West Virginia Code
1 - STATE PUBLIC HEALTH SYSTEM
1A - UNIFORM CREDENTIALING FOR HEAL
1B - SKILLED NURSING FACILITIES FOR
1C - HEALTH CARE PROVIDER TRANSPARE
2 - LOCAL BOARDS OF HEALTH
2A - ALTERNATIVE METHOD OF ORGANIZI
2B - FAMILY PLANNING AND CHILD SPAC
2C - HOME HEALTH SERVICES
2D - CERTIFICATE OF NEED
2E - BIRTHING CENTERS
2F - PARENTAL NOTIFICATION OF ABORT
2G - SPECIAL SUPPLEMENTARY FOOD PRO
2H - PRIMARY CARE SUPPORT PROGRAM
2I - WOMEN'S RIGHT TO KNOW ACT
2J - PREVENTIVE CARE PILOT PROGRAM
2K - PROGRAMS OF ALL-INCLUSIVE CARE
2L - PROVIDER SPONSORED NETWORKS
2M - THE PAIN-CAPABLE UNBORN CHILD
2N - NEONATAL ABSTINENCE CENTERS
2O - UNBORN CHILD PROTECTION FROM D
3 - PREVENTION AND CONTROL OF COMMU
3A - REPOSITORY OF INFORMATION ON M
3B - PERTUSSIS
3C - AIDS-RELATED MEDICAL TESTING A
3D - TUBERCULOSIS TESTING, CONTROL,
4 - SEXUALLY TRANSMITTED DISEASES
4A - PRENATAL EXAMINATION
4B - AUTOPSIES ON BODIES OF DECEASE
4C - EMERGENCY MEDICAL SERVICES ACT
4D - AUTOMATED EXTERNAL DEFIBRILLAT
4E - UNIFORM MATERNAL SCREENING ACT
4F - EXPEDITED PARTNER THERAPY
5 - VITAL STATISTICS
5A - CANCER CONTROL
5B - HOSPITALS AND SIMILAR INSTITUT
5C - NURSING HOMES
5D - ASSISTED LIVING RESIDENCES
5E - REGISTRATION AND INSPECTION OF
5F - HEALTH CARE FINANCIAL DISCLOSU
5G - OPEN HOSPITAL PROCEEDINGS
5H - CHRONIC PAIN CLINIC LICENSING
5I - HOSPICE LICENSURE ACT
5J - CLINICAL LABORATORIES QUALITY
5K - EARLY INTERVENTION SERVICES FO
5L - LONG-TERM CARE OMBUDSMAN PROGR
5M - OSTEOPOROSIS PREVENTION EDUCAT
5N - RESIDENTIAL CARE COMMUNITIES
5O - MEDICATION ADMINISTRATION BY U
5P - SENIOR SERVICES
5Q - THE JAMES "TIGER" MO
5R - THE ALZHEIMER'S SPECIAL CARE S
5S - OLDER WEST VIRGINIANS ACT
5T - OFFICE OF DRUG CONTROL POLICY
5U - ARTHRITIS PREVENTION EDUCATION
5V - EMERGENCY MEDICAL SERVICES RET
5W - WEST VIRGINIA OFFICIAL PRESCRI
5X - CAREGIVER ADVISE, RECORD AND E
5Y - MEDICATION-ASSISTED TREATMENT
5Z - COALITION FOR DIABETES MANAGEM
6 - HOTELS AND RESTAURANTS
7 - PURE FOOD AND DRUGS
8 - ELECTROLOGISTS
8A - NARCOTIC DRUGS
8B - DANGEROUS DRUGS ACT
9 - OFFENSES GENERALLY
9A - TOBACCO USAGE RESTRICTIONS
9B - IMPLEMENTING TOBACCO MASTER SE
9C - STATE TOBACCO GROWERS' SETTLEM
9D - ENFORCEMENT OF STATUTES IMPLEM
9E - DELIVERY SALES OF TOBACCO
