Relates to life-sustaining treatment standards

BILL NUMBER:S7154A

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 Improve- ment Acts." The hills 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 regard- ing 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 § 2981(5)(d) to delete a clause relating to agent decisions regarding artificial nutri- tion 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 artifi- cial 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 princi- pal'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 misinterpre- tation.

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.

Prior legislative history

2013: A.7371 reported 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.