SB 55 - CPR - orders not to resuscitate

Georgia Senate - 1995/1996 Sessions

SB 55 - CPR - orders not to resuscitate

Page Numbers - 1/ 2/ 3/ 4/ 5/ 6/ 7
Code Sections - 31-39-6.1/ 31-39-6/ 31-39-7
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1. Johnson  1st           2. Oliver  42nd

Senate Comm: Judy / House Comm: H&E / Senate Vote: Yeas 50 Nays 1 --------------------------------------------- Senate Action House --------------------------------------------- 1/12/95 Read 1st time 2/22/95 2/15/95 Favorably Reported 3/1/95 Sub Committee Amend/Sub Sub 2/16/95 Read 2nd Time 2/27/95 2/20/95 Read 3rd Time 3/8/95 2/21/95 Passed/Adopted 3/8/95 FS Comm/Floor Amend/Sub CS 3/14/95* Amend/Sub Agreed To Amend/Sub Disagreed To 3/15/95* 3/15/95 Conf Comm Appointed 3/17/95 3/17/95 Conf Comm Rep Adopted 3/17/95 3/28/95 Sent To Governor 4/18/95 Signed by Governor 355 Act/Veto Number 4/18/95 Effective Date --------------------------------------------- *2/20/95 Pursuant to Senate Rule 143, action suspended. *3/14/95 Senate agrees to House substitute as amended by Senate. *3/15/95 House disagrees to Senate amendment to House substitute. --------------------------------------------- CC# SENATE CONFEREES HOUSE CONFEREES SENATE HOUSE #1 Johnson, E. - 1st Skipper - 137th Adopted Adopted Farrow - 54th Childers - 13th 3/17/95 3/17/95 Oliver - 42nd Parsons - 40th Code Sections amended: 31-39-2, 31-39-4,31-39-5, 31-39-6, 31-39-6.1, 31-39-7
SB 55 95 SB55/AP SENATE BILL 55 By: Senators Johnson of the 1st and Oliver of the 42nd A BILL TO BE ENTITLED AN ACT 1- 1 To amend Chapter 39 of Title 31 of the Official Code of 1- 2 Georgia Annotated, regarding orders not to resuscitate, so 1- 3 as to change the provisions regarding definitions; to 1- 4 provide what constitutes such orders; to change the Said chapter is further amended by striking Code SectionS " a - 1- 6 authorize such orders to be carried out by certain emergency 1- 7 medical services providers and health care personnel under 1- 8 certain conditions; to provide for identifying bracelets and 1- 9 necklaces and their status as such orders; to change the 1-10 provisions relating to cancellation and revocation of such 1-11 orders; to limit the duties and liability of certain health 1-12 care providers and other health care facilities; to provide 1-13 an effective date; to repeal conflicting laws; and for other 1-14 purposes. 1-15 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: SECTION 1. 1-16 Chapter 39 of Title 31 of the Official Code of Georgia 1-17 Annotated, regarding orders not to resuscitate, is amended 1-18 by adding after paragraph (6) of Code Section 31-39-2, 1-19 relating to definitions, the following paragraph: 1-20 "(6.1) 'Emergency medical technician' means a person 1-21 certified as an emergency medical technician, paramedic, 1-22 or cardiac technician under Chapter 11 of this title." SECTION 1.1. 1-23 Said chapter is further amended by striking paragraph (7) of 1-24 said Code Section 31-39-2, relating to definitions, and 1-25 inserting in its place the following: 1-26 "(7) 'Health care facility' means an institution which 1-27 is licensed as a hospital or nursing home pursuant to 1-28 Article 1 of Chapter 7 of this title or licensed as a 1-29 hospice pursuant to Article 9 of Chapter 7 of this 1-30 title, or a home health agency licensed pursuant to 1-31 Article 7 of Chapter 7 of this title." S. B. 55 -1- (Index) SB55/AP SECTION 2. 2- 1 Said chapter is further amended by striking subsection (a) 2- 2 of Code Section 31-39-4, relating to persons authorized to 2- 3 issue an order not to resuscitate, and inserting in its 2- 4 place the following: 2- 5 "(a) It shall be lawful for the attending physician to 2- 6 issue an order not to resuscitate pursuant to the 2- 7 requirements of this chapter. Such an Any written order 2- 8 shall be issued in writing by the attending physician 2- 9 using the term 'do not resuscitate,' 'DNR,' 'order not to 2-10 resuscitate,' 'no code,' or substantially similar language 2-11 in the patient's chart and shall be effective upon 2-12 issuance constitute a legally sufficient order and shall 2-13 authorize a physician, health care professional, or 2-14 emergency medical technician to withhold or withdraw 2-15 cardiopulmonary resuscitation. Such an order shall remain 2-16 effective, whether or not the patient is receiving 2-17 treatment from or is a resident of a health care facility, 2-18 until the order is canceled as provided in Code Section 2-19 31-39-5 or until consent for such order is revoked as 2-20 provided in Code Section 31-39-6, whichever occurs 2-21 earlier. An attending physician who has issued such an 2-22 order and who transfers care of the patient to another 2-23 physician shall inform the receiving physician and the 2-24 health care facility, if applicable, of the order." SECTION 2.1. 