HLS 14RS-610 ORIGINAL
Page 1 of 5
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Regular Session, 2014
HOUSE BILL NO. 348
BY REPRESENTATIVE BADON
HEALTH: Prohibits termination of life-sustaining procedures for pregnant women
AN ACT1
To enact R.S. 40:1299.58.10(F), 1299.63.1, 1299.64.6(E), and Part XXIV-D of Chapter 52
of Title 40 of the Louisiana Revised Statutes of 1950, to be comprised of R.S.3
40:1299.64.11 through 1299.64.13, relative to life-sustaining procedures; to provide4
for definitions; to require life-sustaining procedures for pregnant women; to provide5
for exceptions; and to provide for related matters.6
Be it enacted by the Legislature of Louisiana:7
Section 1. R.S. 40:1299.58.10(F), 1299.63.1, 1299.64.6(E), and Part XXIV-D of8
Chapter 5 of Title 40 of the Louisiana Revised Statutes of 1950, comprised of R.S.9
40:1299.64.11 through 1299.64.13, are hereby enacted to read as follows:10
§1299.58.10. General application11
* * *12
F. The provisions of this Part shall not apply to a pregnant woman unless13
authorized by R.S. 40:1299.64.11 et seq.14
* * *15
§1299.63.1. General application16
The provisions of this Part shall not apply to a pregnant woman unless17
authorized by R.S. 40:1299.64.11 et seq.18
* * *19 HLS 14RS-610 ORIGINAL
HB NO. 348
Page 2 of 5
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
§1299.64.6. General application1
* * *2
E. The provisions of this Part shall not apply to a pregnant woman unless3
authorized by R.S. 40:1299.64.11 et seq.4
* * *5
PART XXIV-D. LIFE-SUSTAINING PROCEDURES FOR PREGNANT WOMEN6
§1299.64.11. Definitions7
In this Part, unless the context otherwise requires, the following definitions8
are applicable:9
(1) "End-stage medical condition" means an incurable and irreversible10
medical condition in an advanced state caused by injury, disease, or physical illness11
that will, in the opinion of the attending physician to a reasonable degree of medical12
certainty, result in death, despite the introduction or continuation of medical13
treatment. 14
(2) "Incompetent" means a condition in which an individual, despite being15
provided appropriate medical information, communication supports, and technical16
assistance, is documented by a healthcare provider to be one of the following:17
(a) Unable to understand the potential material benefits, risks, and18
alternatives involved in a specific proposed healthcare decision.19
(b) Unable to make that healthcare decision on his own behalf.20
(c) Unable to communicate that healthcare decision to any other person.21
(3) "Life-sustaining procedure" means any medical procedure or intervention22
that, when administered to an individual who has an end-stage medical condition or23
is permanently unconscious, will serve only to prolong the process of dying or24
maintain the individual in a state of permanent unconsciousness. The term includes25
but is not limited to nutrition and hydration administered by gastric tube or26
intravenously or any other artificial or invasive means.27
(4) "Permanently unconscious" means a medical condition that has been28
diagnosed in accordance with currently accepted medical standards and with29 HLS 14RS-610 ORIGINAL
HB NO. 348
Page 3 of 5
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
reasonable medical certainty as total and irreversible loss of consciousness and1
capacity for interaction with the environment. The term includes but is not limited2
to an irreversible vegetative state or irreversible coma.3
§1299.64.12. Advanced directives; pregnancy; life-sustaining procedure required4
A. Notwithstanding a contrary direction contained in an advanced healthcare5
directive executed pursuant to R.S. 40:1299.58.1 et seq. or 1299.60 et seq., the6
existence of a living will, a healthcare decision by a healthcare representative or7
healthcare agent, or any other direction to the contrary, life-sustaining procedures8
including but not limited to cardiopulmonary resuscitation, nutrition, and hydration9
shall be provided to and shall not be withheld or withdrawn from a pregnant woman10
who is incompetent and has an end-stage medical condition or who is permanently11
unconscious.12
B. The provisions of Subsection A of this Section shall not apply in any case13
where, to a reasonable degree of medical certainty as certified on the pregnant14
woman's medical record by the pregnant woman's attending physician and an15
obstetrician who has examined the pregnant woman, the life-sustaining treatment,16
nutrition, and hydration shall do any of the following:17
(1) Not maintain the pregnant woman in such a way as to permit the18
continuing development and live birth of the unborn child.19
(2) Be physically harmful to the pregnant woman.20
(3) Cause pain to the pregnant woman that cannot be alleviated by21
medication.22
§1299.64.13. Physician order for scope of treatment; pregnancy; life-sustaining23
procedure required24
A. Notwithstanding the existence of a physician order for scope of treatment25
executed pursuant to R.S. 40:1299.64.1 et seq. or other direction to the contrary,26
life-sustaining procedures including but not limited to cardiopulmonary resuscitation,27
nutrition, and hydration shall be provided to and shall not be withheld or withdrawn28 HLS 14RS-610 ORIGINAL
HB NO. 348
Page 4 of 5
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
from a pregnant woman who is incompetent and has an end-stage medical condition1
or who is permanently unconscious.2
B. The provisions of Subsection A of this Section shall not apply in any case3
where, to a reasonable degree of medical certainty as certified on the pregnant4
woman's medical record by the pregnant woman's attending physician and an5
obstetrician who has examined the pregnant woman, the life-sustaining treatment,6
nutrition, and hydration shall do any of the following:7
(1) Not maintain the pregnant woman in such a way as to permit the8
continuing development and live birth of the unborn child.9
(2) Be physically harmful to the pregnant woman.10
(3) Cause pain to the pregnant woman that cannot be alleviated by11
medication.12
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Badon HB No. 348
Abstract: Prohibits the withholding or withdrawing of life-sustaining procedures from a
pregnant woman.
