4780-4786

PROBATE CODE
SECTION 4780-4786




4780.  (a) As used in this part:
   (1) "Request regarding resuscitative measures" means a written
document, signed by (A) an individual with capacity, or a legally
recognized health care decisionmaker, and (B) the individual's
physician, that directs a health care provider regarding
resuscitative measures. A request regarding resuscitative measures is
not an advance health care directive.
   (2) "Request regarding resuscitative measures" includes one, or
both of, the following:
   (A) A prehospital "do not resuscitate" form as developed by the
Emergency Medical Services Authority or other substantially similar
form.
   (B) A Physician Orders for Life Sustaining Treatment form, as
approved by the Emergency Medical Services Authority.
   (3) "Physician Orders for Life Sustaining Treatment form" means a
request regarding resuscitative measures that directs a health care
provider regarding resuscitative and life-sustaining measures.
   (b) A legally recognized health care decisionmaker may execute the
Physician Orders for Life Sustaining Treatment form only if the
individual lacks capacity, or the individual has designated that the
decisionmaker's authority is effective pursuant to Section 4682.
   (c) The Physician Orders for Life Sustaining Treatment form and
medical intervention and procedures offered by the form shall be
explained by a health care provider, as defined in Section 4621. The
form shall be completed by a health care provider based on patient
preferences and medical indications, and signed by a physician and
the patient or his or her legally recognized health care
decisionmaker. The health care provider, during the process of
completing the Physician Orders for Life Sustaining Treatment form,
should inform the patient about the difference between an advance
health care directive and the Physician Orders for Life Sustaining
Treatment form.
   (d) An individual having capacity may revoke a Physician Orders
for Life Sustaining Treatment form at any time and in any manner that
communicates an intent to revoke, consistent with Section 4695.
   (e) A request regarding resuscitative measures may also be
evidenced by a medallion engraved with the words "do not resuscitate"
or the letters "DNR," a patient identification number, and a 24-hour
toll-free telephone number, issued by a person pursuant to an
agreement with the Emergency Medical Services Authority.




4781.  As used in this part, "health care provider" includes, but is
not limited to, the following:
   (a) Persons described in Section 4621.
   (b) Emergency response employees, including, but not limited to,
firefighters, law enforcement officers, emergency medical technicians
I and II, paramedics, and employees and volunteer members of legally
organized and recognized volunteer organizations, who are trained in
accordance with standards adopted as regulations by the Emergency
Medical Services Authority pursuant to Sections 1797.170, 1797.171,
1797.172, 1797.182, and 1797.183 of the Health and Safety Code to
respond to medical emergencies in the course of performing their
volunteer or employee duties with the organization.



4781.2.  (a) A health care provider shall treat an individual in
accordance with a Physician Orders for Life Sustaining Treatment
form.
   (b) Subdivision (a) does not apply if the Physician Orders for
Life Sustaining Treatment form requires medically ineffective health
care or health care contrary to generally accepted health care
standards applicable to the health care provider or institution.
   (c) A physician may conduct an evaluation of the individual and,
if possible, in consultation with the individual, or the individual's
legally recognized health care decisionmaker, issue a new order
consistent with the most current information available about the
individual's health status and goals of care.
   (d) The legally recognized health care decisionmaker of an
individual without capacity shall consult with the physician who is,
at that time, the individual's treating physician prior to making a
request to modify that individual's Physician Orders for Life
Sustaining Treatment form.
   (e) An individual with capacity may, at any time, request
alternative treatment to that treatment that was ordered on the form.




4781.4.  If the orders in an individual's request regarding
resuscitative measures directly conflict with his or her individual
health care instruction, as defined in Section 4623, then, to the
extent of the conflict, the most recent order or instruction is
effective.



4781.5.  The legally recognized health care decisionmaker shall make
health care decisions pursuant to this part in accordance with
Sections 4684 and 4714.


4782.  A health care provider who honors a request regarding
resuscitative measures is not subject to criminal prosecution, civil
liability, discipline for unprofessional conduct, administrative
sanction, or any other sanction, as a result of his or her reliance
on the request, if the health care provider (a) believes in good
faith that the action or decision is consistent with this part, and
(b) has no knowledge that the action or decision would be
inconsistent with a health care decision that the individual signing
the request would have made on his or her own behalf under like
circumstances.



4783.  (a) Forms for requests regarding resuscitative measures
printed after January 1, 1995, shall contain the following:

   "By signing this form, the legally recognized health care
decisionmaker acknowledges that this request regarding resuscitative
measures is consistent with the known desires of, and with the best
interest of, the individual who is the subject of the form."

   (b) A printed form substantially similar to that described in
subparagraph (A) of paragraph (2) of subdivision (a) of Section 4780
is valid and enforceable if all of the following conditions are met:
   (1) The form is signed by the individual, or the individual's
legally recognized health care decisionmaker, and a physician.
   (2) The form directs health care providers regarding resuscitative
measures.
   (3) The form contains all other information required by this
section.


4784.  In the absence of knowledge to the contrary, a health care
provider may presume that a request regarding resuscitative measures
is valid and unrevoked.


4785.  This part applies regardless of whether the individual
executing a request regarding resuscitative measures is within or
outside a hospital or other health care institution.



4786.  This part does not repeal or narrow laws relating to health
care decisionmaking.