Texas 2021 - 87th Regular

Texas House Bill HB2609 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		87R602 SCL-F
2		-	By: Parker, Raymond, Oliverson, Guillen, H.B. No. 2609
3		-	et al.
	2	+	By: Parker H.B. No. 2609
4	3
5	4
6	5		A BILL TO BE ENTITLED
7	6		AN ACT
8	7		relating to advance directives or health care or treatment
9	8		decisions made by or on behalf of patients.
10	9		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	10		SECTION 1. This Act may be cited as the Respecting Texas
12	11		Patients' Right to Life Act of 2021.
13	12		SECTION 2. The purpose of this Act is to protect the right
14	13		of patients and their families to decide whether and under what
15	14		circumstances to choose or reject life-sustaining treatment. This
16	15		Act amends the applicable provisions of the Advance Directives Act
17	16		(Chapter 166, Health and Safety Code) to ensure that, when an
18	17		attending physician is unwilling to respect a patient's advance
19	18		directive or a patient's or family's decision to choose the
20	19		treatment necessary to prevent the patient's death,
21	20		life-sustaining medical treatment will be provided until the
22	21		patient can be transferred to a health care provider willing to
23	22		honor the directive or treatment decision.
24	23		SECTION 3. Section 166.045(c), Health and Safety Code, is
25	24		amended to read as follows:
26	25		(c) If an attending physician refuses to comply with a
27	26		directive or treatment decision to provide life-sustaining
28	27		treatment to a patient [and does not wish to follow the procedure
29	28		established under Section 166.046], life-sustaining treatment
30	29		shall be provided to the patient[, but only] until [a reasonable
31	30		opportunity has been afforded for the transfer of] the patient is
32	31		transferred to another physician or health care facility willing to
33	32		comply with the directive or treatment decision to provide
34	33		life-sustaining treatment to the patient.
35	34		SECTION 4. Sections 166.046(a), (b), (d), (e), (e-1), and
36	35		(f), Health and Safety Code, are amended to read as follows:
37	36		(a) If an attending physician refuses to honor a patient's
38	37		advance directive or a health care or treatment decision made by or
39	38		on behalf of a patient, other than a directive or decision to
40	39		provide artificial nutrition and hydration to the patient, the
41	40		physician's refusal shall be reviewed by an ethics or medical
42	41		committee. The attending physician may not be a member of that
43	42		committee. The patient shall be given life-sustaining treatment
44	43		during the review and until the patient is transferred to another
45	44		physician or health care facility willing to comply with the
46	45		directive or treatment decision to provide life-sustaining
47	46		treatment to the patient.
48	47		(b) The patient or the person responsible for the health
49	48		care decisions of the individual who has made the decision
50	49		regarding the directive or treatment decision:
51	50		(1) may be given a written description of the ethics or
52	51		medical committee review process and any other policies and
53	52		procedures related to this section adopted by the health care
54	53		facility;
55	54		(2) shall be informed of the committee review process
56	55		not less than 48 hours before the meeting called to discuss the
57	56		patient's directive, unless the time period is waived by mutual
58	57		agreement;
59	58		(3) at the time of being so informed, shall be
60	59		provided[:
61	60		[(A) a copy of the appropriate statement set
62	61		forth in Section 166.052; and
63	62		[(B)] a copy of the registry list of health care
64	63		providers and referral groups that have volunteered their readiness
65	64		to consider accepting transfer or to assist in locating a provider
66	65		willing to accept transfer that is posted on the website maintained
67	66		by the department under Section 166.053; and
68	67		(4) is entitled to:
69	68		(A) attend the meeting;
70	69		(B) receive a written explanation of the
71	70		recommendations made [decision reached] during the review process;
72	71		(C) receive a copy of the portion of the
73	72		patient's medical record related to the treatment received by the
74	73		patient in the facility for the lesser of:
75	74		(i) the period of the patient's current
76	75		admission to the facility; or
77	76		(ii) the preceding 30 calendar days; and
78	77		(D) receive a copy of all of the patient's
79	78		reasonably available diagnostic results and reports related to the
80	79		medical record provided under Paragraph (C).
81	80		(d) If the attending physician, the patient, or the person
82	81		responsible for the health care decisions of the individual does
83	82		not agree with the recommendations made [decision reached] during
84	83		the review process under Subsection (b), the physician shall make a
85	84		reasonable effort to transfer the patient to a physician who is
86	85		willing to comply with the directive. If the patient is a patient in
87	86		a health care facility, the facility's personnel shall assist the
88	87		physician in arranging the patient's transfer to:
89	88		(1) another physician;
90	89		(2) an alternative care setting within that facility;
91	90		or
92	91		(3) another facility.
