|
|
|
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 Respecting Texas |
|
Patients' Right to Life Act of 2021. |
|
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 to provide |
|
life-sustaining treatment to the patient. |
|
SECTION 4. Sections 166.046(a), (b), (d), (e), (e-1), and |
|
(f), 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 and until the patient is transferred to another |
|
physician or health care facility willing to comply with the |
|
directive or treatment decision to provide life-sustaining |
|
treatment to the patient. |
|
(b) The patient or the person responsible for the health |
|
care decisions of the individual who has made the decision |
|
regarding the directive or treatment decision: |
|
(1) may be given a written description of the ethics or |
|
medical committee review process and any other policies and |
|
procedures related to this section adopted by the health care |
|
facility; |
|
(2) shall be informed of the committee review process |
|
not less than 48 hours before the meeting called to discuss the |
|
patient's directive, unless the time period is waived by mutual |
|
agreement; |
|
(3) at the time of being so informed, shall be |
|
provided[: |
|
[(A) a copy of the appropriate statement set |
|
forth in Section 166.052; and |
|
[(B)] a copy of the registry 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 that is posted on the website maintained |
|
by the department under Section 166.053; and |
|
(4) is entitled to: |
|
(A) attend the meeting; |
|
(B) receive a written explanation of the |
|
recommendations made [decision reached] during the review process; |
|
(C) receive a copy of the portion of the |
|
patient's medical record related to the treatment received by the |
|
patient in the facility for the lesser of: |
|
(i) the period of the patient's current |
|
admission to the facility; or |
|
(ii) the preceding 30 calendar days; and |
|
(D) receive a copy of all of the patient's |
|
reasonably available diagnostic results and reports related to the |
|
medical record provided under Paragraph (C). |
|
(d) If the attending physician, the patient, or the person |
|
responsible for the health care decisions of the individual does |
|
not agree with the recommendations made [decision reached] during |
|
the review process under Subsection (b), the physician shall make a |
|
reasonable effort to transfer the patient to a physician who is |
|
willing to comply with the directive. If the patient is a patient in |
|
a health care facility, the facility's personnel shall assist the |
|
physician in arranging the patient's transfer to: |
|
(1) another physician; |
|
(2) an alternative care setting within that facility; |
|
or |
|
(3) another facility. |
|
(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 ethics |
|
or medical committee consider [has affirmed is] medically |
|
inappropriate treatment, the patient shall be given available |
|
life-sustaining treatment pending transfer under Subsection (d). |
|
This subsection does not authorize withholding or withdrawing pain |
|
management medication, medical procedures necessary to provide |
|
comfort, or any other health care provided to alleviate a patient's |
|
pain. Artificially [The patient is responsible for any costs |
|
incurred in transferring the patient to another facility. The |
|
attending physician, any other physician responsible for the care |
|
of the patient, and the health care facility are not obligated to |
|
provide life-sustaining treatment after the 10th day after both the |
|
written decision and the patient's medical record required under |
|
Subsection (b) are provided to the patient or the person |
|
responsible for the health care decisions of the patient unless |
|
ordered to do so under Subsection (g), except that artificially] |
|
administered nutrition and hydration must be provided unless, based |
|
on reasonable medical judgment, providing artificially |
|
administered nutrition and hydration would: |
|
(1) hasten the patient's death; |
|
(2) be medically contraindicated such that the |
|
provision of the treatment seriously exacerbates life-threatening |
|
medical problems not outweighed by the benefit of the provision of |
|
the treatment; |
|
(3) result in substantial irremediable physical pain |
|
not outweighed by the benefit of the provision of the treatment; |
|
(4) be medically ineffective in prolonging life; or |
|
(5) be contrary to the patient's or surrogate's |
|
clearly documented desire not to receive artificially administered |
|
nutrition or hydration. |
|
(e-1) If during a previous admission to a facility a |
|
patient's attending physician and the review process under |
|
Subsection (b) have determined that life-sustaining treatment is |
|
inappropriate, and the patient is readmitted to the same facility |
|
within six months from the date of the recommendations made |
|
[decision reached] during the review process conducted upon the |
|
previous admission, Subsections (b) through (e) need not be |
|
followed if the patient's attending physician and a consulting |
|
physician who is a member of the ethics or medical committee of the |
|
facility document on the patient's readmission that the patient's |
|
condition either has not improved or has deteriorated since the |
|
review process was conducted. |
|
(f) Life-sustaining treatment under this section may not be |
|
entered in the patient's medical record as medically unnecessary |
|
treatment [until the time period provided under Subsection (e) has |
|
expired]. |
|
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. Section 25.0021(b), Government Code, is amended |
|
to read as follows: |
|
(b) A statutory probate court as that term is defined in |
|
Section 22.007(c), Estates Code, has: |
|
(1) the general jurisdiction of a probate court as |
|
provided by the Estates 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 7. Sections 166.046(g) and 166.052, Health and |
|
Safety Code, are repealed. |
|
SECTION 8. 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, 2021. |