§ 2994-M — Ethics review committees

§ 2994-m. Ethics review committees. 1. Establishment of an ethics\nreview committee, written policy. Each hospital shall establish at least\none ethics review committee or participate in an ethics review committee\nthat serves more than one hospital, and shall adopt a written policy\ngoverning committee functions, composition, and procedure, in accordance\nwith the requirements of this article. A hospital may designate an\nexisting committee, or subcommittee thereof, to carry out the functions\nof the ethics review committee provided the requirements of this section\nare satisfied.\n 2. Functions of the ethics review committee. (a) The ethics review\ncommittee shall consider and respond to any health care matter presented\nto it by a person connected with the case.\n (b) The ethics review committee response to a health care matter may\ninclude:\n (i) providing advice on the ethical aspects of proposed health care;\n (ii) making a recommendation about proposed health care; or\n (iii) providing assistance in resolving disputes about proposed health\ncare.\n (c) Recommendations and advice by the ethics review committee shall be\nadvisory and nonbinding, except as specified in subdivision five of\nsection twenty-nine hundred ninety-four-d of this article and\nsubdivision three of section twenty-nine hundred ninety-four-e of this\narticle.\n 3. Committee membership. The membership of ethics review committees\nmust be interdisciplinary and must include at least five members who\nhave demonstrated an interest in or commitment to patient's rights or to\nthe medical, public health, or social needs of those who are ill. At\nleast three ethics review committee members must be health or social\nservices practitioners, at least one of whom must be a registered nurse\nand one of whom must be a physician, nurse practitioner or physician\nassistant. At least one member must be a person without any governance,\nemployment or contractual relationship with the hospital. In a\nresidential health care facility the facility must offer the residents'\ncouncil of the facility (or of another facility that participates in the\ncommittee) the opportunity to appoint up to two persons to the ethics\nreview committee, none of whom may be a resident of or a family member\nof a resident of such facility, and both of whom shall be persons who\nhave expertise in or a demonstrated commitment to patient rights or to\nthe care and treatment of the elderly or nursing home residents through\nprofessional or community activities, other than activities performed as\na health care provider.\n 4. Procedures for ethics review committee. (a) These procedures are\nrequired only when: (i) the ethics review committee is convened to\nreview a decision by a surrogate to withhold or withdraw life-sustaining\ntreatment for: (A) a patient in a residential health care facility\npursuant to paragraph (b) of subdivision five of section twenty-nine\nhundred ninety-four-d of this article; (B) a patient in a general\nhospital pursuant to paragraph (c) of subdivision five of section\ntwenty-nine hundred ninety-four-d of this article; or (C) an emancipated\nminor patient pursuant to subdivision three of section twenty-nine\nhundred ninety-four-e of this article; or (ii) when a person connected\nwith the case requests the ethics review committee to provide assistance\nin resolving a dispute about proposed care. Nothing in this section\nshall bar health care providers from first striving to resolve disputes\nthrough less formal means, including the informal solicitation of\nethical advice from any source.\n (b)(i) A person connected with the case may not participate as an\nethics review committee member in the consideration of that case.\n (ii) The ethics review committee shall respond promptly, as required\nby the circumstances, to any request for assistance in resolving a\ndispute or consideration of a decision to withhold or withdraw\nlife-sustaining treatment pursuant to paragraphs (b) and (c) of\nsubdivision five of section twenty-nine hundred ninety-four-d of this\narticle made by a person connected with the case. The committee shall\npermit persons connected with the case to present their views to the\ncommittee, and to have the option of being accompanied by an advisor\nwhen participating in a committee meeting.\n (iii) The ethics review committee shall promptly provide the patient,\nwhere there is any indication of the patient's ability to comprehend the\ninformation, the surrogate, other persons on the surrogate list directly\ninvolved in the decision or dispute regarding the patient's care, any\nparent or guardian of a minor patient directly involved in the decision\nor dispute regarding the minor patient's care, an attending\npractitioner, the hospital, and other persons the committee deems\nappropriate, with the following:\n (A) notice of any pending case consideration concerning the patient,\nincluding, for patients, persons on the surrogate list, parents and\nguardians, information about the ethics review committee's procedures,\ncomposition and function; and\n (B) the committee's response to the case, including a written\nstatement of the reasons for approving or disapproving the withholding\nor withdrawal of life-sustaining treatment for decisions considered\npursuant to subparagraph (ii) of paragraph (a) of subdivision five of\nsection twenty-nine hundred ninety-four-d of this article. The\ncommittee's response to the case shall be included in the patient's\nmedical record.\n (iv) Following ethics review committee consideration of a case\nconcerning the withdrawal or withholding of life-sustaining treatment,\ntreatment shall not be withdrawn or withheld until the hospital makes\ndiligent efforts to inform the persons identified in subparagraph (iii)\nof this paragraph have been informed of the committee's response to the\ncase and documents the diligent efforts in the patient's medical record.\n (c) When an ethics review committee is convened to review decisions\nregarding hospice care for a patient in a general hospital or\nresidential health care facility, the responsibilities of this section\nshall be carried out by the ethics review committee of the general\nhospital or residential health care facility, provided that such\ncommittee shall invite a representative from hospice to participate.\n 5. Access to medical records and information; patient confidentiality.\nEthics review committee members and consultants shall have access to\nmedical information and medical records necessary to perform their\nfunction under this article. Any such information or records disclosed\nto committee members, consultants, or others shall be kept confidential\nexcept to the extent necessary to accomplish the purposes of this\narticle or as otherwise provided by law.\n 6. Ethics review committee confidentiality. Notwithstanding any other\nprovisions of law, the proceedings and records of an ethics review\ncommittee shall be kept confidential and shall not be released by\ncommittee members, committee consultants, or other persons privy to such\nproceedings and records; the proceedings and records of an ethics review\ncommittee shall not be subject to disclosure or inspection in any\nmanner, including under article six of the public officers law or\narticle thirty-one of the civil practice law and rules; and, no person\nshall testify as to the proceedings or records of an ethics review\ncommittee, nor shall such proceedings and records otherwise be\nadmissible as evidence in any action or proceeding of any kind in any\ncourt or before any other tribunal, board, agency or person, except\nthat:\n (a) Ethics review committee proceedings and records, in cases where a\ncommittee approves or disapproves of the withholding or withdrawal of\nlife-sustaining treatment pursuant to subdivision five of section\ntwenty-nine hundred ninety-four-d of this article, or subdivision three\nof section twenty-nine hundred ninety-four-e of this article, may be\nobtained by or released to the department;\n (b) Nothing in this subdivision shall prohibit the patient, the\nsurrogate, other persons on the surrogate list, or a parent or guardian\nof a minor patient from voluntarily disclosing, releasing or testifying\nabout committee proceedings or records; and\n (c) Nothing in this subdivision shall prohibit the justice center for\nthe protection of people with special needs or any agency or person\nwithin or under contract with the justice center which provides\nprotection and advocacy services from requiring any information, report\nor record from a hospital in accordance with the provisions of section\nfive hundred fifty-eight of the executive law.\n