Relating to health care decisions related to palliative care, hospice programs, life-sustaining procedures, out-of-hospital do-not-resuscitate orders, durable power of attorney for health care, and probate court guardianship reports

The individuals who have the authority to make such a decision include the patient’s attorney in fact, guardian, spouse, adult child, parent, adult sibling, and close adult friend. The bill defines “close adult friend”. An individual making a decision for such a patient shall be guided by the express or implied intention of the patient. Current law provides that certain individuals in order of priority, including a patient’s attorney in fact, guardian, spouse, adult child, parent, and adult sibling, have the authority to withhold or withdraw life-sustaining procedures from a patient who has a terminal condition, is comatose, incompetent, or incapable of communication, and who has not made a declaration for life-sustaining procedures. The bill broadens these categories to include relatives of the patient and a close adult friend of the patient. The bill provides restrictions on who may act as a witness to the consultation when the decision is made with the patient’s attending provider, rather than with the patient’s attending physician as is required under current law. The bill defines “attending provider” as a physician, physician assistant, or an advanced registered nurse practitioner. Current law requires a patient’s attending physician to receive and record in the patient’s medical record a declaration for life-sustaining procedures on behalf of a patient. If a patient wants to revoke this declaration, a revocation is only effective as to the patient’s attending physician when it is communicated to the patient’s attending physician. Once the patient’s attending physician receives a declaration, the attending physician must determine if the patient has a terminal condition. Under the bill, a patient’s attending provider is required to receive and record in the patient’s medical record any declaration for life-sustaining procedures on behalf of a patient. A revocation is only effective as to the patient’s attending provider when it is communicated to the patient’s attending provider. Once the patient’s attending provider receives a declaration, the attending provider must determine if the patient has a terminal condition. Under current law, an out-of-hospital do-not-resuscitate order for a patient is required to be issued and signed by a patient’s attending physician. Under the bill, an out-of-hospital do-not-resuscitate order is required to be issued and signed by a patient’s attending provider. The bill provides that resuscitation may be withheld or withdrawn from a patient who has a terminal condition, who is comatose, incompetent, or incapable of communication, and who has not executed an out-of-hospital do-not-resuscitate order if there is consultation and written agreement to do so between the patient’s attending provider and the patient’s attorney in fact, guardian, spouse, adult child, parent, adult sibling, relative, or close adult friend. An individual making a health care decision for such a patient shall be guided by the express or implied intention of the patient in making the decision. A witness, as specified in the bill, shall be present at the time of consultation with the patient’s attending provider when a decision is made to withdraw or withhold resuscitation. Under current law, the authority provided to an agent under a durable power of attorney for health care (POA) executed by a patient exists only when the patient’s attending physician determines that the patient is unable to make health care decisions. The agent can consent to a patient’s attending physician withholding life-sustaining care to the patient. The bill provides that the authority provided to an agent under a POA executed by a patient exists only when the patient’s attending provider determines that the patient is unable to make health care decisions. Current law requires a guardian to obtain court approval before the guardian may consent to the withholding or withdrawal of life-sustaining procedures for a protected person. The bill makes an exception to this requirement and allows a guardian to make a decision for the protected person relating to hospice care, life-sustaining procedures, and resuscitation without court approval in circumstances detailed in the bill.