2017-2018 Bill 3487: Do Not Resuscitate Orders - South Carolina Legislature Online

1 South Carolina General Assembly 2 122nd Session, 2017-2018 3 4 H. 3487 5 6 STATUS INFORMATION 7 8 General Bill 9 Sponsors: Reps. Ridgeway, Govan, Duckworth, Hardee and Douglas 10 Document Path: l:\council\bills\cc\15061vr17.docx 11 12 Introduced in the House on January 17, 2017 13 Introduced in the Senate on March 29, 2017 14 Currently residing in the Senate 15 16 Summary: Do not resuscitate orders 17 18 19 HISTORY OF LEGISLATIVE ACTIONS 20 21 Date Body Action Description with journal page number 22 1/17/2017 House Introduced and read first time ( House Journalpage 13) 23 1/17/2017 House Referred to Committee on Judiciary ( House Journalpage 13) 24 1/18/2017 House Recalled from Committee on Judiciary ( House Journalpage 29) 25 1/18/2017 House Referred to Committee on Medical, Military, Public and Municipal Affairs 26 ( House Journalpage 29) 27 3/22/2017 House Committee report: Favorable Medical, Military, Public and Municipal Affairs 28 ( House Journalpage 76) 29 3/28/2017 House Read second time ( House Journalpage 50) 30 3/28/2017 House Roll call Yeas107 Nays1 ( House Journalpage 50) 31 3/29/2017 House Read third time and sent to Senate ( House Journalpage 11) 32 3/29/2017 Senate Introduced and read first time ( Senate Journalpage 11) 33 3/29/2017 Senate Referred to Committee on Medical Affairs ( Senate Journalpage 11) 34 4/25/2017 Senate Committee report: Favorable Medical Affairs ( Senate Journalpage 16) 35 4/26/2017 Scrivener's error corrected 36 37 View the latest legislative information at the website 38 39 40 VERSIONS OF THIS BILL 41 42 1/17/2017 43 3/22/2017 44 4/25/2017 45 4/26/2017 46 1 Indicates Matter Stricken 2 Indicates New Matter 3 4 COMMITTEE REPORT 5 April 25, 2017 6 7 H. 3487 8 9 Introduced by Reps. Ridgeway, Govan, Duckworth, Hardee and 10 Douglas 11 12 S. Printed 4/25/17--S. [SEC 4/26/17 2:48 PM] 13 Read the first time March 29, 2017. 14 15 16 THE COMMITTEE ON MEDICAL AFFAIRS 17 To whom was referred a Bill (H. 3487) to amend Sections 44- 18 78-15, 447820, 447830, 447845, all as amended, 44, etc., 19 respectfully 20 REPORT: 21 That they have duly and carefully considered the same and 22 recommend that the same do pass: 23 24 HARVEY S. PEELER, JR. for Committee. 25

[3487-2] 1 2 3 4 5 6 7 8 9 A BILL 10 11 TO AMEND SECTIONS 44-78-15, 447820, 447830, 447845, 12 ALL AS AMENDED, 447850, AND SECTION 447860, AS 13 AMENDED, CODE OF LAWS OF SOUTH CAROLINA, 1976, 14 RELATING TO DO NOT RESUSCITATE ORDERS, SO AS TO 15 ALLOW A PARENT OR LEGAL GUARDIAN OF A PATIENT 16 WHO IS A CHILD TO REQUEST AND REVOKE A DO NOT 17 RESUSCITATE ORDER FOR EMERGENCY SERVICES FOR 18 THE CHILD. 19 20 Be it enacted by the General Assembly of the State of South 21 Carolina: 22 23 SECTION 1. Section 44-78-15 of the 1976 Code, as last amended 24 by Act 233 of 2016, is further amended to read: 25 26 “Section 44-78-15. As used in this chapter: 27 (1) ‘Child’ means a person under the age of eighteen. 28 (2) ‘Do not resuscitate bracelet’ or ‘bracelet’ means a 29 standardized identification bracelet that: 30 (a) meets the specifications established under Section 31 447830(B) or that is approved by the department under Section 32 447830(B); 33 (b) bears the inscription ‘Do Not Resuscitate’; and 34 (c) signifies that the wearer is a patient who has obtained a 35 do not resuscitate order which has not been revoked. 36 (2)(3) ‘Do not resuscitate order for emergency services’ 37 means a document made pursuant to this article to prevent EMS 38 personnel from employing resuscitative measures or any other 39 medical process that would only extend the patient’s suffering with 40 no viable medical reason to perform the procedure. 41 (3)(4) ‘EMS personnel’ means emergency medical personnel 42 certified by the South Carolina Department of Health and

