age 18+ with significant contact may consent. If none can serve, a team of at least three health professionals, with at least one not directly involved in treatment, may consent. If a care team consents, providers must keep trying to find someone higher on the list.
Sponsors & Cosponsors
Sponsor
Kristin Roers
Republican • Senate
Cosponsors
Emily O'Brien
Republican • House
Jeff Barta
Republican • Senate
Judy Lee
Republican • Senate
Ronald Sorvaag
Republican • Senate
Roll Call Votes
House vote • 4/22/2025
Second reading, passed as amended, yeas 90 nays 3
Yes: 90 • No: 3
Senate vote • 4/16/2025
Second reading, passed, yeas 46 nays 1
Yes: 46 • No: 1
House vote • 3/25/2025
Second reading, passed as amended, yeas 85 nays 6
Yes: 85 • No: 6
Senate vote • 2/19/2025
Second reading, passed, yeas 46 nays 1
Yes: 46 • No: 1
Actions Timeline
Filed with Secretary Of State 04/30
5/2/2025HouseSigned by Governor 04/29
5/1/2025SenateSent to Governor
4/28/2025SenateSigned by President
4/28/2025SenateSigned by Speaker
4/25/2025HouseSecond reading, passed as amended, yeas 90 nays 3
4/22/2025HouseConference committee report adopted
4/22/2025HouseReported back from conference committee, in place of, placed on calendar
4/16/2025HouseSecond reading, passed, yeas 46 nays 1
4/16/2025SenateConference committee report adopted
4/16/2025SenateReported back from conference committee, in place of, placed on calendar
4/15/2025SenateConference committee appointed Hendrix M. Ruby Rohr
4/3/2025HouseConference committee appointed Clemens Roers Van Oosting
4/2/2025SenateRefused to concur
4/2/2025SenateReturned to Senate (12)
3/26/2025SenateSecond reading, passed as amended, yeas 85 nays 6
3/25/2025HouseAmendment adopted, placed on calendar
3/21/2025HouseReported back amended, do pass, amendment placed on calendar 10 1 2
3/20/2025HouseCommittee Hearing 09:30
3/12/2025HouseIntroduced, first reading, referred Human Services Committee
2/21/2025HouseReceived from Senate
2/20/2025HouseSecond reading, passed, yeas 46 nays 1
2/19/2025SenateAmendment adopted, placed on calendar
2/19/2025SenateReported back amended, do pass, amendment placed on calendar 6 0 0
2/18/2025SenateCommittee Hearing 09:45
2/4/2025Senate
Bill Text
Adopted by the Conference Committee
Enrollment
FIRST ENGROSSMENT
FIRST ENGROSSMENT with Conference Committee Amendments
FIRST ENGROSSMENT with House Amendments
INTRODUCED
Prepared by the Legislative Council staff for House Human Services Committee
Prepared by the Legislative Council staff for Senator Lee
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