87R602 SCL-F
By: Parker, Raymond, Oliverson, Guillen, H.B. No. 2609
et al.
A BILL TO BE ENTITLED
AN ACT
relating to advance directives or health care or treatment
decisions made by or on behalf of patients.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. This Act may be cited as the Respecting Texas
Patients' Right to Life Act of 2021.
SECTION 2. The purpose of this Act is to protect the right
of patients and their families to decide whether and under what
circumstances to choose or reject life-sustaining treatment. This
Act amends the applicable provisions of the Advance Directives Act
(Chapter 166, Health and Safety Code) to ensure that, when an
attending physician is unwilling to respect a patient's advance
directive or a patient's or family's decision to choose the
treatment necessary to prevent the patient's death,
life-sustaining medical treatment will be provided until the
patient can be transferred to a health care provider willing to
honor the directive or treatment decision.
SECTION 3. Section 166.045(c), Health and Safety Code, is
amended to read as follows:
(c) If an attending physician refuses to comply with a
directive or treatment decision to provide life-sustaining
treatment to a patient [and does not wish to follow the procedure
established under Section 166.046], life-sustaining treatment
shall be provided to the patient[, but only] until [a reasonable
opportunity has been afforded for the transfer of] the patient is
transferred to another physician or health care facility willing to
comply with the directive or treatment decision to provide
life-sustaining treatment to the patient.
SECTION 4. Sections 166.046(a), (b), (d), (e), (e-1), and
(f), Health and Safety Code, are amended to read as follows:
(a) If an attending physician refuses to honor a patient's
advance directive or a health care or treatment decision made by or
on behalf of a patient, other than a directive or decision to
provide artificial nutrition and hydration to the patient, the
physician's refusal shall be reviewed by an ethics or medical
committee. The attending physician may not be a member of that
committee. The patient shall be given life-sustaining treatment
during the review and until the patient is transferred to another
physician or health care facility willing to comply with the
directive or treatment decision to provide life-sustaining
treatment to the patient.
(b) The patient or the person responsible for the health
care decisions of the individual who has made the decision
regarding the directive or treatment decision:
(1) may be given a written description of the ethics or
medical committee review process and any other policies and
procedures related to this section adopted by the health care
facility;
(2) shall be informed of the committee review process
not less than 48 hours before the meeting called to discuss the
patient's directive, unless the time period is waived by mutual
agreement;
(3) at the time of being so informed, shall be
provided[:
[(A) a copy of the appropriate statement set
forth in Section 166.052; and
[(B)] a copy of the registry list of health care
providers and referral groups that have volunteered their readiness
to consider accepting transfer or to assist in locating a provider
willing to accept transfer that is posted on the website maintained
by the department under Section 166.053; and
(4) is entitled to:
(A) attend the meeting;
(B) receive a written explanation of the
recommendations made [decision reached] during the review process;
(C) receive a copy of the portion of the
patient's medical record related to the treatment received by the
patient in the facility for the lesser of:
(i) the period of the patient's current
admission to the facility; or
(ii) the preceding 30 calendar days; and
(D) receive a copy of all of the patient's
reasonably available diagnostic results and reports related to the
medical record provided under Paragraph (C).
(d) If the attending physician, the patient, or the person
responsible for the health care decisions of the individual does
not agree with the recommendations made [decision reached] during
the review process under Subsection (b), the physician shall make a
reasonable effort to transfer the patient to a physician who is
willing to comply with the directive. If the patient is a patient in
a health care facility, the facility's personnel shall assist the
physician in arranging the patient's transfer to:
(1) another physician;
(2) an alternative care setting within that facility;
or
(3) another facility.
(e) If the patient or the person responsible for the health
care decisions of the patient is requesting life-sustaining
treatment that the attending physician [has decided] and the ethics
or medical committee consider [has affirmed is] medically
inappropriate treatment, the patient shall be given available
life-sustaining treatment pending transfer under Subsection (d).
This subsection does not authorize withholding or withdrawing pain
management medication, medical procedures necessary to provide
comfort, or any other health care provided to alleviate a patient's
pain. Artificially [The patient is responsible for any costs
incurred in transferring the patient to another facility. The
attending physician, any other physician responsible for the care
of the patient, and the health care facility are not obligated to
provide life-sustaining treatment after the 10th day after both the
written decision and the patient's medical record required under
Subsection (b) are provided to the patient or the person
responsible for the health care decisions of the patient unless
ordered to do so under Subsection (g), except that artificially]
administered nutrition and hydration must be provided unless, based
on reasonable medical judgment, providing artificially
administered nutrition and hydration would:
(1) hasten the patient's death;
(2) be medically contraindicated such that the
provision of the treatment seriously exacerbates life-threatening
medical problems not outweighed by the benefit of the provision of
the treatment;
(3) result in substantial irremediable physical pain
not outweighed by the benefit of the provision of the treatment;
(4) be medically ineffective in prolonging life; or
(5) be contrary to the patient's or surrogate's
clearly documented desire not to receive artificially administered
nutrition or hydration.
(e-1) If during a previous admission to a facility a
patient's attending physician and the review process under
Subsection (b) have determined that life-sustaining treatment is
inappropriate, and the patient is readmitted to the same facility
within six months from the date of the recommendations made
[decision reached] during the review process conducted upon the
previous admission, Subsections (b) through (e) need not be
followed if the patient's attending physician and a consulting
physician who is a member of the ethics or medical committee of the
facility document on the patient's readmission that the patient's
condition either has not improved or has deteriorated since the
review process was conducted.
(f) Life-sustaining treatment under this section may not be
entered in the patient's medical record as medically unnecessary
treatment [until the time period provided under Subsection (e) has
expired].
SECTION 5. Section 166.051, Health and Safety Code, is
amended to read as follows:
Sec. 166.051. LEGAL RIGHT OR RESPONSIBILITY NOT AFFECTED.
This subchapter does not impair or supersede any legal right or
responsibility a person may have to effect the withholding or
withdrawal of life-sustaining treatment in a lawful manner,
provided that if an attending physician or health care facility is
unwilling to honor a patient's advance directive or a treatment
decision to provide life-sustaining treatment, life-sustaining
treatment must [is required to] be provided to the patient in
accordance with this chapter[, but only until a reasonable
opportunity has been afforded for transfer of the patient to
another physician or health care facility willing to comply with
the advance directive or treatment decision].
SECTION 6. Section 25.0021(b), Government Code, is amended
to read as follows:
(b) A statutory probate court as that term is defined in
Section 22.007(c), Estates Code, has:
(1) the general jurisdiction of a probate court as
provided by the Estates Code; and
(2) the jurisdiction provided by law for a county
court to hear and determine actions, cases, matters, or proceedings
instituted under:
(A) Section [166.046,] 192.027, 193.007,
552.015, 552.019, 711.004, or 714.003, Health and Safety Code;
(B) Chapter 462, Health and Safety Code; or
(C) Subtitle C or D, Title 7, Health and Safety
Code.
SECTION 7. Sections 166.046(g) and 166.052, Health and
Safety Code, are repealed.
SECTION 8. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2021.