# Georgia House Bill 275 (2012)

A BILL TO BE ENTITLED AN ACT
To amend Chapter 39 of Title 31 of the Official Code of Georgia Annotated, relating to cardiopulmonary resuscitation, so as to clarify the health care providers authorized to effectuate an order not to resuscitate; to provide for definitions; to provide for related matters; to repeal conflicting laws; and for other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: SECTION 1.
Chapter 39 of Title 31 of the Official Code of Georgia Annotated, relating to cardiopulmonary resuscitation, is amended in Code Section 31-39-2, relating to definitions pertaining to cardiopulmonary resuscitation, by adding new paragraphs to read as follows:
    "(5.1) 'Caregiver' means an unlicensed assistant who provides direct health related care to patients or residents, a proxy caregiver performing health maintenance activities as provided in Code Section 43-26-12, or a person performing auxiliary services in the care of patients as provided in Code Section 43-26-12."
    "(8.1) 'Nurse' means a person who is a licensed practical nurse as provided in Code Section 43-26-32 or a registered professional nurse as provided in Code Section 43-26-3."
    "(11.1) 'Physician assistant' means a person licensed as a physician assistant pursuant to Article 4 of Chapter 34 of Title 43."
SECTION 2.
Said chapter is further amended in Code Section 31-39-4, relating to persons authorized to issue an order not to resuscitate, by revising subsection (a) as follows:
    "(a) It shall be lawful for the attending physician to issue an order not to resuscitate pursuant to the requirements of this chapter. Any written order issued by the attending physician using the term 'do not resuscitate,' 'DNR,' 'order not to resuscitate,' 'no code,' or substantially similar language in the patient's chart shall constitute a legally sufficient order and shall authorize a physician, health care professional, nurse, physician assistant, caregiver, or emergency medical technician to withhold or withdraw cardiopulmonary resuscitation. Such an order shall remain effective, whether or not the patient is receiving treatment from or is a resident of a health care facility, until the order is canceled as provided in Code Section 31-39-5 or until consent for such order is revoked as provided in Code Section 31-39-6, whichever occurs earlier. An attending physician who has issued such an order and who transfers care of the patient to another physician shall inform the receiving physician and the health care facility, if applicable, of the order."
SECTION 3.
Said chapter is further amended by revising Code Section 31-39-6, relating to the revocation of consent to an order not to resuscitate, as follows:
    "31-39-6.
    (a) A patient may, at any time, revoke his or her consent to an order not to resuscitate by making either a written or an oral declaration or by any other act evidencing a specific intent to revoke such consent which is communicated to or in the presence of an attending physician, nurse, physician assistant, caregiver or a member of the nursing staff at the health care facility, a health care professional, or an emergency medical technician.
    (b) Any parent or authorized person may at any time revoke his or her consent to an order not to resuscitate a patient by making either a written or an oral declaration or by any other act evidencing a specific intent to revoke such consent which is communicated to or in the presence of an attending physician, nurse, physician assistant, caregiver or a member of the nursing staff at the health care facility, a health care professional, or an emergency medical technician.
    (c) Any physician who is informed of or provided with a revocation of consent pursuant to this Code section shall, either by himself or herself or by designee, immediately include the revocation in the patient's chart, cancel the order, and notify any health care facility staff responsible for the patient's care of the revocation and cancellation. Any member of the nursing staff, or a physician assistant, caregiver, a health care professional, or emergency medical technician who is informed of or provided with a revocation of consent pursuant to this Code section shall immediately notify a physician of such revocation."
SECTION 4.
Said chapter is further amended by revising Code Section 31-39-6.1, relating to form of order not to resuscitate, bracelet or necklace, and revocation or cancellation of order, as follows:
"31-39-6.1. (a) In addition to those orders not to resuscitate authorized elsewhere in this chapter, any physician, health care professional, nurse, physician assistant, caregiver, or emergency medical technician shall be authorized to effectuate an order not to resuscitate for a person who is not a patient in a hospital, nursing home, or licensed hospice and if the order is evidenced in writing containing the patient's name, date of the form, printed name of the attending physician, and signed by signature of the attending physician on a form substantially similar to the following:
'DO NOT RESUSCITATE ORDER
NAME OF PATIENT: __________________________________________________ THIS CERTIFIES THAT AN ORDER NOT TO RESUSCITATE HAS BEEN ENTERED ON THE ABOVE-NAMED PATIENT.
SIGNED:_______________________
ATTENDING PHYSICIAN
PRINTED OR TYPED NAME OF ATTENDING PHYSICIAN: _________________ ATTENDING PHYSICIAN'S TELEPHONE NUMBER: _______________________ DATE:____________________'
(b) A person who is not a patient in a hospital, nursing home, or licensed hospice and who has an order not to resuscitate pursuant to this Code section shall may wear an identifying bracelet on either the wrist or the ankle or an identifying necklace and shall post or place a prominent notice in such person's home. The bracelet shall be substantially similar to identification bracelets worn in hospitals. The bracelet, or necklace, or notice shall be on an orange background and shall provide the following information in boldface type:
'DO NOT RESUSCITATE ORDER
Patient's name: _________________________________________________________ Authorized person's name and telephone number, if applicable: __________________ Patient's physician's printed name and telephone number: ___________________ Date of order not to resuscitate: ___________________________________________'
Any physician, health care professional, nurse, physician assistant, caregiver, or emergency medical technician shall be authorized to regard such a bracelet, or necklace, or notice as a legally sufficient order not to resuscitate in the same manner as an order issued pursuant to this chapter unless such person has actual knowledge that such order has been canceled or consent thereto revoked as provided in this chapter. (c) Any order not to resuscitate evidenced pursuant to subsection (a) or (b) of this Code section may be revoked as provided in Code Section 31-39-6 and may be canceled as provided in Code Section 31-39-5."
SECTION 5.
Said chapter is further amended in Code Section 31-39-7, relating to liability of persons carrying out in good faith decisions regarding cardiopulmonary resuscitation, notification of next of kin or authorized person of patient by physician refusing to comply with an order not to resuscitate, by revising subsections (a) and (b) as follows:
    "(a) No physician, health care professional, nurse, physician assistant, caregiver, health care facility, other licensed facility, emergency medical technician, or person employed by, acting as the agent of, or under contract with any of the foregoing shall be subject to criminal prosecution or civil liability or be deemed to have engaged in unprofessional conduct for carrying out in good faith a decision regarding cardiopulmonary resuscitation authorized by this chapter by or on behalf of a patient or for those actions taken in compliance with the standards and procedures set forth in this chapter.
    (b) No physician, health care professional, nurse, physician assistant, caregiver, health care facility, other licensed facility, emergency medical technician, or person employed by, acting as the agent of, or under contract with any of the foregoing shall be subject to criminal prosecution or civil liability or be deemed to have engaged in unprofessional conduct for providing cardiopulmonary resuscitation to a patient for whom an order not to resuscitate has been issued, provided that such physician or person:
       (1) Reasonably and in good faith was unaware of the issuance of an order not to resuscitate; or
       (2) Reasonably and in good faith believed that consent to the order not to resuscitate had been revoked or canceled."
SECTION 6.
All laws and parts of laws in conflict with this Act are repealed.
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