Section § 4780

Explanation

This California statute explains what a "request regarding resuscitative measures" is, which includes documents like a prehospital ‘do not resuscitate’ (DNR) form or a Physician Orders for Life Sustaining Treatment (POLST) form. These requests guide healthcare providers on how to proceed with resuscitation efforts. They differ from advance health care directives and must be signed by the individual or their legally recognized health care decisionmaker, and their doctor.

If a person cannot make their own decisions, a legal decisionmaker can fill out a POLST form on their behalf. This form must reflect the patient's preferences and is filled out with the assistance of a healthcare provider. Importantly, patients can revoke the POLST form at any time if they have the capacity to do so. Additionally, a medallion with DNR information is also recognized as a valid form of request.

(a)CA Probate Code § 4780(a) As used in this part:
(1)CA Probate Code § 4780(a)(1) “Request regarding resuscitative measures” means a written document, signed by (A) an individual with capacity, or a legally recognized health care decisionmaker, and (B) the individual’s physician, that directs a health care provider regarding resuscitative measures. A request regarding resuscitative measures is not an advance health care directive.
(2)CA Probate Code § 4780(a)(2) “Request regarding resuscitative measures” includes one, or both of, the following:
(A)CA Probate Code § 4780(a)(2)(A) A prehospital “do not resuscitate” form as developed by the Emergency Medical Services Authority or other substantially similar form.
(B)CA Probate Code § 4780(a)(2)(B) A Physician Orders for Life Sustaining Treatment form, as approved by the Emergency Medical Services Authority.
(3)CA Probate Code § 4780(a)(3) “Physician Orders for Life Sustaining Treatment form” means a request regarding resuscitative measures that directs a health care provider regarding resuscitative and life-sustaining measures.
(b)CA Probate Code § 4780(b) A legally recognized health care decisionmaker may execute the Physician Orders for Life Sustaining Treatment form only if the individual lacks capacity, or the individual has designated that the decisionmaker’s authority is effective pursuant to Section 4682.
(c)CA Probate Code § 4780(c) The Physician Orders for Life Sustaining Treatment form and medical intervention and procedures offered by the form shall be explained by a health care provider, as defined in Section 4621. The form shall be completed by a health care provider based on patient preferences and medical indications, and signed by a physician, or a nurse practitioner or a physician assistant acting under the supervision of the physician and within the scope of practice authorized by law, and the patient or his or her legally recognized health care decisionmaker. The health care provider, during the process of completing the Physician Orders for Life Sustaining Treatment form, should inform the patient about the difference between an advance health care directive and the Physician Orders for Life Sustaining Treatment form.
(d)CA Probate Code § 4780(d) An individual having capacity may revoke a Physician Orders for Life Sustaining Treatment form at any time and in any manner that communicates an intent to revoke, consistent with Section 4695.
(e)CA Probate Code § 4780(e) A request regarding resuscitative measures may also be evidenced by a medallion engraved with the words “do not resuscitate” or the letters “DNR,” a patient identification number, and a 24-hour toll-free telephone number, issued by a person pursuant to an agreement with the Emergency Medical Services Authority.

Section § 4781

Explanation

This law section defines who counts as a “health care provider” for legal purposes. It includes individuals specified in another law, Section 4621, and emergency response employees like firefighters, police officers, EMTs, paramedics, and members of organized volunteer groups. These individuals must be trained according to certain regulations to qualify as health care providers.

As used in this part, “health care provider” includes, but is not limited to, the following:
(a)CA Probate Code § 4781(a) Persons described in Section 4621.
(b)CA Probate Code § 4781(b) Emergency response employees, including, but not limited to, firefighters, law enforcement officers, emergency medical technicians I and II, paramedics, and employees and volunteer members of legally organized and recognized volunteer organizations, who are trained in accordance with standards adopted as regulations by the Emergency Medical Services Authority pursuant to Sections 1797.170, 1797.171, 1797.172, 1797.182, and 1797.183 of the Health and Safety Code to respond to medical emergencies in the course of performing their volunteer or employee duties with the organization.

Section § 4781.2

Explanation

This law explains how health care providers should follow a POLST (Physician Orders for Life Sustaining Treatment) form. Health care providers must follow this unless it leads to care that is ineffective or against accepted medical standards. Doctors can evaluate a patient's condition and possibly update the orders in consultation with the patient or their legal decisionmaker. If a patient lacks the ability to make their own decisions, their legal decisionmaker must discuss changes with the current treating doctor before altering the POLST form. Patients who can make their own decisions can ask for different treatments at any time.

