Governor Paterson Signs Family Health Care Decisions Act into Law

ALBANY, NY (03/16/2010)(readMedia)-- Governor David A. Paterson today signed the Family Health Care Decisions Act (FHCDA) into law. The FHCDA allows family members to make health care decisions, including decisions about the withholding or withdrawal of life-sustaining treatment, on behalf of patients who lose their ability to make such decisions and have not prepared advance directives regarding their wishes.

"I could not be more pleased to sign this bill into law today as it will help ensure patients receive medical care more quickly and will help avoid unnecessary suffering," Governor Paterson said. "After nearly two decades of negotiations, New Yorkers now have the right to make health care decisions on behalf of family members who cannot direct their own care."

"I applaud the legislative leaders, particularly Assemblyman Richard Gottfried, Senator Thomas Duane and Senator Kemp Hannon who worked with my office to make today a reality. I also thank the advocacy groups who supported and fought for this Legislation," the Governor added.

Assemblyman Richard N. Gottfried, Chair of the Assembly Health Committee, said: "It has taken 17 years of tortuous struggle to get to this day. Now, families will be able to make medical decisions for loved ones who don't have the ability to do so. Patients will no longer be denied appropriate treatment, subjected to burdensome treatments, or have their wishes, values, or religious beliefs violated. Thanks to Governor Paterson, Senate Health Chair Thomas Duane, and Senator Kemp Hannon for their work in helping make this possible."

Senator Thomas K. Duane, Chair of the Senate Health Committee, said: "The FHCDA will give New Yorkers peace of mind by allowing all parents, all guardians, all partners and all families the ability to make important medical decisions. This law establishes a standard of care for incapacitated persons which has been long overdue. FHCDA is yet another progressive piece of legislation that Governor Paterson has signed into law and he deserves our thanks for his leadership."

The legislation establishes a protocol for health care practitioners to determine whether a patient in a general hospital or nursing home has decision-making capacity. When it is determined that a patient does not have decision-making capacity, the legislation requires the selection of a surrogate from a list of individuals ranked in order of priority, including family members, domestic partners and close friends. Various safeguards are required under the FHCDA to prevent inappropriate decisions, including procedures for a patient, family member or physician to assert objections to the selection of a particular person as a surrogate or to a decision made by a surrogate.

Without a statute such as the FHCDA, the common law of New York State provides that life-sustaining treatment cannot be withdrawn or withheld from an individual who has lost the capacity to make such decisions, unless clear and convincing evidence can be produced to show that the individual would have declined treatment if competent. An advance directive, such as a living will or a health care proxy, can serve as clear and convincing evidence of a patient's wishes, but many people do not prepare such directives while they are competent to do so.

The FHCDA does not apply to individuals without decision-making capacity who have developmental disabilities or who reside in mental health facilities, if health care decisions for these individuals can be made under other laws or regulations. For example, decisions about life-sustaining treatment are authorized under the previously enacted Health Care Decisions Act for persons with developmental disabilities. The FHCDA requires establishment of a special advisory committee to guide the Task Force in careful consideration of whether decision-making for these individuals should be incorporated into the FHCDA.

Even with the passage of the FHCDA, New Yorkers are still encouraged to prepare a health care proxy, which allows an agent to make health care decisions on behalf of an individual if he or she later loses capacity. The proxy form can be tailored to give the agent as much or as little authority as the individual desires, and the agent must make decisions in accordance with the principal's wishes or, if such wishes are not known, in accordance with the principal's best interests. The proxy is able, but not required, to permit decision-making authority regarding life-sustaining treatment. If the principal's wishes regarding the administration of artificial nutrition and hydration are not known, the agent may not make decisions regarding such measures.

The health care proxy form authorized by the Public Health Law and instructions on completing the form are available on the Department of Health's website at: http://www.health.state.ny.us/professionals/patients/health_care_proxy/intro.htm.

###

The following statements were provided in support of the Family Health Care Decisions Act:

Senator Kemp Hannon said: "The passage of the Family Health Care Decision Act is a critical step to ensuring the least suffering for patients and their family members. I support the overarching goals of this significant legislation including, but not limited to, clarifying that decisions regarding life-sustaining treatment are part of the natural continuum of all health care decisions, allowing decisions to end life-sustaining treatment only where the need is clearest, utilizing existing legal standards wherever possible, and maintaining judicial oversight of close decisions. Palliative care and hospice are a part of modern heath care and the Family Health Care Decisions Act will assist in that care; setting forth in law what has been largely an informal process, until now."

State Health Commissioner Richard F. Daines, M.D., said: "Physicians around the State thank Governor Paterson and the Legislature for this bill. We now will be able to work more closely with patients and their families during these difficult times. Doctors, nurses and other medical professionals will welcome the chance to discuss patients' wishes and values with their loved ones."

Daniel Sisto, President of the Healthcare Association of New York State (HANYS), said: "Lost in the gaps of existing law, many families have witnessed what they knew to be the ardent desires of their incapacitated loved ones go unfulfilled for weeks and months, while every participant-from the patient, to family members, to the professionals providing care-has anguished. At the same time, families have been frozen by the lack of legal means to honor the deeply personal wishes of their loved ones. HANYS commends the Governor and the Legislature for providing family members with the legal authority to make health care treatment decisions when their loved ones are incapacitated and have no health care proxy. This legislation is long overdue in helping to resolve these extraordinarily sensitive and personal decisions."

