A coalition of doctors and ethicists, including two from the University of Colorado Anschutz Medical Campus and another from Regis University, are behind a new law signed Wednesday allowing doctors to take better care of the most vulnerable patients in hospitals and emergency rooms.

The `Medical Decision Making for Unrepresented Patients’ law was signed by Gov. John Hickenlooper at a ceremony at the Northern Colorado Medical Center in Greeley. The measure will allow physicians to act as proxies for patients unable to provide consent or with no other proxy available.

Jackie Glover, PhD, professor of pediatrics at CU School of Medicine and Center for Bioethics and Humanities.

“This is a national problem that has been discussed for decades,” said Jackie Glover, PhD, professor of pediatrics who teaches ethics at the Center for Bioethics and Humanities at CU Anschutz. “If you are a patient without family or friends you are appointed a guardian but that’s an awful long process in Colorado.”

Glover along with CU Anschutz Professor of Medicine Jean Abbott, MD, MH and Debra Bennett-Woods, EdU, FACHE, and professor of health services education at Regis University, collaborated with a coalition of ethics committees under the umbrella of the Colorado Health Care Ethics Forum or CHEF to draft the legislation.

“This bill is a matter of social justice,” said Bennet-Woods, “HB16-11101 will enable the care team to provide the right treatment, at the right time and in the right setting.”

Glover said unrepresented patients in hospitals and long-term care facilities can’t speak for themselves and have no family or close friends to speak for them. By one estimate more than 16 percent of patients admitted to ICUs today are unrepresented and the number is growing. By 2020, more than 2 million Americans will have outlived friends and family.

Jean Abbott, MD, MH, professor emerita CU School of Medicine and Center for Bioethics and Humanities.

The group found willing partners in Rep. David Young and Sen. Kevin Lundberg who introduced the measure in the state Legislature.

The law will allow a second doctor, who is not the patient’s attending physician, to serve as a proxy of last resort when a patient is unable to provide consent and no proxy can be found. The hospital ethics committee must oversee this process, ensuring that all reasonable efforts to find a proxy have been made.

But the law will not require physicians to act as proxies. It also won’t replace volunteer guardianship programs, nor will it provide funding for a public guardianship program.

Glover said her group got together, examined what other states do and drafted the legislation. They were surprised at how quickly it advanced through the political process.

Bennet-Woods agreed.

“The process brought together a novel set of stakeholders and has the potential to keep them at the table as best practices are developed and rolled out,” she said.

But the law is only the beginning.

“The hard work is yet to come,” Glover said. “We now have to develop best practices going forward.”

 

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