Texas 2015 - 84th Regular

Texas House Bill HB2984 Compare Versions

Only one version of the bill is available at this time.

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1	1	By: Hughes H.B. No. 2984
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to advance directives or health care or treatment
7	7	decisions made by or on behalf of patients.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. This Act may be cited as the Patient and Family
10	10	Treatment Choice Rights Act of 2015.
11	11	SECTION 2. The purpose of this Act is to protect the right
12	12	of patients and their families to decide whether and under what
13	13	circumstances to choose or reject life-sustaining treatment. This
14	14	Act amends the applicable provisions of the Advance Directives Act
15	15	(Chapter 166, Health and Safety Code) to ensure that, when an
16	16	attending physician is unwilling to respect a patient's advance
17	17	directive or a patient's or family's decision to choose the
18	18	treatment necessary to prevent the patient's death,
19	19	life-sustaining medical treatment will be provided until the
20	20	patient can be transferred to a health care provider willing to
21	21	honor the directive or treatment decision.
22	22	SECTION 3. Section 166.045(c), Health and Safety Code, is
23	23	amended to read as follows:
24	24	(c) If an attending physician refuses to comply with a
25	25	directive or treatment decision to provide life-sustaining
26	26	treatment to a patient and does not wish to follow the procedure
27	27	established under Section 166.046, life-sustaining treatment shall
28	28	be provided to the patient[, but only] until [a reasonable
29	29	opportunity has been afforded for the transfer of] the patient is
30	30	transferred to another physician or health care facility willing to
31	31	comply with the directive or treatment decision.
32	32	SECTION 4. Sections 166.046(a) and (e), Health and Safety
33	33	Code, are amended to read as follows:
34	34	(a) If an attending physician refuses to honor a patient's
35	35	advance directive or a health care or treatment decision made by or
36	36	on behalf of a patient, other than a directive or decision to
37	37	provide artificial nutrition and hydration to the patient, the
38	38	physician's refusal shall be reviewed by an ethics or medical
39	39	committee. The attending physician may not be a member of that
40	40	committee. The patient shall be given life-sustaining treatment
41	41	during the review.
42	42	(e) If the patient or the person responsible for the health
43	43	care decisions of the patient is requesting life-sustaining
44	44	treatment that the attending physician has decided and the review
45	45	process has affirmed is inappropriate treatment, the patient shall
46	46	be given available life-sustaining treatment pending transfer
47	47	under Subsection (d). The patient is responsible for any costs
48	48	incurred in transferring the patient to another facility.[The
49	49	physician and the health care facility are not obligated to provide
50	50	life-sustaining treatment after the 10th day after the written
51	51	decision required under Subsection (b) is provided to the patient
52	52	or the person responsible for the health care decisions of the
53	53	patient unless ordered to do so under Subsection (g).]
54	54	SECTION 5. Section 166.051, Health and Safety Code, is
55	55	amended to read as follows:
56	56	Sec. 166.051. LEGAL RIGHT OR RESPONSIBILITY NOT AFFECTED.
57	57	This subchapter does not impair or supersede any legal right or
58	58	responsibility a person may have to effect the withholding or
59	59	withdrawal of life-sustaining treatment in a lawful manner,
60	60	provided that if an attending physician or health care facility is
61	61	unwilling to honor a patient's advance directive or a treatment
62	62	decision to provide life-sustaining treatment, life-sustaining
63	63	treatment must [is required to] be provided to the patient in
64	64	accordance with this chapter[, but only until a reasonable
65	65	opportunity has been afforded for transfer of the patient to
66	66	another physician or health care facility willing to comply with
67	67	the advance directive or treatment decision].
