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A BILL TO BE ENTITLED
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AN ACT
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relating to the obligation of a physician and a health care facility |
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to provide life-sustaining treatment. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 166.046(e), Health and Safety Code, is |
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amended to read as follows: |
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(e) If the patient or the person responsible for the health |
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care decisions of the patient is requesting life-sustaining |
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treatment that the attending physician has decided and the review |
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process has affirmed is inappropriate treatment, the patient shall |
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be given available life-sustaining treatment pending transfer |
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under Subsection (d). The patient is responsible for any costs |
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incurred in transferring the patient to another facility. The |
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physician and the health care facility are not obligated to provide |
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life-sustaining treatment after the 90th [10th] day after the |
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written decision required under Subsection (b) is provided to the |
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patient or the person responsible for the health care decisions of |
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the patient unless ordered to do so under Subsection (g). |
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SECTION 2. Section 166.052(a), Health and Safety Code, is |
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amended to read as follows: |
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(a) In cases in which the attending physician refuses to |
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honor an advance directive or treatment decision requesting the |
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provision of life-sustaining treatment, the statement required by |
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Section 166.046(b)(3)(A) [166.046(b)(2)(A)] shall be in |
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substantially the following form: |
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When There Is A Disagreement About Medical Treatment: The |
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Physician Recommends Against Life-Sustaining Treatment That You |
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Wish To Continue |
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You have been given this information because you have |
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requested life-sustaining treatment,* which the attending |
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physician believes is not appropriate. This information is being |
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provided to help you understand state law, your rights, and the |
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resources available to you in such circumstances. It outlines the |
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process for resolving disagreements about treatment among |
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patients, families, and physicians. It is based upon Section |
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166.046 of the Texas Advance Directives Act, codified in Chapter |
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166 of the Texas Health and Safety Code. |
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When an attending physician refuses to comply with an advance |
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directive or other request for life-sustaining treatment because of |
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the physician's judgment that the treatment would be inappropriate, |
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the case will be reviewed by an ethics or medical committee. |
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Life-sustaining treatment will be provided through the review. |
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You will receive notification of this review at least 48 |
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hours before a meeting of the committee related to your case. You |
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are entitled to attend the meeting. With your agreement, the |
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meeting may be held sooner than 48 hours, if possible. |
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You are entitled to receive a written explanation of the |
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decision reached during the review process. |
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If after this review process both the attending physician and |
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the ethics or medical committee conclude that life-sustaining |
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treatment is inappropriate and yet you continue to request such |
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treatment, then the following procedure will occur: |
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1. The physician, with the help of the health care facility, |
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will assist you in trying to find a physician and facility willing |
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to provide the requested treatment. |
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2. You are being given a list of health care providers and |
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referral groups that have volunteered their readiness to consider |
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accepting transfer, or to assist in locating a provider willing to |
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accept transfer, maintained by the Department of State Health |
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Services [Texas Health Care Information Council]. You may wish to |
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contact providers or referral groups on the list or others of your |
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choice to get help in arranging a transfer. |
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3. The patient will continue to be given life-sustaining |
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treatment until he or she can be transferred to a willing provider |
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for up to 90 [10] days from the time you were given the committee's |
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written decision that life-sustaining treatment is not |
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appropriate. |
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4. If a transfer can be arranged, the patient will be |
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responsible for the costs of the transfer. |
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5. If a provider cannot be found willing to give the |
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requested treatment within 90 [10] days, life-sustaining treatment |
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may be withdrawn unless a court of law has granted an extension. |
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6. You may ask the appropriate district or county court to |
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extend the 90-day [10-day] period if the court finds that there is a |
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reasonable expectation that a physician or health care facility |
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willing to provide life-sustaining treatment will be found if the |
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extension is granted. |
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*"Life-sustaining treatment" means treatment that, based on |
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reasonable medical judgment, sustains the life of a patient and |
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without which the patient will die. The term includes both |
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life-sustaining medications and artificial life support, such as |
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mechanical breathing machines, kidney dialysis treatment, and |
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artificial nutrition and hydration. The term does not include the |
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administration of pain management medication or the performance of |
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a medical procedure considered to be necessary to provide comfort |
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care, or any other medical care provided to alleviate a patient's |
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pain. |
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SECTION 3. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2007. |