Compassion & Choices of New York has helped establish a a major patient’s rights victory with the signing of the Palliative Care Information Act. We initiated the bill, with extensive help from national Compassion & Choices, and got the chairs of the health committees to sponsor it. We were also largely responsible for it being signed by Governor Paterson by presenting numerous studies, including very recent ones, right up until the day he signed the bill, that demonstrated the need for the it. The law requires that when a physician makes a terminal diagnosis, patients must be offered information and counseling on their palliative care and end-of-life options. They must be informed of the prognosis, risks and benefits of the various options. Although patients now have a right generally to receive this information, too many physicians do not provide it at the end of life, thus depriving patients of their right to make informed decisions about their care and treatment. This law will result in better end-of-life care, greater respect for patient’s wishes and more and earlier referrals to hospice.

The bill that was signed into law and a news release from Assemblyman Gottfried, chair of the Assembly Health Committee, are below. This is landmark legislation which will serve as a model for the nation.



STATE OF NEW YORK
________________________________________________________________________

S.4498 A.7617

2009-2010 Regular Sessions



IN SENATE

April 24, 2009
___________

Introduced by Sen. DUANE -- read twice and ordered printed, and when printed to be committed to the Committee on Health

AN ACT to amend the public health law, in relation to a patient's right to palliative care information

The People of the State of New York, represented in Senate and Assembly, do enact as follows:

Section 1. The public health law is amended by adding a new section
2997-c to read as follows:

§ 2997-c. Palliative care patient information. 1. Definitions. As used in this section, the following terms shall have the following meanings, unless the context clearly requires otherwise:

(a) "Appropriate" means consistent with applicable legal, health and professional standards; the patient's clinical and other circumstances; and the patient's reasonably known wishes and beliefs.
(b) "Attending health care practitioner" means a physician or nurse practitioner who has primary responsibility for the care and treatment of the patient. Where more than one physician or nurse practitioner share that responsibility, each of them has responsibility under this section, unless they agree to assign that responsibility to one of them.
(c) "Palliative care" means health care treatment, including interdisciplinary end-of-life care, and consultation with patients and family members, to prevent or relieve pain and suffering and to enhance the patient's quality of life, including hospice care under article forty of
this chapter.
(d) "Terminal illness or condition" means an illness or condition which can reasonably be expected to cause death within six months, whether or not treatment is provided.
2. If a patient is diagnosed with a terminal illness or condition, the patient's attending health care practitioner shall offer to provide the patient with information and counseling regarding palliative care and end-of-life options appropriate to the patient, including but not limited to: the range of options appropriate to the patient; the prognosis, risks and benefits of the various options; and the patient's legal rights to comprehensive pain and symptom management at the end of life. The information and counseling may be provided orally or in writing. Where the patient lacks capacity to reasonably understand and make informed choices relating to palliative care, the attending health care practitioner shall provide information and counseling under this section to a person with authority to make health care decisions for the patient. The attending health care practitioner may arrange for information and counseling under this section to be provided by another professionally qualified individual.
3. Where the attending health care practitioner is not willing to provide the patient with information and counseling under this section, he or she shall arrange for another physician or nurse practitioner to do so, or shall refer or transfer the patient to another physician or nurse practitioner willing to do so.
§ 2. Paragraph (f) of subdivision 1 of section 207 of the public health law, as added by chapter 573 of the laws of 2008, is relettered paragraph (g) and a new paragraph (h) is added to read as follows:
(h) Palliative care options for patients with a terminal illness or condition.
§ 3. The department of health shall consult with the New York state palliative care education and training council, as established in subdivision 6 of section 2807-n of the public health law, in developing educational documents and rules and regulations related to this act.
§ 4. This act shall take effect immediately, provided that section one of this act shall take effect one hundred eighty days after it shall have become a law.


NEWS FROM
Assembly Health Committee Chair
Richard N. Gottfried
822 Legislative Office Building, Albany, NY 12248 - Tel: 518-455-4941
250 Broadway, #2232, New York, NY 10007 - Tel: 212-312-1492
GottfrR@assembly.state.ny.us
Contact:
For Immediate Release:
Ryan Streeter 518-455-4941 Monday, August 16, 2010
_StreeterR@assembly.state.ny.us_ (mailto:StreeterR@assembly.state.ny.us

End-of-Life Counseling Bill Signed by Governor

Physicians treating patients diagnosed with a terminal illness or condition will be required to offer the patient information about options for end-of-life care including hospice, aggressive pain management, palliative sedation, and other palliative care, under a bill signed into law by Governor David A. Paterson.

"So many patients go through their last days or weeks of life without knowing, understanding, or thinking through their care options," said Assembly Health Committee chair Richard N. Gottfried, sponsor of the bill. "Some patients want aggressive care to the end, and some would prefer other options such as hospice care. But without information, patients and their families cannot make informed thoughtful choices."

"For over a century, New York law has recognized the fundamental concept of 'informed consent' by patients. This new law builds on that. Many physicians find these issues very difficult to raise with patients, or they may be consciously or unconsciously guided by their own
preferences or fears," Gottfried said. "Ordinarily, the law shouldn't tell doctors how to relate to their patients. But sometimes we have to help overcome obstacles to good practice."

The new law requires physicians and nurse practitioners caring for patients diagnosed with a terminal illness to offer information and counseling on the available options for palliative and end-of-life care. The physician or nurse practitioner may do this personally or by referral to another physician or nurse practitioner. Information or counseling would not have to be
provided to a patient who does not want it. Where a patient lacks capacity to understand and make informed choices, the information and counseling shall be offered to the appropriate surrogate, such as a health care agent designated by the patient in a signed health care proxy or a family member under the recently-enacted Family Health Care Decisions Act.

"Dignity at the end of life is a gift not only to the dying, but also to their loved ones. For the family, those final memories are often among the most poignant and enduring," Gottfried said. "Dying patients and their families should have information and counseling available that includes a full range of information about end of life care options including hospice care, aggressive pain management, and palliative sedation. The patient is then empowered to control his or her own health care decisions with full information."

The bill, A. 7617/S. 4498, was sponsored in the Assembly by Mr. Gottfried and in the Senate by Senate Health Committee chair Thomas K. Duane.