Present law authorizes an individual to make an advanced healthcare directive pursuant to
which life-sustaining procedures may be withheld or withdrawn in the event the individual
is comatose, incompetent, or otherwise physically or mentally incapable of communication
and the individual is diagnosed and certified as having a terminal and irreversible condition.
Proposed law retains present law but creates an exception for a pregnant woman unless
authorized by proposed law.
Present law authorizes a member of the military to make an advanced health care directive
pursuant to which life-sustaining procedures may be withheld or withdrawn in the event the
individual is comatose, incompetent, or otherwise physically or mentally incapable of
communication and the individual is diagnosed and certified as having a terminal and
irreversible condition.
Proposed law retains present law but creates an exception for a pregnant woman unless
authorized by proposed law.
Present law authorizes a physician to document, in a physician's order, the wishes of an
individual diagnosed and certified as having a terminal and irreversible condition regarding
which life-sustaining procedures may be withheld or withdrawn in the event the individual
is comatose, incompetent, or otherwise physically or mentally incapable of communication. HLS 14RS-610 ORIGINAL
HB NO. 348
Page 5 of 5
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Proposed law retains present law but creates an exception for a pregnant woman unless
authorized by proposed law.
Proposed law defines "end-stage medical condition" as an incurable and irreversible medical
condition in an advanced state caused by injury, disease, or physical illness that will, in the
opinion of the attending physician to a reasonable degree of medical certainty, result in
death, despite the introduction or continuation of medical treatment.
Proposed law defines "incompetent" as a condition in which an individual, despite being
provided appropriate medical information, communication supports, and technical
assistance, is documented by a healthcare provider to be one of the following:
(1)Unable to understand the potential material benefits, risks, and alternatives involved
in a specific proposed healthcare decision.
(2)Unable to make that healthcare decision on his own behalf.
(3)Unable to communicate that healthcare decision to any other person.
Proposed law defines "life-sustaining procedure" as any medical procedure or intervention
that, when administered to an individual who has an end-stage medical condition or is
permanently unconscious, will serve only to prolong the process of dying or maintain the
individual in a state of permanent unconsciousness. The term includes but is not limited to
nutrition and hydration administered by gastric tube or intravenously or any other artificial
or invasive means.
Proposed law defines "permanently unconscious" as a medical condition that has been
diagnosed in accordance with currently accepted medical standards and with reasonable
medical certainty as total and irreversible loss of consciousness and capacity for interaction
with the environment. The term includes but is not limited to an irreversible vegetative state
or irreversible coma.
Proposed law requires, notwithstanding a contrary direction contained in an advanced health
care directive, the existence of a living will, a healthcare decision by a healthcare
representative or healthcare agent, or any other direction to the contrary, life-sustaining
procedures including but not limited to cardiopulmonary resuscitation, nutrition, and
hydration to be provided to, and not withheld or withdrawn from, a pregnant woman who
is incompetent and has an end-stage medical condition or who is permanently unconscious.
Proposed law requires, notwithstanding the existence of a physician order for scope of
treatment, or any other direction to the contrary, life-sustaining procedures including but not
limited to cardiopulmonary resuscitation, nutrition, and hydration to be provided to, and not
withheld or withdrawn from, a pregnant woman who is incompetent and has an end-stage
medical condition or who is permanently unconscious.
Proposed law provides an exception to proposed law in any case where, to a reasonable
degree of medical certainty as certified on the pregnant woman's medical record by the
pregnant woman's attending physician and an obstetrician who has examined the pregnant
woman, the life-sustaining treatment, nutrition, and hydration shall do any of the following:
(1)Not maintain the pregnant woman in such a way as to permit the continuing
development and live birth of the unborn child.
(2)Be physically harmful to the pregnant woman.
(3)Cause pain to the pregnant woman that cannot be alleviated by medication.
(Adds R.S. 40:1299.58.10(F), 1299.63.1, 1299.64.6(E), and 1299.64.11-1299.64.13)