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A BILL TO BE ENTITLED
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AN ACT
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relating to general procedures and requirements for |
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do-not-resuscitate orders. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter A, Chapter 166, Health and Safety |
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Code, is amended by adding Section 166.012 to read as follows: |
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Sec. 166.012. GENERAL PROCEDURES AND REQUIREMENTS FOR |
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DO-NOT-RESUSCITATE ORDERS. (a) In this section, "DNR order" means |
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an order instructing a health care professional not to attempt |
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cardiopulmonary resuscitation or other life-sustaining treatment |
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on a patient whose circulatory or respiratory function ceases. |
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(b) This section applies to a DNR order used in a health care |
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facility, hospital, or assisted living facility or in hospice |
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settings, including hospice services provided by a home and |
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community support services agency. This section does not apply to |
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an out-of-hospital DNR order as defined by Section 166.081. |
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(c) A DNR order issued for a patient is valid only if the |
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order: |
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(1) is issued in compliance with: |
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(A) the written directions of a patient who was |
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competent at the time the patient wrote the directions; |
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(B) the oral directions of a competent patient |
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delivered to or observed by two competent adult witnesses, at least |
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one of whom must be a person not listed under Section 166.003(2); |
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(C) the directions in an advance directive |
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enforceable under Section 166.005 or executed in accordance with |
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Section 166.032, 166.034, or 166.035; |
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(D) the directions of a patient's legal guardian |
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or agent under a medical power of attorney acting in accordance with |
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Subchapter D; or |
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(E) a treatment decision made in accordance with |
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Section 166.039; or |
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(2) is not contrary to the directions of a patient who |
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was competent at the time the patient conveyed the directions and, |
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in the reasonable medical judgment of the patient's attending |
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physician: |
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(A) the patient's death is imminent, regardless |
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of the provision of cardiopulmonary resuscitation; and |
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(B) the DNR order is medically appropriate. |
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(d) If an individual described by Section 166.039(b)(1), |
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(2), or (3) arrives at the facility and notifies the facility of the |
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individual's arrival after a DNR order is issued under Subsection |
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(c)(2), the order must be disclosed to the individual in accordance |
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with the priority established under Section 166.039(b). |
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(e) The facility may satisfy the notice requirement under |
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Subsection (d) by notifying one person in accordance with the |
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priority established under Section 166.039(b). The facility is not |
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required to notify additional persons beyond the first person |
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notified. |
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(f) A DNR order takes effect at the time the order is issued, |
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provided the order is placed in the patient's medical record as soon |
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as practicable. |
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(g) On admission to a health care facility or on initial |
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provision of hospice services, as applicable, the facility or |
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service provider shall provide to the patient or person authorized |
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to make treatment decisions on behalf of the patient notice of the |
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policies of the facility or service provider regarding the rights |
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of the patient and person authorized to make treatment decisions on |
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behalf of the patient under this section. |
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SECTION 2. The executive commissioner of the Health and |
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Human Services Commission shall adopt rules necessary to implement |
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Section 166.012, Health and Safety Code, as added by this Act, as |
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soon as practicable after the effective date of this Act. |
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SECTION 3. Section 166.012, Health and Safety Code, as |
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added by this Act, applies only to a do-not-resuscitate order |
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issued on or after the effective date of this Act. |
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SECTION 4. This Act takes effect January 15, 2018. |