2-25 Said chapter is further amended by striking paragraph (3) of 2-26 subsection (e) of said Code Section 31-39-4 and inserting in 2-27 its place the following: 2-28 "(3) The patient is receiving inpatient or outpatient 2-29 treatment from or is a resident of a health care 2-30 facility other than a hospice or a home health agency." SECTION 2.2. 2-31 Said chapter is further amended by striking subsection (b) 2-32 and (c) of Code Section 31-39-5, relating to cancellation of 2-33 orders, and inserting in their place the following: 2-34 "(b) If the order not to resuscitate was entered pursuant 2-35 to subsection (c), (d), or (e) of Code Section 31-39-4 and 2-36 the attending physician who issued the order or, if that 2-37 attending physician is unavailable, another attending 2-38 physician, at any time determines that the patient no 2-39 longer qualifies as a candidate for nonresuscitation, the S. B. 55 -2- (Index) SB55/AP 3- 1 attending physician or the physician's designee shall 3- 2 immediately include such determination in the patient's 3- 3 chart, cancel the order, and notify the patient, the 3- 4 person who consented to the order, and all hospital health 3- 5 care facility staff responsible for the patient's care of 3- 6 the cancellation. 3- 7 (c) If an order not to resuscitate was entered pursuant to 3- 8 subsection (c), (d), or (e) of Code Section 31-39-4 and 3- 9 the patient at any time regains decision-making capacity, 3-10 the attending physician who issued the order or, if that 3-11 attending physician is unavailable, another attending 3-12 physician, shall immediately determine if the patient 3-13 consents to the order not to resuscitate and, if the 3-14 patient does not so consent, the attending physician or 3-15 the physician's designee shall cancel the order by an 3-16 appropriate entry on the record and notify all hospital 3-17 health care facility staff responsible for the patient's 3-18 care of the cancellation." SECTION 3. 3-19 Said chapter is further amended by adding after Code Section 3-20 31-39-6 a new Code section to read as follows: 3-21 "31-39-6.1. (Index) 3-22 (a) In addition to those orders not to resuscitate 3-23 authorized elsewhere in this chapter, any physician, 3-24 health care professional, or emergency medical technician 3-25 shall be authorized to effectuate an order not to 3-26 resuscitate for a person who is not a patient in a 3-27 hospital, nursing home, or licensed hospice and the order 3-28 is evidenced in writing containing the patient's name, 3-29 date of the form, printed name of the attending physician, 3-30 and signed by the attending physician on a form 3-31 substantially similar to the following: 3-32 'DO NOT RESUSCITATE ORDER 3-33 NAME OF PATIENT: 3-34 THIS CERTIFIES THAT AN ORDER NOT TO RESUSCITATE HAS BEEN 3-35 ENTERED ON THE ABOVE-NAMED PATIENT. 3-36 SIGNED: 3-37 ATTENDING PHYSICIAN 3-38 PRINTED OR TYPED NAME OF ATTENDING PHYSICIAN: S. B. 55 -3- (Index) SB55/AP 4- 1 ATTENDING PHYSICIAN'S TELEPHONE NUMBER: 4- 2 DATE: ' 4- 3 (b) A person who is not a patient in a hospital, nursing 4- 4 home, or licensed hospice and who has an order not to 4- 5 resuscitate pursuant to this Code section shall wear an 4- 6 identifying bracelet on either the wrist or the ankle or 4- 7 an identifying necklace. The bracelet shall be 4- 8 substantially similar to identification bracelets worn in 4- 9 hospitals. The bracelet or necklace shall be on an orange 4-10 background and shall provide the following information in 4-11 boldface type: 4-12 'DO NOT RESUSCITATE ORDER 4-13 Patient's name: 4-14 Authorized person's name and telephone number, if 4-15 applicable: 4-16 Patient's physician's printed name and telephone 4-17 number: 4-18 Date of order not to resuscitate: ' 4-19 Any physician, health care professional, or emergency 4-20 medical technician shall be authorized to regard such a 4-21 bracelet or necklace as a legally sufficient order not to 4-22 resuscitate in the same manner as an order issued pursuant 4-23 to this chapter unless such person has actual knowledge 4-24 that such order has been canceled or consent thereto 4-25 revoked as provided in this chapter. 4-26 (c) Any order not to resuscitate evidenced pursuant to 4-27 subsection (a) or (b) or this Code section may be revoked 4-28 as provided in Code Section 31-39-6 and may be canceled as 4-29 provided in Code Section 31-39-5." SECTION 4. 4-30 Said chapter is further amended by striking Code Section 4-31 31-39-6, relating to revocation of consent to order not to 4-32 resuscitate, and inserting in its place the following: 4-33 "31-39-6. (Index) 4-34 (a) A patient may, at any time, revoke his or her consent 4-35 to an order not to resuscitate by making either a written 4-36 or an oral declaration or by any other act evidencing a 4-37 specific intent to revoke such consent which is 4-38 communicated to or in the presence of an attending S. B. 55 -4- (Index) SB55/AP 5- 1 physician or a member of the nursing staff at the health 5- 2 care facility, a health care professional, or an emergency 5- 3 medical technician. 