MO SB1536

Adds 11 new sections (404.1100 to 404.1110) to Missouri law creating the "Designated Health Care Decision-Maker Act" for incapacitated patients who lack a guardian, health care power of attorney, or other legal decision-maker

Establishes a priority order for who may serve as designated health care decision-maker: spouse (unless separated), adult child, parent, adult sibling, grandparent or adult grandchild, niece/nephew or other relatives, religious community members, close nonrelatives familiar with patient's values, or any person designated by unanimous agreement

Requires two licensed physicians to determine patient incapacity before a designated decision-maker can act, and mandates reasonable efforts to contact potential decision-makers within 24 hours of incapacity determination

Prohibits withdrawing artificially supplied nutrition and hydration unless two physicians certify the patient is actively dying regardless of intervention or cannot physiologically tolerate such nutrition/hydration

Allows health care providers and facilities to decline compliance with decisions contrary to their religious beliefs or moral convictions, but requires them to facilitate patient transfer and continue life-sustaining care pending transfer