Authorizes nurse practitioners to issue orders not to resuscitate; repealer

5 Co-sponsors

• Velmanette Montgomery
• Ruth Hassell-Thompson
• Suzi Oppenheimer
• Bill Perkins
• Brian X. Foley

Title of bill

An act to amend the public health law, in relation to authorizing nurse practitioners to execute orders not to resuscitate; and to repeal subdivision 4 of section 2977 of such law relating to consent to nonhospital orders not to resuscitate

Purpose or general idea of bill

To allow an attending nurse practitioner to execute an order on behalf of a patient not to resuscitate.

Summary of specific provisions

The bill amends the public health law, to add "attending nurse practitioner," to list of health care providers (currently only attending physicians), who are authorized to execute an order not to resuscitate on behalf of patients and families.

Justification

Modern medicine's ability to save and sustain life has created a new imperative to balance technology with humanity. Doing more is no longer synonymous with doing better. The question of whether and under what circumstances medical intervention should cease and a person should be permitted to die is one of the most controversial issues facing society today. In 1987, in accordance with the proposed legislation from the New York State Task Force on Life and The Law, the legislation enacted and the Governor signed a law to establish policies for DNR orders in community settings, such a private homes. Under current law, the attending physician must obtain the contemporaneous consent of a patient with decisional capacity prior to issuing a DNR. The 1987 law also requires the attending physician to obtain the consent of a minor's parent or legal guardian before issuing a DNR order for the minor. If the minor has decisional capacity, as determined by the attending physician's consultation with the minor's parents, the physician must obtain the minor's assent to issuance of the order. The proposed bill provides a means for a person to express a decision to reject CPR to the attending physician or attending nurse practitioner. The decision by an individual about whether to withhold resuscitation is a deeply personal one. It should be contemplated in consultation with a person's primary care provider, which in many instances is a nurse practitioner. Because current law only allows physicians to execute a DNR, many patients are deprived of the ability to make this decision in collaboration with their primary care provider if such provider is a nurse practitioner. Patients should not be limited to establishing a DNR for themselves with a physician with whom they may have had little or no direct contact.

Legislative history

2005-06: A.7769 - Passed Assembly 2007-08: A.8162- Passed Assembly

Fiscal implications

None.

Effective date

180 days after enactment.