2994-DD - Managing a nonhospital order not to resuscitate.

§  2994-dd.  Managing  a  nonhospital order not to resuscitate. 1. The  attending physician shall record the issuance of a nonhospital order not  to resuscitate in the patient's medical record.    2. A nonhospital order not to  resuscitate  shall  be  issued  upon  a  standard  form  prescribed  by  the commissioner. The commissioner shall  also develop a standard bracelet that may be worn by a  patient  with  a  nonhospital  order not to resuscitate to identify that status; provided,  however, that no person may require a patient to wear  such  a  bracelet  and  that  no  person may require a patient to wear such a bracelet as a  condition for honoring a nonhospital order not  to  resuscitate  or  for  providing health care services.    3.  An  attending  physician who has issued a nonhospital order not to  resuscitate, and who transfers care of the patient to another physician,  shall inform the physician of the order.    4. For each patient for whom a nonhospital order  not  to  resuscitate  has  been issued, the attending physician shall review whether the order  is still appropriate in light of the patient's condition each time he or  she examines the patient, whether in the hospital or elsewhere,  but  at  least  every  ninety  days, provided that the review need not occur more  than once every seven days. The attending  physician  shall  record  the  review  in  the  patient's  medical  record  provided,  however,  that a  registered nurse who provides direct care to the patient may record  the  review  in the medical record at the direction of the physician. In such  case, the attending physician shall include a confirmation of the review  in the patient's medical record within fourteen  days  of  such  review.  Failure  to  comply with this subdivision shall not render a nonhospital  order not to resuscitate ineffective.    5.  A  person  who  has  consented  to  a  nonhospital  order  not  to  resuscitate  may  at  any time revoke his or her consent to the order by  any act evidencing a specific intent to revoke such consent. Any  health  care  professional  informed of a revocation of consent to a nonhospital  order not to resuscitate shall notify the  attending  physician  of  the  revocation.  An  attending  physician who is informed that a nonhospital  order not to resuscitate has been revoked shall record the revocation in  the patient's medical record, cancel the order and make diligent efforts  to retrieve the form issuing the order, and the  standard  bracelet,  if  any.    6.  The  commissioner may authorize the use of one or more alternative  forms for issuing a nonhospital order not to resuscitate  (in  place  of  the  standard  form prescribed by the commissioner under subdivision two  of this section). Such alternative form or forms may  also  be  used  to  issue  a  non-hospital do not intubate order. Any such alternative forms  intended for use for persons with mental  retardation  or  developmental  disabilities  or persons with mental illness who are incapable of making  their own health care decisions or who have a  guardian  of  the  person  appointed  pursuant  to  article eighty-one of the mental hygiene law or  article seventeen-A of the surrogate's court procedure act must also  be  approved  by  the  commissioner  of mental retardation and developmental  disabilities or the commissioner of mental health,  as  appropriate.  An  alternative  form  under  this  subdivision shall otherwise conform with  applicable federal and state  law.  This  subdivision  does  not  limit,  restrict  or  impair the use of an alternative form for issuing an order  not to resuscitate in a general  hospital  or  residential  health  care  facility  under article twenty-eight of this chapter or a hospital under  subdivision ten of section 1.03 of the mental hygiene law  or  a  school  under section 13.17 of the mental hygiene law.