New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 48B - DECISION-MAKING FOR THE TERMINALLY ILL › Subchapter 7 - INDIVIDUALS WITHOUT CAPACITY TO MAKE MEDICAL TREATMENT DECISIONS FOR WHOM BGS IS PROVIDING GUARDIANSHIP SERVICES › Section 10:48B-7.5 - Do Not Resuscitate (DNR) Orders for individuals receiving BGS services

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The following procedures shall be
				followed when a recommendation has been made by the treating practitioner to
				execute a DNR Order for an individual for whom BGS is providing guardianship
				services:
1. The treating practitioner will
				submit a written recommendation for a DNR Order indicating the diagnosis and
				prognosis of the individual and the benefit or not if Cardiopulmonary
				Resuscitation (CPR) is instituted. If the individual is not terminally ill or
				permanently unconscious and the attending physician is recommending that CPR is
				medically contraindicated for the individual, the attending physician will
				specify in the written recommendation the reasons CPR is
				contraindicated.
2. The staff of
				BGS will search the records for an advance directive or seek information on a
				contemporaneous or previously expressed wish of the individual.
3. A second treating physician will indicate
				in writing his or her concurrence with the treating practitioner's
				recommendation for a DNR Order.
4.
				The staff of BGS will contact the next of kin or interested persons to
				establish their perception of the individuals' wishes or what is in the best
				interest of the individual.
5. The
				Chief of BGS, or his or her designee, may request consultation by a recognized
				Ethics Committee if the BGS staff seeks a recommendation regarding a DNR Order
				request. The Ethics Committee shall consider the request in accordance with
				10:48B-7.3(a)1 
				iii, except the committee will consider a DNR request.
6. If the Chief of BGS, or his or her
				designee concurs with the recommendation for a DNR Order, the Chief or his or
				her designee shall prepare a certification based upon the following:
i. The recommendation of the treating
				practitioner, including a diagnosis, prognosis, and a medical treatment plan;
ii. The concurrence and
				recommendations of a second treating physician;
iii. A brief history of the individual's
				abilities and description of the progression of the illness;
iv. The disposition of any family members or
				interested parties;
v. The
				observations by the BGS guardian of the individual;
vi. The recommended medical treatment support
				plan to include hospice or palliative care, as appropriate; and
vii. Any additional information deemed
				relevant to the decision.
7. Once the certification has been completed,
				the Chief of BGS or his or her designee shall communicate consent to the DNR
				Order to the treating practitioner and provide DRNJ with a copy of the
				certification no later than the next business day.
8. If an emergent request for a DNR Order is
				made by the treating practitioner and the Chief of BGS, or his or her designee,
				agrees with the request and concurs that the request meets the requirements of
				this chapter, consent will be given to the treating practitioner to enter a DNR
				order.
9. The Chief of BGS, or his
				or her designee, will prepare a certification pursuant to (a)6 above and send a
				copy to DRNJ, no later than the next business day.