Section 340.1540 Life-Sustaining Treatments

Section 340

Section 340.1540

Life-Sustaining Treatments

a)         Every facility shall respect the residents' right to make

decisions relating to their own medical treatment, including the right to

accept, reject, or limit life-sustaining treatment. Every facility shall

establish a policy concerning the implementation of such rights. Included

within this policy shall be:

1)         implementation of Living Wills or Powers of Attorney for

Health Care in accordance with the Living Will Act (Ill. Rev. Stat. 1991, ch.

110 ½, pars. 701 et seq.) [755 ILCS 35] and the Powers of Attorney for Health

Care Law (Ill. Rev. Stat. 1991, ch. 110 ½, pars. 804-1 et seq.) [755 ILCS

45/Art. IV];

2)

the implementation of physician orders limiting

resuscitation such as those commonly referred to as

"Do-Not-Resuscitate" orders.  This policy may only prescribe the

format, method of documentation and duration of any physician orders limiting

resuscitation.  Any orders under this policy shall be honored by the facility;

(Section 2-104.2 of the Act)

3)         procedures for providing life-sustaining treatments available

to residents at the facility;

4)         procedures detailing staff's responsibility with respect to

the provision of life-sustaining treatment when a resident has chosen to

accept, reject, or limit life-sustaining treatment, or when a resident has failed

or has not yet been given the opportunity to make these choices; and

5)         procedures for educating both direct and indirect care staff

in the application of those specific provisions of the policy for which they

are responsible.

b)         For the purposes of this Section:

1)         "Agent" means a person acting under a Health Care

Power of Attorney in accordance with the Powers of Attorney for Health Care

Law;

2)         "Life-sustaining treatment" means any medical

treatment, procedure, or intervention that, in the judgement of the attending

physician, when applied to a resident, would serve only to prolong the dying

process

For the purposes of this Section:

1)         "Agent" means a person acting under a Health Care

Power of Attorney in accordance with the Powers of Attorney for Health Care

Law;

2)         "Life-sustaining treatment" means any medical

treatment, procedure, or intervention that, in the judgement of the attending

physician, when applied to a resident, would serve only to prolong the dying

process.  Those procedures can include, but are not limited to, cardiopulmonary

resuscitation (CPR), assisted ventilation, renal dialysis, surgical procedures,

blood transfusions, and the administration of drugs, antibiotics, and

artificial nutrition and hydration.  Those procedures do not include performing

the Heimlich maneuver or clearing the airway, as indicated;

3)         "Surrogate" means a surrogate decision maker acting

in accordance with the Health Care Surrogate Act (Ill. Rev. Stat. 1991, ch. 110

½, pars. 851-1 et seq.) [755 ILCS 40].

c)         Within 30 days of admission for new residents, and within one

year of the effective date of this Section for all residents who were admitted

prior to the effective date of this Section, residents, agents, or surrogates

shall be given written information describing the facility's policies required

by this Section and shall be given the opportunity to:

1)         execute a Living Will or Power of Attorney for Health Care in

accordance with State law, if they have not already done so; and/or

2)         decline consent to any or all of the life-sustaining

treatments available at the facility.

d)         Any decision made by a resident, an agent, or a surrogate

pursuant to subsection (c) above must be recorded in the resident's medical

record.  Any subsequent changes or modifications must also be recorded in the

medical record

with State law, if they have not already done so; and/or

2)         decline consent to any or all of the life-sustaining

treatments available at the facility.

d)         Any decision made by a resident, an agent, or a surrogate

pursuant to subsection (c) above must be recorded in the resident's medical

record.  Any subsequent changes or modifications must also be recorded in the

medical record.

e)         The facility shall honor all decisions made by a resident, an

agent, or a surrogate pursuant to subsection (c) above and may not discriminate

in the provision of health care on the basis of such decision or will transfer

care in accordance with the Living Will Act, the Powers of Attorney for Health

Care Law, the Health Care Surrogate Act or the Right of Conscience Act (Ill.

Rev. Stat. 1991, ch. 111 ½, pars. 5301 et seq.) [745 ILCS 70].

f)         The resident, agent, or surrogate may change his or her

decision regarding life-sustaining treatments by notifying the treating

facility of this decision change orally or in writing in accordance with State

law.

g)         The physician shall confirm the resident's choice by writing

appropriate orders in the patient record or will transfer care in accordance

with the Living Will Act, the Powers of Attorney for Health Care Law, the

Health Care Surrogate Act or the Right of Conscience Act.

h)         If no choice is made pursuant to subsection (c) above, and in

the absence of any physician's order to the contrary, then the facility's

policy with respect to the provision of life-sustaining treatment shall control

until and if such a decision is made by the resident, agent, or surrogate in

accordance with the requirements of the Health Care Surrogate Act.