NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A3245A
SPONSOR: Rosenthal TITLE OF BILL:
An act to amend the public health law, in relation to the artificial
hydration and nutrition decision standard
PURPOSE:•
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, includ-
ing life-sustaining treatment decisions, for patients who lack deci-
sion-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 one amends subdivision 4 of section 2980 of the public health
law.
Section two amends the fourth undesignated paragraph of paragraph (d) of
subdivision 5 of section 2981 of the public health law.
Section three amends subdivision 2 of section 2982 of the public health
law.
Section four sets forth the effective date.
JUSTIFICATION:
This bill makes the decision-making standard for an agent under the
Health Care Proxy Law like 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, includ-
ing 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 defi-
nition of "best interests," and which no applies to decisions by surro-
gates, applicable to decisions by health care agents.
LEGISLATIVE HISTORY:;
2023-24: A.1448 - Referred to Health; S.2777 - Referred to Health
2021-22: A.2634 - Referred to Codes; S.4967 - Referred to Health
2019-20: A.730-A - Referred to Health
2017-18: A.4055 - Referred to Health
2015-16: A.674 - Referred to Health
2013-14: A.9566-B - Reported to Rules;
S.7154-A - Referred to Health
FISCAL IMPLICATIONS:
None to the State.
EFFECTIVE DATE:
90 days.
STATE OF NEW YORK
________________________________________________________________________
3245--A
2025-2026 Regular Sessions
IN ASSEMBLY
January 27, 2025
___________
Introduced by M. of A. ROSENTHAL, BRONSON, DAVILA -- read once and
referred to the Committee on Health -- 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
hydration and nutrition 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, including
5 hydration and nutrition.
6 § 2. The fourth undesignated paragraph of paragraph (d) of subdivision
7 5 of section 2981 of the public health law, as added by chapter 752 of
8 the laws of 1990, is amended to read as follows:
9 NOTE: Although not necessary, and neither encouraged nor discouraged,
10 you may wish to state instructions or wishes, and limit your agent's
11 authority. [Unless your agent knows your wishes about artificial nutri-
12 tion and hydration, your agent will not have authority to decide about
13 artificial nutrition and hydration.] For example, you may state your
14 wishes regarding withholding or withdrawing life-sustaining treatment
15 (including hydration and nutrition) to guide your agent's decisions. If
16 you choose to state instructions, wishes, or limits, please do so below:
17 ______________________________________________________________________
18 ______________________________________________________________________
19 ______________________________________________________________________
20 § 3. Subdivision 2 of section 2982 of the public health law, as
21 amended by chapter 619 of the laws of 2024, is amended to read as
22 follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD00668-04-5
A. 3245--A 2
1 2. Decision-making standard. After consultation with a licensed physi-
2 cian, registered nurse, physician assistant, nurse practitioner,
3 licensed psychologist, licensed master social worker, or a licensed
4 clinical social worker, the agent shall make health care decisions: (a)
5 in accordance with the principal's wishes, including the principal's
6 religious and moral beliefs; or (b) if the principal's wishes are not
7 reasonably known and cannot with reasonable diligence be ascertained, in
8 accordance with the principal's best interests[; provided, however, that
9 if the principal's wishes regarding the administration of artificial
10 nutrition and hydration are not reasonably known and cannot with reason-
11 able diligence be ascertained, the agent shall not have the authority to
12 make decisions regarding these measures].
13 § 4. This act shall take effect on the ninetieth day after it shall
14 have become a law; provided, however, that the amendments to sections
15 2981 and 2982 of the public health law made by sections two and three of
16 this act shall apply to decisions made pursuant to health care proxies
17 created prior to the effective date of this act as well as those created
18 thereafter; and provided, further, that if chapter 619 of the laws of
19 2024 shall not have taken effect on or before such date then section
20 three of this act shall take effect on the same date and in the same
21 manner as such chapter of the laws of 2024, takes effect.
