Texas 2017 - 85th Regular

Texas House Bill HB439 Compare Versions

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

Old	New	Differences
1	1	85R2607 SCL-D
2	2	By: Collier H.B. No. 439
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to an advance directive and do-not-resuscitate order of a
8	8	pregnant patient.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 166.033, Health and Safety Code, is
11	11	amended to read as follows:
12	12	Sec. 166.033. FORM OF WRITTEN DIRECTIVE. A written
13	13	directive may be in the following form:
14	14	DIRECTIVE TO PHYSICIANS AND FAMILY OR SURROGATES
15	15	Instructions for completing this document:
16	16	This is an important legal document known as an Advance
17	17	Directive. It is designed to help you communicate your wishes about
18	18	medical treatment at some time in the future when you are unable to
19	19	make your wishes known because of illness or injury. These wishes
20	20	are usually based on personal values. In particular, you may want
21	21	to consider what burdens or hardships of treatment you would be
22	22	willing to accept for a particular amount of benefit obtained if you
23	23	were seriously ill.
24	24	You are encouraged to discuss your values and wishes with
25	25	your family or chosen spokesperson, as well as your physician. Your
26	26	physician, other health care provider, or medical institution may
27	27	provide you with various resources to assist you in completing your
28	28	advance directive. Brief definitions are listed below and may aid
29	29	you in your discussions and advance planning. Initial the
30	30	treatment choices that best reflect your personal preferences.
31	31	Provide a copy of your directive to your physician, usual hospital,
32	32	and family or spokesperson. Consider a periodic review of this
33	33	document. By periodic review, you can best assure that the
34	34	directive reflects your preferences.
35	35	In addition to this advance directive, Texas law provides for
36	36	two other types of directives that can be important during a serious
37	37	illness. These are the Medical Power of Attorney and the
38	38	Out-of-Hospital Do-Not-Resuscitate Order. You may wish to discuss
39	39	these with your physician, family, hospital representative, or
40	40	other advisers. You may also wish to complete a directive related
41	41	to the donation of organs and tissues.
42	42	DIRECTIVE
43	43	I, __________, recognize that the best health care is based
44	44	upon a partnership of trust and communication with my physician. My
45	45	physician and I will make health care or treatment decisions
46	46	together as long as I am of sound mind and able to make my wishes
47	47	known. If there comes a time that I am unable to make medical
48	48	decisions about myself because of illness or injury, I direct that
49	49	the following treatment preferences be honored:
50	50	If, in the judgment of my physician, I am suffering with a
51	51	terminal condition from which I am expected to die within six
52	52	months, even with available life-sustaining treatment provided in
53	53	accordance with prevailing standards of medical care:
54	54	__________ I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR __________ I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR
55	55	__________ I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR
56	56	__________ I request that I be kept alive in this terminal condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.) __________ I request that I be kept alive in this terminal condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)
57	57	__________ I request that I be kept alive in this terminal condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)
58	58	If, in the judgment of my physician, I am suffering with an
59	59	irreversible condition so that I cannot care for myself or make
60	60	decisions for myself and am expected to die without life-sustaining
61	61	treatment provided in accordance with prevailing standards of care:
62	62	__________ I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR __________ I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR
63	63	__________ I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR
64	64	__________ I request that I be kept alive in this irreversible condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.) __________ I request that I be kept alive in this irreversible condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)
65	65	__________ I request that I be kept alive in this irreversible condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)
66	66	Additional requests: (After discussion with your physician,
67	67	you may wish to consider listing particular treatments in this
68	68	space that you do or do not want in specific circumstances, such as
69	69	artificially administered nutrition and hydration, intravenous
70	70	antibiotics, etc. Be sure to state whether you do or do not want the
71	71	particular treatment.)
72	72	After signing this directive, if my representative or I elect
73	73	hospice care, I understand and agree that only those treatments
74	74	needed to keep me comfortable would be provided and I would not be
75	75	given available life-sustaining treatments.
76	76	If I do not have a Medical Power of Attorney, and I am unable
77	77	to make my wishes known, I designate the following person(s) to make
78	78	health care or treatment decisions with my physician compatible
79	79	with my personal values:
80	80	1. __________
81	81	2. __________
82	82	(If a Medical Power of Attorney has been executed, then an
83	83	agent already has been named and you should not list additional
84	84	names in this document.)
