N.J. Admin. Code § 10:48B-7.3

Current through Register Vol. 56, No. 19, October 7, 2024

Section 10:48B-7.3 - Withholding or withdrawing life-sustaining medical treatment (LSMT) for individuals for whom BGS is providing guardianship services

(a) The following procedures shall be followed:

1. When a recommendation to authorize the withholding or withdrawal of LSMT is received by staff of BGS, the recommendation shall be referred to an Ethics Committee recognized by the Assistant Commissioner or his or her designee, pursuant to 10:48B-3.1, for review.

i. In preparation for presentation of a recommendation for withholding or withdrawing LSMT to an Ethics Committee recognized by the Assistant Commissioner or his or her designee, the Chief of BGS or his or her designee shall:

(1) Request a search of the individual's records to determine whether or not an advance directive or POLST exists;

(2) Obtain a description in writing from the treating practitioner of the diagnosis and prognosis of the individual, which substantiates the reasonableness of withholding or withdrawing potentially LSMT based upon the finding that such treatment would be more burdensome than beneficial, and contrary to the individual's best interest;

(A) The treating practitioner will include in the written description specific treatment recommendations for the individual.

(3) Obtain a second opinion that confirms the individual's diagnosis and prognosis; and

(4) Develop a profile detailing the relevant factors in a consideration to withhold or withdraw potentially LSMT including, but not limited to: permanently unconscious state, uncontrolled pain, severe and permanent physical and mental deterioration, or other similar criteria.

ii. When the information under (a)1i above has been gathered, BGS will request a review by a recognized Ethics Committee. In accordance with 10:48B-3.1(a) and 7.2(a), the Ethics Committee shall have a consultative role in reviewing a request to withhold or withdraw potentially LSMT.

iii. When considering a request to withhold or withdraw potentially LSMT, the members of the Ethics Committee shall consider:

(1) The recommendation of the treating practitioner, including the diagnosis, prognosis, and medical treatment plan for the individual;

(2) A confirmation of the diagnosis and prognosis of the individual by a second physician;

(3) The wishes of the individual as may have been expressed in an advance directive;

(4) The contemporaneous wishes of the individual, if available;

(5) The benefits and burdens to the individual of initiating or continuing potentially LSMT;

(6) The wishes of the individual's family members or other interested persons;

(7) The "best interest" standard as applied with respect to withholding or withdrawing LSMT, excluding consideration of any pre-existing, non-terminal developmental disability, the benefits or burdens to third parties or the cost of continuing medical treatment;

(8) Medical treatment support plan for the individual; and

(9) Any additional information deemed relevant to the decision.

iv. The Ethics Committee shall invite the Chief of BGS or his or her designee, as well as a representative of DRNJ, to attend the meeting.

v. If a majority of the members of the Ethics Committee agree that it would be appropriate to withhold or withdraw potentially LSMT, this recommendation shall be forwarded in writing to the chief of BGS or his or her designee immediately.

vi. If a majority of the members of the Ethics Committee agree that the withholding or withdrawing of LSMT would be inappropriate, or are unable to reach a consensus, this shall be reported to the chief of BGS or his or her designee. The chief of BGS or his or her designee will make the decision as to rendering or withholding consent.

N.J. Admin. Code § 10:48B-7.3

Amended by 49 N.J.R. 99(a), effective 1/3/2017