California nursing homes must consult patient or rep for psychiatric drugs, end-of-life care

A California appeals court ruled July 22 that nursing home physicians and staff must consult with patients who have been found mentally incompetent, or those patient's representatives, before administering psychiatric drugs or making end-of-life decisions, according to The San Francisco Chronicle.

The verdict comes in response to a 1992 California law, which allowed nursing home physicians to make health decisions for mentally incompetent residents with no close friends or relatives to advocate on their behalf. A superior court judge ruled that the law violated patients' rights in 2016, but the law has remained in effect during the state's appeal.

The July 22 ruling means the law can stay in effect as long as providers go through certain procedures first. A nursing home must tell the patient and someone representing the patient that he or she has been found mentally incompetent to make healthcare decisions. Next, the nursing home must consult with an independent representative, who reviews the physician's treatment decisions. 

Treatment could involve antipsychotic medications as well as end-of-life decisions, such as whether to offer hospice care instead of continuing treatment for a terminally ill patient.


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