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The Texas government has passed SB 11 an act “relating to general procedures and requirements for certain do-not-resuscitate orders; creating a criminal offense.” As of April 1, 2018, one can be jailed for offenses involving DNR orders.  When new laws are passed they often require new regulations to interpret them as well as statements from the state attorney general on how they are to be enforced and viewed. While those steps have not yet been taken, the threat to physician practice and patient autonomy in this law necessitates taking a further look at it now.

 

A do-not-resuscitate (DNR) order is a physician’s order, entered into the medical chart, instructing that in the event of cardiac arrest, no attempts should be made to resuscitate the patient. In most places, a patient or—if the patient is incompetent or incapacitated—a medical power of attorney or legal surrogate can make a request for an order to be entered into the chart. A patient can indicate a desire regarding DNR orders in an advance directive, a POLST form, or a conversation with a health care provider that is documented in the chart.

 

The law is part of an attempt to by the right-to-life movement in Texas to roll back the advance directives act, especially the futility provision. This bill is described as “restoring the rights of hospitalized patient.” The reality is that the bill creates undue burdens for health care providers and hospitals while undermining patient’s abilities to make advance decisions for their end of life care. These efforts are all about eliminating patient choice.

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Bioethics.net

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