N.Y. Public Health Law 2994-M – Ethics review committees
§ 2994-m. Ethics review committees. 1. Establishment of an ethics review committee, written policy. Each hospital shall establish at least one ethics review committee or participate in an ethics review committee that serves more than one hospital, and shall adopt a written policy governing committee functions, composition, and procedure, in accordance with the requirements of this article. A hospital may designate an existing committee, or subcommittee thereof, to carry out the functions of the ethics review committee provided the requirements of this section are satisfied.
Terms Used In N.Y. Public Health Law 2994-M
- Attending practitioner: means a physician, nurse practitioner or physician assistant, selected by or assigned to a patient pursuant to hospital policy, who has primary responsibility for the treatment and care of the patient. See N.Y. Public Health Law 2994-A
- Committee membership: Legislators are assigned to specific committees by their party. Seniority, regional balance, and political philosophy are the most prominent factors in the committee assignment process.
- Contract: A legal written agreement that becomes binding when signed.
- Decisions regarding hospice care: means the decision to enroll or disenroll in hospice, and consent to the hospice plan of care and modifications to that plan. See N.Y. Public Health Law 2994-A
- Emancipated minor patient: means a minor patient who is the parent of a child, or who is sixteen years of age or older and living independently from his or her parents or guardian. See N.Y. Public Health Law 2994-A
- Ethics review committee: means the interdisciplinary committee established in accordance with the requirements of section twenty-nine hundred ninety-four-m of this article. See N.Y. Public Health Law 2994-A
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- General hospital: means a general hospital as defined in subdivision ten of section twenty-eight hundred one of this chapter excluding a ward, wing, unit or other part of a general hospital operated for the purpose of providing services for persons with mental illness pursuant to an operating certificate issued by the commissioner of mental health. See N.Y. Public Health Law 2994-A
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- guardian: means a health care guardian or a legal guardian of the person of a minor. See N.Y. Public Health Law 2994-A
- Health care: means any treatment, service, or procedure to diagnose or treat an individual's physical or mental condition. See N.Y. Public Health Law 2994-A
- Health care provider: means an individual or facility licensed, certified, or otherwise authorized or permitted by law to administer health care in the ordinary course of business or professional practice. See N.Y. Public Health Law 2994-A
- Hospice: means a hospice as defined in article forty of this chapter, without regard to where the hospice care is provided. See N.Y. Public Health Law 2994-A
- Hospital: means a general hospital, a residential health care facility, or hospice. See N.Y. Public Health Law 2994-A
- Life-sustaining treatment: means any medical treatment or procedure without which the patient will die within a relatively short time, as determined by an attending physician to a reasonable degree of medical certainty. See N.Y. Public Health Law 2994-A
- Minor: means any person who is not an adult. See N.Y. Public Health Law 2994-A
- Nurse practitioner: means a nurse practitioner certified pursuant to § 6910 of the education law who is practicing in accordance with subdivision three of § 6902 of the education law. See N.Y. Public Health Law 2994-A
- Patient: means a person admitted to a hospital. See N.Y. Public Health Law 2994-A
- Person connected with the case: means the patient, any person on the surrogate list, a parent or guardian of a minor patient, the hospital administrator, an attending physician, any other health or social services practitioner who is or has been directly involved in the patient's care, and any duly authorized state agency, including the facility director or regional director for a patient transferred from a mental hygiene facility and the facility director for a patient transferred from a correctional facility. See N.Y. Public Health Law 2994-A
- Residential health care facility: means a residential health care facility as defined in subdivision three of section twenty-eight hundred one of this chapter. See N.Y. Public Health Law 2994-A
- Surrogate: means the person selected to make a health care decision on behalf of a patient pursuant to section twenty-nine hundred ninety-four-d of this article. See N.Y. Public Health Law 2994-A
- Surrogate list: means the list set forth in subdivision one of section twenty-nine hundred ninety-four-d of this article. See N.Y. Public Health Law 2994-A
- Testify: Answer questions in court.
2. Functions of the ethics review committee. (a) The ethics review committee shall consider and respond to any health care matter presented to it by a person connected with the case.
(b) The ethics review committee response to a health care matter may include:
(i) providing advice on the ethical aspects of proposed health care;
(ii) making a recommendation about proposed health care; or
(iii) providing assistance in resolving disputes about proposed health care.
(c) Recommendations and advice by the ethics review committee shall be advisory and nonbinding, except as specified in subdivision five of section twenty-nine hundred ninety-four-d of this article and subdivision three of section twenty-nine hundred ninety-four-e of this article.
