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A BILL TO BE ENTITLED
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AN ACT
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relating to withdrawal of certain life-sustaining treatment. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 166, Health and Safety |
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Code, is amended by adding Section 166.0335 to read as follows: |
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Sec. 166.0335. ADDITIONAL FORM FOR WITHHOLDING ARTIFICIAL |
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NUTRITION AND HYDRATION. (a) If the patient or person responsible |
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for the health care decisions of the patient desires the |
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withholding of artificial nutrition and hydration, the patient or |
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responsible person must execute a written, signed statement on a |
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form prescribed by the department that the patient does not wish to |
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receive artificial nutrition, artificial hydration, or both. |
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(b) The form described by Subsection (a) must be delivered |
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in person by the patient or person responsible for the health care |
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decisions of the patient to the physician and the facility |
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administrator, who shall provide a signed receipt to the patient or |
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responsible person acknowledging that the physician and facility |
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administrator have received the completed form. |
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(c) On receipt of the form under Subsection (b), the |
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physician shall place that form in a separate and conspicuously |
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colored section at or near the top of the patient's medical chart or |
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record. |
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(d) Notwithstanding any other provision of this chapter, |
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artificial nutrition and hydration may not be withdrawn if a form |
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has not been delivered under this section. |
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(e) The department by rule shall adopt a form for use under |
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this section. |
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SECTION 2. Section 166.046, Health and Safety Code, is |
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amended by adding Subsection (b-1) to read as follows: |
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(b-1) An ethics or medical committee under this section may |
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not find that the provision of artificial nutrition and hydration |
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is inappropriate treatment if the patient or the person responsible |
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for the health care decisions of the patient has not delivered an |
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executed form under Section 166.0335. |
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SECTION 3. 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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The ethics or medical review committee may not determine that |
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the provision of artificial nutrition and hydration is |
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inappropriate if you wish to continue artificial nutrition and |
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hydration. Artificial nutrition and hydration may only be |
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withdrawn at your written, signed request. |
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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, other than artificial nutrition and hydration, is |
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inappropriate and yet you continue to request such treatment, then |
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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 Texas Health Care Information |
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Council. You may wish to contact providers or referral groups on |
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the list or others of your choice to get help in arranging a |
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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 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 10 days, life-sustaining treatment may |
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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 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 4. (a) Except as provided by Subsection (b) of this |
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section, the change in law made by this Act applies only to a health |
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care or treatment decision made on or after the effective date of |
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this Act. |
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(b) A physician, facility, or other health care provider may |
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not withdraw artificial nutrition and hydration on or after the |
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effective date of this Act without a form issued in accordance with |
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Section 166.0335, Health and Safety Code, as added by this Act, |
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regardless of whether the patient or other person responsible for |
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the health care decisions of the patient has issued an advance |
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directive that authorizes the withdrawal of artificial nutrition |
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and hydration before, on, or after the effective date of this Act. |
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This section does not require the resumption of the provision of |
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artificial nutrition and hydration for a patient for whom that |
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treatment was legally discontinued before the effective date of |
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this Act under the law as it existed immediately before the |
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effective date of this Act. |
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SECTION 5. This Act takes effect September 1, 2013. |