5- 4 (b) Any parent or authorized person may at any time revoke 5- 5 his or her consent to an order not to resuscitate a 5- 6 patient by making either a written or an oral declaration 5- 7 or by any other act evidencing a specific intent to revoke 5- 8 such consent which is communicated to or in the presence 5- 9 of an attending physician or a member of the nursing staff 5-10 at the health care facility, a health care professional, 5-11 or an emergency medical technician. 5-12 (c) Any physician who is informed of or provided with a 5-13 revocation of consent pursuant to this Code section shall, 5-14 either by himself or herself or by designee, immediately 5-15 include the revocation in the patient's chart, cancel the 5-16 order, and notify any health care facility staff 5-17 responsible for the patient's care of the revocation and 5-18 cancellation. Any member of the nursing staff, a health 5-19 care professional, or emergency medical technician who is 5-20 informed of or provided with a revocation of consent 5-21 pursuant to this Code section shall immediately notify a 5-22 physician of such revocation." SECTION 5. 5-23 Said chapter is further amended by striking Code Section 5-24 31-39-7, relating to liability of persons carrying out in 5-25 good faith decisions regarding cardiopulmonary 5-26 resuscitation, and inserting in its place the following: 5-27 "31-39-7. (Index) 5-28 (a) No physician, health care professional, health care 5-29 facility, emergency medical technician, or person employed 5-30 by, acting as the agent of, or under contract with any of 5-31 the foregoing shall be subject to criminal prosecution or 5-32 civil liability or be deemed to have engaged in 5-33 unprofessional conduct for carrying out in good faith a 5-34 decision regarding cardiopulmonary resuscitation 5-35 authorized by this chapter by or on behalf of a patient or 5-36 for those actions taken in compliance with the standards 5-37 and procedures set forth in this chapter. 5-38 (b) No physician, health care professional, health care 5-39 facility, emergency medical technician, or person employed 5-40 by, acting as the agent of, or under contract with any of 5-41 the foregoing shall be subject to criminal prosecution or S. B. 55 -5- (Index) SB55/AP 6- 1 civil liability or be deemed to have engaged in 6- 2 unprofessional conduct for providing cardiopulmonary 6- 3 resuscitation to a patient for whom an order not to 6- 4 resuscitate has been issued, provided that such physician 6- 5 or person: 6- 6 (1) Reasonably and in good faith was unaware of the 6- 7 issuance of an order not to resuscitate; or 6- 8 (2) Reasonably and in good faith believed that consent 6- 9 to the order not to resuscitate had been revoked or 6-10 canceled. 6-11 (c) No persons shall be civilly liable for failing or 6-12 refusing in good faith to effectuate an order not to 6-13 resuscitate. No person shall be subject to criminal 6-14 prosecution or civil liability for consenting or declining 6-15 to consent in good faith, on behalf of a patient, to the 6-16 issuance of an order not to resuscitate pursuant to this 6-17 chapter. 6-18 (d) Any attending physician who fails or refuses to comply 6-19 with an order not to resuscitate entered pursuant to this 6-20 chapter shall endeavor to advise promptly the patient, if 6-21 conscious, or the next of kin or authorized person of the 6-22 patient that such physician is unwilling to effectuate the 6-23 order. The attending physician shall thereafter at the 6-24 election of the next of kin or authorized person: 6-25 (1) Make a good faith attempt to effect the transfer of 6-26 the patient to another physician who will effectuate the 6-27 order not to resuscitate; or 6-28 (2) Permit the next of kin or authorized person to 6-29 obtain another physician who will effectuate the order 6-30 not to resuscitate. 6-31 (e) Any emergency medical technician who fails or refuses 6-32 to comply with an order not to resuscitate entered 6-33 pursuant to this chapter shall endeavor to advise promptly 6-34 the patient, if conscious, or the next of kin or 6-35 authorized person of the patient, if reasonably available, 6-36 that such emergency medical technician is unwilling to 6-37 effectuate the order." SECTION 6. 6-38 This Act shall become effective upon its approval by the 6-39 Governor or upon its becoming law without such approval. S. B. 55 -6- (Index) SB55/AP SECTION 7. 7- 1 All laws and parts of laws in conflict with this Act are 7- 2 repealed. S. B. 55 -7- (Index)

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