9F - COUNTERFEIT CIGARETTES
10 - UNIFORM DETERMINATION OF DEAT
11 - SEXUAL STERILIZATION
12 - SANITARY DISTRICTS FOR SEWAGE
13 - SEWAGE WORKS AND STORMWATER W
13A - PUBLIC SERVICE DISTRICTS
13B - COMMUNITY IMPROVEMENT ACT
13C - DRINKING WATER TREATMENT REV
13D - REGIONAL WATER AND WASTEWATE
13E - COMMUNITY ENHANCEMENT ACT
14 - BARBERS AND COSMETOLOGISTS
15 - STATE HOUSING LAW
16 - HOUSING COOPERATION LAW
17 - NATIONAL DEFENSE HOUSING
18 - SLUM CLEARANCE
19 - ANATOMICAL GIFT ACT
20 - AIR POLLUTION CONTROL
21 - BLOOD DONATIONS
22 - DETECTION AND CONTROL OF PHEN
22A - TESTING OF NEWBORN INFANTS F
22B - BIRTH SCORE PROGRAM
23 - TRANSFUSION OF BLOOD; TRANSPL
24 - STATE HEMOPHILIA PROGRAM
25 - DETECTION OF TUBERCULOSIS, HI
26 - WEST VIRGINIA SOLID WASTE MAN
27 - STORAGE AND DISPOSAL OF RADIO
27A - BAN ON CONSTRUCTION OF NUCLE
28 - ASSISTANCE TO KOREAN AND VIET
29 - HEALTH CARE RECORDS
29A - WEST VIRGINIA HOSPITAL FINAN
29B - HEALTH CARE AUTHORITY
29C - INDIGENT CARE
29D - STATE HEALTH CARE
29E - LEGISLATIVE OVERSIGHT COMMIS
29F - UNINSURED AND UNDERINSURED P
29G - WEST VIRGINIA HEALTH INFORMA
29H - INTERAGENCY HEALTH COUNCIL
29I - WEST VIRGINIA HEALTH CARE AU
30 - WEST VIRGINIA HEALTH CARE DEC
30A - MEDICAL POWER OF ATTORNEY
30B - HEALTH CARE SURROGATE ACT
30C - DO NOT RESUSCITATE ACT
16 - 30 C- 1
16 - 30 C- 2
16 - 30 C- 3
16 - 30 C- 4
16 - 30 C- 5
16 - 30 C- 6
16 - 30 C- 7
16 - 30 C- 8
16 - 30 C- 9
16 - 30 C- 10
16 - 30 C- 11
16 - 30 C- 12
16 - 30 C- 13
16 - 30 C- 14
16 - 30 C- 15
16 - 30 C- 16
31 - COMMUNITY RIGHT TO KNOW
32 - ASBESTOS ABATEMENT
33 - BREAST AND CERVICAL CANCER PR
34 - LICENSURE OF RADON MITIGATORS
35 - LEAD ABATEMENT
36 - NEEDLESTICK INJURY PREVENTION
37 - BODY PIERCING STUDIO BUSINESS
38 - TATTOO STUDIO BUSINESS
39 - PATIENT SAFETY ACT
40 - STATEWIDE BIRTH DEFECTS INFOR
41 - ORAL HEALTH IMPROVEMENT ACT
42 - COMPREHENSIVE BEHAVIORAL HEAL
43 - ENGINE COOLANT AND ANTIFREEZE
44 - THE PULSE OXIMETRY NEWBORN TE
45 - TANNING FACILITIES
46 - ACCESS TO OPIOID ANTAGONISTS
47 - ALCOHOL AND DRUG OVERDOSE PRE
48 - WEST VIRGINIA ABLE ACT
49 - WEST VIRGINIA CLEARANCE FOR A
50 - EPINEPHRINE AUTO-INJECTOR AVA
51 - RIGHT TO TRY ACT
52 - COALITION FOR RESPONSIBLE PAI
53 - ESTABLISHING ADDITIONAL SUBST
CHAPTER 16. PUBLIC HEALTH.
