SB169: Practical nurses, licensed; authority to pronounce death for a patient in hospice, etc.
Be it enacted by the General Assembly of Virginia:
1. That § 54.1-2972 of the Code of Virginia is amended and reenacted as follows:
§ 54.1-2972. When person deemed medically and legally dead; determination of death; nurses', licensed practical nurses', or physician assistants' authority to pronounce death under certain circumstances.
A. A person shall be medically and legally dead if:
1. In the opinion of a physician duly authorized to practice medicine in the Commonwealth, based on the ordinary standards of medical practice, there is the absence of spontaneous respiratory and spontaneous cardiac functions and, because of the disease or condition that directly or indirectly caused these functions to cease, or because of the passage of time since these functions ceased, attempts at resuscitation would not, in the opinion of such physician, be successful in restoring spontaneous life-sustaining functions, and, in such event, death shall be deemed to have occurred at the time these functions ceased; or
2. In the opinion of a physician, who shall be duly licensed to practice medicine in the Commonwealth and board-eligible or board-certified in the field of neurology, neurosurgery, or critical care medicine, when based on the ordinary standards of medical practice, there is irreversible cessation of all functions of the entire brain, including the brain stem, and, in the opinion of such physician, based on the ordinary standards of medical practice and considering the irreversible cessation of all functions of the entire brain, including the brain stem, and the patient's medical record, further attempts at resuscitation or continued supportive maintenance would not be successful in restoring such functions, and, in such event, death shall be deemed to have occurred at the time when all such functions have ceased.
B. A registered nurse or a physician assistant may pronounce death if the following criteria are satisfied: (i) the nurse is employed by or the physician assistant works at (a) a home care organization as defined in § 32.1-162.7, (b) a hospice as defined in § 32.1-162.1, (c) a hospital or nursing home as defined in § 32.1-123, including state-operated hospitals for the purposes of this section, (d) the Department of Corrections, or (e) a continuing care retirement community registered with the State Corporation Commission pursuant to Chapter 49 (§ 38.2-4900 et seq.) of Title 38.2; (ii) the nurse or physician assistant is directly involved in the care of the patient; (iii) the patient's death has occurred; (iv) the patient is under the care of a physician when his death occurs; (v) the patient's death has been anticipated; (vi) the physician is unable to be present within a reasonable period of time to determine death; and (vii) there is a valid Do Not Resuscitate Order pursuant to § 54.1-2987.1 for the patient who has died. A licensed practical nurse may pronounce death for a patient in hospice pursuant to a valid Do Not Resuscitate Order issued in accordance with § 54.1-2987.1. The nurse, licensed practical nurse, or physician assistant shall inform the patient's attending and consulting physicians of the patient's death as soon as practicable.
The nurse, licensed practical nurse, or physician assistant shall have the authority to pronounce death in accordance with such procedural regulations, if any, as may be promulgated by the Board of Medicine; however, if the circumstances of the death are not anticipated or the death requires an investigation by the Office of the Chief Medical Examiner, the nurse, licensed practical nurse, or physician assistant shall notify the Office of the Chief Medical Examiner of the death and the body shall not be released to the funeral director.
This subsection shall not authorize a nurse, licensed practical nurse, or physician assistant to determine the cause of death. Determination of cause of death shall continue to be the responsibility of the attending physician, except as provided in § 32.1-263. Further, this subsection shall not be construed to impose any obligation to carry out the functions of this subsection.
This subsection shall not relieve any registered nurse, licensed practical nurse, or physician assistant from any civil or criminal liability that might otherwise be incurred for failure to follow statutes or Board of Nursing or Board of Medicine regulations.
C. The alternative definitions of death provided in subdivisions A 1 and 2 may be utilized for all purposes in the Commonwealth, including the trial of civil and criminal cases.
Be it enacted by the General Assembly of Virginia:
1. That § 54.1-2972 of the Code of Virginia is amended and reenacted as follows:
§ 54.1-2972. When person deemed medically and legally dead; determination of death; nurses', licensed practical nurses', or physician assistants' authority to pronounce death under certain circumstances.
A. A person shall be medically and legally dead if:
1. In the opinion of a physician duly authorized to practice medicine in the Commonwealth, based on the ordinary standards of medical practice, there is the absence of spontaneous respiratory and spontaneous cardiac functions and, because of the disease or condition that directly or indirectly caused these functions to cease, or because of the passage of time since these functions ceased, attempts at resuscitation would not, in the opinion of such physician, be successful in restoring spontaneous life-sustaining functions, and, in such event, death shall be deemed to have occurred at the time these functions ceased; or
2. In the opinion of a physician, who shall be duly licensed to practice medicine in the Commonwealth and board-eligible or board-certified in the field of neurology, neurosurgery, or critical care medicine, when based on the ordinary standards of medical practice, there is irreversible cessation of all functions of the entire brain, including the brain stem, and, in the opinion of such physician, based on the ordinary standards of medical practice and considering the irreversible cessation of all functions of the entire brain, including the brain stem, and the patient's medical record, further attempts at resuscitation or continued supportive maintenance would not be successful in restoring such functions, and, in such event, death shall be deemed to have occurred at the time when all such functions have ceased.
