HF 4665

as introduced - 92nd Legislature (2021 - 2022) Posted on 04/07/2022 01:11pm

A bill for an act
relating to health care; establishing procedures to follow if a physician refuses to
comply with a patient's health care directive; proposing coding for new law in
Minnesota Statutes, chapter 145C.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [145C.18] FAILURE TO COMPLY WITH A HEALTH CARE
DIRECTIVE.
new text end

new text begin (a) If an attending physician refuses to comply with a patient's health care directive or
a health care or treatment decision made by or on behalf of a patient, requesting the provision
of life-sustaining care or treatment, including artificially administered nutrition and hydration,
the physician's refusal shall be reviewed by the ethics or medical committee of the health
care facility in which the patient is admitted. The committee shall affirm the physician's
decision only if the provision of such care or treatment will, to a reasonable medical certainty:
new text end

new text begin (1) cause the patient substantial and intractable physical pain, that will continue for an
indefinite period of time, and there are no reasonable grounds to believe the patient would
wish such painful care or treatment to commence or continue;
new text end

new text begin (2) cause the patient life-threatening ancillary complications and no care or treatment
less likely to cause such complications is available; or
new text end

new text begin (3) be altogether useless in prolonging the patient's life since death from an underlying
terminal condition is inevitable and imminent.
new text end

new text begin In the case of artificially administered nutrition and hydration, such care is altogether useless
in prolonging life if the patient is incurably unable to assimilate nutrients or fluids or is
likely to die from an underlying terminal condition before death from starvation or
dehydration occurs. The committee may affirm the physician's decision to withhold
life-sustaining care or treatment from a patient that cannot be provided without denying the
same care or treatment to another patient and may not affirm a decision to withhold or
withdraw such care or treatment if the patient is pregnant. The patient shall be given all
necessary life-sustaining care and treatment during the review process, including the provision
of artificially administered nutrition and hydration, along with care and treatment to enhance
pain relief and minimize suffering, unless the provision of any such care or treatment poses
an immediate threat to the life of the patient.
new text end

new text begin (b) If the patient's health care directive or a health care or treatment decision made by
or on behalf of the patient is requesting life-sustaining care or treatment that the attending
physician has decided and the ethics or medical committee has affirmed is medically
inappropriate, the patient shall be given all necessary life-sustaining care and treatment
pending transfer to another physician or health care facility willing to comply with such
directive or care or treatment decision, including the provision of artificially administered
nutrition and hydration, along with care and treatment to enhance pain relief and minimize
suffering, unless the provision of any such care or treatment poses an immediate threat to
the life of the patient. Except for the provision of artificially administered nutrition and
hydration, along with care and treatment to enhance pain relief and minimize suffering, the
attending physician, any other physician responsible for the care of the patient, and the
health care facility are not obligated to provide life-sustaining care or treatment after the
21st calendar day after the written decision of the committee is provided to the patient or
the patient's surrogate unless ordered to do so under paragraph (c). If the committee does
not affirm the attending physician's refusal to provide life-sustaining care or treatment, all
necessary care and treatment, including the provision of artificially administered nutrition
and hydration, along with care and treatment to enhance pain relief and minimize suffering,
unless the provision of any such care or treatment poses an immediate threat to the life of
the patient, shall be provided to the patient until the transfer of the patient to another physician
within the health care facility willing to comply with the patient's health care directive or
health care or treatment decision is completed.
new text end

new text begin (c) The patient or the patient's surrogate may submit a motion for the extension of time
to affect a transfer under paragraph (b) in a district court in this state with jurisdiction over
the matter. In such proceeding, the district court may extend the time period provided under
paragraph (b). If the court finds, by a preponderance of the evidence, that the ethics or
medical committee of the health facility affirmed the attending physician's refusal to comply
with the patient's health care directive or a health care or treatment decision made by or on
behalf of the patient, requesting the provision of life-sustaining care or treatment, without
satisfying the requirements under paragraph (a), the district court shall extend the time
period for providing all necessary life sustaining care and treatment to the patient until the
transfer of the patient to another physician or health care facility willing to comply with the
health care directive or care or treatment decision is completed.
new text end