N.Y. Public Health Law § 2994-dd: Managing a nonhospital order not to resuscitate

§ 2994-dd. Managing a nonhospital order not to resuscitate. 1. The

attending practitioner shall record the issuance of a nonhospital order

not to resuscitate in the patient's medical record.

2. A nonhospital order not to resuscitate shall be issued upon a

standard form prescribed by the commissioner. A standard bracelet or

other article may be worn by a patient with a nonhospital order not to

resuscitate to identify that status; provided, however, that no person

may require a patient to wear such an article and that no person may

require a patient to wear such an article as a condition for honoring a

nonhospital order not to resuscitate or for providing health care

services.

3. An attending practitioner who has issued a nonhospital order not to

resuscitate, and who transfers care of the patient to another physician,

nurse practitioner or physician assistant, shall inform the physician,

nurse practitioner or physician assistant of the order.

4. For each patient for whom a nonhospital order not to resuscitate

has been issued, the attending practitioner shall review whether the

order is still appropriate in light of the patient's condition each time

he or she examines the patient, whether in the hospital or elsewhere,

but at least every ninety days, provided that the review need not occur

more than once every seven days. The attending practitioner shall record

the review in the patient's medical record provided, however, that a

physician assistant or a registered nurse, other than the attending

nurse practitioner, who provides direct care to the patient may record

the review in the medical record at the direction of the physician. In

such case, the attending practitioner shall include a confirmation of

the review in the patient's medical record within fourteen days of such

review. Failure to comply with this subdivision shall not render a

nonhospital order not to resuscitate ineffective.

5. A person who has consented to a nonhospital order not to

resuscitate may at any time revoke his or her consent to the order by

any act evidencing a specific intent to revoke such consent. Any health

care professional, other than the attending practitioner, informed of a

revocation of consent to a nonhospital order not to resuscitate shall

notify the attending practitioner of the revocation. An attending

practitioner who is informed that a nonhospital order not to resuscitate

has been revoked shall record the revocation in the patient's medical

record, cancel the order and make diligent efforts to retrieve the form

issuing the order, and the standard bracelet, if any.

6. The commissioner may authorize the use of one or more alternative

forms for issuing a nonhospital order not to resuscitate (in place of

the standard form prescribed by the commissioner under subdivision two

of this section). Such alternative form or forms may also be used to

issue a non-hospital do not intubate order. Any such alternative forms

intended for use for persons with developmental disabilities or persons

with mental illness who are incapable of making their own health care

decisions or who have a guardian of the person appointed pursuant to

article eighty-one of the mental hygiene law or article seventeen-A of

the surrogate's court procedure act must also be approved by the

commissioner of developmental disabilities or the commissioner of mental

health, as appropriate. An alternative form under this subdivision shall

otherwise conform with applicable federal and state law. This

subdivision does not limit, restrict or impair the use of an alternative

form for issuing an order not to resuscitate in a general hospital or

residential health care facility under article twenty-eight of this

chapter or a hospital under subdivision ten of section 1.03 of the

mental hygiene law or a facility certified or operated by the office for

people with developmental disabilities.