June 1, 2010, marked the implementation date for the Family Health Care Decisions Act, a new law that allows family members and others who are closest to the patient to act as surrogates and make decisions regarding medical treatment for a loved one in certain limited situations. The law includes numerous safeguards to ensure sound medical treatment and that decisions are made consistent with the patient’s wishes and best interests. The current law applies only to patients in general hospitals or residents in nursing homes; it does not apply to people at home, in assisted living facilities, or in hospice care. There is, however, a separate section on out-of-hospital do not resuscitate (DNR) orders.
This act establishes a process for determining whether an adult patient without a health care proxy has decision-making capacity. If an attending physician and a consulting physician agree that the patient lacks the capacity to make health care decisions, the law establishes a priority list for choosing a person to be the surrogate decision maker. Anyone lower in the hierarchy (e.g., an adult child instead of a spouse) or in the same category (e.g., another sibling) can challenge the designation. The law also sets out a series of procedural requirements intended to protect vulnerable patients and make sure that the choice of surrogate and the surrogate’s decision are subject to review.
Catskill Area Hospice and Palliative Care is supporting the Hospice and Palliative Care Association of New York State to ensure that this landmark legislation is expanded to include all patients in all settings. If you have any question on this issue, contact Lola Rathbone at 607-432-6773.
