New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 48B - DECISION-MAKING FOR THE TERMINALLY ILL
Subchapter 7 - INDIVIDUALS WITHOUT CAPACITY TO MAKE MEDICAL TREATMENT DECISIONS FOR WHOM BGS IS PROVIDING GUARDIANSHIP SERVICES
Section 10:48B-7.5 - Do Not Resuscitate (DNR) Orders for individuals receiving BGS services

Universal Citation: NJ Admin Code 10:48B-7.5

Current through Register Vol. 56, No. 18, September 16, 2024

(a) The following procedures shall be followed when a recommendation has been made by the treating practitioner to execute a DNR Order for an individual for whom BGS is providing guardianship services:

1. The treating practitioner will submit a written recommendation for a DNR Order indicating the diagnosis and prognosis of the individual and the benefit or not if Cardiopulmonary Resuscitation (CPR) is instituted. If the individual is not terminally ill or permanently unconscious and the attending physician is recommending that CPR is medically contraindicated for the individual, the attending physician will specify in the written recommendation the reasons CPR is contraindicated.

2. The staff of BGS will search the records for an advance directive or seek information on a contemporaneous or previously expressed wish of the individual.

3. A second treating physician will indicate in writing his or her concurrence with the treating practitioner's recommendation for a DNR Order.

4. The staff of BGS will contact the next of kin or interested persons to establish their perception of the individuals' wishes or what is in the best interest of the individual.

5. The Chief of BGS, or his or her designee, may request consultation by a recognized Ethics Committee if the BGS staff seeks a recommendation regarding a DNR Order request. The Ethics Committee shall consider the request in accordance with 10:48B-7.3(a)1 iii, except the committee will consider a DNR request.

6. If the Chief of BGS, or his or her designee concurs with the recommendation for a DNR Order, the Chief or his or her designee shall prepare a certification based upon the following:

i. The recommendation of the treating practitioner, including a diagnosis, prognosis, and a medical treatment plan;

ii. The concurrence and recommendations of a second treating physician;

iii. A brief history of the individual's abilities and description of the progression of the illness;

iv. The disposition of any family members or interested parties;

v. The observations by the BGS guardian of the individual;

vi. The recommended medical treatment support plan to include hospice or palliative care, as appropriate; and

vii. Any additional information deemed relevant to the decision.

7. Once the certification has been completed, the Chief of BGS or his or her designee shall communicate consent to the DNR Order to the treating practitioner and provide DRNJ with a copy of the certification no later than the next business day.

8. If an emergent request for a DNR Order is made by the treating practitioner and the Chief of BGS, or his or her designee, agrees with the request and concurs that the request meets the requirements of this chapter, consent will be given to the treating practitioner to enter a DNR order.

9. The Chief of BGS, or his or her designee, will prepare a certification pursuant to (a)6 above and send a copy to DRNJ, no later than the next business day.

(b) Any interested party may seek resolution by a court of competent jurisdiction, in the event that he or she disagrees with the decision made by the Chief of BGS or his or her designee.

(c) In the event an immediate family member and/or DRNJ, objects to the decision of the Chief of BGS or his or her designee to consent to a DNR Order, the decision will not be implemented without a court order.

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