Relating to health care decisions related to palliative care, hospice programs, life-sustaining procedures, and out-of-hospital do-not-resuscitate orders

This bill relates to health care decisions related to palliative care, hospice programs, life-sustaining procedures, and out-of-hospital do-not-resuscitate orders. Current law requires a hospice program to provide palliative care in order to be eligible for a license. The bill removes this requirement and requires a hospice program to provide care directed at symptom management to be eligible to receive a license. Under the bill, if a patient who has a terminal condition, and is comatose, incompetent, or incapable of communication, and has not expressed their desire regarding palliative care or a hospice program, certain individuals in order of priority have the authority to make the decision to place the patient in a hospice program. The individuals who have the authority to make such a decision include an attorney in fact, a guardian, the patient’s spouse, an adult child or stepchild, a parent or stepparent, adult sibling or adult stepsibling, a relative of the patient, and a 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 in making the decision. Current law provides that certain individuals in order of priority, including an attorney in fact, a guardian, the patient’s spouse, an adult child, a parent, and an adult sibling, have the authority to withhold or withdraw life-sustaining procedures from a patient who has a terminal condition, and who 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 stepchildren, stepparents, and stepsiblings, 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 physician. The bill provides that resuscitation may be withheld or withdrawn from a patient who has a terminal condition, and who is comatose, incompetent, or incapable of communication, and who has not executed an out-of-hospital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 between the patient’s attending physician and certain individuals, in order of priority, making the decision. The individuals who are authorized to make such a decision include an attorney in fact, a guardian, the patient’s spouse, an adult child or stepchild, a parent or stepparent, adult sibling or adult stepsibling, a relative of the patient, and a 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 physician when a decision is made to withdraw or withhold resuscitation. 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.