N.Y. Public Health Law § 2994-m: Ethics review committees

§ 2994-m. Ethics review committees. 1. Establishment of an ethics

review committee, written policy. Each hospital shall establish at least

one ethics review committee or participate in an ethics review committee

that serves more than one hospital, and shall adopt a written policy

governing committee functions, composition, and procedure, in accordance

with the requirements of this article. A hospital may designate an

existing committee, or subcommittee thereof, to carry out the functions

of the ethics review committee provided the requirements of this section

are satisfied.

2. Functions of the ethics review committee. (a) The ethics review

committee shall consider and respond to any health care matter presented

to it by a person connected with the case.

(b) The ethics review committee response to a health care matter may

include:

(i) providing advice on the ethical aspects of proposed health care;

(ii) making a recommendation about proposed health care; or

(iii) providing assistance in resolving disputes about proposed health

care.

(c) Recommendations and advice by the ethics review committee shall be

advisory and nonbinding, except as specified in subdivision five of

section twenty-nine hundred ninety-four-d of this article and

subdivision three of section twenty-nine hundred ninety-four-e of this

article.

3. Committee membership. The membership of ethics review committees

must be interdisciplinary and must include at least five members who

have demonstrated an interest in or commitment to patient's rights or to

the medical, public health, or social needs of those who are ill. At

least three ethics review committee members must be health or social

services practitioners, at least one of whom must be a registered nurse

and one of whom must be a physician, nurse practitioner or physician

assistant. At least one member must be a person without any governance,

employment or contractual relationship with the hospital. In a

residential health care facility the facility must offer the residents'

council of the facility (or of another facility that participates in the

committee) the opportunity to appoint up to two persons to the ethics

review committee, none of whom may be a resident of or a family member

of a resident of such facility, and both of whom shall be persons who

have expertise in or a demonstrated commitment to patient rights or to

the care and treatment of the elderly or nursing home residents through

professional or community activities, other than activities performed as

a health care provider.

4. Procedures for ethics review committee. (a) These procedures are

required only when: (i) the ethics review committee is convened to

review a decision by a surrogate to withhold or withdraw life-sustaining

treatment for: (A) a patient in a residential health care facility

pursuant to paragraph (b) of subdivision five of section twenty-nine

hundred ninety-four-d of this article; (B) a patient in a general

hospital pursuant to paragraph (c) of subdivision five of section

twenty-nine hundred ninety-four-d of this article; or (C) an emancipated

minor patient pursuant to subdivision three of section twenty-nine

hundred ninety-four-e of this article; or (ii) when a person connected

with the case requests the ethics review committee to provide assistance

in resolving a dispute about proposed care. Nothing in this section

shall bar health care providers from first striving to resolve disputes

through less formal means, including the informal solicitation of

ethical advice from any source.

(b)(i) A person connected with the case may not participate as an

ethics review committee member in the consideration of that case.

(ii) The ethics review committee shall respond promptly, as required

by the circumstances, to any request for assistance in resolving a

dispute or consideration of a decision to withhold or withdraw

life-sustaining treatment pursuant to paragraphs (b) and (c) of

subdivision five of section twenty-nine hundred ninety-four-d of this

article made by a person connected with the case. The committee shall

permit persons connected with the case to present their views to the

committee, and to have the option of being accompanied by an advisor

when participating in a committee meeting.

(iii) The ethics review committee shall promptly provide the patient,

where there is any indication of the patient's ability to comprehend the

information, the surrogate, other persons on the surrogate list directly

involved in the decision or dispute regarding the patient's care, any

parent or guardian of a minor patient directly involved in the decision

or dispute regarding the minor patient's care, an attending

practitioner, the hospital, and other persons the committee deems

appropriate, with the following:

(A) notice of any pending case consideration concerning the patient,

including, for patients, persons on the surrogate list, parents and

guardians, information about the ethics review committee's procedures,

composition and function; and

(B) the committee's response to the case, including a written

statement of the reasons for approving or disapproving the withholding

or withdrawal of life-sustaining treatment for decisions considered

pursuant to subparagraph (ii) of paragraph (a) of subdivision five of

section twenty-nine hundred ninety-four-d of this article. The

committee's response to the case shall be included in the patient's

medical record.

(iv) Following ethics review committee consideration of a case

concerning the withdrawal or withholding of life-sustaining treatment,

treatment shall not be withdrawn or withheld until the hospital makes

diligent efforts to inform the persons identified in subparagraph (iii)

of this paragraph have been informed of the committee's response to the

case and documents the diligent efforts in the patient's medical record.

(c) When an ethics review committee is convened to review decisions

regarding hospice care for a patient in a general hospital or

residential health care facility, the responsibilities of this section

shall be carried out by the ethics review committee of the general

hospital or residential health care facility, provided that such

committee shall invite a representative from hospice to participate.

5. Access to medical records and information; patient confidentiality.

Ethics review committee members and consultants shall have access to

medical information and medical records necessary to perform their

function under this article. Any such information or records disclosed

to committee members, consultants, or others shall be kept confidential

except to the extent necessary to accomplish the purposes of this

article or as otherwise provided by law.

6. Ethics review committee confidentiality. Notwithstanding any other

provisions of law, the proceedings and records of an ethics review

committee shall be kept confidential and shall not be released by

committee members, committee consultants, or other persons privy to such

proceedings and records; the proceedings and records of an ethics review

committee shall not be subject to disclosure or inspection in any

manner, including under article six of the public officers law or

article thirty-one of the civil practice law and rules; and, no person

shall testify as to the proceedings or records of an ethics review

committee, nor shall such proceedings and records otherwise be

admissible as evidence in any action or proceeding of any kind in any

court or before any other tribunal, board, agency or person, except

that:

(a) Ethics review committee proceedings and records, in cases where a

committee approves or disapproves of the withholding or withdrawal of

life-sustaining treatment pursuant to subdivision five of section

twenty-nine hundred ninety-four-d of this article, or subdivision three

of section twenty-nine hundred ninety-four-e of this article, may be

obtained by or released to the department;

(b) Nothing in this subdivision shall prohibit the patient, the

surrogate, other persons on the surrogate list, or a parent or guardian

of a minor patient from voluntarily disclosing, releasing or testifying

about committee proceedings or records; and

(c) Nothing in this subdivision shall prohibit the justice center for

the protection of people with special needs or any agency or person

within or under contract with the justice center which provides

protection and advocacy services from requiring any information, report

or record from a hospital in accordance with the provisions of section

five hundred fifty-eight of the executive law.