HCS HB 182 -- OUTSIDE THE HOSPITAL DO-NOT-RESUSCITATE ACT

This bill establishes the Outside the Hospital Do-not-resuscitate
Act which requires that a copy of a do-not-resuscitate order must
be included as the first page of a patient's medical record.  A
patient or patient's representative and the patient's attending
physician may execute an outside the hospital do-not-resuscitate
order.  The Department of Health and Senior Services must develop
and approve uniform forms and personal identifiers.  The
identifiers must alert any emergency medical technician,
paramedic, first responder, or other health care provider of the
existence of the order for the patient.

The bill specifies that the outside the hospital
do-not-resuscitate order will only be effective when the patient
has not been admitted to or is not being treated within a
hospital.  These orders and protocols will not authorize the
withholding or withdrawal of other medical interventions such as
intravenous fluids, oxygen, or therapies other than
cardiopulmonary resuscitation.  An outside the hospital
do-not-resuscitate order will not be in effect when a patient is
pregnant or when believing in good faith that a patient is
pregnant.

Emergency medical technicians, paramedics, first responders, and
other health care providers are required to comply with an
outside the hospital do-not-resuscitate order or identifier
unless the patient or patient's representative expresses to the
personnel in any manner, before or after the onset of a cardiac
or respiratory arrest, the desire to be resuscitated.  A
physician or a health care facility other than a hospital that is
unwilling or unable to comply with this order must take all
reasonable steps to transfer the patient to another physician or
facility where the order will be followed.

The bill specifies the individuals and entities that are exempt
from civil or criminal liability for withholding or withdrawing
resuscitation pursuant to an order or identifier if the actions
were performed in good faith and without gross negligence.
Anyone who knowingly conceals, cancels, defaces, or obliterates
an order or identifier without the individual's consent or
knowingly falsifies or forges a revocation will be guilty of a
class A misdemeanor.  Anyone who knowingly executes, falsifies,
or forges an order without the individual's consent or knowingly
conceals or withholds the knowledge of a revocation of an order
will be guilty of a class D felony.

Missouri House of Representatives
94th General Assembly, 1st Regular Session
Last Updated July 25, 2007 at 11:18 am