senate Bill S7154A

2013-2014 Legislative Session

Relates to life-sustaining treatment standards

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Archive: Last Bill Status - In Committee


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jun 17, 2014 print number 7154a
amend and recommit to health
May 01, 2014 referred to health

Bill Amendments

Original
A (Active)
Original
A (Active)

S7154 - Bill Details

See Assembly Version of this Bill:
A9566B
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Amd §§2980, 2981 & 2982, Pub Health L

S7154 - Bill Texts

view summary

Relates to life-sustaining treatment standards.

view sponsor memo
BILL NUMBER:S7154

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 Improvement Acts." The bills make
technical/minor, clarifying and coordinating amendments and other
improvements to the NYS laws that govern health care decisions,
including life-sustaining treatment decisions, for patients who lack
decision-making capacity. The SDMIAs address these topics:

*SDMIA 1 Technical / Minor Amendments

*SDMIA 2 Repeals PHL Art. 29-B Orders Not to Resuscitate for Patients
in Mental Hygiene Facilities

*SDMIA 3 Determining Patient Incapacity

*SDMIA 4 Decisions by a Health Care Agent About Artificial Nutrition
and Hydration

*SDMIA 5 Confirm the Primacy of a Patient's Clear Prior Decision

*SDMIA 6 Restore Medical Futility as a Basis for a DNR Order

*SDMIA 7 Life-Sustaining Treatment Decisions for Developmentally
Disabled Persons

This bill, SDMIA 4, makes the agents decision regarding 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
nutrition and hydration because of the change made by Section 2.

Section 2 deletes a clause relating to agent decisions regarding
artificial 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 principal'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.

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 1987 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
definition of "best interests," and which no applies to decisions by
surrogates, applicable to decisions by health care agents.

PRIOR LEGISLATIVE HISTORY:

S.5321 (Sen. Hannon) (2013)/ A.7371 (M. of A. Gottfried)(2013)
included all of these provisions, as well as other provisions.

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.

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

                                  7154

                            I N  S E N A T E

                               May 1, 2014
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law, in  relation  to  the  artificial
  nutrition and hydration decision standard

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

  Section 1. Paragraph (d) of subdivision  5  of  section  2981  of  the
public  health  law,  as  added  by  chapter 752 of the laws of 1990, is
amended to read as follows:
  (d) A health care proxy may, but need not, be in the following form:
                             Health Care Proxy
  I             (name of principal)               hereby appoint  (name,
home  address  and telephone number of agent) as my health care agent to
make any and all health care decisions for me, except to  the  extent  I
state otherwise.
  This  health care proxy shall take effect in the event I become unable
to make my own health care decisions.
  NOTE: Although not necessary, and neither encouraged nor  discouraged,
you  may  wish  to  state instructions or wishes, and limit your agent's
authority. [Unless your agent knows your wishes about artificial  nutri-
tion  and  hydration, your agent will not have authority to decide about
artificial  nutrition  and  hydration.]   If   you   choose   to   state
instructions, wishes, or limits, please do so below:
  ______________________________________________________________________
  ______________________________________________________________________
  ______________________________________________________________________
  I  direct my agent to make health care decisions in accordance with my
wishes and instructions as stated above or as otherwise known to him  or
her.  I  also  direct my agent to abide by any limitations on his or her
authority as stated above or as otherwise known to him or her.
  In the event the person  I  appoint  above  is  unable,  unwilling  or
unavailable to act as my health care agent, I hereby appoint (name, home
address  and  telephone  number  of  alternate  agent) as my health care
agent.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD13622-01-4

