A09566 Summary:

BILL NO    A09566B

SAME AS    SAME AS S07154-A

SPONSOR    Rosenthal

COSPNSR    Gottfried

MLTSPNSR   

Amd SS2980, 2981 & 2982, Pub Health L

Relates to life-sustaining treatment standards.
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A09566 Actions:

BILL NO    A09566B

05/07/2014 referred to health
05/16/2014 amend and recommit to health
05/16/2014 print number 9566a
05/20/2014 reported referred to codes
06/16/2014 amend and recommit to codes
06/16/2014 print number 9566b
06/18/2014 reported referred to rules
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A09566 Votes:

There are no votes for this bill in this legislative session.
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A09566 Memo:

BILL NUMBER:A9566B

TITLE OF BILL:  An act to amend the public health law, in relation to
the artificial nutrition and hydration decision standard

PURPOSE OF GENERAL IDEA OF BILL:  This is one of a series of seven
bills, informally referred to as the "Surrogate Decision-Making
Improvement Acts." The bills make technical/minor, clarifying and
coordinating amendments and other improvements to the Family Health
Care Decisions Act (FHCDA) (Ch. 8, Laws of 2010) and other laws that
govern health care decisions, including life-sustaining treatment
decisions, for patients who lack decision-making capacity.  This bill
makes the standards for a health care agent's decision regarding
artificial nutrition and hydration consistent with the Family Health
Care Decision Act (FHCDA).

SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends the model health care proxy form in PHL S 2981(5)(d)
to delete a clause relating to agent decisions regarding artificial
nutrition and hydration because of the change made by Section 2, and
to add more general language prompting the principal to express his or
her wishes about life-sustaining treatment, including nutrition and
hydration provided by means of medical treatment.

Section 2 deletes a clause relating to agent decisions regarding
artificial nutrition and hydration to make the decision-making
standard consistent with the standard in the FHCDA, allowing a
surrogate to make such decisions based on the surrogate's wishes,
including the principal's religious and moral beliefs, or if the
principal's wishes are not reasonably known and cannot with reasonable
diligence be ascertained, in accordance with the principal's best
interests.

Section 3 is the effective date: ninety days after it becomes a law.

JUSTIFICATION:  This bill makes the decision-making standard for an
agent under the Health Care Proxy Law similar to the standard for a
surrogate under the Family Health Care Decisions Act (FHCDA).

Specifically, the FHCDA provides that a surrogate must make decisions
about life-sustaining treatment, including artificial nutrition and
hydration, based on the patient's wishes or, if the patient's wishes
are not reasonably known, based on the patient's best interests. In
contrast, the 1990 Health Care Proxy Law allows the patient's
designated agent to make decisions about artificial nutrition and
hydration only if the decision is based on the patient's reasonably
known wishes, and not if the decision is based on the patient's best
interests. There is little basis for this disparity in standards.
Moreover, the special rule for decisions about artificial nutrition
and hydration in the Health Care Proxy Law has been a source of
enduring confusion and misinterpretation.

This amendment would make the FHCDA standard, with its careful
definition of "best interests," and which no applies to decisions by
surrogates, applicable to decisions by health care agents.


PRIOR LEGISLATIVE HISTORY: 2013: A.7371 reported referred to codes
2014: A9566-A referred to codes

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: This act shall take effect ninety days after the date
on which this act shall have become a law. The amendments to article
29-C of the public health law shall apply to decisions made pursuant
to health care proxies created prior to this act becoming law as well
as those created thereafter.
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A09566 Text:

                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________

                                        9566--B

                                 I N  A S S E M B L Y

                                      May 7, 2014
                                      ___________

       Introduced by M. of A. ROSENTHAL, GOTTFRIED -- read once and referred to
         the Committee on Health -- committee discharged, bill amended, ordered
         reprinted as amended and recommitted to said committee -- reported and
         referred  to  the  Committee  on  Codes  -- committee discharged, bill
         amended, ordered reprinted as amended and recommitted to said  commit-
         tee

       AN  ACT  to  amend  the public health law, in relation to the artificial
         nutrition and hydration decision standard

         THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
       BLY, DO ENACT AS FOLLOWS:

    1    Section  1. Subdivision 4 of section 2980 of the public health law, as
    2  added by chapter 752 of the laws of 1990, is amended to read as follows:
    3    4. "Health care" means any treatment, service or procedure to diagnose
    4  or treat an individual's physical or mental condition.  PROVIDING NUTRI-
    5  TION OR HYDRATION ORALLY, WITHOUT RELIANCE ON MEDICAL TREATMENT, IS  NOT
    6  HEALTH CARE UNDER THIS ARTICLE AND IS NOT SUBJECT TO THIS ARTICLE.
    7    S 2. The fourth undesignated paragraph of paragraph (d) of subdivision
    8  5  of  section 2981 of the public health law, as added by chapter 752 of
    9  the laws of 1990, is amend to read as follows:
   10    NOTE: Although not necessary, and neither encouraged nor  discouraged,
   11  you  may  wish  to  state instructions or wishes, and limit your agent's
   12  authority. [Unless your agent knows your wishes about artificial  nutri-
   13  tion  and  hydration, your agent will not have authority to decide about
   14  artificial nutrition and hydration.] FOR EXAMPLE,  YOU  MAY  STATE  YOUR
   15  WISHES  REGARDING  WITHHOLDING  OR WITHDRAWING LIFE-SUSTAINING TREATMENT
   16  (INCLUDING HYDRATION AND NUTRITION PROVIDED BY MEANS OF  MEDICAL  TREAT-
   17  MENT)   TO  GUIDE  YOUR  AGENT'S  DECISIONS.  If  you  choose  to  state
   18  instructions, wishes, or limits, please do so below:
   19    ______________________________________________________________________
   20    ______________________________________________________________________
   21    ______________________________________________________________________
   22    S 3. Subdivision 2 of section  2982  of  the  public  health  law,  as
   23  amended  by  chapter  230  of  the  laws  of 2004, is amended to read as
   24  follows:

        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD13622-05-4
       A. 9566--B                          2

    1    2. Decision-making standard. After consultation with a licensed physi-
    2  cian, registered nurse, licensed psychologist,  licensed  master  social
    3  worker,  or  a  licensed  clinical  social  worker, the agent shall make
    4  health care decisions: (a) in accordance with  the  principal's  wishes,
    5  including  the  principal's  religious  and moral beliefs; or (b) if the
    6  principal's wishes are not reasonably known and cannot  with  reasonable
    7  diligence be ascertained, in accordance with the principal's best inter-
    8  ests[;  provided,  however, that if the principal's wishes regarding the
    9  administration of artificial nutrition and hydration are not  reasonably
   10  known  and  cannot  with  reasonable diligence be ascertained, the agent
   11  shall not have the authority to make  decisions  regarding  these  meas-
   12  ures].
   13    S  4.  This  act shall take effect on the ninetieth day after it shall
   14  have become a law, provided that the amendments  to  sections  2981  and
   15  2982 of the public health law made by sections two and three of this act
   16  shall  apply  to  decisions made pursuant to health care proxies created
   17  prior to the effective date of this act as well as those created  there-
   18  after.
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