Transcript Legislative Update Child Protective Services

WITHHOLDING AND WITHDRAWING
LIFE SUSTAINING TREATMENT
“DNR”
DO NOT RESUSCITATE
WITHHOLDING OR WITHDRAWING LIFE
SUSTAINING TREATMENT
Withhold
• Refrain from
applying life support
Withdraw
• Disconnect life
support previously
applied
“LIFE SUSTAINING TREATMENT”
§ 166.002(10) TEXAS HEALTH & SAFETY CODE
• "Life-sustaining treatment" means treatment that,
based on reasonable medical judgment, sustains the
life of a patient and without which the patient will
die. The term includes both life-sustaining
medications and artificial life support, such as
mechanical breathing machines, kidney dialysis
treatment, and artificial nutrition and hydration.
The term does not include the administration of
pain management medication or the performance
of a medical procedure considered to be necessary
to provide comfort care, or any other medical care
provided to alleviate a patient's pain.
Before a DNR is
considered………..
A written statement from the attending
physician certifying that the child has a
terminal or irreversible condition must be
obtained with the physician recommending
withholding or withdrawing life-sustaining
treatment
“TERMINAL”
§ 166.002(13) TEXAS HEALTH & SAFETY CODE
• an incurable condition caused by injury, disease, or
illness that according to reasonable medical
judgment will produce death within six months,
even with available life-sustaining treatment
provided in accordance with the prevailing
standard of medical care.
“IRREVERSIBLE CONDITION”
§ 166.002(9) TEXAS HEALTH & SAFETY CODE
• means a condition, injury, or illness:
(A) that may be treated but is never cured or
eliminated;
(B) that leaves a person unable to care for or
make decisions for the person's own self; and
(C) that, without life-sustaining treatment
provided in accordance with the prevailing
standard of medical care, is fatal.
When Parents Retain Their Rights
Parents
decide on the
DNR
DFPS DOES
NOT have
legal
authority to
consent
DFPS Caseworker Responsibility When
Parents Retain Their Rights
Inform the parents of the
recommendation for a DNR
Arrange for the parents to discuss
recommendation with physician
directly
Inform the attorney representing
DFPS, the AAL/GAL, & DFPS Regional
Attorney about parent’s decision
If Parents Consent:
•Parents execute the
DNR Order and sign
documents
If Parents Refuse
to Consent:
•DFPS takes no
further action
If Parents Cannot be
Located:
Once parent/GAL
makes decision, DFPS
to inform all parties
whether DNR was
executed
•DFPS required to notify
all parties including DFPS
Regional Attorney
•Attorney representing
DFPS may request a GAL
to explore child’s best
interest
When Parents Lose Their Rights or Are
Deceased
Arrange for review by committee
(hospitalized children) or InfantCare Review/Ethics committee
arrange for a second medical
opinion if necessary to ensure
objectivity
Notify the Court
If Court Wishes to be
Involved, DFPS:
If Court Does Not Wish to be
Involved, DFPS:
Presents situation to court
Notifies Court of final
decision
Involves AAL/GAL
Complies with Court’s
directive