85S10127 JG-F
	By: Klick	H.B. No. 152

	A BILL TO BE ENTITLED
	AN ACT
	relating to advance directives or health care or treatment
	decisions made by or on behalf of patients.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  This Act may be cited as the Texas Patient
	Autonomy Restoration Act of 2017.
	SECTION 2.  The purpose of this Act is to protect the right
	of patients and their families to decide whether and under what
	circumstances to choose or reject life-sustaining treatment. This
	Act amends the applicable provisions of the Advance Directives Act
	(Chapter 166, Health and Safety Code) to ensure that, when an
	attending physician is unwilling to respect a patient's advance
	directive or a patient's or family's decision to choose the
	treatment necessary to prevent the patient's death,
	life-sustaining medical treatment will be provided until the
	patient can be transferred to a health care provider willing to
	honor the directive or treatment decision.
	SECTION 3.  Section 166.045(c), Health and Safety Code, is
	amended to read as follows:
	(c)  If an attending physician refuses to comply with a
	directive or treatment decision to provide life-sustaining
	treatment to a patient [and does not wish to follow the procedure
	established under Section 166.046], life-sustaining treatment
	shall be provided to the patient[, but only] until [a reasonable
	opportunity has been afforded for the transfer of] the patient is
	transferred to another physician or health care facility willing to
	comply with the directive or treatment decision to provide
	life-sustaining treatment to the patient.
	SECTION 4.  Sections 166.046(a), (b), (e), and (f), Health
	and Safety Code, are amended to read as follows:
	(a)  If an attending physician refuses to honor a patient's
	advance directive or a health care or treatment decision made by or
	on behalf of a patient, other than a directive or decision to
	provide artificial nutrition and hydration to the patient, the
	physician's refusal shall be reviewed by an ethics or medical
	committee. The attending physician may not be a member of that
	committee. [The patient shall be given life-sustaining treatment
	during the review.]
	(b)  The patient or the person responsible for the health
	care decisions of the individual who has made the decision
	regarding the directive or treatment decision:
	(1)  may be given a written description of the ethics or
	medical committee review process and any other policies and
	procedures related to this section adopted by the health care
	facility;
	(2)  shall be informed of the committee review process
	not less than 48 hours before the meeting called to discuss the
	patient's directive, unless the time period is waived by mutual
	agreement;
	(3)  at the time of being so informed, shall be
	provided[:
	[(A)     a copy of the appropriate statement set
	forth in Section 166.052; and
	[(B)]  a copy of the registry list of health care
	providers and referral groups that have volunteered their readiness
	to consider accepting transfer or to assist in locating a provider
	willing to accept transfer that is posted on the website maintained
	by the department under Section 166.053; and
	(4)  is entitled to:
	(A)  attend the meeting;
	(B)  receive a written explanation of the decision
	reached during the review process;
	(C)  receive a copy of the portion of the
	patient's medical record related to the treatment received by the
	patient in the facility for the lesser of:
	(i)  the period of the patient's current
	admission to the facility; or
	(ii)  the preceding 30 calendar days; and
	(D)  receive a copy of all of the patient's
	reasonably available diagnostic results and reports related to the
	medical record provided under Paragraph (C).
	(e)  If the patient or the person responsible for the health
	care decisions of the patient is requesting life-sustaining
	treatment that the attending physician has decided and the ethics
	or medical committee has affirmed is medically inappropriate
	treatment, the patient shall be given available life-sustaining
	treatment pending transfer under Subsection (d).  This subsection
	does not authorize withholding or withdrawing pain management
	medication, medical procedures necessary to provide comfort, or any
	other health care provided to alleviate a patient's
	pain.  Artificially [The patient is responsible for any costs
	incurred in transferring the patient to another facility.     The
	attending physician, any other physician responsible for the care
	of the patient, and the health care facility are not obligated to
	provide life-sustaining treatment after the 10th day after both the
	written decision and the patient's medical record required under
	Subsection (b) are provided to the patient or the person
	responsible for the health care decisions of the patient unless
	ordered to do so under Subsection (g), except that artificially]
	administered nutrition and hydration must be provided unless, based
	on reasonable medical judgment, providing artificially
	administered nutrition and hydration would:
	(1)  hasten the patient's death;
	(2)  be medically contraindicated such that the
	provision of the treatment seriously exacerbates life-threatening
	medical problems not outweighed by the benefit of the provision of
	the treatment;
	(3)  result in substantial irremediable physical pain
	not outweighed by the benefit of the provision of the treatment;
	(4)  be medically ineffective in prolonging life; or
	(5)  be contrary to the patient's or surrogate's
	clearly documented desire not to receive artificially administered
	nutrition or hydration.
	(f)  Life-sustaining treatment under this section may not be
	entered in the patient's medical record as medically unnecessary
	treatment [until the time period provided under Subsection (e) has
	expired].
	SECTION 5.  Section 166.051, Health and Safety Code, is
	amended to read as follows:
	Sec. 166.051.  LEGAL RIGHT OR RESPONSIBILITY NOT AFFECTED.
	This subchapter does not impair or supersede any legal right or
	responsibility a person may have to effect the withholding or
	withdrawal of life-sustaining treatment in a lawful manner,
	provided that if an attending physician or health care facility is
	unwilling to honor a patient's advance directive or a treatment
	decision to provide life-sustaining treatment, life-sustaining
	treatment must [is required to] be provided to the patient in
	accordance with this chapter[, but only until a reasonable
	opportunity has been afforded for transfer of the patient to
	another physician or health care facility willing to comply with
	the advance directive or treatment decision].
	SECTION 6.  Section 25.0021(b), Government Code, as
	effective September 1, 2017, is amended to read as follows:
	(b)  A statutory probate court as that term is defined in
	Section 22.007(c), Estates Code, has:
	(1)  the general jurisdiction of a probate court as
	provided by the Estates Code; and
	(2)  the jurisdiction provided by law for a county
	court to hear and determine actions, cases, matters, or proceedings
	instituted under:
	(A)  Section [166.046,] 192.027, 193.007,
	552.015, 552.019, 711.004, or 714.003, Health and Safety Code;
	(B)  Chapter 462, Health and Safety Code; or
	(C)  Subtitle C or D, Title 7, Health and Safety
	Code.
	SECTION 7.  Sections 166.046(g) and 166.052, Health and
	Safety Code, are repealed.
	SECTION 8.  This Act takes effect immediately if it receives
	a vote of two-thirds of all the members elected to each house, as
	provided by Section 39, Article III, Texas Constitution.  If this
	Act does not receive the vote necessary for immediate effect, this
	Act takes effect on the 91st day after the last day of the
	legislative session.