Restores medical futility as a basis for DNR

◆ The sponsor's argument

Why Gustavo Rivera says this is needed

For over 20 years under the former do not resuscitate (DNR) law (PHL Art 29-8), a surrogate could consent to a DNR order if the patient met anyone of four clinical criteria, one of which being a finding by two physicians that resuscitation "will be unsuccessful in restoring cardiac and respiratory function or that the patient will experience repeated arrest in a short time period before death occurs." The former DNR law also allowed a DNR order to be entered on that basis for a patient who did not have a surrogate. That law applied to all patients, including developmentally disabled patients. The Family Health Care Decision Act (FHCDA), in contrast, establishes standards for the withdrawal or withholding of a broad range of life sustaining treatment. Accordingly it does not have a standard specif- ically relating to medically futile resuscitation. Chapter 8 of the laws of 2010 made the FHCDA apply to DNR orders for most patients in hospi- tals and nursing homes. Similarly, SCPA § 1750-b does not have a standard specifically relating to medically futile resuscitation. Chapter 8 of the laws of 2010 made SCPA § 1750-b apply to DNR orders for developmentally disabled patients. This loss of the long-established "medical futility" grounds for a DNR was inadvertent. Experience has shown that the broader FHCDA and SCPA § 1750-b standards, especially the standards for patients who do not have surrogates, can be difficult to apply to decisions about resuscitation. This bill would restore the former DNR law's medical futility standard as an alternative basis for writing a DNR order under the FHCDA and under SCPA § 1750-b, with the addition of nurse practitioners to conform with Chapter 430 of 2017, which added them as eligible practitioners to execute DNRs.

This is the sponsor's own case for the bill, quoted from their memorandum. It is not Agora's description of what the bill does.