93	92		(e) If the patient or the person responsible for the health
94	93		care decisions of the patient is requesting life-sustaining
95	94		treatment that the attending physician [has decided] and the ethics
96	95		or medical committee consider [has affirmed is] medically
97	96		inappropriate treatment, the patient shall be given available
98	97		life-sustaining treatment pending transfer under Subsection (d).
99	98		This subsection does not authorize withholding or withdrawing pain
100	99		management medication, medical procedures necessary to provide
101	100		comfort, or any other health care provided to alleviate a patient's
102	101		pain. Artificially [The patient is responsible for any costs
103	102		incurred in transferring the patient to another facility. The
104	103		attending physician, any other physician responsible for the care
105	104		of the patient, and the health care facility are not obligated to
106	105		provide life-sustaining treatment after the 10th day after both the
107	106		written decision and the patient's medical record required under
108	107		Subsection (b) are provided to the patient or the person
109	108		responsible for the health care decisions of the patient unless
110	109		ordered to do so under Subsection (g), except that artificially]
111	110		administered nutrition and hydration must be provided unless, based
112	111		on reasonable medical judgment, providing artificially
113	112		administered nutrition and hydration would:
114	113		(1) hasten the patient's death;
115	114		(2) be medically contraindicated such that the
116	115		provision of the treatment seriously exacerbates life-threatening
117	116		medical problems not outweighed by the benefit of the provision of
118	117		the treatment;
119	118		(3) result in substantial irremediable physical pain
120	119		not outweighed by the benefit of the provision of the treatment;
121	120		(4) be medically ineffective in prolonging life; or
122	121		(5) be contrary to the patient's or surrogate's
123	122		clearly documented desire not to receive artificially administered
124	123		nutrition or hydration.
125	124		(e-1) If during a previous admission to a facility a
126	125		patient's attending physician and the review process under
127	126		Subsection (b) have determined that life-sustaining treatment is
128	127		inappropriate, and the patient is readmitted to the same facility
129	128		within six months from the date of the recommendations made
130	129		[decision reached] during the review process conducted upon the
131	130		previous admission, Subsections (b) through (e) need not be
132	131		followed if the patient's attending physician and a consulting
133	132		physician who is a member of the ethics or medical committee of the
134	133		facility document on the patient's readmission that the patient's
135	134		condition either has not improved or has deteriorated since the
136	135		review process was conducted.
137	136		(f) Life-sustaining treatment under this section may not be
138	137		entered in the patient's medical record as medically unnecessary
139	138		treatment [until the time period provided under Subsection (e) has
140	139		expired].
141	140		SECTION 5. Section 166.051, Health and Safety Code, is
142	141		amended to read as follows:
143	142		Sec. 166.051. LEGAL RIGHT OR RESPONSIBILITY NOT AFFECTED.
144	143		This subchapter does not impair or supersede any legal right or
145	144		responsibility a person may have to effect the withholding or
146	145		withdrawal of life-sustaining treatment in a lawful manner,
147	146		provided that if an attending physician or health care facility is
148	147		unwilling to honor a patient's advance directive or a treatment
149	148		decision to provide life-sustaining treatment, life-sustaining
150	149		treatment must [is required to] be provided to the patient in
151	150		accordance with this chapter[, but only until a reasonable
152	151		opportunity has been afforded for transfer of the patient to
153	152		another physician or health care facility willing to comply with
154	153		the advance directive or treatment decision].
155	154		SECTION 6. Section 25.0021(b), Government Code, is amended
156	155		to read as follows:
157	156		(b) A statutory probate court as that term is defined in
158	157		Section 22.007(c), Estates Code, has:
159	158		(1) the general jurisdiction of a probate court as
160	159		provided by the Estates Code; and
161	160		(2) the jurisdiction provided by law for a county
162	161		court to hear and determine actions, cases, matters, or proceedings
163	162		instituted under:
164	163		(A) Section [166.046,] 192.027, 193.007,
165	164		552.015, 552.019, 711.004, or 714.003, Health and Safety Code;
166	165		(B) Chapter 462, Health and Safety Code; or
167	166		(C) Subtitle C or D, Title 7, Health and Safety
168	167		Code.
169	168		SECTION 7. Sections 166.046(g) and 166.052, Health and
170	169		Safety Code, are repealed.
171	170		SECTION 8. This Act takes effect immediately if it receives
172	171		a vote of two-thirds of all the members elected to each house, as
173	172		provided by Section 39, Article III, Texas Constitution. If this
174	173		Act does not receive the vote necessary for immediate effect, this
175	174		Act takes effect September 1, 2021.