PRINTER'S NO. 588
No. 560 Session of 1997
INTRODUCED BY GREENLEAF, DELP, EARLL, LEMMOND AND MELLOW,
FEBRUARY 28, 1997
REFERRED TO PUBLIC HEALTH AND WELFARE, FEBRUARY 28, 1997
AN ACT
1 Amending Title 20 (Decedents, Estates and Fiduciaries) of the
2 Pennsylvania Consolidated Statutes, providing for do-not-
3 resuscitate orders; granting powers to and imposing duties
4 upon the Department of Health; and imposing penalties.
5 The General Assembly of the Commonwealth of Pennsylvania
6 hereby enacts as follows:
7 Section 1. Section 5403 of Title 20 of the Pennsylvania
8 Consolidated Statutes is amended by adding definitions to read:
9 § 5403. Definitions.
10 The following words and phrases when used in this chapter
11 shall have the meanings given to them in this section unless the
12 context clearly indicates otherwise:
13 * * *
14 "Department." The Department of Health of the Commonwealth.
15 "Do-not-resuscitate order" or "DNR order." A directive that
16 cardiopulmonary resuscitation; intubation, meaning any advanced
17 airway management; defibrillation; cardiac resuscitation
18 medications; and artificial ventilation should not be
1 administered to a particular individual.
2 * * *
3 Section 2. Title 20 is amended by adding a section to read:
4 § 5414.1. Do-not-resuscitate orders.
5 (a) Liability.--No physician or other health care provider
6 who, consistent with this section, withholds life-sustaining
7 treatment in compliance with a do-not-resuscitate identification
8 or order shall, as a result of withholding such treatment, be
9 subject to criminal or civil liability or be found to have
10 committed an act of unprofessional conduct.
11 (b) DNR identification.--Through the use of a do-not-
12 resuscitate identification card, form, necklace or bracelet of
13 uniform size and design, approved by the department by
14 regulation, a person may signify to a health care provider,
15 including emergency medical services personnel, that the
16 person's attending physician has issued a do-not-resuscitate
17 order and that the grounds for the do-not-resuscitate order are
18 in the person's medical records.
19 (c) Issuance of do-not-resuscitate identification or
20 order.--Only a person's attending physician may issue a do-not-
21 resuscitate identification or order for that person.
22 (d) Revocation.--A do-not-resuscitate order may be revoked
23 at any time and in any manner, including removal by a person of
24 his or her do-not-resuscitate identification, without regard to
25 the person's mental or physical condition.
26 (e) Emergency medical services.--
27 (1) Notwithstanding the provisions of section 5413
28 (relating to emergency medical services), emergency medical
29 services personnel shall comply with a do-not-resuscitate
30 order if a do-not-resuscitate identification is apparent and
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1 immediately available, as provided for in subsection (b), or
2 if a do-not-resuscitate order is issued directly to the
3 emergency medical services personnel by a physician.
4 (2) Emergency medical services personnel who comply with
5 a do-not-resuscitate order, as provided for in paragraph (1),
6 shall not be subject to criminal or civil liability or be
7 found to have committed an act of unprofessional conduct.
8 (f) Unwillingness to comply.--If a physician or other health
9 care provider cannot in good conscience comply with a do-not-
10 resuscitate order or if the policies of the health care provider
11 preclude compliance with a do-not-resuscitate order, the
12 physician or other health care provider shall comply with
13 section 5409(a) (relating to unwillingness to comply; transfer
14 of declarant). Section 5409(b) shall apply to an employee or
15 staff member of a health care provider who is unwilling to
16 participate in the withholding of life-sustaining treatment in
17 compliance with a do-not-resuscitate order.
18 (g) Effect on suicide and life insurance.--The withholding
19 of life-sustaining treatment in compliance with a do-not-
20 resuscitate order shall not constitute suicide or homicide and
21 shall not have any effect on life insurance, as provided for in
22 section 5410 (relating to effect on suicide and life insurance).
23 (h) No presumption.--This section shall not create a
24 presumption concerning the intent of any person who does not
25 possess do-not-resuscitate identification with respect to the
26 withholding of the life-sustaining procedures encompassed by a
27 do-not-resuscitate order.
28 Section 3. Section 5415 of Title 20 is amended to read:
29 § 5415. Penalties.
30 (a) Unlawful acts relating to declaration.--Any person who
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1 willfully conceals, cancels, defaces, obliterates or damages the
2 declaration of another without the consent of the declarant
3 commits a felony of the third degree. Any person who falsifies
4 or forges the declaration of another, or willfully conceals or
5 withholds personal knowledge of a revocation as provided in
6 section 5406 (relating to revocation), with the intent to cause
7 a withholding or withdrawal of life-sustaining treatment
8 contrary to the wishes of the declarant and, because of such an
9 act, directly causes life-sustaining treatment to be withheld or
10 withdrawn and death to be hastened shall be subject to
11 prosecution for criminal homicide as provided in 18 Pa.C.S. Ch.
12 25 (relating to criminal homicide). Any person who willfully, by
13 undue influence, fraud or duress, causes a person to execute a
14 declaration pursuant to this chapter commits a felony of the
15 third degree.
16 (b) Unlawful acts relating to DNR order or identification.--
17 Any person who willfully conceals, cancels, defaces, obliterates
18 or damages the do-not-resuscitate identification of another
19 without the consent of the individual who possesses the
20 identification commits a felony of the third degree. Any person
21 who falsifies or forges the do-not-resuscitate identification of
22 another or willfully conceals or withholds personal knowledge of
23 a revocation of a do-not-resuscitate identification with the
24 intent to cause a withholding of life-sustaining treatment
25 contrary to the wishes of the individual who possesses the do-
26 not-resuscitate identification and, because of the person's act,
27 directly causes life-sustaining treatment to be withheld and
28 death to be hastened shall be subject to prosecution for
29 criminal homicide as provided in 18 Pa.C.S. Ch. 25.
30 Section 4. The Department of Health shall promulgate rules
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1 and regulations to implement this act.
2 Section 5. This act shall apply on the effective date of the
3 rules and regulations promulgated under section 4 of this act.
4 Section 6. This act shall take effect immediately.
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