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House passes amended advance health-care directive bill clarifying physician assistant role
Summary
Lawmakers approved a House amendment to first-substitute SB117 to clarify that physician assistants may participate in implementing advanced health-care directives only under a delegation-of-service agreement with an attending physician and removed psychologists from the bill; the measure passed 42-28.
The Utah House approved a revised version of first-substitute Senate Bill 117 on Feb. 17 after floor amendments clarified the professional roles involved in advanced health-care directives.
Representative Paul Mascaro (sponsor) explained that the amendment removes psychologists from the list of professionals who could express advanced health-care directives and explicitly states that physician assistants may participate only under a delegation-of-service agreement with an attending physician. "With this amendment...psychologists are not a part of this bill anymore," Mascaro said, adding the amendment restores a standard of practice that existed prior to an inadvertent omission in 2007.
Opponents urged caution about extending life-and-death decision authority. Representative Harper said while the amendment "improved the bill," he remained concerned about critical end-of-life decisions in rural areas and argued the bill should be defeated. Representative Falk asked whether physician assistants take the Hippocratic oath and whether patients have the right to be informed when a PA rather than a physician is implementing directives; Mascaro replied that PAs "cannot make any decisions in and of [themselves]" and act under the direction of the attending physician.
After debate the amended first substitute passed the House by recorded vote, 42-28, and was returned to the Senate for further consideration.
Why it matters: the legislation addresses who may participate in implementing advanced health-care directives and clarifies oversight and delegation requirements for physician assistants — an issue with implications for hospital practice, patient notification and rural health-care delivery.
What’s next: the amended measure will go back to the Senate for consideration of the House changes.
