Impasse broken, do-not-resuscitate bill advances

Updated Aug 10, 2017
State Rep. Greg Bonnen, R-Friendswood, center, shown here in an April 2016 hearing, helped broker an agreement with interested parties on a bill strengthening patient protections for do-not-resuscitate orders. RALPH BARRERA/AMERICAN-STATESMAN

Hours of frequently tense negotiations have broken an impasse over a bill to require specific patient approval for do-not-resuscitate orders in hospitals, making it all but certain that Gov. Greg Abbott will be able to sign legislation on one of his 20 priorities for the special legislative session.

With the signed agreement in hand, the House State Affairs Committee voted 9-0 Thursday to approve a revamped version of Senate Bill 11 that the sponsor, Rep. Greg Bonnen, R-Friendswood, said preserves the “fundamental policy” of the original bill while offering protections sought by doctors, nurses and hospital employees.

“As long as they are acting in good faith, they are not in any way punished or penalized for any honest error or omission” for failing to heed a do-not-resuscitate order, said Bonnen, a neurosurgeon. “If they’re acting in good faith, trying to help without knowing that a DNR had been issued, they are not in violation of the law.”

Bonnen said he will fight any attempts to amend SB 11 on the House floor as part of the agreement with groups that oppose abortion, the Texas Medical Association, disability rights advocates and the Texas Catholic Conference of Bishops. The agreement also was negotiated with Rep. Byron Cook, the Republican chairman of State Affairs, and members of Abbott’s office.

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The pact includes a signed letter from Sen. Charles Perry, R-Lubbock, stating that he will ask the Senate to concur with changes made by the House — an agreement that the Senate’s Republican majority is unlikely to ignore.

When the Senate passed the bill last month, Perry acknowledged that it needed work and expressed hope that the House could arrive at the needed fixes.

The new SB 11 requires in-hospital do-not-resuscitate orders from an attending doctor to be in writing or, if given verbally by the patient, witnessed by “two competent adult witnesses.”

SB 11 also requires doctors to inform the patient — or legal guardian or person with medical power of attorney for patients who are not competent to make their own choices — before placing the order in a patient’s chart.

Do-not-resuscitate orders are valid if not contrary to a competent patient’s desires and if, in the doctor’s reasonable judgment, a patient’s death is imminent and “the DNR order is medically appropriate,” SB 11 says.

Doctors, nurses or hospital employees who intentionally conceal, cancel or falsify a do-not-resuscitate order — or conceal a patient’s revocation of such an order — can be punished with up to one year in jail. Those who intentionally fail to follow a do-not-resuscitate order also could be disciplined by medical licensing boards.