Texas amends health code for out-of-hospital DNR orders affecting pregnant patients

On November 13, 2024, Texas State Legislature introduced Senate Bill 360, a significant piece of legislation aimed at amending existing health and safety codes related to out-of-hospital Do Not Resuscitate (DNR) orders. This bill seeks to clarify and enhance the procedures surrounding DNR orders, particularly in the context of pregnant individuals and the documentation process.

The primary purpose of Senate Bill 360 is to streamline the execution and recognition of out-of-hospital DNR orders, ensuring that they are properly documented and respected by healthcare professionals. Key provisions include amendments that require the attending physician and witnesses to sign the DNR order, thereby formalizing the process and making it part of the declarant's medical record. Additionally, the bill allows individuals of child-bearing age to specify how their pregnancy affects their DNR orders, addressing a critical gap in the current legislation that previously restricted the withholding of life-sustaining treatment from pregnant patients.

The introduction of this bill has sparked notable discussions among lawmakers and healthcare advocates. Supporters argue that it provides essential clarity and respects the autonomy of individuals regarding their medical decisions, particularly in sensitive situations involving pregnancy. However, some opposition has emerged, primarily from groups concerned about the implications of allowing DNR orders for pregnant individuals, fearing it may lead to ethical dilemmas in emergency medical situations.

The economic and social implications of Senate Bill 360 are significant. By clarifying the legal framework surrounding DNR orders, the bill aims to reduce confusion and potential legal disputes in emergency healthcare settings, which could ultimately lead to more efficient use of medical resources. Furthermore, it reflects a growing recognition of patient rights and the importance of informed consent in medical care, aligning Texas with broader national trends toward patient-centered healthcare policies.

As the bill moves through the legislative process, its potential impact on healthcare practices and patient rights in Texas will be closely monitored. If passed, Senate Bill 360 is set to take effect on September 1, 2025, marking a pivotal shift in how DNR orders are handled in out-of-hospital settings. The ongoing debates surrounding the bill will likely shape its final form and implementation, highlighting the complexities of balancing patient autonomy with ethical medical practices.