Bill regulating do-not-resuscitate orders heads to governor's desk

The Texas Senate on Tuesday evening voted to adopt a House-amended version of Senate Bill 11, which requires doctors to obtain explicit legal permission from patients before issuing do-not-resuscitate orders.

The measure has undergone a whirlwind of changes since the Senate first voted to approve it last month — most notably, the addition of legal protections for medical personnel who work with patients receiving end-of-life care.

The Senate voted 21–10 to pass the measure, which now advances to Gov. Greg Abbott's desk. It is one of only a handful of special session agenda items that have made it all the way to the governor — even as the special session nears its Wednesday conclusion. (Update, Aug. 16: Abbott signed the bill into law Wednesday.)

The revised bill creates a criminal penalty for doctors who willfully violate a patient's do-not-resuscitate wishes, and an exception to that penalty for doctors who err "in good faith." The bill has also been updated with a revised definition of do-not-resuscitate orders and the addition of certain notification requirements.

Sen. Charles Perry, the bill's author, acknowledged last month that the Senate version of the bill was flawed, and he signed on early to support the House's changes. The Lubbock Republican said Tuesday that the House's changes are "substantive" and "appropriate." 

Sen. José Rodríguez, D-El Paso, questioned the need for creating a class A misdemeanor offense. The penalty for intentionally violating a patient's DNR wishes could include up to a year in prison, a fine of up to $4,000, or both.

"This needed to be a bill of substance regarding violation of the DNR process," Perry countered. "This is someone's life. This is the heart of the bill."

The do-not-resuscitate issue, which stalled earlier this year during the Legislature's regular session, appeared dead during the special session as well when it hit a snag in the House State Affairs Committee. But lawmakers reached a compromise with stakeholder groups, and the lower chamber passed the bill on Saturday. 

Do-not-resuscitate orders must either be given in writing or in the presence of two "competent" adult witnesses.