ARTICLE 30C. DO NOT RESUSCITATE ACT.
The article may be cited as the "Do Not Resuscitate Act."
(a) Findings. -- The Legislature hereby finds that:
(1) Although cardiopulmonary resuscitation has saved the lives of persons experiencing sudden, unexpected death, present medical data indicates that cardiopulmonary resuscitation rarely leads to prolonged survival in persons with chronic illnesses in whom death is expected;
(2) In many circumstances, the performance of cardiopulmonary resuscitation on persons may cause infliction of unwanted and unnecessary pain and suffering;
(3) All persons have a right to make health care decisions including the right to refuse cardiopulmonary resuscitation;
(4) Persons with incapacity have the right to have health care decisions made for them by surrogate decision-makers;
(5) Existing emergency medical services protocols require their personnel to proceed with cardiopulmonary resuscitation when they find a person in a cardiac or respiratory arrest even if such person has completed a living will or medical power of attorney, indicating that he/she does not wish to receive cardiopulmonary resuscitation; and
(6) The administration of cardiopulmonary resuscitation by emergency medical services personnel to persons who have indicated by a living will or medical power of attorney or other means that they do not wish to receive such resuscitation offends the dignity of the person and conflicts with standards of accepted medical practice.
(b) Purpose. -- It is the purpose of this article to ensure that the right of a person to self-determination relating to cardiopulmonary resuscitation is protected. It is the intent of the Legislature by enacting this article to give direction to emergency medical services personnel and other health care providers in regard to the performance of cardiopulmonary resuscitation.
As used in this article, unless the context clearly requires otherwise, the following definitions apply:
(a) "Attending physician" means the physician selected by or assigned to the person who has primary responsibility for treatment or care of the person and who is a licensed physician. If more than one physician shares that responsibility, any of those physicians may act as the attending physician under the provisions of this article.
(b) "Cardiopulmonary resuscitation" means those measures used to restore or support cardiac or respiratory function in the event of a cardiac or respiratory arrest.
(c) "Do-not-resuscitate identification" means a standardized identification necklace, bracelet, card or physician orders for scope of treatment form as set forth in this article that signifies that a do-not-resuscitate order has been issued for the possessor.
(d) "Do-not-resuscitate order" means an order issued by a licensed physician that cardiopulmonary resuscitation should not be administered to a particular person.
(e) "Emergency medical services personnel" means paid or volunteer firefighters, law-enforcement officers, emergency medical technicians, paramedics or other emergency services personnel, providers or entities acting within the usual course of their professions.
(f) "Health care decision" means a decision to give, withhold or withdraw informed consent to any type of health care, including, but not limited to, medical and surgical treatments, including life-prolonging interventions, nursing care, hospitalization, treatment in a nursing home or other extended care facility, home health care and the gift or donation of a body organ or tissue.
(g) "Health care facility" means a facility established to administer and provide health care services and which is commonly known by a wide variety of titles, including, but not limited to, hospitals, medical centers, ambulatory health care facilities, physicians' offices and clinics, extended care facilities operated in connection with hospitals, nursing homes and extended care facilities operated in connection with rehabilitation centers.
(h) "Health care provider" means any physician, dentist, nurse, paramedic, psychologist or other person providing medical, dental, nursing, psychological or other health care services of any kind.
(i) "Home" means any place of residence other than a health care facility and includes residential board and care homes and personal care homes.
(j) "Incapacity" or words of like import means the inability because of physical or mental impairment, to appreciate the nature and implications of a health care decision, to make an informed choice regarding the alternatives presented and to communicate that choice in an unambiguous manner.
(k) "Physician orders for scope of treatment (POST) form" means a standardized form containing orders by a qualified physician that details a person's life-sustaining wishes as provided by section twenty-five, article thirty of this chapter.
(l) "Qualified physician" means a physician licensed to practice medicine who has personally examined the person.
