85R7686 SCL-F     By: Hughes, et al. S.B. No. 1213       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 Texas Patient   Autonomy Restoration Act of 2017.          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), (e), 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.]          (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 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).          (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 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.          (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 [3(ii), Texas Probate] Code, has:                (1)  the general jurisdiction of a probate court as   provided by the Estates [Texas Probate] 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.  To the extent of any conflict, this Act prevails   over another Act of the 85th Legislature, Regular Session, 2017,   relating to nonsubstantive additions to and corrections in enacted   codes.          SECTION 9.  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, 2017.