By Naishtat H.B. No. 1430
74R5212 KLL-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to medical care decisions for persons with terminal
1-3 conditions or for persons who lack capacity to make those
1-4 decisions.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Sections 672.002(5)-(9), Health and Safety Code,
1-7 are amended to read as follows:
1-8 (5) "Directly involved in the financial affairs of the
1-9 health facility" means serving as an officer, director, partner, or
1-10 business office employee of the health facility or of any parent
1-11 organization of the health facility.
1-12 (6) "Incompetent" means lacking the ability, based on
1-13 reasonable medical judgment, to understand and appreciate the
1-14 nature and consequences of a treatment decision, including the
1-15 significant benefits and harms of and reasonable alternatives to a
1-16 proposed treatment decision.
1-17 (7) <(6)> "Life-sustaining procedure" means a medical
1-18 procedure or intervention that uses mechanical or other artificial
1-19 means to sustain, restore, or supplant a vital function, and only
1-20 artificially postpones the moment of death of a patient in a
1-21 terminal condition whose death is imminent or will result within a
1-22 relatively short time without the application of the procedure.
1-23 The term does not include the administration of medication or the
1-24 performance of a medical procedure considered to be necessary to
2-1 provide comfort or care or to alleviate pain.
2-2 (8) <(7)> "Physician" means a physician licensed by
2-3 the Texas State Board of Medical Examiners or a properly
2-4 credentialed physician who holds a commission in the uniformed
2-5 services of the United States and who is serving on active duty in
2-6 this state.
2-7 (9) <(8)> "Qualified patient" means a patient with a
2-8 terminal condition that has been diagnosed and certified in writing
2-9 by the attending physician <and one other physician> who has <have>
2-10 personally examined the patient.
2-11 (10) <(9)> "Terminal condition" means an incurable or
2-12 irreversible condition caused by injury, disease, or illness that
2-13 would produce death without the application of life-sustaining
2-14 procedures, according to reasonable medical judgment, and in which
2-15 the application of life-sustaining procedures serves only to
2-16 postpone the moment of the patient's death.
2-17 SECTION 2. Section 672.004, Health and Safety Code, is
2-18 amended to read as follows:
2-19 Sec. 672.004. Form of Written Directive. A written
2-20 directive may be in the following form:
2-21 "DIRECTIVE TO PHYSICIANS
2-22 "Directive made this __________ day of __________ (month,
2-23 year).
2-24 "I __________, being of sound mind, wilfully and voluntarily
2-25 make known my desire that my life shall not be artificially
2-26 prolonged under the circumstances set forth in this directive.
2-27 "1. If at any time I should have an incurable or irreversible
3-1 condition caused by injury, disease, or illness certified to be a
3-2 terminal condition by my attending physician <two physicians>, and
3-3 if the application of life-sustaining procedures would serve only
3-4 to artificially postpone the moment of my death, and if my
3-5 attending physician determines that my death is imminent or will
3-6 result within a relatively short time without the application of
3-7 life-sustaining procedures, I direct that those procedures be
3-8 withheld or withdrawn, and that I be permitted to die naturally.
3-9 "2. In the absence of my ability to give directions regarding
3-10 the use of those life-sustaining procedures, it is my intention
3-11 that this directive be honored by my family and physicians as the
3-12 final expression of my legal right to refuse medical or surgical
3-13 treatment and accept the consequences from that refusal.
3-14 "3. If I have been diagnosed as pregnant and that diagnosis
3-15 is known to my physician, this directive has no effect during my
3-16 pregnancy.
3-17 "4. This directive is in effect until it is revoked.
3-18 "5. I understand the full import of this directive and I am
3-19 emotionally and mentally competent to make this directive.
3-20 "6. I understand that I may revoke this directive at any
3-21 time.
3-22 "Signed _____________________
3-23 (City, County, and State of
3-24 Residence)
3-25 I am not related to the declarant by blood or marriage. I
3-26 would not be entitled to any portion of the declarant's estate on
3-27 the declarant's death. I am not the attending physician of the
4-1 declarant or an employee of the attending physician. I am not a
4-2 patient in the health care facility in which the declarant is a
4-3 patient. I have no claim against any portion of the declarant's
4-4 estate on the declarant's death. Furthermore, if I am an employee
4-5 of a health facility in which the declarant is a patient, I am not
4-6 involved in providing direct patient care to the declarant and am
4-7 not directly involved in the financial affairs of the health
4-8 facility.
4-9 "Witness ____________________
4-10 "Witness ___________________"
4-11 SECTION 3. Sections 672.009(b) and (c), Health and Safety
4-12 Code, are amended to read as follows:
4-13 (b) If the patient does not have a legal guardian, the
4-14 attending physician and at least two persons, if available, of the
4-15 following categories, in the following priority, may make a
4-16 treatment decision that may include a decision to withhold or
4-17 withdraw life-sustaining procedures:
4-18 (1) the patient's spouse;
4-19 (2) an adult child of the patient who has the waiver
4-20 and consent of all other qualified adult children of the patient to
4-21 act as the sole decision maker;
4-22 (3) a majority of the patient's reasonably available
4-23 adult children;
4-24 (4) <(3)> the patient's parents; or
4-25 (5) <(4)> the patient's nearest living relative or the
4-26 individual clearly identified to act for the patient by the patient
4-27 before the patient became comatose, incompetent, or otherwise
5-1 mentally or physically incapable of communication.
5-2 (c) A treatment decision made under Subsection (a) or (b)
5-3 must be based on knowledge of what the patient would desire, if
5-4 known, or if not known, according to an assessment by the decision
5-5 makers of the patient's best interests.
5-6 SECTION 4. Section 672.021, Health and Safety Code, is
5-7 amended to read as follows:
5-8 Sec. 672.021. Legal Right or Responsibility not Affected.
5-9 This chapter does not impair or supersede any legal right or
5-10 responsibility a person may have under a constitution, other
5-11 statute, rule, or court decision to effect the withholding or
5-12 withdrawal of life-sustaining procedures <in a lawful manner>.
5-13 SECTION 5. Section 135.004(b), Civil Practice and Remedies
5-14 Code, is amended to read as follows:
5-15 (b) A witness may not, at the time of execution, be:
5-16 (1) the agent;
5-17 (2) an employee of the principal's health or
5-18 residential care provider if the employee:
5-19 (A) is providing direct patient or resident care
5-20 to the principal; or
5-21 (B) is an officer, director, partner, or
5-22 business office employee of the provider or of any parent
5-23 organization of the provider <or the provider's employee>;
5-24 (3) the principal's spouse or heir;
5-25 (4) a person entitled to any part of the estate of the
5-26 principal on the death of the principal under a will or deed in
5-27 existence or by operation of law; or
6-1 (5) any other person who has any claim against the
6-2 estate of the principal.
6-3 SECTION 6. The changes made by this Act to the suggested
6-4 wording of a directive provided by Section 672.004, Health and
6-5 Safety Code, do not affect the validity of a directive that uses
6-6 the form provided by Section 672.004 before the effective date of
6-7 this Act, regardless of the date on which the directive is
6-8 executed.
6-9 SECTION 7. This Act takes effect September 1, 1995.
6-10 SECTION 8. The importance of this legislation and the
6-11 crowded condition of the calendars in both houses create an
6-12 emergency and an imperative public necessity that the
6-13 constitutional rule requiring bills to be read on three several
6-14 days in each house be suspended, and this rule is hereby suspended.