(m) "Representative" means a person designated by a principal to make health care decisions in accordance with article thirty-a of this chapter.
(n) "Surrogate decision maker" or "surrogate" means an individual eighteen years of age or older who is reasonably available, is willing to make health care decisions on behalf of an incapacitated person, possesses the capacity to make health care decisions and is identified or selected by the attending physician or advanced nurse practitioner in accordance with applicable provisions of article thirty of this chapter as the person or persons who is to make decisions pursuant to this article: Provided, That a representative named in the incapacitated person's medical power of attorney, if such document has been completed, shall have priority over a surrogate decision maker.
(o) "Trauma" means blunt or penetrating bodily injuries from impact which occur in situations, including, but not limited to, motor vehicle collisions, mass casualty incidents and industrial accidents.
The provisions of this article apply to all persons regardless of whether or not they have completed a living will or medical power of attorney. For the purposes of direction to emergency medical services personnel, a do not resuscitate order does not apply to treatment rendered at the site where trauma has occurred to persons who experience a cardiac or respiratory arrest as the result of severe trauma.
§16-30C-5. Presumed consent to cardiopulmonary resuscitation; health care facilities not required to expand to provide cardiopulmonary resuscitation.
(a) Every person shall be presumed to consent to the administration of cardiopulmonary resuscitation in the event of cardiac or respiratory arrest, unless one or more of the following conditions, of which the health care provider has actual knowledge, apply:
(1) A do-not-resuscitate order in accordance with the provisions of this article has been issued for that person;
(2) A completed living will for that person is in effect, pursuant to the provisions of article thirty of this chapter, and the person is in a terminal condition or a persistent vegetative state; or
(3) A completed medical power of attorney for that person is in effect, pursuant to the provisions of article thirty of this chapter, in which the person indicated that he or she does not wish to receive cardiopulmonary resuscitation, or his or her representative has determined that the person would not wish to receive cardiopulmonary resuscitation.
(4) A completed physician orders for scope of treatment form in which a qualified physician has ordered do-not-resuscitate.
(b) Nothing in this article shall require a nursing home, personal care home, hospice or extended care facility operated in connection with hospitals to institute or maintain the ability to provide cardiopulmonary resuscitation or to expand its existing equipment, facilities or personnel to provide cardiopulmonary resuscitation: Provided, That if a health care facility does not provide cardiopulmonary resuscitation, this policy shall be communicated in writing to the person, representative or surrogate decision maker prior to admission.
(a) An attending physician may issue a do-not-resuscitate order for persons who are present in or residing at home or in a health care facility if the person, representative or surrogate has consented to the order. A do-not-resuscitate order shall be issued in writing in the form as described in this section for a person not present or residing in a health care facility. For persons present in health care facilities, a do-not-resuscitate order shall be issued in accordance with the policies and procedures of the health care facility or in accordance with the provisions of this article.
(b) Persons may request their physicians to issue do-not-resuscitate orders for them.
(c) The representative or surrogate decision maker may consent to a do-not-resuscitate order for a person with incapacity. A do-not-resuscitate order written by a physician for a person with incapacity with the consent of the representative or surrogate decision maker is valid and shall be respected by health care providers.
(d) A parent may consent to a do-not-resuscitate order for his or her minor child, provided that a second physician who has examined the child concurs with the opinion of the attending physician that the provision of cardiopulmonary resuscitation would be contrary to accepted medical standards. If the minor is between the ages of sixteen and eighteen and, in the opinion of the attending physician, the minor is of sufficient maturity to understand the nature and effect of a do-not-resuscitate order, then no such order shall be valid without the consent of such minor. In the event of a conflict between the wishes of the parents or guardians and the wishes of the mature minor, the wishes of the mature minor shall prevail. For purposes of this section, no minor less than sixteen years of age shall be considered mature. Nothing in this article shall be interpreted to conflict with the provisions of the child abuse prevention and treatment act and implementing regulations at 45 CFR 1340. In the event conflict is unavoidable, federal law and regulation shall govern.
