Oregon Administrative Rules › Chapter 309 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: BEHAVIORAL HEALTH SERVICES › Division 114 - INFORMED CONSENT TO TREATMENT AND TRAINING BY PATIENTS IN STATE INSTITUTIONS › Section 309-114-0020 - Involuntary Administration of Significant Procedures to Persons Committed to the Division with Good Cause

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Good
			 cause: Good cause exists to administer a significant procedure to a person
			 committed to the Division without informed consent if in the opinion of the
			 treating physician or psychiatric nurse practitioner after consultation with
			 the treatment team, the following factors are satisfied:
(a) Pursuant to OAR
			 309-114-0010(2),
			 the person is deemed unable to consent to, refuse, withhold or withdraw consent
			 to the significant procedure. This determination must be documented on the
			 treating physician's or psychiatric nurse practitioner's informed consent form
			 and the independent examining physician's evaluation form. It must include the
			 specific questions asked and answers given regarding the patient's ability to
			 weigh the risks and benefits of the proposed treatment, alternative treatment
			 and no treatment including, but not limited to all relevant factors listed in
			 309-114-0010(3)(a).
(b) The proposed significant procedure will
			 likely restore or prevent deterioration of the person's mental or physical
			 health, alleviate extreme suffering or save or extend the person's life. This
			 factor is established conclusively for purposes of a hearing under OAR
			 309-114-0025 by introducing into
			 evidence the treating physician's or psychiatric nurse practitioner's informed
			 consent form and the independent examining physician's evaluation form, unless
			 this factor is affirmatively raised as an issue by the patient or his or her
			 representative at the hearing.
(c)
			 The proposed significant procedure is the most appropriate treatment for the
			 person's condition according to current clinical practice and other less
			 intrusive procedures have been considered and all criteria and information set
			 forth in OAR 309-114-0010(3)(a)
			 were considered. This factor is established conclusively for purposes of a
			 hearing under 309-114-0025 by introducing into
			 evidence the treating physician's or psychiatric nurse practitioner's informed
			 consent form and the independent examining physician's evaluation form, unless
			 this factor is affirmatively raised as an issue by the patient or his or her
			 representative at the hearing.
(d)
			 The institution made a conscientious effort to obtain informed consent from the
			 patient. This factor is established conclusively for purposes of a hearing
			 under OAR 309-114-0025 by introducing into
			 evidence the treating physician's or psychiatric nurse practitioner's informed
			 consent form unless this factor is affirmatively raised as an issue by the
			 patient or his or her representative at the hearing. If the institution has
			 reason to believe a patient has limited English language proficiency or the
			 patient requests it, the institution will make reasonable accommodations to
			 provide the patient with meaningful access to the informed consent process,
			 such as providing the patient with the opportunity to have an interpreter
			 orally translate written materials into the patient's native language and
			 provide translation during the treating physician's or psychiatric nurse
			 practitioner's attempts to obtain informed consent. A "conscientious effort" to
			 obtain informed consent means the patient's treating physician or psychiatric
			 nurse practitioner made at least two good faith attempts to obtain informed
			 consent by attempting to explain the procedure to the patient and documenting
			 those efforts in the patient's record.
(e) Because of the preliminary nature of
			 their commitment, the following additional findings must be made for patients
			 under ORS 161.370 jurisdiction in order to
			 show good cause under this rule:
(A)
			 Medication is not requested for the sole purpose of restoring trial competency;
			 and
(B) The patient is being
			 medicated because of the patient's dangerousness or to treat the patient's
			 grave disability.