(a)CA Probate Code § 4781.2(a) A health care provider shall treat an individual in accordance with a Physician Orders for Life Sustaining Treatment form.
(b)CA Probate Code § 4781.2(b) Subdivision (a) does not apply if the Physician Orders for Life Sustaining Treatment form requires medically ineffective health care or health care contrary to generally accepted health care standards applicable to the health care provider or institution.
(c)CA Probate Code § 4781.2(c) A physician may conduct an evaluation of the individual and, if possible, in consultation with the individual, or the individual’s legally recognized health care decisionmaker, issue a new order consistent with the most current information available about the individual’s health status and goals of care.
(d)CA Probate Code § 4781.2(d) The legally recognized health care decisionmaker of an individual without capacity shall consult with the physician who is, at that time, the individual’s treating physician prior to making a request to modify that individual’s Physician Orders for Life Sustaining Treatment form.
(e)CA Probate Code § 4781.2(e) An individual with capacity may, at any time, request alternative treatment to that treatment that was ordered on the form.

Section § 4781.4

Explanation

If a person's wishes about resuscitation conflict with their own prior health care directions, the most recent set of instructions or orders will be followed.

If the orders in an individual’s request regarding resuscitative measures directly conflict with his or her individual health care instruction, as defined in Section 4623, then, to the extent of the conflict, the most recent order or instruction is effective.

Section § 4781.5

Explanation

This law states that the person who is legally authorized to make health care decisions for someone else must follow the guidelines set out in Sections 4684 and 4714 when doing so.

The legally recognized health care decisionmaker shall make health care decisions pursuant to this part in accordance with Sections 4684 and 4714.

Section § 4782

Explanation

If a healthcare provider follows a request about resuscitation, they won't face legal trouble as long as they honestly think they're acting correctly and don't know if the patient would've chosen differently if they could decide for themselves.

A health care provider who honors a request regarding resuscitative measures is not subject to criminal prosecution, civil liability, discipline for unprofessional conduct, administrative sanction, or any other sanction, as a result of his or her reliance on the request, if the health care provider (a) believes in good faith that the action or decision is consistent with this part, and (b) has no knowledge that the action or decision would be inconsistent with a health care decision that the individual signing the request would have made on his or her own behalf under like circumstances.

Section § 4783

Explanation

This California statute states that any forms created after January 1, 1995, for making decisions about resuscitative measures, such as CPR, must include a section confirming that the form aligns with the person's wishes and best interests. The form is considered valid if it is signed by either the person or their authorized health care decision-maker, as well as a doctor, if it provides directions to health care providers about resuscitative treatments, and if it meets all other requirements outlined in this section.

(a)CA Probate Code § 4783(a) Forms for requests regarding resuscitative measures printed after January 1, 1995, shall contain the following:
“By signing this form, the legally recognized health care decisionmaker acknowledges that this request regarding resuscitative measures is consistent with the known desires of, and with the best interest of, the individual who is the subject of the form.”
(b)CA Probate Code § 4783(b) A printed form substantially similar to that described in subparagraph (A) of paragraph (2) of subdivision (a) of Section 4780 is valid and enforceable if all of the following conditions are met:
(1)CA Probate Code § 4783(b)(1) The form is signed by the individual, or the individual’s legally recognized health care decisionmaker, and a physician.
(2)CA Probate Code § 4783(b)(2) The form directs health care providers regarding resuscitative measures.
(3)CA Probate Code § 4783(b)(3) The form contains all other information required by this section.

Section § 4784

Explanation

This law says that if a health care provider doesn't have any reason to think otherwise, they can assume that instructions about resuscitation, like whether to perform CPR, are still valid and haven't been canceled.

In the absence of knowledge to the contrary, a health care provider may presume that a request regarding resuscitative measures is valid and unrevoked.

Section § 4785

Explanation

This law states that the rules about resuscitation preferences apply no matter where a person is, whether inside a hospital or somewhere else.

This part applies regardless of whether the individual executing a request regarding resuscitative measures is within or outside a hospital or other health care institution.

Section § 4786

Explanation

This law makes it clear that any guidelines or rules it introduces do not change or reduce existing laws about making health care decisions.

This part does not repeal or narrow laws relating to health care decisionmaking.