Medical Decision-Making for Unrepresented Patients – California Appeals Court Clarifies Procedures

This week, the California Court of Appeal published a 73-page decision on how nursing homes must make treatment decisions for unrepresented residents. The decades-old California Health and Safety Code § 1418.8 establishes an interdisciplinary team (IDT) procedure for nursing home residents who lack capacity to make their own health care decisions. But, in 2016, pursuant to a petition from California Advocates for Nursing Home Reform (CANHR), the Alameda County Superior Court held the statute unconstitutional for failing to offer due process protections such as notice to the resident.  The Court of Appeal reversed. construing the statute to uphold its constitutionality. First, the court held that the IDT process may be used both (1) to authorize the administration of anti-psychotic medications in nursing homes, and (2) for decisions to create or make a change to POLSTs, DNRs or comfort care orders, and to transfer patients to hospice care. Second, the court interpreted 1418.8 to require nursing homes to provide: "(1) Notice: Written and oral notice must be provided to every resident for whom section 1418.8 is invoked, of (a) any determination of the resident’s incapacity; (b) any determination that no surrogate decisionmaker for the resident is available; (c) any medical intervention proposed by the attending physician; (d) the fact that a decision will be made by the IDT on a proposed medica...
Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Health Care syndicated Source Type: blogs