BILL REQ. #:  H-5137.3 

READ FIRST TIME 02/06/08.   

     AN ACT Relating to end-of-life health care directives; amending RCW 43.70.480; and adding a new section to chapter 4.24 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1   RCW 43.70.480 and 2000 c 70 s 1 are each amended to read as follows:
     (1) The department of health shall adopt guidelines and protocols for how emergency medical personnel shall respond when summoned to the site of an injury or illness for the treatment of a person who has signed a written directive ((or)), durable power of attorney, or medical order form developed by the department pursuant to subsection (2) of this section requesting that ((he or she not receive futile emergency medical)) life-sustaining treatment, as defined by RCW 70.122.020(5) and emergency treatment including, but not limited to, "resuscitate" or "do not resuscitate" orders, or related comfort care be provided, withheld, or withdrawn under specified circumstances.
     ((The guidelines shall include development of)) (2) The department shall develop a simple medical order form for documenting a person's life-sustaining and emergency treatment preferences, which clearly indicates "resuscitate" or "do not resuscitate" and other choices for life-sustaining and emergency treatment or related comfort care that shall be ((used statewide)) followed by emergency medical personnel certified under chapters 18.71 and 18.73 RCW.
     (3) The form must be signed by:
     (a) An advanced registered nurse practitioner, naturopathic physician, osteopathic physician, osteopathic physician assistant, physician, or physician assistant; and
     (b)(i) The person; or
     (ii) The person's legal representative, as defined in RCW 7.70.065, following the informed consent criteria in RCW 7.70.060.
     (4) Emergency medical personnel who, in good faith, provide, withhold, or withdraw treatment from a person in accordance with the directions stated on a medical order form developed and endorsed by the department of health under this section and executed in accordance with subsection (3) of this section shall be immune from civil or criminal liability, including professional conduct sanctions, unless the provider failed to act in accordance with the standards of care required by RCW 7.70.040.
     (5) The form may also be followed by other providers as defined in section 2 of this act, for the purposes of identifying and implementing a person's requests regarding providing, withholding, or withdrawing life-sustaining treatment, emergency treatment including "resuscitate" or "do not resuscitate," or treatment related to comfort care. The provisions of this section do not supersede other legal requirements applicable to providers. Providers may not require any person to execute the form. The provider must follow informed consent requirements under chapter 7.70 RCW. In addition, health care facilities, health facilities, and adult family homes must comply with all licensing and certification requirements.

NEW SECTION.  Sec. 2   A new section is added to chapter 4.24 RCW to read as follows:
     (1) For the purposes of this section, "provider" means:
     (a) An advanced registered nurse practitioner, naturopathic physician, osteopathic physician, osteopathic physician assistant, physician, or physician assistant;
     (b) A health care provider acting within the provider's licensed scope of practice and under the direction of an advanced registered nurse practitioner, osteopathic physician, osteopathic physician assistant, physician, or physician assistant;
     (c) A kidney disease treatment center and its personnel; or
     (d) A health facility as defined in chapter 70.122 RCW and its personnel, health care facility as defined in chapter 71.32 RCW and its personnel, or adult family home as defined in chapter 70.128 RCW and its personnel.
     (2) Nothing in this act shall be interpreted to permit providers or personnel to act outside the scope of their practice.
     (3) Any provider who, in good faith, provides, withholds, or withdraws life-sustaining treatment, emergency treatment including "resuscitate" or "do not resuscitate," or related treatment for comfort care from a person in accordance with the directions stated on a medical order form developed and endorsed by the department of health under RCW 43.70.480 and signed in accordance with RCW 43.70.480(3) shall be immune from civil or criminal liability, including professional conduct sanctions. The immunity authorized by this subsection does not include immunity from the provider's failure to provide, withhold, or withdraw treatment in accordance with the standard of care required by RCW 7.70.040.