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Who cares
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Sponsors
2 Co-sponsors
History
- Referred to higher education
- Delivered to assembly
- Passed senateVote 51–11
- Advanced to third reading
- 2nd report cal.
- 1st report cal.1411
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Authorizes nurse practitioners to execute orders not to resuscitate and orders relating to life sustaining treatments
In Assembly Committee · Higher Education · Sponsor Richard Gottfried
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
Title of bill
An act to amend the public health law, in relation to authorizing nurse practitioners to execute orders not to resuscitate and orders pertaining to life sustaining treatments
Purpose
This bill would add "attending nurse practitioner," to the list of health care providers who are authorized to execute an order not to resuscitate, as well as orders pertaining to life sustaining treatments.
Summary of provisions
The bill amends the public health law, to add "attending nurse practitioner," to the list of health care providers who are authorized to execute an order not to resuscitate, as well as orders pertaining to life sustaining treatments.
Read the full memo (745 words)
Existing law
Currently only attending physicians, are authorized to execute an order not to resuscitate, as well as orders pertaining to life sustaining treatments, 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 legislature 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.
More recently, in 2010, the legislature enacted and the Governor signed into law the Family Health Care Decisions Act, which enabled family members to make health care decisions, including decisions about the withholding or withdrawal of life-sustaining treatment, on behalf of patients who lose their ability to make such decisions and have not prepared advance directives regarding their wishes. Those orders, however, are also currently required to be executed by an attending physician.
The proposed bill provides a means for a person to express a decision to reject CPR, and family members to exercise certain decisions regarding life sustaining treatments, to the attending physician or attending nurse practitioner. It is long understood that nurse practitioners possess the knowledge and training necessary to competently execute these types of orders. In fact, because more and more frequently the nurse practitioner is serving as a patient's general primary care treatment provider - particularly in nursing home settings - the NP may be most equipped and available to execute these orders due to the trusting relationship that is established with the patient and his or her family.
Given the deeply personal nature of the decision to refuse possible life-sustaining treatment, it is imperative that patients and their families have the opportunity to make these decisions in consultation with their trusted health care provider of choice. Because current law only allows physicians to execute these orders, 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 or other orders pertaining to life sustaining treatments for their loved ones with a physician with whom they may have had little or no direct contact.
In 2010, the Family Health Care Decisions Act ("FHCDA") was enacted, and a bill that would have authorized NPs to execute DNR orders passed both houses of the legislature. Governor Paterson vetoed that legislation pertaining to nurse practitioner because its provisions were inconsistent with the new FHCDA. This legislation has been amended to account for those statutory changes. In addition, this bill takes into account comments made in 2010 by representatives from the greater medical and health care community that acknowledged the important role that NPs play, particularly in rural communities and long-term care settings such as nursing homes and hospitals.
Legislative history
New bill
Fiscal implications
None.
Effective date
This act shall take effect on the one hundred eightieth day after it shall have become a law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.