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