Texas 2017 - 85th 1st C.S.

Texas House Bill HB152 Compare Versions

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

Old	New	Differences
1	1	85S10127 JG-F
2	2	By: Klick H.B. No. 152
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to advance directives or health care or treatment
8	8	decisions made by or on behalf of patients.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. This Act may be cited as the Texas Patient
11	11	Autonomy Restoration Act of 2017.
12	12	SECTION 2. The purpose of this Act is to protect the right
13	13	of patients and their families to decide whether and under what
14	14	circumstances to choose or reject life-sustaining treatment. This
15	15	Act amends the applicable provisions of the Advance Directives Act
16	16	(Chapter 166, Health and Safety Code) to ensure that, when an
17	17	attending physician is unwilling to respect a patient's advance
18	18	directive or a patient's or family's decision to choose the
19	19	treatment necessary to prevent the patient's death,
20	20	life-sustaining medical treatment will be provided until the
21	21	patient can be transferred to a health care provider willing to
22	22	honor the directive or treatment decision.
23	23	SECTION 3. Section 166.045(c), Health and Safety Code, is
24	24	amended to read as follows:
25	25	(c) If an attending physician refuses to comply with a
26	26	directive or treatment decision to provide life-sustaining
27	27	treatment to a patient [and does not wish to follow the procedure
28	28	established under Section 166.046], life-sustaining treatment
29	29	shall be provided to the patient[, but only] until [a reasonable
30	30	opportunity has been afforded for the transfer of] the patient is
31	31	transferred to another physician or health care facility willing to
32	32	comply with the directive or treatment decision to provide
33	33	life-sustaining treatment to the patient.
34	34	SECTION 4. Sections 166.046(a), (b), (e), and (f), Health
35	35	and Safety Code, are amended to read as follows:
36	36	(a) If an attending physician refuses to honor a patient's
37	37	advance directive or a health care or treatment decision made by or
38	38	on behalf of a patient, other than a directive or decision to
39	39	provide artificial nutrition and hydration to the patient, the
40	40	physician's refusal shall be reviewed by an ethics or medical
41	41	committee. The attending physician may not be a member of that
42	42	committee. [The patient shall be given life-sustaining treatment
43	43	during the review.]
44	44	(b) The patient or the person responsible for the health
45	45	care decisions of the individual who has made the decision
46	46	regarding the directive or treatment decision:
47	47	(1) may be given a written description of the ethics or
48	48	medical committee review process and any other policies and
49	49	procedures related to this section adopted by the health care
50	50	facility;
51	51	(2) shall be informed of the committee review process
52	52	not less than 48 hours before the meeting called to discuss the
53	53	patient's directive, unless the time period is waived by mutual
54	54	agreement;
55	55	(3) at the time of being so informed, shall be
56	56	provided[:
57	57	[(A) a copy of the appropriate statement set
58	58	forth in Section 166.052; and
59	59	[(B)] a copy of the registry list of health care
60	60	providers and referral groups that have volunteered their readiness
61	61	to consider accepting transfer or to assist in locating a provider
62	62	willing to accept transfer that is posted on the website maintained
63	63	by the department under Section 166.053; and
64	64	(4) is entitled to:
65	65	(A) attend the meeting;
66	66	(B) receive a written explanation of the decision
67	67	reached during the review process;
68	68	(C) receive a copy of the portion of the
69	69	patient's medical record related to the treatment received by the
70	70	patient in the facility for the lesser of:
71	71	(i) the period of the patient's current
72	72	admission to the facility; or
73	73	(ii) the preceding 30 calendar days; and
74	74	(D) receive a copy of all of the patient's
75	75	reasonably available diagnostic results and reports related to the
76	76	medical record provided under Paragraph (C).
77	77	(e) If the patient or the person responsible for the health
78	78	care decisions of the patient is requesting life-sustaining
79	79	treatment that the attending physician has decided and the ethics
80	80	or medical committee has affirmed is medically inappropriate
81	81	treatment, the patient shall be given available life-sustaining
82	82	treatment pending transfer under Subsection (d). This subsection
83	83	does not authorize withholding or withdrawing pain management
84	84	medication, medical procedures necessary to provide comfort, or any
85	85	other health care provided to alleviate a patient's
86	86	pain. Artificially [The patient is responsible for any costs
87	87	incurred in transferring the patient to another facility. The
88	88	attending physician, any other physician responsible for the care
89	89	of the patient, and the health care facility are not obligated to
90	90	provide life-sustaining treatment after the 10th day after both the
91	91	written decision and the patient's medical record required under
92	92	Subsection (b) are provided to the patient or the person
93	93	responsible for the health care decisions of the patient unless
94	94	ordered to do so under Subsection (g), except that artificially]
95	95	administered nutrition and hydration must be provided unless, based
96	96	on reasonable medical judgment, providing artificially
97	97	administered nutrition and hydration would:
98	98	(1) hasten the patient's death;
99	99	(2) be medically contraindicated such that the
100	100	provision of the treatment seriously exacerbates life-threatening
101	101	medical problems not outweighed by the benefit of the provision of
102	102	the treatment;
103	103	(3) result in substantial irremediable physical pain
104	104	not outweighed by the benefit of the provision of the treatment;
105	105	(4) be medically ineffective in prolonging life; or
106	106	(5) be contrary to the patient's or surrogate's
107	107	clearly documented desire not to receive artificially administered
108	108	nutrition or hydration.
109	109	(f) Life-sustaining treatment under this section may not be
110	110	entered in the patient's medical record as medically unnecessary
111	111	treatment [until the time period provided under Subsection (e) has
112	112	expired].
113	113	SECTION 5. Section 166.051, Health and Safety Code, is
114	114	amended to read as follows:
115	115	Sec. 166.051. LEGAL RIGHT OR RESPONSIBILITY NOT AFFECTED.
116	116	This subchapter does not impair or supersede any legal right or
117	117	responsibility a person may have to effect the withholding or
118	118	withdrawal of life-sustaining treatment in a lawful manner,
119	119	provided that if an attending physician or health care facility is
120	120	unwilling to honor a patient's advance directive or a treatment
121	121	decision to provide life-sustaining treatment, life-sustaining
122	122	treatment must [is required to] be provided to the patient in
123	123	accordance with this chapter[, but only until a reasonable
124	124	opportunity has been afforded for transfer of the patient to
125	125	another physician or health care facility willing to comply with
126	126	the advance directive or treatment decision].
127	127	SECTION 6. Section 25.0021(b), Government Code, as
128	128	effective September 1, 2017, is amended to read as follows:
129	129	(b) A statutory probate court as that term is defined in
130	130	Section 22.007(c), Estates Code, has:
131	131	(1) the general jurisdiction of a probate court as
132	132	provided by the Estates Code; and
133	133	(2) the jurisdiction provided by law for a county
134	134	court to hear and determine actions, cases, matters, or proceedings
135	135	instituted under:
136	136	(A) Section [166.046,] 192.027, 193.007,
137	137	552.015, 552.019, 711.004, or 714.003, Health and Safety Code;
138	138	(B) Chapter 462, Health and Safety Code; or
139	139	(C) Subtitle C or D, Title 7, Health and Safety
140	140	Code.
141	141	SECTION 7. Sections 166.046(g) and 166.052, Health and
142	142	Safety Code, are repealed.
143	143	SECTION 8. This Act takes effect immediately if it receives
144	144	a vote of two-thirds of all the members elected to each house, as
145	145	provided by Section 39, Article III, Texas Constitution. If this
146	146	Act does not receive the vote necessary for immediate effect, this
147	147	Act takes effect on the 91st day after the last day of the
148	148	legislative session.