190.600. Citation of act--definitions.
Citation of act--definitions.
190.600. 1. Sections 190.600 to 190.621 shall be known and may becited as the "Outside the Hospital Do-Not-Resuscitate Act".
2. As used in sections 190.600 to 190.621, unless the context clearlyrequires otherwise, the following terms shall mean:
(1) "Attending physician":
(a) A physician licensed under chapter 334, RSMo, selected by orassigned to a patient who has primary responsibility for treatment and careof the patient; or
(b) If more than one physician shares responsibility for thetreatment and care of a patient, one such physician who has been designatedthe attending physician by the patient or the patient's representativeshall serve as the attending physician;
(2) "Cardiopulmonary resuscitation" or "CPR", emergency medicaltreatment administered to a patient in the event of the patient's cardiacor respiratory arrest, and shall include cardiac compression, endotrachealintubation and other advanced airway management, artificial ventilation,defibrillation, administration of cardiac resuscitation medications, andrelated procedures;
(3) "Department", the department of health and senior services;
(4) "Emergency medical services personnel", paid or volunteerfirefighters, law enforcement officers, first responders, emergency medicaltechnicians, or other emergencyservice personnel acting within the ordinary course and scope of theirprofessions, but excluding physicians;
(5) "Health care facility", any institution, building, or agency orportion thereof, private or public, excluding federal facilities andhospitals, whether organized for profit or not, used, operated, or designedto provide health services, medical treatment, or nursing, rehabilitative,or preventive care to any person or persons. Health care facility includesbut is not limited to ambulatory surgical facilities, health maintenanceorganizations, home health agencies, hospices, infirmaries, renal dialysiscenters, long-term care facilities licensed under sections 198.003 to198.186, RSMo, medical assistance facilities, mental health centers,outpatient facilities, public health centers, rehabilitation facilities,and residential treatment facilities;
(6) "Hospital", a place devoted primarily to the maintenance andoperation of facilities for the diagnosis, treatment, or care for not lessthan twenty-four consecutive hours in any week of three or more nonrelatedindividuals suffering from illness, disease, injury, deformity, or otherabnormal physical conditions; or a place devoted primarily to provide fornot less than twenty-four consecutive hours in any week medical or nursingcare for three or more nonrelated individuals. Hospital does not includeany long-term care facility licensed under sections 198.003 to 198.186,RSMo;
(7) "Outside the hospital do-not-resuscitate identification" or"outside the hospital DNR identification", a standardized identificationcard, bracelet, or necklace of a single color, form, and design asdescribed by rule of the department that signifies that the patient'sattending physician has issued an outside the hospital do-not-resuscitateorder for the patient and has documented the grounds for the order in thepatient's medical file;
(8) "Outside the hospital do-not-resuscitate order" or "outside thehospital DNR order", a written physician's order signed by the patient andthe attending physician, or the patient's representative and the attendingphysician, in a form promulgated by rule of the department which authorizesemergency medical services personnel to withhold or withdrawcardiopulmonary resuscitation from the patient in the event of cardiac orrespiratory arrest;
(9) "Outside the hospital do-not-resuscitate protocol" or "outsidethe hospital DNR protocol", a standardized method or procedure promulgatedby rule of the department for the withholding or withdrawal ofcardiopulmonary resuscitation by emergency medical services personnel froma patient in the event of cardiac or respiratory arrest;
(10) "Patient", a person eighteen years of age or older who is notincapacitated, as defined in section 475.010, RSMo, and who is otherwisecompetent to give informed consent to an outside the hospitaldo-not-resuscitate order at the time such order is issued, and who, withhis or her attending physician, has executed an outside the hospitaldo-not-resuscitate order under sections 190.600 to 190.621. A person whohas a patient's representative shall also be a patient for the purposes ofsections 190.600 to 190.621, if the person or the person's patient'srepresentative has executed an outside the hospital do-not-resuscitateorder under sections 190.600 to 190.621;
(11) "Patient's representative":
(a) An attorney in fact designated in a durable power of attorney forhealth care for a patient determined to be incapacitated under sections404.800 to 404.872, RSMo; or
(b) A guardian or limited guardian appointed under chapter 475, RSMo,to have responsibility for an incapacitated patient.
(L. 2007 H.B. 182)