New Hampshire SB 74: relative to advance directives for health care decisions.

Bill Text

Health and Human Services
March 25, 2021
2021-1022s
08/05
Amendment to SB 74
Amend the bill by replacing all after the enacting clause with the following:
1 Advance Health Care Directives. Amend RSA 137-J:1-3 to read as follows:
137-J:1 Purpose and Policy.
I. The state of New Hampshire recognizes that [a person has] individual persons have
the [a] right, founded in the autonomy and sanctity of [the] a person, to control the decisions
relating to the rendering of [his or her] their own medical care. In order that the rights of persons
may be respected even after such persons lack the capacity to make health care decisions for
themselves, and to encourage communication between patients and their attending [physicians, PAs,
or APRNs] practitioners, the general court declares that the laws of this state shall recognize the
right of a competent person to make a written directive:
(a) Delegating to an agent in the durable power of attorney for health care the
authority to make health care decisions on the person's behalf, in the event such person is unable to
make those decisions [for himself or herself] independently, either due to permanent or temporary
lack of capacity to make health care decisions;
(b) Stating the person’s wishes in the living will about end of life care and
providing guidance to the person's agent, surrogate, and/or [Instructing his or her] attending
practitioner physician, PA, or APRN to provide, withhold, or withdraw life-sustaining treatment, in
the event such person is near death or is permanently unconscious] .
II. All persons have a right to make health care decisions and to refuse health care
treatments, including the right to refuse cardiopulmonary resuscitation. It is the purpose of the
"Do Not Resuscitate" provisions of this chapter to ensure that the right of a person to self-
determination relating to cardiopulmonary resuscitation is protected, and to give direction to
emergency services personnel and other health care providers in regard to the performance of
cardiopulmonary resuscitation.
III. While all persons have a right to make a written directive, not all take advantage of that
right, and it is the purpose of the surrogacy provisions of this chapter to ensure that health care
decisions can be made in a timely manner by a person's next of kin or loved one without involving
court action. This chapter specifies a process to establish a surrogate decision-maker when there is
no [valid advance directive] agent appointed under a durable power of attorney for health
care or a guardian, as defined in RSA 464-A, to make health care decisions.
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Amendment to SB 74
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IV. This chapter seeks to simplify and clarify the process by which a person may
execute a health care advance directive by combining in one form the durable power of
attorney for health care document and the living will, either of which (or both) may be
executed by the person. The law recognizes that it is preferable for a person to choose an
agent under a durable power of attorney for health care document who can make decisions
in real time and under then existing circumstances regarding health care decisions that
best reflect the person's values, as articulated orally or in writing by the person. The law
also recognizes that a person may wish to execute a living will that sets forth their wishes
about end of life care that would be used by an agent or surrogate as guidance in
implementing the person's wishes.
137-J:2 Definitions. In this chapter:
I. “Actively dying” means an incurable condition caused by injury, disease, or
illness which is such that death is imminent and the application of life-sustaining
treatment would, to a reasonable degree of medical certainty only postpone the moment of
death to another imminent moment, as certified in the principal's medical record by 2
physicians, or a physician and another attending practitioner who is not under the
supervision of the certifying physician.
[I.] II. "Advance directive" means a [directive] document allowing a person to give
directions and guidance about future medical care [or] and to designate another person to make
medical decisions if [he or she] the principal should lose the capacity to make health care decisions.
The term "advance [directives] directive" shall include [living wills and] a durable [powers] power
of attorney for health care and a living will.
[II.] III. "Advanced practice registered nurse" or " APRN" means a registered nurse who is
licensed in good standing in the state of New Hampshire as having specialized clinical qualifications.
[III.] IV. "Agent" means an adult to whom authority to make health care decisions is
delegated under[ an advance directive] a durable power of attorney for health care.
[IV.] V. "Attending [physician, PA, or APRN] practitioner" means the physician, physician
assistant, or advanced practice registered nurse, selected by or