Texas 2019 - 86th Regular

Texas House Bill HB3158 Compare Versions

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

Old	New	Differences
1	1	86R7244 SCL-F
2	2	By: Raymond H.B. No. 3158
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 Respecting Texas
11	11	Patients' Right to Life Act of 2019.
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), (d), (e), (e-1), and
35	35	(f), Health 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 and until the patient is transferred to another
44	44	physician or health care facility willing to comply with the
45	45	directive or treatment decision to provide life-sustaining
46	46	treatment to the patient.
47	47	(b) The patient or the person responsible for the health
48	48	care decisions of the individual who has made the decision
49	49	regarding the directive or treatment decision:
50	50	(1) may be given a written description of the ethics or
51	51	medical committee review process and any other policies and
52	52	procedures related to this section adopted by the health care
53	53	facility;
54	54	(2) shall be informed of the committee review process
55	55	not less than 48 hours before the meeting called to discuss the
56	56	patient's directive, unless the time period is waived by mutual
57	57	agreement;
58	58	(3) at the time of being so informed, shall be
59	59	provided[:
60	60	[(A) a copy of the appropriate statement set
61	61	forth in Section 166.052; and
62	62	[(B)] a copy of the registry list of health care
63	63	providers and referral groups that have volunteered their readiness
64	64	to consider accepting transfer or to assist in locating a provider
65	65	willing to accept transfer that is posted on the website maintained
66	66	by the department under Section 166.053; and
67	67	(4) is entitled to:
68	68	(A) attend the meeting;
69	69	(B) receive a written explanation of the
70	70	recommendations made [decision reached] during the review process;
71	71	(C) receive a copy of the portion of the
72	72	patient's medical record related to the treatment received by the
73	73	patient in the facility for the lesser of:
74	74	(i) the period of the patient's current
75	75	admission to the facility; or
76	76	(ii) the preceding 30 calendar days; and
77	77	(D) receive a copy of all of the patient's
78	78	reasonably available diagnostic results and reports related to the
79	79	medical record provided under Paragraph (C).
80	80	(d) If the attending physician, the patient, or the person
81	81	responsible for the health care decisions of the individual does
82	82	not agree with the recommendations made [decision reached] during
83	83	the review process under Subsection (b), the physician shall make a
84	84	reasonable effort to transfer the patient to a physician who is
85	85	willing to comply with the directive. If the patient is a patient in
86	86	a health care facility, the facility's personnel shall assist the
87	87	physician in arranging the patient's transfer to:
88	88	(1) another physician;
89	89	(2) an alternative care setting within that facility;
90	90	or
91	91	(3) another facility.
92	92	(e) If the patient or the person responsible for the health
93	93	care decisions of the patient is requesting life-sustaining
94	94	treatment that the attending physician [has decided] and the ethics
95	95	or medical committee consider [has affirmed is] medically
96	96	inappropriate treatment, the patient shall be given available
97	97	life-sustaining treatment pending transfer under Subsection (d).
98	98	This subsection does not authorize withholding or withdrawing pain
99	99	management medication, medical procedures necessary to provide
100	100	comfort, or any other health care provided to alleviate a patient's
101	101	pain. Artificially [The patient is responsible for any costs
102	102	incurred in transferring the patient to another facility. The
103	103	attending physician, any other physician responsible for the care
104	104	of the patient, and the health care facility are not obligated to
105	105	provide life-sustaining treatment after the 10th day after both the
106	106	written decision and the patient's medical record required under
107	107	Subsection (b) are provided to the patient or the person
108	108	responsible for the health care decisions of the patient unless
109	109	ordered to do so under Subsection (g), except that artificially]
110	110	administered nutrition and hydration must be provided unless, based
111	111	on reasonable medical judgment, providing artificially
112	112	administered nutrition and hydration would:
113	113	(1) hasten the patient's death;
114	114	(2) be medically contraindicated such that the
115	115	provision of the treatment seriously exacerbates life-threatening
116	116	medical problems not outweighed by the benefit of the provision of
117	117	the treatment;
118	118	(3) result in substantial irremediable physical pain
119	119	not outweighed by the benefit of the provision of the treatment;
120	120	(4) be medically ineffective in prolonging life; or
121	121	(5) be contrary to the patient's or surrogate's
122	122	clearly documented desire not to receive artificially administered
123	123	nutrition or hydration.
124	124	(e-1) If during a previous admission to a facility a
125	125	patient's attending physician and the review process under
126	126	Subsection (b) have determined that life-sustaining treatment is
127	127	inappropriate, and the patient is readmitted to the same facility
128	128	within six months from the date of the recommendations made
129	129	[decision reached] during the review process conducted upon the
130	130	previous admission, Subsections (b) through (e) need not be
131	131	followed if the patient's attending physician and a consulting
132	132	physician who is a member of the ethics or medical committee of the
133	133	facility document on the patient's readmission that the patient's
134	134	condition either has not improved or has deteriorated since the
135	135	review process was conducted.
136	136	(f) Life-sustaining treatment under this section may not be
137	137	entered in the patient's medical record as medically unnecessary
138	138	treatment [until the time period provided under Subsection (e) has
139	139	expired].
140	140	SECTION 5. Section 166.051, Health and Safety Code, is
141	141	amended to read as follows:
142	142	Sec. 166.051. LEGAL RIGHT OR RESPONSIBILITY NOT AFFECTED.
143	143	This subchapter does not impair or supersede any legal right or
144	144	responsibility a person may have to effect the withholding or
145	145	withdrawal of life-sustaining treatment in a lawful manner,
146	146	provided that if an attending physician or health care facility is
147	147	unwilling to honor a patient's advance directive or a treatment
148	148	decision to provide life-sustaining treatment, life-sustaining
149	149	treatment must [is required to] be provided to the patient in
150	150	accordance with this chapter[, but only until a reasonable
151	151	opportunity has been afforded for transfer of the patient to
152	152	another physician or health care facility willing to comply with
153	153	the advance directive or treatment decision].
154	154	SECTION 6. Section 25.0021(b), Government Code, is amended
155	155	to read as follows:
156	156	(b) A statutory probate court as that term is defined in
157	157	Section 22.007(c), Estates Code, has:
158	158	(1) the general jurisdiction of a probate court as
159	159	provided by the Estates Code; and
160	160	(2) the jurisdiction provided by law for a county
161	161	court to hear and determine actions, cases, matters, or proceedings
162	162	instituted under:
163	163	(A) Section [166.046,] 192.027, 193.007,
164	164	552.015, 552.019, 711.004, or 714.003, Health and Safety Code;
165	165	(B) Chapter 462, Health and Safety Code; or
166	166	(C) Subtitle C or D, Title 7, Health and Safety
167	167	Code.
168	168	SECTION 7. Sections 166.046(g) and 166.052, Health and
169	169	Safety Code, are repealed.
170	170	SECTION 8. This Act takes effect immediately if it receives
171	171	a vote of two-thirds of all the members elected to each house, as
172	172	provided by Section 39, Article III, Texas Constitution. If this
173	173	Act does not receive the vote necessary for immediate effect, this
174	174	Act takes effect September 1, 2019.