By: Hughes H.B. No. 2984
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to advance directives or health care or treatment
  decisions made by or on behalf of patients.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  This Act may be cited as the Patient and Family
  Treatment Choice Rights Act of 2015.
         SECTION 2.  The purpose of this Act is to protect the right
  of patients and their families to decide whether and under what
  circumstances to choose or reject life-sustaining treatment.  This
  Act amends the applicable provisions of the Advance Directives Act
  (Chapter 166, Health and Safety Code) to ensure that, when an
  attending physician is unwilling to respect a patient's advance
  directive or a patient's or family's decision to choose the
  treatment necessary to prevent the patient's death,
  life-sustaining medical treatment will be provided until the
  patient can be transferred to a health care provider willing to
  honor the directive or treatment decision.
         SECTION 3.  Section 166.045(c), Health and Safety Code, is
  amended to read as follows:
         (c)  If an attending physician refuses to comply with a
  directive or treatment decision to provide life-sustaining
  treatment to a patient and does not wish to follow the procedure
  established under Section 166.046, life-sustaining treatment shall
  be provided to the patient[, but only] until [a reasonable
  opportunity has been afforded for the transfer of] the patient is
  transferred to another physician or health care facility willing to
  comply with the directive or treatment decision.
         SECTION 4.  Sections 166.046(a) and (e), Health and Safety
  Code, are amended to read as follows:
         (a)  If an attending physician refuses to honor a patient's
  advance directive or a health care or treatment decision made by or
  on behalf of a patient, other than a directive or decision to
  provide artificial nutrition and hydration to the patient, the
  physician's refusal shall be reviewed by an ethics or medical
  committee.  The attending physician may not be a member of that
  committee.  The patient shall be given life-sustaining treatment
  during the review.
         (e)  If the patient or the person responsible for the health
  care decisions of the patient is requesting life-sustaining
  treatment that the attending physician has decided and the review
  process has affirmed is inappropriate treatment, the patient shall
  be given available life-sustaining treatment pending transfer
  under Subsection (d).  The patient is responsible for any costs
  incurred in transferring the patient to another facility.[The
  physician and the health care facility are not obligated to provide
  life-sustaining treatment after the 10th day after the written
  decision required under Subsection (b) is provided to the patient
  or the person responsible for the health care decisions of the
  patient unless ordered to do so under Subsection (g).]
         SECTION 5.  Section 166.051, Health and Safety Code, is
  amended to read as follows:
         Sec. 166.051.  LEGAL RIGHT OR RESPONSIBILITY NOT AFFECTED.  
  This subchapter does not impair or supersede any legal right or
  responsibility a person may have to effect the withholding or
  withdrawal of life-sustaining treatment in a lawful manner,
  provided that if an attending physician or health care facility is
  unwilling to honor a patient's advance directive or a treatment
  decision to provide life-sustaining treatment, life-sustaining
  treatment must [is required to] be provided to the patient in
  accordance with this chapter[, but only until a reasonable
  opportunity has been afforded for transfer of the patient to
  another physician or health care facility willing to comply with
  the advance directive or treatment decision].
         SECTION 6.  Sections 166.052(a) and (b), Health and Safety
  Code, are amended to read as follows:
         (a)  In cases in which the attending physician refuses to
  honor an advance directive or treatment decision requesting the
  provision of life-sustaining treatment, other than a directive or
  decision to provide artificial nutrition and hydration, the
  statement required by Section 166.046(b)(3)(A) [166.046(b)(2)(A)]
  shall be in substantially the following form:
  When There Is A Disagreement About Medical Treatment:  The
  Physician Recommends Against Life-Sustaining Treatment That You
  Wish To Continue
         You have been given this information because you have
  requested life-sustaining treatment,* other than artificial
  nutrition and hydration, which the attending physician believes is
  not appropriate.  This information is being provided to help you
  understand state law, your rights, and the resources available to
  you in such circumstances.  It outlines the process for resolving
  disagreements about treatment among patients, families, and
  physicians.  It is based upon Section 166.046 of the Texas Advance
  Directives Act, codified in Chapter 166 of the Texas Health and
  Safety Code.
         When an attending physician refuses to comply with an advance
  directive or other request for life-sustaining treatment, other
  than artificial nutrition and hydration, because of the physician's
  judgment that the treatment would be inappropriate, the case will
  be reviewed by an ethics or medical committee.  Life-sustaining
  treatment will be provided through the review.
         You will receive notification of this review at least 48
  hours before a meeting of the committee related to your case.  You
  are entitled to attend the meeting.  With your agreement, the
  meeting may be held sooner than 48 hours, if possible.
         You are entitled to receive a written explanation of the
  decision reached during the review process.
         If after this review process both the attending physician and
  the ethics or medical committee conclude that life-sustaining
  treatment, other than artificial nutrition and hydration, is
  inappropriate and yet you continue to request such treatment, then
  the following procedure will occur:
         1.  The physician, with the help of the health care facility,
  will assist you in finding [trying to find] a physician and facility
  willing to provide the requested treatment.