85	85	If the above persons are not available, or if I have not
86	86	designated a spokesperson, I understand that a spokesperson will be
87	87	chosen for me following standards specified in the laws of Texas.
88	88	If, in the judgment of my physician, my death is imminent within
89	89	minutes to hours, even with the use of all available medical
90	90	treatment provided within the prevailing standard of care, I
91	91	acknowledge that all treatments may be withheld or removed except
92	92	those needed to maintain my comfort. [I understand that under Texas
93	93	law this directive has no effect if I have been diagnosed as
94	94	pregnant.] This directive will remain in effect until I revoke it.
95	95	No other person may do so.
96	96	Signed__________ Date__________ City, County, State of
97	97	Residence __________
98	98	Two competent adult witnesses must sign below, acknowledging
99	99	the signature of the declarant. The witness designated as Witness 1
100	100	may not be a person designated to make a health care or treatment
101	101	decision for the patient and may not be related to the patient by
102	102	blood or marriage. This witness may not be entitled to any part of
103	103	the estate and may not have a claim against the estate of the
104	104	patient. This witness may not be the attending physician or an
105	105	employee of the attending physician. If this witness is an employee
106	106	of a health care facility in which the patient is being cared for,
107	107	this witness may not be involved in providing direct patient care to
108	108	the patient. This witness may not be an officer, director, partner,
109	109	or business office employee of a health care facility in which the
110	110	patient is being cared for or of any parent organization of the
111	111	health care facility.
112	112	Witness 1 __________ Witness 2 __________
113	113	Definitions:
114	114	"Artificially administered nutrition and hydration" means
115	115	the provision of nutrients or fluids by a tube inserted in a vein,
116	116	under the skin in the subcutaneous tissues, or in the
117	117	gastrointestinal tract.
118	118	"Irreversible condition" means a condition, injury, or
119	119	illness:
120	120	(1) that may be treated, but is never cured or
121	121	eliminated;
122	122	(2) that leaves a person unable to care for or make
123	123	decisions for the person's own self; and
124	124	(3) that, without life-sustaining treatment provided
125	125	in accordance with the prevailing standard of medical care, is
126	126	fatal.
127	127	Explanation: Many serious illnesses such as cancer, failure
128	128	of major organs (kidney, heart, liver, or lung), and serious brain
129	129	disease such as Alzheimer's dementia may be considered irreversible
130	130	early on. There is no cure, but the patient may be kept alive for
131	131	prolonged periods of time if the patient receives life-sustaining
132	132	treatments. Late in the course of the same illness, the disease may
133	133	be considered terminal when, even with treatment, the patient is
134	134	expected to die. You may wish to consider which burdens of
135	135	treatment you would be willing to accept in an effort to achieve a
136	136	particular outcome. This is a very personal decision that you may
137	137	wish to discuss with your physician, family, or other important
138	138	persons in your life.
139	139	"Life-sustaining treatment" means treatment that, based on
140	140	reasonable medical judgment, sustains the life of a patient and
141	141	without which the patient will die. The term includes both
142	142	life-sustaining medications and artificial life support such as
143	143	mechanical breathing machines, kidney dialysis treatment, and
144	144	artificially administered nutrition and hydration. The term does
145	145	not include the administration of pain management medication, the
146	146	performance of a medical procedure necessary to provide comfort
147	147	care, or any other medical care provided to alleviate a patient's
148	148	pain.
149	149	"Terminal condition" means an incurable condition caused by
150	150	injury, disease, or illness that according to reasonable medical
151	151	judgment will produce death within six months, even with available
152	152	life-sustaining treatment provided in accordance with the
153	153	prevailing standard of medical care.
154	154	Explanation: Many serious illnesses may be considered
155	155	irreversible early in the course of the illness, but they may not be
156	156	considered terminal until the disease is fairly advanced. In
157	157	thinking about terminal illness and its treatment, you again may
158	158	wish to consider the relative benefits and burdens of treatment and
159	159	discuss your wishes with your physician, family, or other important
160	160	persons in your life.
161	161	SECTION 2. Sections 166.049 and 166.098, Health and Safety
162	162	Code, are repealed.
163	163	SECTION 3. This Act takes effect immediately if it receives
164	164	a vote of two-thirds of all the members elected to each house, as
165	165	provided by Section 39, Article III, Texas Constitution. If this
166	166	Act does not receive the vote necessary for immediate effect, this
167	167	Act takes effect September 1, 2017.
168	168
169	169	__________ I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR
170	170
171	171	__________ I request that I be kept alive in this terminal condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)
172	172
173	173	__________ I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR
174	174
175	175	__________ I request that I be kept alive in this irreversible condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)