Bill Text: TX HB3158 | 2019-2020 | 86th Legislature | Introduced


Bill Title: Relating to advance directives or health care or treatment decisions made by or on behalf of patients.

Spectrum: Partisan Bill (Republican 29-1)

Status: (Introduced) 2019-03-13 - Referred to Public Health [HB3158 Detail]

Download: Texas-2019-HB3158-Introduced.html
  86R7244 SCL-F
 
  By: Raymond H.B. No. 3158
 
 
 
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 2019.
         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, 2019.
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