Kenneth E. Raske, President of the Greater New York Hospital Association, said: "With Governor David A. Paterson signing the Family Health Care Decisions Act into law, hospitals in New York will be able to work more closely than ever with patients and their families in providing quality care that is consistent with patients' wishes and personal values. After 17 years of coming up short, we are thrilled that New Yorkers can finally make treatment decisions for incapacitated loved ones."

Barbara Shack, Chair of the Steering Committee of the Family Decisions Coalition and Member of the New York State Task Force on Life and the Law, said: "By signing the Family Health Care Decisions Act into law today, Governor Paterson is giving countless families across the state peace of mind at an otherwise difficult time in their lives. We are grateful to the Governor, Senator Duane, Assemblyman Gottfried and the many advocates who worked to make this day a reality after 17 years."

Beth E. Roxland, J.D., M.Bioethics, Executive Director of the New York State Task Force on Life and the Law, said: "The passage of the Family Health Care Decisions Act represents the consummation of intensive efforts over the past 17 years by patient advocates, clinicians and family members to improve decision-making and care for patients without capacity across the State of New York. This Act is based on recommendations made by the New York State Task Force on Life and the Law – a multi-disciplinary commission convened to develop public policy on issues arising at the interface of medicine, ethics and law – in its 1992 report 'When Others Must Choose: Deciding for Patients Without Capacity.' Enactment of this historic legislation is a wonderful achievement for patients who lack a health care proxy and the ability to make their own health care decisions."

Robert J. Murphy, Executive Vice President of Government Affairs for the New York State Health Facilities Association, said: "The New York State Health Facilities Association is most appreciative to the Legislature and the Governor for recognizing the need for and importance of this truly patient oriented initiative."

David Hannan, M.D., President of the Medical Society of the State of New York, said: "We are pleased after so many years of effort we have enacted this legislation which is of such critical importance to all New Yorkers. This legislation will assure that critical decisions about life-sustaining treatment are made in the context of family or other personal relationships. We congratulate Governor David Paterson, Senator Thomas Duane and Assemblymember Richard Gottfried for their tireless work in achieving this goal."

Tina Gerardi, CEO of the New York State Nurses Association, said: "This law will extend protections to patients and allow nurses to deliver care in a manner consistent with the patient's wishes and beliefs. The nursing community cannot ask for more than that. We applaud the Governor for signing this long-awaited bill into law."

Donna Lieberman, Executive Director of the New York Civil Liberties Union, said: "The Family Health Care Decisions Act provides a more rational and humane approach to providing medical care when a loved one becomes incapacitated. This important law empowers families and protects the right of all New Yorkers to make the health care decisions they want."

Dennis Bozzi, President and CEO of the New York Association of Homes & Services for the Aging, said: "Many nursing home residents have neither a living will nor a health care proxy, leaving providers and families with no other option but the courts for treatment decisions. Our courts are reluctant to make these kinds of decisions and often cannot respond quickly, leaving the patient and loved ones in a painful limbo. The Family Health Care Decision Act will provide a far more humane process and a sensitivity to the moral values and religious beliefs of residents and their families."

M. Tracey Brooks, President and CEO of Family Planning Advocates of New York State, said: "As an organization whose focus is on making sure families and loved ones have the information they need to make important health care decisions and choices, we commend the passage of this common sense bill and the leadership of Governor Paterson, Assemblyman Dick Gottfried and Senator Tom Duane in making it a health care reality in New York State."

Arthur A. Levin, MPH, Director of the Center for Medical Consumers, said: "The passage and signing of the Family Health Care Decisions Act is an important victory for all New Yorkers who now need not worry what might happen should they become unable to make medical decisions for themselves. It is respectful of the beliefs and wishes of individuals and of the desire of those close to them to ensure that loved ones and close friends have the benefit of compassionate, quality care no matter the circumstances. I applaud Governor Paterson for signing into law this important legislation."

Linda A. Lambert, CAE, Executive Director of the New York Chapter of the American College of Physicians, said: "The New York Chapter of the American College of Physicians, representing more than 11,000 physician specialists in Internal Medicine across New York State, thank the members of the Legislature for passing the Family Health Care Decisions Act, and the Governor for signing it so quickly. It has been a long wait to achieve this victory for patients and their families, easing some of the needless burden and suffering for those family members and surrogates who must make painful but necessary decisions about end of life care."

Michael Getnick, President of the New York State Bar Association, said: "The New York State Bar Association has long supported this measure and we applaud our state leaders for their efforts to finally give families the right to make important medical decisions on behalf of their incapacitated loved ones. We commend Governor Paterson for signing the Family Health Care Decision Act into law giving New Yorkers the peace of mind that in times of great anguish, their family members will be treated with dignity in accordance with their wishes."

Kathy A. McMahon, President and CEO of the Hospice and Palliative Care Association of New York State, said: "On behalf of the patients and families served by hospice and palliative care, we are delighted that New York State now has surrogate decision making statute in place. The Family Health Care Decisions Act will make quality hospice and palliative care more accessible to New Yorkers, and we commend the Governor for signing it into law today."

###

Additional news available at www.ny.gov/governor/press | High resolution images available at www.ny.gov/governor/mediaimages | password: paterson | New York State | Executive Chamber | press.office@chamber.state.ny.us | 212.681.4640 | 518.474.8418