By: Perry, et al. S.B. No. 11
A BILL TO BE ENTITLED
AN ACT
relating to general procedures and requirements for
do-not-resuscitate orders.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 166, Health and Safety
Code, is amended by adding Section 166.012 to read as follows:
Sec. 166.012. GENERAL PROCEDURES AND REQUIREMENTS FOR
DO-NOT-RESUSCITATE ORDERS. (a) In this section, "DNR order" means
an order instructing a health care professional not to attempt
cardiopulmonary resuscitation or other life-sustaining treatment
on a patient whose circulatory or respiratory function ceases.
(b) This section applies to a DNR order used in a health care
facility, including a hospital or an assisted living facility, or
in hospice settings, including hospice services provided by a home
and community support services agency. This section does not apply
to an out-of-hospital DNR order as defined by Section 166.081.
(c) A DNR order issued for a patient is valid only if the
order:
(1) is issued in compliance with:
(A) the written directions of a patient who was
competent at the time the patient wrote the directions;
(B) the oral directions of a competent patient
delivered to or observed by two competent adult witnesses, at least
one of whom must be a person not listed under Section 166.003(2);
(C) the directions in an advance directive
enforceable under Section 166.005 or executed in accordance with
Section 166.032, 166.034, or 166.035;
(D) the directions of a patient's legal guardian
or agent under a medical power of attorney acting in accordance with
Subchapter D; or
(E) a treatment decision made in accordance with
Section 166.039; or
(2) is not contrary to the directions of a patient who
was competent at the time the patient conveyed the directions and,
in the reasonable medical judgment of the patient's attending
physician:
(A) the patient's death is imminent, regardless
of the provision of cardiopulmonary resuscitation; and
(B) the DNR order is medically appropriate.
(d) If an individual described by Section 166.039(b)(1),
(2), or (3) arrives at the facility and notifies the facility of the
individual's arrival after a DNR order is issued under Subsection
(c)(2), the order must be disclosed to the individual in accordance
with the priority established under Section 166.039(b).
(e) The facility may satisfy the notice requirement under
Subsection (d) by notifying one person in accordance with the
priority established under Section 166.039(b). The facility is not
required to notify additional persons beyond the first person
notified.
(f) A DNR order takes effect at the time the order is issued,
provided the order is placed in the patient's medical record as soon
as practicable.
(g) On admission to a health care facility or on initial
provision of hospice services, as applicable, the facility or
service provider shall provide to the patient or person authorized
to make treatment decisions on behalf of the patient notice of the
policies of the facility or service provider regarding the rights
of the patient and person authorized to make treatment decisions on
behalf of the patient under this section.
SECTION 2. The executive commissioner of the Health and
Human Services Commission shall adopt rules necessary to implement
Section 166.012, Health and Safety Code, as added by this Act, as
soon as practicable after the effective date of this Act.
SECTION 3. Section 166.012, Health and Safety Code, as
added by this Act, applies only to a do-not-resuscitate order
issued on or after the effective date of this Act.
SECTION 4. This Act takes effect April 1, 2018.