[3487] 3 1 Environmental Control including first responders who have 2 completed a Department of Health and Environmental Control 3 approved medical first responder program. 4 (4)(5) ‘Health care provider’ means a person licensed to 5 practice medicine or osteopathy pursuant to Chapter 47, Title 40. 6 (5)(6) ‘Palliative treatment’ means the degree of treatment 7 which must be provided to a patient in the routine delivery of 8 emergency medical services, which assures the comfort and 9 alleviation of pain and suffering to all extents possible, regardless 10 of whether the patient has executed a document as provided for in 11 this chapter. 12 (6)(7) ‘Resuscitative treatment’ means artificial stimulation 13 of the cardiopulmonary systems of the human body, through either 14 electrical, mechanical, or manual means including, but not limited 15 to, cardiopulmonary resuscitation. 16 (7)(8) ‘Terminal condition’ means an incurable or 17 irreversible condition that within reasonable medical judgment 18 could cause death within a reasonably short period of time if life 19 sustaining procedures are not used.” 20 21 SECTION 2. Section 447820 of the 1976 Code, as last amended 22 by Act 233 of 2016, if further amended to read: 23 24 “Section 447820. (A) A An adult, married minor, or judicially 25 emancipated minor patient who has a terminal condition, a 26 surrogate for a patient with a terminal condition under the Adult 27 Health Care Consent Act, or an agent of a person with a terminal 28 condition named by the patient in a Health Care Power of 29 Attorney, or a parent or legal guardian of a patient who is a child 30 with a terminal condition who is neither married nor judicially 31 emancipated, may request a health care provider responsible for 32 the care of the patient to execute a ‘do not resuscitate order for 33 emergency services’ if the: 34 (1) patient has a terminal condition; and 35 (2) terminal condition has been diagnosed by a health care 36 provider and the health care provider’s record establishes the time, 37 date, and medical condition which gives rise to the diagnosis of a 38 terminal condition. 39 (B) At the request of the patient for whom a do not resuscitate 40 order is written or his surrogate or agent, The health care provider 41 who executes the do not resuscitate order shall make the order in 42 writing on a form conforming to the requirements of Section 43 447830(A), and either shall:

[3487] 4 1 (1) affix to the wrist of the patient a do not resuscitate 2 bracelet that meets the specifications established under Section 3 447830(B); or 4 (2) provide the patient or his surrogate or agent, or the parent 5 or legal guardian of a patient who is a child, with an order form, 6 from a commercial vendor approved by the department pursuant to 7 Section 447830(B), to allow the patient to order a do not 8 resuscitate bracelet from the commercial vendor.” 9 10 SECTION 3. Section 447830 of the 1976 Code, as last amended 11 by Act 233 of 2016, is further amended to read: 12 13 “Section 447830. (A) A document purporting to be a ‘do not 14 resuscitate order’ for EMS purposes must be in substantially the 15 following form: 16 NOTICE TO EMS PERSONNEL 17 This notice is to inform all emergency medical personnel who 18 may be called to render assistance to ______he/she 19 has a terminal condition which has been diagnosed by me and has 20 specifically requested that no resuscitative efforts including 21 artificial stimulation of the cardiopulmonary system by electrical, 22 mechanical, or manual means be made in the event of 23 cardiopulmonary arrest. 24 REVOCATION PROCEDURE 25 THIS FORM MAY BE REVOKED BY AN ORAL 26 STATEMENT BY THE PATIENT, OR THE PARENT OR 27 LEGAL GUARDIAN OF A PATIENT WHO IS A CHILD, TO 28 EMS PERSONNEL OR BY MUTILATING, OBLITERATING, 29 OR DESTROYING THE DOCUMENT IN ANY MANNER. 30 Date:______31 ______32 Patient’s signature (or surrogate or agent) 33 ______34 Physician’s signature 35 ______36 Physician’s address 37 ______38 Physician’s telephone number 39 (B) The department may approve a do not resuscitate bracelet 40 developed and distributed by a commercial vendor if the bracelet 41 contains an emblem that displays an internationally recognized 42 medical symbol on the front and the words ‘South Carolina Do 43 Not Resuscitate EMS’ and the patient’s first name and last name

[3487] 5 1 on the back. The department may not approve a do not resuscitate 2 bracelet developed and distributed by a commercial vendor if the 3 vendor does not require a health care provider’s order for the 4 bracelet before distributing it to a patient. 5 (C) The cost of obtaining a bracelet must be borne by the 6 patient, or the parent or legal guardian of a patient who is a child, 7 and may not be provided by the department at the expense of the 8 department. 9 (D) The vendor approved by the department shall not fulfill a 10 request for a do not resuscitate bracelet without receiving a health 11 care provider’s order for the bracelet with the request.” 12 13 SECTION 4. Section 447845(A) of the 1976 Code, as last 14 amended by Act 233 of 2016, is further amended to read: 15 16 “(A) A health care provider and an EMS personnel shall follow 17 the request of the patient, or the parent or legal guardian of a 18 patient who is a child, and must not provide resuscitative measures 19 when the patient has a ‘do not resuscitate order for emergency 20 medical services’ or is wearing a ‘do not resuscitate bracelet’, 21 except where the: 22 (1) order is revoked pursuant to Section 447860; or 23 (2) bracelet, when applicable, appears to have been tampered 24 with or removed.” 25 26 SECTION 5. Section 447850 of the 1976 Code is amended to 27 read: 28 29 “Section 447850. (A) Nothing in this chapter may be 30 construed to condone, authorize, or approve mercy killing or 31 euthanasia or to permit any affirmative action or deliberate act to 32 end life other than to allow the natural process of dying. 33 (B) No person under the age of eighteen years may request or 34 receive a ‘do not resuscitate order for emergency medical services’ 35 as provided for in this article. 36 (C)(B) The withholding of resuscitative measures pursuant to 37 this article does not constitute suicide for any purpose.” 38 39 SECTION 6. Section 447860 of the 1976 Code, as last amended 40 by Act 233 of 2016, is further amended to read: 41

[3487] 6 1 “Section 447860. A patient, or a parent or legal guardian of a 2 patient who is a child, may revoke a ‘do not resuscitate order for 3 emergency services’ by: 4 (1) mutilating, obliterating, or destroying the ‘do not 5 resuscitate order for emergency medical services’ document in any 6 manner; 7 (2) orally expressing to an emergency medical technician, first 8 responder, or to a person who serves as a member of an emergency 9 health care facility’s personnel, the desire to be resuscitated, after 10 which the emergency medical technician, first responder, or the 11 member of the emergency health care facility shall disregard the 12 ‘do not resuscitate order for emergency medical services’ 13 document and, if applicable, promptly remove the bracelet; 14 (3) defacing, burning, cutting, or otherwise destroying the 15 bracelet, if applicable; or 16 (4) removing the bracelet or asking another person to remove 17 the bracelet.” 18 19 SECTION 7. This act takes effect upon approval by the 20 Governor. 21 XX 22

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