S. 7154                             2

  I understand that, unless I revoke  it,  this  proxy  will  remain  in
effect  indefinitely  or until the date or occurrence of the condition I
have stated below:
  (Please  complete  the  following  if you do NOT want this health care
proxy to be in effect indefinitely):
  This proxy shall expire:           (Specify date or condition)
Signature:
  Address:
  Date:
  I declare that the person who signed or asked  another  to  sign  this
document  is  personally known to me and appears to be of sound mind and
acting willingly and free from duress. He or she signed (or asked anoth-
er to sign for him or her) this document in my presence and that  person
signed  in  my  presence. I am not the person appointed as agent by this
document.
  Witness:
  Address:
  Witness:
  Address:
  S 2. Subdivision 2 of section  2982  of  the  public  health  law,  as
amended  by  chapter  230  of  the  laws  of 2004, is amended to read as
follows:
  2. Decision-making standard. After consultation with a licensed physi-
cian, registered nurse, licensed psychologist,  licensed  master  social
worker,  or  a  licensed  clinical  social  worker, the agent shall make
health care decisions: (a) in accordance with  the  principal's  wishes,
including  the  principal's  religious  and moral beliefs; or (b) if the
principal's wishes are not reasonably known and cannot  with  reasonable
diligence be ascertained, in accordance with the principal's best inter-
ests[;  provided,  however, that if the principal's wishes regarding the
administration of artificial nutrition and hydration are not  reasonably
known  and  cannot  with  reasonable diligence be ascertained, the agent
shall not have the authority to make  decisions  regarding  these  meas-
ures].
  S  3.  This  act shall take effect on the ninetieth day after it shall
have become a law, provided that the amendments  to  sections  2981  and
2982  of  the public health law made by sections one and two of this act
shall apply to decisions made pursuant to health  care  proxies  created
prior  to the effective date of this act as well as those created there-
after.

S7154A (ACTIVE) - Bill Details

See Assembly Version of this Bill:
A9566B
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Amd §§2980, 2981 & 2982, Pub Health L

S7154A (ACTIVE) - Bill Texts

view summary

Relates to life-sustaining treatment standards.

view sponsor memo
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.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 7154--A

                            I N  S E N A T E

                               May 1, 2014
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed  to  the  Committee  on  Health  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN  ACT  to  amend  the public health law, in relation to the artificial
  nutrition and hydration decision standard

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

  Section  1. Subdivision 4 of section 2980 of the public health law, as
added by chapter 752 of the laws of 1990, is amended to read as follows:
  4. "Health care" means any treatment, service or procedure to diagnose
or treat an individual's physical or mental condition.  PROVIDING NUTRI-
TION OR HYDRATION ORALLY, WITHOUT RELIANCE ON MEDICAL TREATMENT, IS  NOT
HEALTH CARE UNDER THIS ARTICLE AND IS NOT SUBJECT TO THIS ARTICLE.
  S 2. The fourth undesignated paragraph of paragraph (d) of subdivision
5  of  section 2981 of the public health law, as added by chapter 752 of
the laws of 1990, is amend to read as follows:
  NOTE: Although not necessary, and neither encouraged nor  discouraged,
you  may  wish  to  state instructions or wishes, and limit your agent's
authority. [Unless your agent knows your wishes about artificial  nutri-
tion  and  hydration, your agent will not have authority to decide about
artificial nutrition and hydration.] FOR EXAMPLE,  YOU  MAY  STATE  YOUR
WISHES  REGARDING  WITHHOLDING  OR WITHDRAWING LIFE-SUSTAINING TREATMENT
(INCLUDING HYDRATION AND NUTRITION PROVIDED BY MEANS OF  MEDICAL  TREAT-
MENT)   TO  GUIDE  YOUR  AGENT'S  DECISIONS.  If  you  choose  to  state
instructions, wishes, or limits, please do so below:
  ______________________________________________________________________
  ______________________________________________________________________
  ______________________________________________________________________
  S 3. Subdivision 2 of section  2982  of  the  public  health  law,  as
amended  by  chapter  230  of  the  laws  of 2004, is amended to read as
follows:
  2. Decision-making standard. After consultation with a licensed physi-
cian, registered nurse, licensed psychologist,  licensed  master  social

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD13622-07-4

S. 7154--A                          2

worker,  or  a  licensed  clinical  social  worker, the agent shall make
health care decisions: (a) in accordance with  the  principal's  wishes,
including  the  principal's  religious  and moral beliefs; or (b) if the
principal's  wishes  are not reasonably known and cannot with reasonable
diligence be ascertained, in accordance with the principal's best inter-
ests[; provided, however, that if the principal's wishes  regarding  the
administration  of artificial nutrition and hydration are not reasonably
known and cannot with reasonable diligence  be  ascertained,  the  agent
shall  not  have  the  authority to make decisions regarding these meas-
ures].
  S 4. This act shall take effect on the ninetieth day  after  it  shall
have  become  a  law,  provided that the amendments to sections 2981 and
2982 of the public health law made by sections two and three of this act
shall apply to decisions made pursuant to health  care  proxies  created
prior  to the effective date of this act as well as those created there-
after.

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