(e) If a surrogate decision maker is not reasonably available or capable of making a decision regarding a do-not-resuscitate order, an attending physician may issue a do-not-resuscitate order for a person with incapacity in a health care facility: Provided, That a second physician who has personally examined the person concurs in the opinion of the attending physician that the provision of cardiopulmonary resuscitation would be contrary to accepted medical standards.
(f) For persons not present or residing in a health care facility, the do-not-resuscitate order shall be noted on a physician orders for scope of treatment form or in the following form on a card suitable for carrying on the person:
"As treating physician of ____________________________ and a licensed physician, I order that this person SHALL NOT BE RESUSCITATED in the event of cardiac or respiratory arrest. This order has been discussed with ___________________________________ or his/her representative ____________________________________ or his/her surrogate decision maker ____________________________ who has given consent as evidenced by his/her signature below.
Physician Name _________________________________________________________
Physician Signature ______________________________________________________
Person Signature ________________________________________________________
Surrogate Decision Maker Signature _________________________________________
(g) For persons residing in a health care facility, the do-not-resuscitate order shall be reflected in at least one of the following forms:
(1) Forms required by the policies and procedures of the health care facility;
(2) The do-not-resuscitate card as set forth in subsection (f) of this section; or
(3) The physician orders for scope of treatment form.
(a) Health care providers shall comply with the do-not-resuscitate order when presented with one of the following:
(1) A do-not-resuscitate order completed by a physician on a form as specified in section six of this article;
(2) Do-not-resuscitate identification as set forth in section thirteen of this article;
(3) A do-not-resuscitate order for a person present or residing in a health care facility issued in accordance with the health care facility's policies and procedures; or
(4) A physician orders for scope of treatment form in which a qualified physician has documented a do-not-resuscitate order.
(b) Pursuant to this article, health care providers shall respect do-not-resuscitate orders for persons in health care facilities, ambulances, homes and communities within this state.
(a) At any time a person in a health care facility may revoke his or her previous request for or consent to a do not resuscitate order by making either a written, oral or other act of communication to a physician or other professional staff of the health care facility.
(b) At any time a person residing at home may revoke his/her do not resuscitate order by destroying such order and removing do not resuscitate identification on his or her person. The person is responsible for notifying his or her physician of the revocation.
(c) At any time a representative or surrogate decision-maker may revoke his or her consent to a do not resuscitate order for a person with incapacity in a health care facility by notifying a physician or other professional staff of the health care facility of the revocation of consent in writing, or by orally notifying the attending physician in the presence of a witness eighteen years of age or older.
(d) At any time a representative or surrogate decision-maker may revoke his or her consent for a person with incapacity residing at home by destroying such order and removing do not resuscitate identification from the person. The representative or surrogate decision-maker is responsible for notifying the person's physician of the revocation.
(e) The attending physician who is informed of or provided with a revocation of consent pursuant to this section shall immediately cancel the do not resuscitate order if the person is in a health care facility and notify the professional staff of the health care facility responsible for the person's care of the revocation and cancellation. Any professional staff of the health care facility who is informed of or provided with a revocation of consent pursuant to this section shall immediately notify the attending physician of such revocation.
(f) Only a licensed physician may cancel the issuance of a do not resuscitate order.
§16-30C-9. Protection of persons carrying out in good faith do not resuscitate order; notification of representative or surrogate decision-maker by physician refusing to comply with do not resuscitate order.
(a) No health care provider, health care facility, or individual employed by, acting as the agent of, or under contract with any of the foregoing shall be subject to criminal prosecution or civil liability for carrying out in good faith a do not resuscitate order authorized by this article on behalf of a person as instructed by the person, representative or surrogate decision-maker or for those actions taken in compliance with the standards and procedures set forth in this article.
