Case Study 6

New Statutory Powers for

Advanced Practice Registered Nurses

On October 1, 2018, a new law became effective as it applies to

certain advanced directives. The change gives advanced practice

registered nurses the authority to perform certain functions that could

previously only be performed by physicians.

Public Act 18-168 (“the Act”) defines an advanced practice registered

(a/k/a APRN) to mean an advanced practice registered nurse

licensed under Connecticut law who is selected by or assigned to a patient

and has the primary responsibility for the treatment and care of that patient.

With respect to a living will (which is one type of advanced directive),

the Act amends Section 19a-575 as follows: If the time comes when I am

incapacitated to the point when I can no longer actively take part in

decisions for my own life and am unable to direct my physician or

advanced practice registered nurse as to my own medical care, I wish

this statement to stand as a testament of my wishes. I request that if my

condition is deemed terminal or if it is determined that I will be permanently

unconscious, I be allowed to die and not be kept alive through life support

systems. By terminal condition, I mean that I have an incurable or

irreversible medical condition which, without the administration of life

support systems, will – in the opinion of my attending physician or

advanced practice registered nurse – result in death within a relatively

short time.

The Act also amends Section 19a-577 of the Connecticut General

Statutes with respect to an appointment of health care representative

(which is another type of advanced directive). The Appointment of Health

Care Representative form now reads as follows: I appoint [Name] to be my

health care representative. If my attending physician or advanced

practice registered nurse
determines that I am unable to understand and

appreciate the nature and consequences of health care decisions and to

reach and communicate an informed decision regarding treatment, my

health care representative is authorized to (1) accept or refuse any

treatment, service or procedure used to diagnose or treat my physical or

mental condition and (2) make the decision to provide, withhold or

withdraw life support systems.

So in the context of a living will, the APRN now has the power under

the law to render an opinion about whether someone’s terminal condition

will result in death within a relatively short period of time, if they don’t

receive life support. Similarly, in the context of an appointment of health

care representative, the APRN now has the power under the law to make a

determination as to whether someone understands and appreciates the

nature and consequences of making health care decisions for themselves

and whether they can also make an informed decision and communicate it

to a doctor or an APRN. Thus, the change in the law now gives the APRN

– in addition to a doctor – the authority to do things that previously were

reserved only for physicians.

Some folk might disagree with giving APRN’s the same kind of power

as doctors but one thing is clear: it is now the law in the State of

Connecticut. If you have questions about how or whether Connecticut’s

modified advanced directive statute applies to you, contact the estate

planning attorneys at Cipparone & Zaccaro. We help to create clear and

understandable estate plans for people by taking the time to explain the law

and how it might apply to you.

About the Author  (click name for contact information)

Mark Pancrazio is a shareholder at Cipparone & Zaccaro, P.C. in New London CT.  Mark brings a wealth of experience in various areas of the law, including estate and trust administration, estate and trust litigation, estate planning, conservatorships and probate law. Mark is currently a member of the Elder Law Section of the Connecticut Bar Association and a former member of the Western Connecticut Senior Alliance. Mark practiced law in Danbury, CT before joining the firm.
(860) 442-0150

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