New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 49 - ADMINISTRATION MANUAL › Subchapter 9 - PROVIDER AND BENEFICIARY'S RIGHTS AND RESPONSIBILITIES; ADMINISTRATIVE PROCESS › Section 10:49-9.15 - Advance directives

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The following
				words and terms, when used in this section, shall have the following meanings,
				unless the context clearly indicates otherwise.
"Advance directive" means a written expression of a patient's
				  preferences regarding the provision, withholding or withdrawal of a medical
				  service, treatment or procedure in the event that the patient subsequently
				  lacks decision making capacity. An advance directive may include a proxy
				  directive or an instruction directive, or both.
"Decision making capacity" means a patient's ability to
				  understand and appreciate the nature and consequences of health care decisions,
				  including the benefits and risks of each, and alternatives to any proposed
				  health care, and to reach an informed decision. A patient's decision making
				  capacity is evaluated relative to the demands of a particular health care
				  decision.
"Declarant" means a competent adult 18 years of age or older
				  who executes an advance directive.
"Health care decision" means a decision to accept or to
				  refuse any treatment, service or procedure used to diagnose, treat or care for
				  a patient's physical or mental condition, including life-sustaining treatment.
				  "Health care decision" also means a decision to accept or to refuse the
				  services of a particular physician, nurse, other health care professional or
				  health care institution, including a decision to accept or to refuse a transfer
				  of care.
"Health care institution" means institutions, facilities, and
				  agencies licensed, certified, or otherwise authorized by State law to
				  administer health care in the ordinary course of business, including hospitals,
				  nursing homes, residential health care facilities, home health care agencies,
				  personal care service agencies, and hospice programs operating in this State,
				  mental health institutions, facilities or agencies, or institutions, facilities
				  and agencies for the developmentally disabled. For purposes of this section,
				  "health care institution" also means a managed care organization contracted
				  pursuant to N.J.A.C. 10:74 to provide medical services to beneficiaries of the
				  New Jersey Medicaid/NJ KidCare/NJ FamilyCare program.
"Health care professional" means an individual, as opposed to
				  a health care institution, licensed by this State to administer health care in
				  the ordinary course of business or practice of a profession.
"Health care representative" means the individual designated
				  by a declarant pursuant to the proxy directive part of an advance directive for
				  the purpose of making health care decisions on the declarant's behalf, and
				  includes an individual designated as an alternate health care representative
				  who is acting as the declarant's health care representative in accordance with
				  the terms and order of priority stated in an advance directive.
"Instruction directive" means a writing which provides
				  instructions and direction regarding the declarant's wishes for health care in
				  the event that the declarant subsequently lacks decision making
				  capacity.
"Life-sustaining treatment" means the use of any medical
				  device or procedure, artificially provided fluids and nutrition, drugs, surgery
				  or therapy that uses mechanical or other artificial means to sustain, restore
				  or supplant a vital bodily function, and thereby increase the expected life
				  span of a patient.
"Nurse" means a person currently licensed to practice as a
				  registered professional nurse who is certified by the New Jersey State Board of
				  Nursing in accordance with N.J.A.C. 13:37-7, and with
				  45:11-23 et seq., or similarly
				  licensed and certified by a comparable agency of the state in which he or she
				  practices.
"Other health care professionals" means licensed health care
				  professionals other than physicians and nurses.
"Patient" means an individual who is under the care of a
				  physician, nurse or other health care professional.
"Physician" means an individual (M.D. or D.O.) licensed to
				  practice medicine and surgery in this State.
"Proxy directive" means a writing which designates a health
				  care representative in the event the declarant subsequently lacks decision
				  making capacity.
(b)
				Participating health care institutions shall establish written policies and
				procedures concerning the rights of patients to make decisions regarding their
				medical care and their right to execute advance directives. In addition to
				policies affirming patients' rights:
1.
				Private religiously-affiliated health care institutions may develop
				institutional policies and practices defining circumstances under which they
				will decline to participate in the withholding or withdrawing of specific
				measures to sustain life. Such policies and practices shall be written, and
				shall be properly communicated to patients and their families and health care
				representatives before or at the time of the patient's admission or enrollment.
				If the institution's policies and practices appear to conflict with the legal
				rights of a patient wishing to forego health care, the health care institution
				shall attempt to resolve the conflict. If a mutually satisfactory accommodation
				cannot be reached, the health care institution shall take all reasonable steps
				to effect the appropriate, timely and respectful transfer of the patient to the
				care of another health care institution appropriate to the patient's needs, and
				shall assure that the patient is not abandoned or treated disrespectfully;
				and
2. Health care institutions
				shall include in their policies a statement informing physicians, nurses and
				other health care professionals of their rights and responsibilities, to assure
				that such rights and responsibilities are understood, including the right to
				decline to participate in withholding or withdrawing life-sustaining treatment,
				in accordance with sincerely held personal or professional convictions, and to
				provide a forum for discussion and consultation on the subject of such
				rights.