83R7888 JSC-F
	By: Hancock	S.B. No. 675

	A BILL TO BE ENTITLED
	AN ACT
	relating to certain advance directives and health care and
	treatment decisions.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Sections 166.045(c) and (d), Health and Safety
	Code, are amended to read as follows:
	(c)  If an attending physician refuses to comply with a
	directive or treatment decision for a reason not prohibited under
	Section 166.0455 and does not wish to follow the procedure
	established under Section 166.046, life-sustaining treatment shall
	be provided to the patient, but only until a reasonable opportunity
	has been afforded for the transfer of the patient to another
	physician or health care facility willing to comply with the
	directive or treatment decision.
	(d)  A physician, health professional acting under the
	direction of a physician, or health care facility is not civilly or
	criminally liable or subject to review or disciplinary action by
	the person's appropriate licensing board if the person has not
	violated Section 166.0455 and has complied with the procedures
	outlined in Section 166.046.
	SECTION 2.  Subchapter B, Chapter 166, Health and Safety
	Code, is amended by adding Section 166.0455 to read as follows:
	Sec. 166.0455.  LIMITATION ON REFUSAL TO EFFECTUATE CERTAIN
	ADVANCE DIRECTIVES OR TREATMENT DECISIONS. A physician, health
	care facility, or health care professional may not refuse to honor a
	patient's advance directive or a health care or treatment decision
	made by or on behalf of a patient that directs the provision of
	life-sustaining treatment and may not consider life-sustaining
	treatment to be inappropriate treatment under Section 166.046 based
	on:
	(1)  the lesser value the physician, facility, or
	professional places on extending the life of an elderly, disabled,
	or terminally ill patient compared to the value of extending the
	life of a patient who is younger, not disabled, or not terminally
	ill; or
	(2)  a disagreement between the physician, facility, or
	professional and the patient, or the person authorized to make a
	treatment decision for the patient under Section 166.039, over the
	greater weight the patient or person places on extending the
	patient's life above the risk of disability.
	SECTION 3.  Section 166.046, Health and Safety Code, is
	amended by amending Subsections (a) and (g) and adding Subsection
	(c-1) to read as follows:
	(a)  If an attending physician refuses to honor a patient's
	advance directive or a health care or treatment decision made by or
	on behalf of a patient for a reason not prohibited under Section
	166.0455, the physician's refusal shall be reviewed by an ethics or
	medical committee. The attending physician may not be a member of
	that committee. The patient shall be given life-sustaining
	treatment during the review.
	(c-1)  If, during the course of the committee review process,
	the ethics or medical committee finds that the physician refused to
	honor a patient's advanced directive or health care or treatment
	decision made by or on behalf of the patient for a reason prohibited
	under Section 166.0455, the committee may not approve withdrawal of
	life-sustaining treatment to that patient on the basis of that
	physician's evaluation.
	(g)  At the request of the patient or the person responsible
	for the health care decisions of the patient, the appropriate
	district or county court shall extend the time period provided
	under Subsection (e) only if the court finds, by a preponderance of
	the evidence, that:
	(1)  there is a reasonable expectation that a physician
	or health care facility that will honor the patient's directive
	will be found if the time extension is granted; or
	(2)  the decision to withdraw life-sustaining
	treatment is for a reason prohibited under Section 166.0455.
	SECTION 4.  Section 166.051, Health and Safety Code, is
	amended to read as follows:
	Sec. 166.051.  LEGAL RIGHT OR RESPONSIBILITY NOT AFFECTED.
	This subchapter does not impair or supersede any legal right or
	responsibility a person may have to effect the withholding or
	withdrawal of life-sustaining treatment in a lawful manner,
	provided that if an attending physician or health care facility is
	unwilling to honor a patient's advance directive or a treatment
	decision to provide life-sustaining treatment for a reason not
	prohibited under Section 166.0455, life-sustaining treatment is
	required to be provided the patient, but only until a reasonable
	opportunity has been afforded for transfer of the patient to
	another physician or health care facility willing to comply with
	the advance directive or treatment decision.
	SECTION 5.  Section 166.158(c), Health and Safety Code, is
	amended to read as follows:
	(c)  A principal's health or residential care provider who
	finds it impossible to follow a directive by the agent because of a
	conflict with this subchapter or the medical power of attorney
	shall inform the agent as soon as is reasonably possible. The agent
	may select another attending physician. The procedures established
	under Sections 166.045 and 166.046 and the limitations provided
	under Section 166.0455 apply if the agent's directive concerns
	providing, withholding, or withdrawing life-sustaining treatment.
	SECTION 6.  Section 166.166, Health and Safety Code, is
	amended to read as follows:
	Sec. 166.166.  OTHER RIGHTS OR RESPONSIBILITIES NOT
	AFFECTED. This subchapter does not limit or impair any legal right
	or responsibility that any person, including a physician or health
	or residential care provider, may have to make or implement health
	care decisions on behalf of a person, provided that if an attending
	physician or health care facility is unwilling to honor a patient's
	advance directive or a treatment decision to provide
	life-sustaining treatment for a reason not prohibited under Section
	166.0455, life-sustaining treatment is required to be provided the
	patient, but only until a reasonable opportunity has been afforded
	for transfer of the patient to another physician or health care
	facility willing to comply with the advance directive or treatment
	decision.
	SECTION 7.  The changes in law made by this Act apply only to
	a health care or treatment decision made on or after the effective
	date of this Act.
	SECTION 8.  This Act takes effect immediately if it receives
	a vote of two-thirds of all the members elected to each house, as
	provided by Section 39, Article III, Texas Constitution.  If this
	Act does not receive the vote necessary for immediate effect, this
	Act takes effect September 1, 2013.