(b) No health care provider, health care facility, individual employed by, acting as agent of, or under contract with any of the foregoing or other individual who witnesses a cardiac or respiratory arrest shall be subject to criminal prosecution or civil liability for providing cardiopulmonary resuscitation to a person for whom a do not resuscitate order has been issued, provided that such physician or individual:
(1) Reasonably and in good faith was unaware of the issuance of a do not resuscitate order; or
(2) Reasonably and in good faith believed that consent to the do not resuscitate order had been revoked or canceled.
(c) Any physician who refused to issue a do not resuscitate order at a person's request or to comply with a do not resuscitate order entered pursuant to this article shall take reasonable steps to advise promptly the person, representative, or surrogate decision-maker of the person that such physician is unwilling to effectuate the order. The attending physician shall thereafter at the election of the person, representative or surrogate decision-maker permit the person, representative or surrogate decision-maker to obtain another physician.
(a) No policy of life insurance shall be legally impaired, modified, or invalidated in any manner by the issuance of a do not resuscitate order notwithstanding any term of the policy to the contrary.
(b) A person may not prohibit or require the issuance of a do not resuscitate order for an individual as a condition of such individual's being insured or receiving health care services.
If a person with a do-not-resuscitate order is transferred from one health care facility to another health care facility, the health care facility initiating the transfer shall communicate the existence of a do-not-resuscitate order to the receiving facility prior to the transfer. The written do-not-resuscitate order, the do-not-resuscitate card as described in section six of this article or the physician orders for scope of treatment form shall accompany the person to the health care facility receiving the person and shall remain effective until a physician at the receiving facility issues admission orders. The do-not-resuscitate card or the physician orders for scope of treatment form shall be kept as the first page in the person's transfer records.
(a) Nothing in this article shall impair or supersede any legal right or legal responsibility which any person may have to effect the withholding of cardiopulmonary resuscitation in any lawful manner. In such respect, the provisions of this article are cumulative.
(b) Nothing in this article shall be construed to preclude a court of competent jurisdiction from approving the issuance of a do not resuscitate order under circumstances other than those under which such an order may be issued pursuant to the provisions of this article.
(a) The secretary of the Department of Health and Human Resources, no later than July 1, 1994, shall implement the statewide distribution of do-not-resuscitate forms as described in section six of this article.
(b) Do-not-resuscitate identification as set forth in this article may consist of either a medical condition bracelet or necklace with the inscription of the patient's name, date of birth in numerical form and "WV do-not-resuscitate" on it. Such identification shall be issued only upon presentation of a properly executed do-not-resuscitate order form as set forth in section six of this article, a physician orders for scope of treatment form in which a qualified physician has documented a do-not-resuscitate order, or a do-not-resuscitate order properly executed in accordance with a health care facility's written policy and procedure.
(c) The secretary of the Department of Health and Human Resources, no later than July 1, 1994, shall be responsible for establishing a system for the distribution of the do-not-resuscitate identification bracelets and necklaces.
(d) The secretary of the Department of Health and Human Resources, no later than July 1, 1994, shall develop and implement a statewide educational effort to inform the public of their right to accept or refuse cardiopulmonary resuscitation and to request their physician to write a do-not-resuscitate order for them.
The withholding of cardiopulmonary resuscitation from a person in accordance with the provisions of this article does not, for any purpose, constitute suicide or murder. The withholding of cardiopulmonary resuscitation from a person in accordance with the provisions of this article, however, shall not relieve any individual of responsibility for any criminal acts that may have caused the person's condition. Nothing in this article shall be construed to legalize, condone, authorize or approve mercy killing or assisted suicide.
It is the intention of the Legislature to recognize that existence of do not resuscitate identification correctly expresses the will of any person who bears it and that foreign courts recognize this expression and give full faith and credit to do not resuscitate identification.
The provisions of this article are severable and if any provision, section or part thereof shall be held invalid, unconstitutional or inapplicable to any person or circumstance, such invalidity, unconstitutionality or inapplicability shall not affect or impair any other remaining provisions contained herein.