Lawmakers to clarify rules on when someone can be resuscitated

Hospital bed (KXAN Photo)
Hospital bed (KXAN Photo)

AUSTIN (KXAN) — Lawmakers will again attempt to clarify state rules around “do not resuscitate” orders — the policies doctors use to decide whether to attempt CPR or another life-saving maneuver when someone is going die.

State Rep. Greg Bonnen, R-Friendswood, is a neurosurgeon at his day job. He says many people might not know current law places “do not resuscitate” orders in the hands of the physician.

“The key question is — is that a decision of the patient or is that a decision of the doctor?” Rep. Bonnen said.

One of the issues on Gov. Greg Abbott’s special session call is to give that life or death power over to the patient. Bonnen’s bill ran out of time during regular session. It would require a patient to write the order down or require that patient’s next-of-kin give it verbally as long as there are independent witnesses.

“Sometimes, unfortunately, it’s a value judgement about that person’s life and their quality of life and I think that’s a value judgment that rests with the patient,” said Rep. Bonnen.

Dr. Arlo Weltge, MD, spoke to us by phone from Houston, where he’s an ER doctor.

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“Good intentions can be very valuable, but sometimes good intentions lead to misunderstandings,” said Dr. Weltge. He worries that the bill as written is too black and white.

Dr. Weltge says the bill needs nuances, where black and white situations may not work, like if a doctor needs to act fast.

“In the middle of the night in a busy emergency department for someone who shows up, there might not be additional witnesses that could be brought into the room,” said Dr. Weltge.

Because force is needed to resuscitate someone on the brink of death through CPR, sometimes a large amount of physical harm can be inflicted. If a patient does not want to be resuscitated, they get a do not resuscitate (DNR).

Gov. Abbott put the issue on his special session agenda, so over the next 30 days lawmakers can change Texas laws about DNRs. A similar bill is expected to pass the Senate and come over to the House within the week.

“Patient protections relating to Do-Not-Resuscitate orders must be strengthened and clarified under law,” said Gov. Abbott in a recent press release. “As leaders of this state, we have a responsibility to protect life at all stages.”

House Bill 43 by Rep. Bonnen would apply to health care facilities, hospitals, assisted living facilities or hospices. The bill would require a DNR to be written directions of a competent patient, oral directions of a competent patient in front of their medical decision-maker, or the directions of a patient’s legal guardian or medical power of attorney.

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