68	68	SECTION 6. Sections 166.052(a) and (b), Health and Safety
69	69	Code, are amended to read as follows:
70	70	(a) In cases in which the attending physician refuses to
71	71	honor an advance directive or treatment decision requesting the
72	72	provision of life-sustaining treatment, other than a directive or
73	73	decision to provide artificial nutrition and hydration, the
74	74	statement required by Section 166.046(b)(3)(A) [166.046(b)(2)(A)]
75	75	shall be in substantially the following form:
76	76	When There Is A Disagreement About Medical Treatment: The
77	77	Physician Recommends Against Life-Sustaining Treatment That You
78	78	Wish To Continue
79	79	You have been given this information because you have
80	80	requested life-sustaining treatment,* other than artificial
81	81	nutrition and hydration, which the attending physician believes is
82	82	not appropriate. This information is being provided to help you
83	83	understand state law, your rights, and the resources available to
84	84	you in such circumstances. It outlines the process for resolving
85	85	disagreements about treatment among patients, families, and
86	86	physicians. It is based upon Section 166.046 of the Texas Advance
87	87	Directives Act, codified in Chapter 166 of the Texas Health and
88	88	Safety Code.
89	89	When an attending physician refuses to comply with an advance
90	90	directive or other request for life-sustaining treatment, other
91	91	than artificial nutrition and hydration, because of the physician's
92	92	judgment that the treatment would be inappropriate, the case will
93	93	be reviewed by an ethics or medical committee. Life-sustaining
94	94	treatment will be provided through the review.
95	95	You will receive notification of this review at least 48
96	96	hours before a meeting of the committee related to your case. You
97	97	are entitled to attend the meeting. With your agreement, the
98	98	meeting may be held sooner than 48 hours, if possible.
99	99	You are entitled to receive a written explanation of the
100	100	decision reached during the review process.
101	101	If after this review process both the attending physician and
102	102	the ethics or medical committee conclude that life-sustaining
103	103	treatment, other than artificial nutrition and hydration, is
104	104	inappropriate and yet you continue to request such treatment, then
105	105	the following procedure will occur:
106	106	1. The physician, with the help of the health care facility,
107	107	will assist you in finding [trying to find] a physician and facility
108	108	willing to provide the requested treatment.
109	109	2. You are being given a list of health care providers and
110	110	referral groups that have volunteered their readiness to consider
111	111	accepting transfer, or to assist in locating a provider willing to
112	112	accept transfer, maintained by the Department of State Health
113	113	Services [Texas Health Care Information Council]. You may wish to
114	114	contact providers or referral groups on the list or others of your
115	115	choice to get help in arranging a transfer.
116	116	3. The patient will [continue to] be given life-sustaining
117	117	treatment until he or she can be transferred to a willing provider
118	118	[for up to 10 days from the time you were given the committee's
119	119	written decision that life-sustaining treatment is not
120	120	appropriate].
121	121	4. If a transfer can be arranged, the patient will be
122	122	responsible for the costs of the transfer.
123	123	[5. If a provider cannot be found willing to give the
124	124	requested treatment within 10 days, life-sustaining treatment may
125	125	be withdrawn unless a court of law has granted an extension.
126	126	[6. You may ask the appropriate district or county court to
127	127	extend the 10-day period if the court finds that there is a
128	128	reasonable expectation that a physician or health care facility
129	129	willing to provide life-sustaining treatment will be found if the
130	130	extension is granted.]
131	131	*"Life-sustaining treatment" means treatment that, based on
132	132	reasonable medical judgment, sustains the life of a patient and
133	133	without which the patient will die. The term includes both
134	134	life-sustaining medications and artificial life support, such as
135	135	mechanical breathing machines, kidney dialysis treatment, and
136	136	artificial nutrition and hydration. The term does not include the
137	137	administration of pain management medication or the performance of
138	138	a medical procedure considered to be necessary to provide comfort
139	139	care, or any other medical care provided to alleviate a patient's
140	140	pain.
