36-419. Do-not-resuscitate orders; minors; parental communication; definitions

A. For an unemancipated minor who is not under juvenile court jurisdiction pursuant to section 8-202, a provider may not implement a do-not-resuscitate order without communicating with at least one of the minor's parents or the minor's legal guardian.  The communication must include a discussion of both of the following:

1. The minor's care plan, including implementing a do-not-resuscitate order and what the do-not-resuscitate order means for the minor.

2. The rights provided under subsections E and G of this section.

B. The communication with the minor's parents or legal guardian pursuant to subsection A of this section shall be made with a witness present, other than the parents or legal guardian, who is willing to confirm that this communication took place. The provider shall immediately document and record the communication in the minor's medical record indicating whom the communication was with, who witnessed the communication and the date and time of the communication.  The provider shall ask the minor's parents or legal guardian to sign a written acknowledgement of this communication.

C. The requirements of subsections A and B of this section do not apply if the provider makes a reasonably diligent and documented effort to contact the minor's parents or legal guardian without success for at least forty-eight hours.  If a do-not-resuscitate order is entered for the minor, the reason for that order shall be documented in the minor's medical record.

D. This section does not require a provider to initially provide or continue resuscitative measures on a minor if the resuscitative measures would be medically inappropriate because providing the treatment would, in the provider's reasonable medical judgment, either:

1. Create a greater risk of causing or hastening the minor's death.

2. Be potentially harmful or cause unnecessary pain, suffering or injury to the minor because there is no further benefit to the minor in performing resuscitative measures.

E. At any point during the process described in subsections A and B of this section, a parent or legal guardian has the right to request that the minor be transferred to another facility.  If the parent or legal guardian requests a transfer, the provider shall provide reasonable time for the parent or legal guardian to find another provider that will accept the minor before implementing a do-not-resuscitate order.  The provider shall provide the minor's medical records to any accredited facility that requires the medical records to determine whether the facility is willing to care for the minor.  If an accredited facility is willing to accept the minor, the provider shall make reasonable efforts to facilitate the transfer.

F. A parent or guardian may petition a superior court in the county in which the minor resides or in which the minor is receiving treatment for an order enjoining a violation or threatened violation of this section or to resolve a conflict between the parents.  On receiving a petition, the superior court shall issue an order fixing the date, time and place of a hearing on the petition and order that notice of the hearing be given to the interested parties.  A preliminary hearing may be held without notice if the court determines that holding that hearing without notice is necessary to prevent imminent danger to the minor's life.  In the court's discretion, a hearing may be conducted in a courtroom, in a health care facility or at some other suitable place.  A do-not-resuscitate order may not be implemented pending the final determination of the proceedings, including any appeals.

G. On request of a patient or resident or a prospective patient or resident, a provider shall disclose in writing any policies relating to a patient or resident or the services a patient or resident may receive involving resuscitation or life-sustaining measures, including any policies related to treatments deemed nonbeneficial, ineffective, futile or inappropriate. This subsection does not require a provider to have a written policy relating to or involving resuscitation, life-sustaining measures or nonbeneficial treatment for unemancipated minor patients or adult patients or residents.

H. For the purposes of this section:

1. "Do-not-resuscitate order":

(a) Means an order in a patient's medical record that reflects a decision to forgo cardiopulmonary resuscitative measures.

(b) Does not include withholding other medical interventions deemed necessary to provide a patient with comfort care or to alleviate pain.

2. "Provider" means a health care facility, a nursing home, a physician who is licensed pursuant to title 32, chapter 13 or 17 or a nurse who is licensed pursuant to title 32, chapter 15.