3. Committee membership. The membership of ethics review committees must be interdisciplinary and must include at least five members who have demonstrated an interest in or commitment to patient's rights or to the medical, public health, or social needs of those who are ill. At least three ethics review committee members must be health or social services practitioners, at least one of whom must be a registered nurse and one of whom must be a physician, nurse practitioner or physician assistant. At least one member must be a person without any governance, employment or contractual relationship with the hospital. In a residential health care facility the facility must offer the residents' council of the facility (or of another facility that participates in the committee) the opportunity to appoint up to two persons to the ethics review committee, none of whom may be a resident of or a family member of a resident of such facility, and both of whom shall be persons who have expertise in or a demonstrated commitment to patient rights or to the care and treatment of the elderly or nursing home residents through professional or community activities, other than activities performed as a health care provider.
4. Procedures for ethics review committee. (a) These procedures are required only when: (i) the ethics review committee is convened to review a decision by a surrogate to withhold or withdraw life-sustaining treatment for: (A) a patient in a residential health care facility pursuant to paragraph (b) of subdivision five of section twenty-nine hundred ninety-four-d of this article; (B) a patient in a general hospital pursuant to paragraph (c) of subdivision five of section twenty-nine hundred ninety-four-d of this article; or (C) an emancipated minor patient pursuant to subdivision three of section twenty-nine hundred ninety-four-e of this article; or (ii) when a person connected with the case requests the ethics review committee to provide assistance in resolving a dispute about proposed care. Nothing in this section shall bar health care providers from first striving to resolve disputes through less formal means, including the informal solicitation of ethical advice from any source.
(b)(i) A person connected with the case may not participate as an ethics review committee member in the consideration of that case.
(ii) The ethics review committee shall respond promptly, as required by the circumstances, to any request for assistance in resolving a dispute or consideration of a decision to withhold or withdraw life-sustaining treatment pursuant to paragraphs (b) and (c) of subdivision five of section twenty-nine hundred ninety-four-d of this article made by a person connected with the case. The committee shall permit persons connected with the case to present their views to the committee, and to have the option of being accompanied by an advisor when participating in a committee meeting.
(iii) The ethics review committee shall promptly provide the patient, where there is any indication of the patient's ability to comprehend the information, the surrogate, other persons on the surrogate list directly involved in the decision or dispute regarding the patient's care, any parent or guardian of a minor patient directly involved in the decision or dispute regarding the minor patient's care, an attending practitioner, the hospital, and other persons the committee deems appropriate, with the following:
(A) notice of any pending case consideration concerning the patient, including, for patients, persons on the surrogate list, parents and guardians, information about the ethics review committee's procedures, composition and function; and
(B) the committee's response to the case, including a written statement of the reasons for approving or disapproving the withholding or withdrawal of life-sustaining treatment for decisions considered pursuant to subparagraph (ii) of paragraph (a) of subdivision five of section twenty-nine hundred ninety-four-d of this article. The committee's response to the case shall be included in the patient's medical record.
(iv) Following ethics review committee consideration of a case concerning the withdrawal or withholding of life-sustaining treatment, treatment shall not be withdrawn or withheld until the persons identified in subparagraph (iii) of this paragraph have been informed of the committee's response to the case.
(c) When an ethics review committee is convened to review decisions regarding hospice care for a patient in a general hospital or residential health care facility, the responsibilities of this section shall be carried out by the ethics review committee of the general hospital or residential health care facility, provided that such committee shall invite a representative from hospice to participate.
5. Access to medical records and information; patient confidentiality. Ethics review committee members and consultants shall have access to medical information and medical records necessary to perform their function under this article. Any such information or records disclosed to committee members, consultants, or others shall be kept confidential except to the extent necessary to accomplish the purposes of this article or as otherwise provided by law.
6. Ethics review committee confidentiality. Notwithstanding any other provisions of law, the proceedings and records of an ethics review committee shall be kept confidential and shall not be released by committee members, committee consultants, or other persons privy to such proceedings and records; the proceedings and records of an ethics review committee shall not be subject to disclosure or inspection in any manner, including under Article 6 of the public officers law or Article 31 of the civil practice law and rules; and, no person shall testify as to the proceedings or records of an ethics review committee, nor shall such proceedings and records otherwise be admissible as evidence in any action or proceeding of any kind in any court or before any other tribunal, board, agency or person, except that:
(a) Ethics review committee proceedings and records, in cases where a committee approves or disapproves of the withholding or withdrawal of life-sustaining treatment pursuant to subdivision five of section twenty-nine hundred ninety-four-d of this article, or subdivision three of section twenty-nine hundred ninety-four-e of this article, may be obtained by or released to the department;
(b) Nothing in this subdivision shall prohibit the patient, the surrogate, other persons on the surrogate list, or a parent or guardian of a minor patient from voluntarily disclosing, releasing or testifying about committee proceedings or records; and
(c) Nothing in this subdivision shall prohibit the justice center for the protection of people with special needs or any agency or person within or under contract with the justice center which provides protection and advocacy services from requiring any information, report or record from a hospital in accordance with the provisions of § 558 of the executive law.