Tag: dnr orders

Bioethics Blogs

Taking Patient Autonomy Out of the DNR

by Craig Klugman, Ph.D.

The Texas government has passed SB 11 an act “relating to general procedures and requirements for certain do-not-resuscitate orders; creating a criminal offense.” As of April 1, 2018, one can be jailed for offenses involving DNR orders.  When new laws are passed they often require new regulations to interpret them as well as statements from the state attorney general on how they are to be enforced and viewed. While those steps have not yet been taken, the threat to physician practice and patient autonomy in this law necessitates taking a further look at it now.…

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Texas Outlaws DNR Orders Written without Consent

The Texas Legislature has passed and the Governor has signed S.B.11.  This effectively bans non-consensual DNR orders. 

Look for my analysis of this legislation and its relationship to TADA at ICEL2, next month in Halifax.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Few Americans Plan For End-of-Life Decisions, Even If They Are Sick

Michael S. Dauber, MA, GBI Visiting Scholar

Many moral dilemmas faced by clinicians, patients, and their families arise when individuals have not made plans for the end of their lives or discussed their wishes with their loved ones. To prevent and mitigate these issues, ethicists have suggested for decades that individuals should complete documents such as advanced directives like living wills (legal documents that indicate one’s wishes for interventions like intubation and cardiopulmonary resuscitation (CPR)), and to name a healthcare proxy (an individual to make decisions on one’s behalf in the event one becomes unable). Such measures tend to make it easier for individuals to address moral dilemmas in practice and to determine the ethically appropriate surrogate decision maker for a patient.

According to a recent study published in Health Affairs, few Americans have taken either of these measures. Researchers compiled results from over 150 studies of end-of-life planning measures and determined that only 36.7 percent of those surveyed had completed some sort of advanced directive, with 29.3 percent of those individuals completing living wills and 33 percent empowering a healthcare proxy. The study also found that 42 percent of individuals aged 65 or older had completed some sort of advanced directive, as opposed to 32 percent of individuals younger than 65.

There are several reasons why individuals may be hesitant to complete healthcare proxies. Many young people may feel they can put off decisions about care at the end of their lives because such matters are comparatively unlikely to occur in the short term.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Texas Senate Passes Bill Limiting When Clinicians May Write DNR Orders

Senator Perry

This week, the Texas Senate passed S.B. 11. This bill adds a new section 166.012 to the Health and Safety Code that specifies new procedures and requirements for do-not-resuscitate orders.

In short, the bill permits DNR orders to…

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Texas Senate Passes Bill Limiting When Clinicians May Write DNR Orders

Senator Perry

This week, the Texas Senate passed S.B. 11. This bill adds a new section 166.012 to the Health and Safety Code that specifies new procedures and requirements for do-not-resuscitate orders.

In short, the bill permits DNR orders to…

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Texas Legislature Special Session Tackles DNR Orders and Medical Futility

The Texas Legislature is holding a special session that starts today. The session, which follows a five-month regular session that concluded May 29, can last no more than 30 days.


One of the agenda items is “strengthening patient protections relating to do-not-resuscitate orders.”  Already four bills have been introduced.


HB 152, like many bills over the past decade, would amend TADA by eliminating the 10 day transfer period. The amendment would require continued treatment until transfer.


The other three bills are identical. Among other things, HB 12, HB 43, and SB 11 would require patient or surrogate consent for DNR orders unless all three of the following are satisfied:

  1. It is not contrary to the directions of a patient who was competent at the time the patient conveyed the directions.
  2. The patient ’s death is imminent, regardless of the provision of cardiopulmonary resuscitation.
  3. The DNR order is medically appropriate.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Texas Special Legislative Session to Narrow DNR Orders

Last week, Texas Governor Greg Abbott announced a legislative special session that will begin on July 18th, 2017.


Among the items included on the special session call is “strengthening patient protections relating to do-not-resuscitate orders.” This is presumably a reference to H.B. 2063 supported by Texas Right to Life.  

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Kansas Enacts Simon’s Law Forbidding DNR Orders without Consent

Kansas has now joined Idaho, Minnesota, New York, Oklahoma, and Ontario as a “red light” (or partial “red light”) state.  On Friday, Governor Brownback signed Simon’s Law (S.B. 85).


Effective July 1, 2017, Simon’s Law forbids clinicians from writing a DNR for a minor without parental consent.  I will present a complete analysis of the implications next Friday in Kansas City.  

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Supreme Court of California Allows Strong Rebuke of Government Interference with Advance Directives

Dick Magney

At the end of January 2017, the Supreme Court of California refused a request from Humboldt County to “depublish” a Court of Appeal opinion excoriating the County for unjustifiably interfering with a patient’s advance directive (No. S239048).


On the basis of an “appallingly inadequate evidentiary showing” of caregiver neglect Humboldt County misled a trial court and got a trial court to grant its petition to override Dick Magney’s advance directive and remove his wife as healthcare agent. For weeks, the County directed treatment that Magney never wanted.  (More at North Coast Journal)


In a lengthy published opinion, the Court of Appeal chastised the County for losing “sight of the fact that the Health Care Decisions Law does not provide a forum to debate the wisdom of a particular individual’s health care choices.” Absent a showing an advance directive is invalid or terminated, its instructions “are controlling.”


For more on “unwanted medical treatment,” see my “Legal Briefing: New Penalties for Disregarding Advance Directives and DNR Orders” coming soon in 28(1) Journal of Clinical Ethics.  And see my comprehensive review here.    

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Minnesota Will Require Schools to Honor DNR Orders

Scarlet Wagner

Minnesota legislators have just introduced bills requiring schools to honor students’ Do Not Resuscitate, Do Not Intubate, and Allow Natural Death orders.

“In the event of a medical emergency involving a student with a DNR-DNI-A…

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.