A09670 Summary:

BILL NO    A09670A

SAME AS    SAME AS S07155-A

SPONSOR    Pretlow (MS)

COSPNSR    Gottfried

MLTSPNSR   

Amd S2994-f, Pub Health L

Relates to disputes between a surrogate and a hospital or individual health
care provider; cites when the requirement of a provider to provide
life-sustaining treatment following a surrogate's directive does not apply.
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A09670 Actions:

BILL NO    A09670A

05/14/2014 referred to health
05/20/2014 reported referred to codes
06/16/2014 amend and recommit to codes
06/16/2014 print number 9670a
06/18/2014 reported referred to rules
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A09670 Votes:

There are no votes for this bill in this legislative session.
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A09670 Memo:

BILL NUMBER:A9670A

TITLE OF BILL:  An act to amend the public health law, in relation to
disputes between a surrogate and a hospital or individual health care
provider

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 clarifies that the provisions relating to disputes between a
surrogate and a hospital or individual health care provider do not
apply when the hospital or individual health care provider is carrying
out a patient's prior decision that meet standards set forth in the
FHCDA.

SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends PHL section 2994-f to clarify that the provisions
relating to disputes between a surrogate and a hospital or individual
health care provider do not apply when the hospital or individual
health care provider is carrying out a patient's prior decision that
meet standards set forth in PHL S 2994-d, provided that the surrogate
in such instance retains the right to request ethics committee review
of the case or judicial review in accordance with other provisions in
the FHCDA.

Section 2 is the effective date: immediately.

JUSTIFICATION:  This amendment ensures that a surrogate's objection
will not prohibit a provider from following the clearly expressed
prior wishes of a patient.

The Family Health Care Decisions Act (FHCDA) now states that if a
surrogate directs the provision of life-sustaining treatment, but the
hospital or individual health care provider "does not wish to provide
such treatment," the hospital or individual provider nevertheless must
either comply with the surrogate's decision, transfer the patient or
seek court review.

The provision is appropriate as applied to a dispute between the
surrogate and the provider. However, it does not clearly or
appropriately apply to disputes between a surrogate and the patient
himself, as evidenced by the patient's clear prior decision. .Indeed,
it would be constitutionally and ethically problematic to apply this
clause to override a patient's clear prior decision.

Notably, the FHCDA provides that a provider does not need to seek the
consent of a surrogate when a patient has made a decision about
proposed health care in accordance with certain requirements. PHL
2994-d.3(a)(ii). Accordingly, this amendment clarifies that the
provision relating to a dispute between the surrogate and the provider
does not apply "when the hospital or individual health care provider


is carrying out a patient's decision made pursuant to paragraph (ii)
of subdivision 3 of section twenty-nine hundred ninety-four-d of this
article."

The amendment recognizes that the surrogate retains other means to
challenge the patient's prior decision, i.e.: through the ethics
review committee process or judicial review.

PRIOR LEGISLATIVE HISTORY: 2013: A.7371 reported referred to codes
2014: A. 9670 reported to codes

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: This act shall take effect immediately.
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A09670 Text:

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

                                        9670--A

                                 I N  A S S E M B L Y

                                     May 14, 2014
                                      ___________

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

       AN ACT to amend the public health law, in relation to disputes between a
         surrogate and a hospital or individual health care provider

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

    1    Section  1.  Subdivision 3 of section 2994-f of the public health law,
    2  as added by chapter 8 of the  laws  of  2010,  is  amended  to  read  as
    3  follows:
    4    3.  Notwithstanding  the provisions of this section or subdivision one
    5  of section twenty-nine hundred  ninety-four-q  of  this  article,  if  a
    6  surrogate directs the provision of life-sustaining treatment, the denial
    7  of which in reasonable medical judgment would be likely to result in the
    8  death of the patient, a hospital or individual health care provider that
    9  does  not  wish  to provide such treatment shall nonetheless comply with
   10  the surrogate's decision pending either transfer of  the  patient  to  a
   11  willing  hospital or individual health care provider, or judicial review
   12  in accordance with section twenty-nine  hundred  ninety-four-r  of  this
   13  article.  THIS REQUIREMENT SHALL NOT APPLY WHEN THE HOSPITAL OR INDIVID-
   14  UAL HEALTH CARE PROVIDER IS  CARRYING  OUT  A  PATIENT'S  DECISION  MADE
   15  PURSUANT  TO  SUBPARAGRAPH (II) OF PARAGRAPH (A) OF SUBDIVISION THREE OF
   16  SECTION TWENTY-NINE HUNDRED NINETY-FOUR-D OF THIS ARTICLE; PROVIDED THAT
   17  THE SURROGATE IN SUCH INSTANCE  RETAINS  THE  RIGHT  TO  REQUEST  ETHICS
   18  COMMITTEE  REVIEW  OF  THE  CASE PURSUANT TO SECTION TWENTY-NINE HUNDRED
   19  NINETY-FOUR-M OF THIS ARTICLE, OR JUDICIAL  REVIEW  IN  ACCORDANCE  WITH
   20  SECTION TWENTY-NINE HUNDRED NINETY-FOUR-R OF THIS ARTICLE.
   21    S 2. This act shall take effect immediately.


        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD13624-02-4
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