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
nurse (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.
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