141	141	(b) In cases in which the attending physician refuses to
142	142	comply with an advance directive or treatment decision requesting
143	143	the withholding or withdrawal of life-sustaining treatment, the
144	144	statement required by Section 166.046(b)(3)(A) shall be in
145	145	substantially the following form:
146	146	When There Is A Disagreement About Medical Treatment: The
147	147	Physician Recommends Life-Sustaining Treatment That You Wish To
148	148	Stop
149	149	You have been given this information because you have
150	150	requested the withdrawal or withholding of life-sustaining
151	151	treatment*, other than artificial nutrition and hydration, and the
152	152	attending physician refuses to comply with that request. The
153	153	information is being provided to help you understand state law,
154	154	your rights, and the resources available to you in such
155	155	circumstances. It outlines the process for resolving disagreements
156	156	about treatment among patients, families, and physicians. It is
157	157	based upon Section 166.046 of the Texas Advance Directives Act,
158	158	codified in Chapter 166 of the Texas Health and Safety Code.
159	159	When an attending physician refuses to comply with an advance
160	160	directive or other request for withdrawal or withholding of
161	161	life-sustaining treatment for any reason, the case will be reviewed
162	162	by an ethics or medical committee. Life-sustaining treatment will
163	163	be provided through the review.
164	164	You will receive notification of this review at least 48
165	165	hours before a meeting of the committee related to your case. You
166	166	are entitled to attend the meeting. With your agreement, the
167	167	meeting may be held sooner than 48 hours, if possible.
168	168	You are entitled to receive a written explanation of the
169	169	decision reached during the review process.
170	170	If you or the attending physician do not agree with the
171	171	decision reached during the review process, and the attending
172	172	physician still refuses to comply with your request to withhold or
173	173	withdraw life-sustaining treatment, then the following procedure
174	174	will occur:
175	175	1. The physician, with the help of the health care facility,
176	176	will assist you in finding [trying to find] a physician and facility
177	177	willing to withdraw or withhold the life-sustaining treatment.
178	178	2. You are being given a list of health care providers and
179	179	referral groups that have volunteered their readiness to consider
180	180	accepting transfer, or to assist in locating a provider willing to
181	181	accept transfer, maintained by the Department of State Health
182	182	Services [Texas Health Care Information Council]. You may wish to
183	183	contact providers or referral groups on the list or others of your
184	184	choice to get help in arranging a transfer.
185	185	*"Life-sustaining treatment" means treatment that, based on
186	186	reasonable medical judgment, sustains the life of a patient and
187	187	without which the patient will die. The term includes both
188	188	life-sustaining medications and artificial life support, such as
189	189	mechanical breathing machines, kidney dialysis treatment, and
190	190	artificial nutrition and hydration. The term does not include the
191	191	administration of pain management medication or the performance of
192	192	a medical procedure considered to be necessary to provide comfort
193	193	care, or any other medical care provided to alleviate a patient's
194	194	pain.
195	195	SECTION 7. Section 25.0021(b), Government Code, is amended
196	196	to read as follows:
197	197	(b) A statutory probate court as that term is defined in
198	198	Section 3(ii), Texas Probate Code, has:
199	199	(1) the general jurisdiction of a probate court as
200	200	provided by the Texas Probate Code; and
201	201	(2) the jurisdiction provided by law for a county
202	202	court to hear and determine actions, cases, matters, or proceedings
203	203	instituted under:
204	204	(A) Section[166.046,]192.027,193.007, 552.015,
205	205	552.019, 711.004, or 714.003, Health and Safety Code;
206	206	(B) Chapter 462, Health and Safety Code; or
207	207	(C) Subtitle C or D, Title 7, Health and Safety
208	208	Code.
209	209	SECTION 8. Sections 166.046(f) and (g), Health and Safety
210	210	Code, are repealed.
211	211	SECTION 9. This Act takes effect immediately if it receives
212	212	a vote of two-thirds of all the members elected to each house, as
213	213	provided by Section 39, Article III, Texas Constitution. If this
214	214	Act does not receive the vote necessary for immediate effect, this
215	215	Act takes effect September 1, 2015.