HBA-MPM, MPM H.B. 2801 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 2801 By: Longoria Public Health 4/8/1999 Introduced BACKGROUND AND PURPOSE Currently, state law provides for protection of the right of patients and their families to reject lifesustaining treatment, however, it does not provide equal protection for patients and their families who choose life-sustaining treatment. A physician who denies lifesaving treatment against the will of a patient has immunity from civil and criminal liability. While the physician has a duty to make a reasonable effort to transfer the patient to another physician, there is no requirement that the patient be given lifesaving treatment pending transfer. Some Texas hospitals now have procedures under which lifesaving treatment may be involuntarily denied by an ethics committee, after which treatment is not provided even pending transfer. H.B. 2801 requires that lifesaving treatment be provided to a patient for a period of 14 days (subject to court extension) when a physician wishes to deny it in order to enable time to effect the patient's transfer to a willing provider of lifesaving medical treatment. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 135.008(c), Civil Practice and Remedies Code, as follows: (c) Requires an attending physician of a principal or a health care provider who refuses to follow a directive by the agent to comply with the procedure established under proposed Section 672.0165, Health and Safety Code. Deletes text requiring a principal's health or residential care provider who finds it impossible to follow a directive by the agent because of a conflict with this chapter or the durable power of attorney for health care to inform the agent as soon as reasonably possible. Deletes text authorizing the agent to select another attending physician. SECTION 2. Amends Section 135.018, Civil Practice and Remedies Code, to provide that this section does not authorize a violation of proposed Section 672.0165, Health and Safety Code. SECTION 3. Amends Section 672.016, Health and Safety Code, as follows: Sec. 672.016. New title: LIABILITY FOR FAILURE TO EFFECTUATE DIRECTIVE. Deletes "Limitation of" from title. Provides that a physician or health professional acting under the direction of a physician who complies with proposed Section 672.0165, Health and Safety Code, is not civilly or criminally liable for failing to effectuate a qualified patient's directive. Deletes text requiring an attending physician to make a reasonable effort to transfer a patient to another physician if the physician refuses to comply with a directive or treatment decision. SECTION 4. Amends Chapter 672, Health and Safety Code, by adding Section 672.0165, as follows: Sec. 672.0165. DUTY TO TRANSFER PATIENT. (a) Requires an attending physician or health care facility (facility) who refuses to comply with a directive or treatment decision to comply with this section. Requires the physician or facility to assist in arranging transfer of a patient to another physician or facility that is willing to comply with the directive or treatment decision and prohibits the physician or facility from impeding the transfer. (b) Requires the physician or facility to provide the patient with available treatment as, in reasonable medical judgment, is necessary to prevent the patient's death until the transfer is completed, if the directive or treatment decision with which the physician or facility is unwilling to comply is for the provision of treatment. Provides that this subsection does not require a physician or facility to provide treatment that cannot be provided to the patient without denying the same treatment to another patient. (c) Provides that the obligation to provide treatment under Subsection (b) continues until the 14th day after the physician or facility provides written notice of the refusal to comply with the directive or treatment decision to certain persons and the end of any period of extension established under Subsection (g). (d) Authorizes the patient, if competent, or a person legally responsible for making health care decisions on the patient's behalf if the patient is incompetent, to apply to a probate court for an extension of the period established under Subsection (c). (e) Provides that the applicant must notify the attending physician or facility of an application made under Subsection (d). (f) Requires the court to promptly hold a hearing on the application at which each party is authorized to present evidence and argument. Authorizes the court to grant brief extensions of the period established under Subsection (c) as necessary to preserve the status quo until the hearing can be held and a decision rendered. (g) Requires the court, after the hearing, to grant the extension for a specified period as determined by the court if it finds by a preponderance of evidence, that, if the extension is granted, there is a reasonable prospect that a facility willing to accept the transfer of the patient and to comply with the directive or treatment decision will be found. SECTION 5. Amends Section 672.021, Health and Safety Code, to provide that this section does not authorize a violation of proposed Section 672.0165, Health and Safety Code. SECTION 6.Emergency clause. Effective date: upon passage.