SOUTH CAROLINA DO NOT RESUSCITATE ORDERS

Under South Carolina law, only Emergency Medical Service (EMS) Do Not Resuscitate Orders are covered by statutory law.

Those who have not signed health care powers of attorney are covered under the Adult Health Care Consent Act (AHCCA).

While the AHCCA does not authorize the termination of life support, the EMS DNR law allows people acting as surrogates under the AHCCA to sign an EMS DNR. Quite inconsistent.

§ 44-78-10. Short title.

As used in this chapter:

(1) "Do not resuscitate order for emergency services" means a document made in accordance with this article to prevent EMS personnel from employing resuscitative measures or any other medical process that would only extend the patient's suffering with no viable medical reason to perform the procedure;

(2) "EMS personnel" means emergency medical personnel certified by the South Carolina Department of Health and Environmental Control, and for purposes of this chapter, "EMS personnel" includes first responders who have completed a Department of Health and Environmental Control approved medical first responder program;

(3) "Health care provider" means a person licensed to practice medicine or osteopathy pursuant to Title 40, Chapter 47;

(4) "Palliative treatment" means the degree of treatment which must be provided to a patient in the routine delivery of emergency medical services, which assures the comfort and alleviation of pain and suffering to all extents possible, regardless of whether the patient has executed a document as provided for in this chapter;

(5) "Resuscitative treatment" means artificial stimulation of the cardiopulmonary systems of the human body, through either electrical, mechanical, or manual means including, but not limited to, cardiopulmonary resuscitation;

(6) "Terminal condition" means an incurable or irreversible condition that within reasonable medical judgment could cause death within a reasonably short period of time if life sustaining procedures are not used.

§ 44-78-20. Terminal patient may request health care provider to execute "do not resuscitate order for emergency services"; conditions.

A patient who has a terminal condition or a surrogate for a patient with a terminal condition under the Adult Health Care Consent Act or an agent of a person with a terminal condition named by the patient in a Health Care Power of Attorney may request a health care provider responsible for the care of the patient to execute a "do not resuscitate order for emergency services" if the following conditions apply:

(1) the patient has a terminal condition;

(2) the terminal condition has been diagnosed by a health care provider and the health care provider's record establishes the time, date, and medical condition which gives rise to the diagnosis of a terminal condition.

§ 44-78-25. Duties of EMS personnel when presented with "do not resuscitate order".
When called to render emergency medical services, EMS personnel must not use any resuscitative treatment if the patient has a "do not resuscitate order for emergency services" and the document is presented to the EMS personnel upon their arrival. EMS personnel must provide that degree of palliative care called for under the circumstances which exist at the time treatment is rendered.

§ 44-78-30. Required form for "do not resuscitate order"; revocation procedure.

A document purporting to be a "do not resuscitate order" for EMS purposes must be in substantially the following form:

NOTICE TO EMS PERSONNEL
This notice is to inform all emergency medical personnel who may be called to render assistance to __________ he/she has a terminal condition which has been diagnosed by me and has specifically requested that no resuscitative efforts including artificial stimulation of the cardiopulmonary system by electrical, mechanical, or manual means be made in the event of cardiopulmonary arrest.
REVOCATION PROCEDURE

THIS FORM MAY BE REVOKED BY AN ORAL STATEMENT BY THE PATIENT TO EMS PERSONNEL OR BY MUTILATING, OBLITERATING, OR DESTROYING THE DOCUMENT IN ANY MANNER.

Date:__________

____________________

Patient's signature (or surrogate or agent)

____________________

Physician's signature

____________________

Physician's address

____________________

Physician's telephone number


44-78-40. Full resuscitative measures required in absence of order.

In the absence of a "do not resuscitate order for emergency medical services", EMS personnel shall give full resuscitative measures as are medically indicated in all cases.

44-78-50. Chapter not condonation of mercy killing; minors ineligible for "do not resuscitate orders"; compliance with article not suicide.

(A) Nothing in this chapter may be construed to condone, authorize, or approve mercy killing or euthanasia or to permit any affirmative action or deliberate act to end life other than to allow the natural process of dying.

(B) No person under the age of eighteen years may request or receive a "do not resuscitate order for emergency medical services" as provided for in this article.

(C) The withholding of resuscitative measures pursuant to this article does not constitute suicide for any purpose.

§ 44-78-60. Means of revocation of "do not resuscitate order". A "do not resuscitate order for emergency services" may be revoked by an oral statement by the patient to EMS personnel or by mutilating, obliterating, or destroying the document in any manner.