Palliative Care Information Act
Effective February 9, 2011, Chapter 331 of the Laws of 2010 (commonly known as the Palliative Care Information Act) amends the Public Health Law by adding section 2997-c, which requires physicians and nurse practitioners to offer terminally-ill patients information and counseling concerning palliative care and end-of-life options. Under the law, information and counseling concerning palliative care and end-of-life options must be offered only to patients with an illness or condition that is reasonably expected to cause death within six months. Palliative care, as defined by the law, is "health care treatment, including interdisciplinary end-of-life care, and consultation with patients and family members, to prevent or relieve pain and suffering and to enhance the patient's quality of life, including hospice care."
The law is intended to ensure that patients are fully informed of the options available to them when they are faced with a terminal illness or condition, so that they are empowered to make choices consistent with their goals for care, and wishes and beliefs, and to optimize their quality of life. The law is not intended to limit the options available to terminally-ill patients. Nor is it intended to discourage conversations about palliative care with patients whose life expectancy exceeds six months. As discussed below, it is often appropriate to discuss palliative care with patients earlier in the disease progression.
Summary of the Law
Public Health Law section 2997-c requires the "attending health care practitioner" to offer to provide patients with a terminal illness with information and counseling regarding palliative care and end-of-life options appropriate to the patient, including:
- Range of options appropriate to the patient;
- Risks and benefits of various options;
- Patient's "legal rights to comprehensive pain and symptom management at the end of life."
The information and counseling may be provided orally or in writing.
- The attending health care practitioner may arrange for information and counseling under this section to be provided by another professionally qualified individual.
- If the attending health care practitioner is "not willing to provide the patient with information and counseling," he/she must "arrange for another physician or nurse practitioner to do so," or must "refer or transfer the patient to another physician or nurse practitioner."
When the patient lacks medical decision-making capacity, the information and counseling must be provided to the person who has authority to make health care decisions for the patient.
- means consistent with applicable legal, health and professional standards; the patient's clinical and other circumstances; and the patient's reasonably known wishes and beliefs.
- "Attending health care practitioner"
- means a physician or nurse practitioner who has primary responsibility for the care and treatment of the patient. Where more than one physician or nurse practitionershare that responsibility, each of them has responsibility under this section, unless they agree to assign that responsibility to one of them.
- "Palliative care"
- means health care treatment, including interdisciplinary end-of-life care, and consultation with patients and family members, to prevent or relieve pain and suffering and to enhance the patient's quality of life, including hospice care under article forty of [the Public Health Law].
- "Terminal illness or condition"
- means an illness or condition which can reasonably be expected to cause death within six months, whether or not treatment is provided.