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Ethics & Laws

New York’s laws about advance care planning and end-of-life decisions are based on the nationally recommended ethical framework for these decisions, as surveyed and reported by New York’s Task Force on Life and the Law. New York’s Task Force on Life and the Law has provided guidance on many legal and ethical issues in healthcare since 1985. Over the decades the membership on the Task Force has changed, but its purpose – to give advice to New York’s government on cutting edge legal and ethical issues in healthcare – has remained the same. The Task Force members are primarily not government employees; they’re experts in the fields of law, medicine, and bioethics. Their recommendations have been put into many laws affecting healthcare in New York, including end-of-life care.

Laws

Current laws pertinent to advance care planning and end-of-life care include (in order of passage):

DNR Law

1987 DNR Law – New York State created Public Health Law 29-CCC, the first non-hospital DNR law in the country. This law was the result of a Task Force report titled Do Not Resuscitate Orders.

Health Care Proxy Law

1990 Health Care Proxy Law – New York State created Public Health Law Article 29-C so that all New Yorkers may appoint a health care agent if they have the capacity to do so. This law was the result of a Task Force report titled Life-Sustaining Treatment: Making Decisions and Appointing a Health Care Agent.

Surrogate’s Court Procedure Act 1750-b

2006 Surrogate’s Court Procedure Act Article 17-A, sub-section 1750-b – The SCPA was updated to allow end-of-life decisions to be made for individuals with significant intellectual or developmental disabilities. The law defines the list of surrogates for individuals with intellectual or developmental disabilities who do not have capacity to make their own medical decisions and who also cannot complete a health care proxy.

MOLST

2008 – New York State Public Health Law was amended to allow the Commissioner of NYSDOH to approve an alternate form (MOLST) to be used statewide and in all settings, including non-hospital (community) settings. MOLST is the alternate form approved by the Commissioner of NYSDOH. EMS can now honor DNR and DNI orders on MOLST forms statewide. The MOLST form is the only tool for non-hospital DNI orders in New York State.

Family Health Care Decisions Act

2010 Family Health Care Decisions Act – New York State created Public Health Law Article 29-CC. FHCDA created surrogacy laws in NYS. FHCDA is based on the 1992 Task Force Report, When Others Must Choose. FHCDA initially applied to hospitals and nursing homes only. Checklists 3, 4, 5 the Checklist for Minor Patients and the OPWDD Checklist grew out of FHCDA. In 2011 FHCDA was updated to include hospice. In 2017 FHCDA was updated again to allow “attending nurse practitioners” to act the same as “attending physicians” with regards to the areas of withholding/withdrawing life-sustaining treatment that are governed by FHCDA; these changes will be effective May 28, 2018.

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