California Code of Regulations
Title 15 - Crime Prevention and Corrections
Division 3 - Adult Institutions, Programs and Parole
Chapter 2 - Rules and Regulations of Health Care Services
Subchapter 2 - Patient's Entitlements and Responsibilities
Article 6 - Health Care Directives
Section 3999.241 - Physician Orders for Life Sustaining Treatment

Universal Citation: 15 CA Code of Regs 3999.241

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

(a) The California Department of Corrections and Rehabilitation (CDCR) shall make the CDCR 7465, Physician Orders for Life Sustaining Treatment (POLST), available to all patients. CDCR health care staff shall discuss end of life decision-making and goals of care, as well as patients' right to name a legally recognized decision-maker and to specify their end of life preferences with patients who are elderly, frail, have serious medical or surgical conditions, or who have less than six months life expectancy.

(b) In the event a patient requests medical treatment contrary to accepted medical standards, or if the requested medical care would be medically ineffective, or for reasons of conscience, the health care provider or facility may decline to comply with the preferences of the patient or the patient's legally recognized decision-maker.

(c) If a patient with a completed POLST transfers to or from another CDCR institution or outside health care facility, the receiving institution or facility shall accept the POLST.

(d) Do not resuscitate.

(1) If the patient requests "Do Not Attempt Resuscitation/Do Not Resuscitate (DNR)" status, every effort shall be made to relieve the patient's suffering and maintain comfort (e.g., palliative treatment for pain, dyspnea, major hemorrhage, or other medical conditions).

(2) In the absence of a CDCR 7465 specifying DNR, full Cardiopulmonary Resuscitation shall be initiated for any patient experiencing cardiac or respiratory arrest unless otherwise indicated.

(3) If there is suspicion that a patient's cardiorespiratory arrest is not a part of a natural or expected death (e.g., attempted suicide or possibly suffering harm by another), then resuscitation shall be attempted despite the presence of a CDCR 7465 stating no attempt at resuscitation.

(4) The PCP shall be responsible for discussing with the patient and, if necessary, legally recognized decision-maker and documenting in the health record whether the POLST/DNR orders are to be maintained or suspended during anesthesia and surgery.

(5) A DNR order written without a POLST means only that the patient is not to receive resuscitative measures in the event of a full arrest. Any other limits on medical interventions, such as "do not intubate" or "no blood products," must be specifically ordered.

1. New section filed 7-1-2019 as an emergency; operative 7-1-2019 (Register 2019, No. 27). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 12-9-2019 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 12-5-2019 as an emergency; operative 12-10-2019 (Register 2019, No. 49). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 3-9-2020 or emergency language will be repealed by operation of law on the following day.
3. New section refiled 3-9-2020 as an emergency; operative 3-10-2020 (Register 2020, No. 11). A Certificate of Compliance must be transmitted to OAL by 6-8-2020 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 3-9-2020 order transmitted to OAL 6-8-2020 and filed 7-20-2020 (Register 2020, No. 30).

Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code; Sections 4600 et seq., Probate Code; and Plata v. Newsom (No. C01-1351 JST), U.S. District Court, Northern District of California.

Disclaimer: These regulations may not be the most recent version. California may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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