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HB 2122: do-not-resuscitate orders; minors; parental consent |
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PRIME SPONSOR: Representative Barto, LD 15 BILL STATUS: Senate Engrossed Senate 3rd Read: 29-0-1-0 |
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Outlines
provisions on do-not-resuscitate (DNR) orders as it pertains to minors and
outlines the roles of the different parties.
History
A.R.S. §§ 36-2271—2284 details the laws that protect minors in regard to public health and safety. The law requires written consent of a parent or legal guardian of a minor before any surgical procedures upon a minor except in the case of an emergency. Mental health screenings in a nonclinical setting cannot be performed upon a minor without the prior written or oral consent of a parent or guardian except in the case of an emergency. The law prohibits the denial of nutrition and medical treatment of minors with the intent to cause or allow the death of an infant for reasons including, but not limited to, disability. Health care institutions are required to report any denial or deprivation of necessary medical or surgical treatment to the administrators and must make available to parents with a newborn child born with a disability any information regarding agencies available to assistance or information.
Provisions
1. Prohibits a provider from implementing a DNR or similar physician's order on a patient, who is under the age of 18 and not emancipated, without the verbal or written consent of both parents unless one parent has sole legal decision-making or the guardian. (Sec. 1)
2. Establishes that in all cases where oral consent was given by the parent, or parent if one parent has sole legal decision making, or guardian, that two witnesses are required to be present and willing to attest to the consent given and the consent must be recorded in the patient's medical record specifying who provided consent, to whom consent was provided, the names of the witnesses and the date and time consent was granted. (Sec. 1)
3. Allows either parent or the guardian of the patient who granted the original consent of a DNR to revoke the prior consent orally or in writing. (Sec. 1)
4. Establishes that the revocation of the prior consent takes precedence over the prior consent and the revocation must be immediately recorded in the patient's medical record specifying who provided the revocation, to whom the revocation was provided, which parent or guardian revoked consent, the names of the witnesses and the date and time the revocation was obtained. (Sec. 1)
6. Asserts a DNR cannot be implemented until the final determination of the superior court if a petition is made. (Sec. 1)
7. Allows a parent or guardian to petition the superior court in the county of residence or treatment for an order enjoining a violation or threatened violation or to resolve a conflict. (Sec. 1)
8. Directs the superior court, upon receival of the petition, to issue an order to the interested parties fixing the date, time and place of the hearing, order that notice be given to the interested parties, and permits the court to hold a preliminary hearing without notice to prevent imminent danger to a child's life. (Sec. 1)
9. Instructs that for children under juvenile court jurisdiction, the juvenile court may:
a. Issue an end-of-life medical decision order or any other medical decision order; or
b. Appoint a guardian for the child for the purpose of issuing end-of-life orders. (Sec. 1)
10. Prohibits the juvenile court from appointing DCS as guardian for a child to make end-of-life medical decisions. (Sec. 1)
11. Instructs that if a child under juvenile court jurisdiction is returned to the custody of the parent or guardian, the parent or guardian is allowed to revoke the consent for the end-of-life medical decision order ordered by the court for the child. (Sec. 1)
12. Requires the written or oral consent for revocation to be immediately recorded in the patient's medical record specifying who provided the revocation, to whom the revocation was provided, which parent or guardian revoked consent, the names of the witnesses and the date and time the revocation was obtained. (Sec. 1)
13. Requires a health care facility, nursing home, nurse or physician to disclose policies relating to a patient or resident or the services a patient or resident may be receiving involving resuscitation or life-sustaining measures, including any policies related to treatments deemed nonbeneficial, ineffective, futile, or inappropriate, within the health care facility or nursing home to a patient or resident upon request. (Sec. 1)
14. Specifies that a health care facility, nursing home or physician are not required to have a written policy relating to or involving resuscitation, life-sustaining measure or nonbeneficial treatment for unemancipated minor patients or adult patients or residents. (Sec. 1)
15. Defines term. (Sec. 1)
16. Cites this act as Simon's Law. (Sec. 2)
Senate Engrossed
2. Prohibits a provider from implementing a DNR for an unemancipated minor without communicating with at least one of the minor's parents or legal guardian and outlines the communication and documentation requirements.
3. Removes the allowance for either parent, or the guardian, of the patient who granted the original consent of a DNR to revoke the prior consent orally or in writing.
4. Exempts a provider that makes a reasonably diligent and documented effort to contact the minor's parents or legal guardian without success for 48 hours from communication requirements and states that, if the DNR is entered for the minor, the reason for that order must be documented in the minor's medical record.
5. States that a provider is not required 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 judgement, either:
a. Create a greater risk of causing or hastening the minor's death; or
b. 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.
6. Grants the parent or legal guardians the right to request, at any time during the process, that the minor be transferred to another facility and, if they request a transfer, the provider must provide reasonable time for the parent or legal guardian to find another provider that will accept the minor before implementing a DNR order.
7. Requires the provider to 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 and, if an accredited facility is willing to accept the minor, must make reasonable efforts to facilitate the transfer.
8. Removes the provision stating that when the parents or guardians of a minor are unable to agree on the decision to implement or revoke a DNR either parent may petition to resolve the conflict based on a presumption in favor of providing cardiopulmonary resuscitation.
9. Removes the provision surrounding a child under juvenile court jurisdiction.
10. Replaces the phrase health care facility, nursing home, physician or nurse with the term provider.
11. Removes the definition for end-of-life medical decision order.
12. Defines do-not-resuscitate order and provider.
13. Makes technical and conforming changes.
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17. Fifty-fourth Legislature HB 2122
18. First Regular Session Version 4: Senate Engrossed
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