         2.  You are being given a list of health care providers and
  referral groups that have volunteered their readiness to consider
  accepting transfer, or to assist in locating a provider willing to
  accept transfer, maintained by the Department of State Health
  Services [Texas Health Care Information Council].  You may wish to
  contact providers or referral groups on the list or others of your
  choice to get help in arranging a transfer.
         3.  The patient will [continue to] be given life-sustaining
  treatment until he or she can be transferred to a willing provider
  [for up to 10 days from the time you were given the committee's
  written decision that life-sustaining treatment is not
  appropriate].
         4.  If a transfer can be arranged, the patient will be
  responsible for the costs of the transfer.
         [5.     If a provider cannot be found willing to give the
  requested treatment within 10 days, life-sustaining treatment may
  be withdrawn unless a court of law has granted an extension.
         [6.     You may ask the appropriate district or county court to
  extend the 10-day period if the court finds that there is a
  reasonable expectation that a physician or health care facility
  willing to provide life-sustaining treatment will be found if the
  extension is granted.]
         *"Life-sustaining treatment" means treatment that, based on
  reasonable medical judgment, sustains the life of a patient and
  without which the patient will die.  The term includes both
  life-sustaining medications and artificial life support, such as
  mechanical breathing machines, kidney dialysis treatment, and
  artificial nutrition and hydration.  The term does not include the
  administration of pain management medication or the performance of
  a medical procedure considered to be necessary to provide comfort
  care, or any other medical care provided to alleviate a patient's
  pain.
         (b)  In cases in which the attending physician refuses to
  comply with an advance directive or treatment decision requesting
  the withholding or withdrawal of life-sustaining treatment, the
  statement required by Section 166.046(b)(3)(A) shall be in
  substantially the following form:
  When There Is A Disagreement About Medical Treatment:  The
  Physician Recommends Life-Sustaining Treatment That You Wish To
  Stop
         You have been given this information because you have
  requested the withdrawal or withholding of life-sustaining
  treatment*, other than artificial nutrition and hydration, and the
  attending physician refuses to comply with that request.  The
  information is being provided to help you understand state law,
  your rights, and the resources available to you in such
  circumstances.  It outlines the process for resolving disagreements
  about treatment among patients, families, and physicians.  It is
  based upon Section 166.046 of the Texas Advance Directives Act,
  codified in Chapter 166 of the Texas Health and Safety Code.
         When an attending physician refuses to comply with an advance
  directive or other request for withdrawal or withholding of
  life-sustaining treatment for any reason, the case will be reviewed
  by an ethics or medical committee.  Life-sustaining treatment will
  be provided through the review.
         You will receive notification of this review at least 48
  hours before a meeting of the committee related to your case.  You
  are entitled to attend the meeting. With your agreement, the
  meeting may be held sooner than 48 hours, if possible.
         You are entitled to receive a written explanation of the
  decision reached during the review process.
         If you or the attending physician do not agree with the
  decision reached during the review process, and the attending
  physician still refuses to comply with your request to withhold or
  withdraw life-sustaining treatment, then the following procedure
  will occur:
         1.  The physician, with the help of the health care facility,
  will assist you in finding [trying to find] a physician and facility
  willing to withdraw or withhold the life-sustaining treatment.
         2.  You are being given a list of health care providers and
  referral groups that have volunteered their readiness to consider
  accepting transfer, or to assist in locating a provider willing to
  accept transfer, maintained by the Department of State Health
  Services [Texas Health Care Information Council].  You may wish to
  contact providers or referral groups on the list or others of your
  choice to get help in arranging a transfer.
         *"Life-sustaining treatment" means treatment that, based on
  reasonable medical judgment, sustains the life of a patient and
  without which the patient will die.  The term includes both
  life-sustaining medications and artificial life support, such as
  mechanical breathing machines, kidney dialysis treatment, and
  artificial nutrition and hydration.  The term does not include the
  administration of pain management medication or the performance of
  a medical procedure considered to be necessary to provide comfort
  care, or any other medical care provided to alleviate a patient's
  pain.
         SECTION 7.  Section 25.0021(b), Government Code, is amended
  to read as follows:
         (b)  A statutory probate court as that term is defined in
  Section 3(ii), Texas Probate Code, has:
               (1)  the general jurisdiction of a probate court as
  provided by the Texas Probate Code; and
               (2)  the jurisdiction provided by law for a county
  court to hear and determine actions, cases, matters, or proceedings
  instituted under:
                     (A)  Section[166.046,]192.027,193.007, 552.015,
  552.019, 711.004, or 714.003, Health and Safety Code;
                     (B)  Chapter 462, Health and Safety Code; or
                     (C)  Subtitle C or D, Title 7, Health and Safety
  Code.
         SECTION 8.  Sections 166.046(f) and (g), Health and Safety
  Code, are repealed.
         SECTION 9.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2015.