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This entry was published on 2020-06-19
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SECTION 2994-M
Ethics review committees
Public Health (PBH) CHAPTER 45, ARTICLE 29-CC
§ 2994-m. Ethics review committees. 1. Establishment of an ethics
review committee, written policy. Each hospital shall establish at least
one ethics review committee or participate in an ethics review committee
that serves more than one hospital, and shall adopt a written policy
governing committee functions, composition, and procedure, in accordance
with the requirements of this article. A hospital may designate an
existing committee, or subcommittee thereof, to carry out the functions
of the ethics review committee provided the requirements of this section
are satisfied.

2. Functions of the ethics review committee. (a) The ethics review
committee shall consider and respond to any health care matter presented
to it by a person connected with the case.

(b) The ethics review committee response to a health care matter may
include:

(i) providing advice on the ethical aspects of proposed health care;

(ii) making a recommendation about proposed health care; or

(iii) providing assistance in resolving disputes about proposed health
care.

(c) Recommendations and advice by the ethics review committee shall be
advisory and nonbinding, except as specified in subdivision five of
section twenty-nine hundred ninety-four-d of this article and
subdivision three of section twenty-nine hundred ninety-four-e of this
article.

3. Committee membership. The membership of ethics review committees
must be interdisciplinary and must include at least five members who
have demonstrated an interest in or commitment to patient's rights or to
the medical, public health, or social needs of those who are ill. At
least three ethics review committee members must be health or social
services practitioners, at least one of whom must be a registered nurse
and one of whom must be a physician, nurse practitioner or physician
assistant. At least one member must be a person without any governance,
employment or contractual relationship with the hospital. In a
residential health care facility the facility must offer the residents'
council of the facility (or of another facility that participates in the
committee) the opportunity to appoint up to two persons to the ethics
review committee, none of whom may be a resident of or a family member
of a resident of such facility, and both of whom shall be persons who
have expertise in or a demonstrated commitment to patient rights or to
the care and treatment of the elderly or nursing home residents through
professional or community activities, other than activities performed as
a health care provider.

4. Procedures for ethics review committee. (a) These procedures are
required only when: (i) the ethics review committee is convened to
review a decision by a surrogate to withhold or withdraw life-sustaining
treatment for: (A) a patient in a residential health care facility
pursuant to paragraph (b) of subdivision five of section twenty-nine
hundred ninety-four-d of this article; (B) a patient in a general
hospital pursuant to paragraph (c) of subdivision five of section
twenty-nine hundred ninety-four-d of this article; or (C) an emancipated
minor patient pursuant to subdivision three of section twenty-nine
hundred ninety-four-e of this article; or (ii) when a person connected
with the case requests the ethics review committee to provide assistance
in resolving a dispute about proposed care. Nothing in this section
shall bar health care providers from first striving to resolve disputes
through less formal means, including the informal solicitation of
ethical advice from any source.

(b)(i) A person connected with the case may not participate as an
ethics review committee member in the consideration of that case.

(ii) The ethics review committee shall respond promptly, as required
by the circumstances, to any request for assistance in resolving a
dispute or consideration of a decision to withhold or withdraw
life-sustaining treatment pursuant to paragraphs (b) and (c) of
subdivision five of section twenty-nine hundred ninety-four-d of this
article made by a person connected with the case. The committee shall
permit persons connected with the case to present their views to the
committee, and to have the option of being accompanied by an advisor
when participating in a committee meeting.

(iii) The ethics review committee shall promptly provide the patient,
where there is any indication of the patient's ability to comprehend the
information, the surrogate, other persons on the surrogate list directly
involved in the decision or dispute regarding the patient's care, any
parent or guardian of a minor patient directly involved in the decision
or dispute regarding the minor patient's care, an attending
practitioner, the hospital, and other persons the committee deems
appropriate, with the following:

(A) notice of any pending case consideration concerning the patient,
including, for patients, persons on the surrogate list, parents and
guardians, information about the ethics review committee's procedures,
composition and function; and

(B) the committee's response to the case, including a written
statement of the reasons for approving or disapproving the withholding
or withdrawal of life-sustaining treatment for decisions considered
pursuant to subparagraph (ii) of paragraph (a) of subdivision five of
section twenty-nine hundred ninety-four-d of this article. The
committee's response to the case shall be included in the patient's
medical record.

(iv) Following ethics review committee consideration of a case
concerning the withdrawal or withholding of life-sustaining treatment,
treatment shall not be withdrawn or withheld until the persons
identified in subparagraph (iii) of this paragraph have been informed of
the committee's response to the case.

(c) When an ethics review committee is convened to review decisions
regarding hospice care for a patient in a general hospital or
residential health care facility, the responsibilities of this section
shall be carried out by the ethics review committee of the general
hospital or residential health care facility, provided that such
committee shall invite a representative from hospice to participate.

5. Access to medical records and information; patient confidentiality.
Ethics review committee members and consultants shall have access to
medical information and medical records necessary to perform their
function under this article. Any such information or records disclosed
to committee members, consultants, or others shall be kept confidential
except to the extent necessary to accomplish the purposes of this
article or as otherwise provided by law.

6. Ethics review committee confidentiality. Notwithstanding any other
provisions of law, the proceedings and records of an ethics review
committee shall be kept confidential and shall not be released by
committee members, committee consultants, or other persons privy to such
proceedings and records; the proceedings and records of an ethics review
committee shall not be subject to disclosure or inspection in any
manner, including under article six of the public officers law or
article thirty-one of the civil practice law and rules; and, no person
shall testify as to the proceedings or records of an ethics review
committee, nor shall such proceedings and records otherwise be
admissible as evidence in any action or proceeding of any kind in any
court or before any other tribunal, board, agency or person, except
that:

(a) Ethics review committee proceedings and records, in cases where a
committee approves or disapproves of the withholding or withdrawal of
life-sustaining treatment pursuant to subdivision five of section
twenty-nine hundred ninety-four-d of this article, or subdivision three
of section twenty-nine hundred ninety-four-e of this article, may be
obtained by or released to the department;

(b) Nothing in this subdivision shall prohibit the patient, the
surrogate, other persons on the surrogate list, or a parent or guardian
of a minor patient from voluntarily disclosing, releasing or testifying
about committee proceedings or records; and

(c) Nothing in this subdivision shall prohibit the justice center for
the protection of people with special needs or any agency or person
within or under contract with the justice center which provides
protection and advocacy services from requiring any information, report
or record from a hospital in accordance with the provisions of section
five hundred fifty-eight of the executive law.