B. A registered nurse [ , a licensed practical nurse,
] or a physician assistant may pronounce death if the following criteria are
satisfied: (i) the nurse [ or licensed practical nurse ] is
employed by or the physician assistant works at (a) a home care organization as
defined in § 32.1-162.7, (b) a hospice as defined in § 32.1-162.1, (c) a
hospital or nursing home as defined in § 32.1-123, including state-operated
hospitals for the purposes of this section, (d) the Department of Corrections,
or (e) a continuing care retirement community registered with the State
Corporation Commission pursuant to Chapter 49 (§ 38.2-4900 et seq.) of Title
38.2; (ii) the nurse [ , licensed practical nurse, ] or physician
assistant is directly involved in the care of the patient; (iii) the patient's
death has occurred; (iv) the patient is under the care of a physician when his
death occurs; (v) the patient's death has been anticipated; (vi) the physician
is unable to be present within a reasonable period of time to determine death;
and (vii) there is a valid Do Not Resuscitate Order pursuant to § 54.1-2987.1
for the patient who has died. [ A licensed practical nurse may pronounce
death for a patient in hospice pursuant to a valid Do Not Resuscitate Order
issued in accordance with § 54.1-2987.1. ] The nurse, licensed practical
nurse, or physician assistant shall inform the patient's attending and
consulting physicians of the patient's death as soon as practicable.
The nurse, licensed practical nurse, or physician assistant shall have the authority to pronounce death in accordance with such procedural regulations, if any, as may be promulgated by the Board of Medicine; however, if the circumstances of the death are not anticipated or the death requires an investigation by the Office of the Chief Medical Examiner, the nurse, licensed practical nurse, or physician assistant shall notify the Office of the Chief Medical Examiner of the death and the body shall not be released to the funeral director.
This subsection shall not authorize a nurse, licensed practical nurse, or physician assistant to determine the cause of death. Determination of cause of death shall continue to be the responsibility of the attending physician, except as provided in § 32.1-263. Further, this subsection shall not be construed to impose any obligation to carry out the functions of this subsection.
This subsection shall not relieve any registered nurse, licensed practical nurse, or physician assistant from any civil or criminal liability that might otherwise be incurred for failure to follow statutes or Board of Nursing or Board of Medicine regulations.
C. The alternative definitions of death provided in subdivisions A 1 and 2 may be utilized for all purposes in the Commonwealth, including the trial of civil and criminal cases.
SENATE BILL NO. 169
Be it enacted by the General Assembly of Virginia:
1. That § 54.1-2972 of the Code of Virginia is amended and reenacted as follows:
§ 54.1-2972. When person deemed medically and legally dead; determination of death; nurses', licensed practical nurses', or physician assistants' authority to pronounce death under certain circumstances.
A. A person shall be medically and legally dead if:
1. In the opinion of a physician duly authorized to practice medicine in the Commonwealth, based on the ordinary standards of medical practice, there is the absence of spontaneous respiratory and spontaneous cardiac functions and, because of the disease or condition that directly or indirectly caused these functions to cease, or because of the passage of time since these functions ceased, attempts at resuscitation would not, in the opinion of such physician, be successful in restoring spontaneous life-sustaining functions, and, in such event, death shall be deemed to have occurred at the time these functions ceased; or
2. In the opinion of a physician, who shall be duly licensed to practice medicine in the Commonwealth and board-eligible or board-certified in the field of neurology, neurosurgery, or critical care medicine, when based on the ordinary standards of medical practice, there is irreversible cessation of all functions of the entire brain, including the brain stem, and, in the opinion of such physician, based on the ordinary standards of medical practice and considering the irreversible cessation of all functions of the entire brain, including the brain stem, and the patient's medical record, further attempts at resuscitation or continued supportive maintenance would not be successful in restoring such functions, and, in such event, death shall be deemed to have occurred at the time when all such functions have ceased.
B. A registered nurse, a licensed practical nurse, or a physician assistant may pronounce death if the following criteria are satisfied: (i) the nurse or licensed practical nurse is employed by or the physician assistant works at (a) a home care organization as defined in § 32.1-162.7, (b) a hospice as defined in § 32.1-162.1, (c) a hospital or nursing home as defined in § 32.1-123, including state-operated hospitals for the purposes of this section, (d) the Department of Corrections, or (e) a continuing care retirement community registered with the State Corporation Commission pursuant to Chapter 49 (§ 38.2-4900 et seq.) of Title 38.2; (ii) the nurse, licensed practical nurse, or physician assistant is directly involved in the care of the patient; (iii) the patient's death has occurred; (iv) the patient is under the care of a physician when his death occurs; (v) the patient's death has been anticipated; (vi) the physician is unable to be present within a reasonable period of time to determine death; and (vii) there is a valid Do Not Resuscitate Order pursuant to § 54.1-2987.1 for the patient who has died. The nurse, licensed practical nurse, or physician assistant shall inform the patient's attending and consulting physicians of the patient's death as soon as practicable.
The nurse, licensed practical nurse, or physician assistant shall have the authority to pronounce death in accordance with such procedural regulations, if any, as may be promulgated by the Board of Medicine; however, if the circumstances of the death are not anticipated or the death requires an investigation by the Office of the Chief Medical Examiner, the nurse, licensed practical nurse, or physician assistant shall notify the Office of the Chief Medical Examiner of the death and the body shall not be released to the funeral director.
This subsection shall not authorize a nurse, licensed practical nurse, or physician assistant to determine the cause of death. Determination of cause of death shall continue to be the responsibility of the attending physician, except as provided in § 32.1-263. Further, this subsection shall not be construed to impose any obligation to carry out the functions of this subsection.
This subsection shall not relieve any registered nurse, licensed practical nurse, or physician assistant from any civil or criminal liability that might otherwise be incurred for failure to follow statutes or Board of Nursing or Board of Medicine regulations.
C. The alternative definitions of death provided in subdivisions A 1 and 2 may be utilized for all purposes in the Commonwealth, including the trial of civil and criminal cases.