The Vermont Statutes Online

Title 18 : Health

Chapter 231 : Advance Directives for Health Care, Disposition of Remains, and Surrogate Decision Making

Subchapter 001 : ADVANCE DIRECTIVES AND DISPOSITION OF REMAINS

• § 9708. Authority and obligations of health care providers, health care facilities, and residential care facilities regarding DNR orders and COLST

  (a) As used in this section, “clinician” shall have the same meaning as in section 9701 of this title and shall also include a duly licensed medical doctor, osteopathic physician, advanced practice registered nurse or nurse practitioner, or physician assistant who treated the patient outside Vermont and held a valid license to practice in the state in which the patient was located at the time the DNR/COLST was issued.

  (b) A DNR order and a COLST shall be issued on the Department of Health’s “Vermont DNR/COLST form” as designated by rule by the Department of Health.

  (c) Notwithstanding subsection (b) of this section, health care facilities and residential care facilities may document DNR/COLST orders in the patient’s medical record in a facility-specific manner when the patient is in their care.

  (d) A DNR order must:

  (1) be signed by the patient’s clinician;

  (2) certify that the clinician has consulted, or made an effort to consult, with the patient, and the patient’s agent or guardian, if there is an appointed agent or guardian;

  (3) include either:

  (A) the name of the patient; agent; guardian, in accordance with 14 V.S.A. § 3075(g); or surrogate giving informed consent for the DNR and the individual’s relationship to the patient; or

  (B) certification that the patient’s clinician and one other named clinician have determined that resuscitation would not prevent the imminent death of the patient, should the patient experience cardiopulmonary arrest; and

  (4) if the patient is in a health care facility or a residential care facility, certify that the requirements of the facility’s DNR protocol required by section 9709 of this title have been met.

  (e) A COLST must:

  (1) be signed by the patient’s clinician; and

  (2) include the name of the patient; agent; guardian, in accordance with 14 V.S.A. § 3075(g); or surrogate giving informed consent for the COLST and the individual’s relationship to the patient.

  (f) [Repealed.]

  (g) A patient’s clinician issuing a DNR/COLST order shall:

  (1) place a copy of the completed DNR/COLST order in the patient’s medical record; and

  (2) provide instructions to the patient as to the appropriate means of displaying the DNR/COLST order.

  (h) A clinician who issues a DNR order shall authorize issuance of a DNR identification to the patient. Uniform minimum requirements for DNR identification shall be determined by the Department of Health by rule not later than January 1, 2016.

  (i) Every health care provider, health care facility, and residential care facility shall honor a DNR/COLST order or a DNR identification unless the provider or facility:

  (1) believes in good faith, after consultation with the agent or guardian where possible and appropriate, that:

  (A) the patient wishes to have the DNR/COLST order revoked; or

  (B) the patient with the DNR identification is not the individual for whom the DNR order was issued; and

  (2) documents the basis for the good faith belief in the patient’s medical record.

  (j) A DNR/COLST order executed prior to July 1, 2011 shall be a valid order if the document complies with the statutory requirements in effect at the time the document was executed or with the provisions of this chapter.

  (k) A health care provider shall honor in good faith an out-of-state DNR order, orders for life sustaining treatment, or out-of-state DNR identification if there is no reason to believe that what has been presented is invalid.

  (l) A DNR order precludes efforts to resuscitate only in the event of cardiopulmonary arrest and does not affect other therapeutic interventions that may be appropriate for the patient. (Added 2005, No. 55, § 1, eff. Sept. 1, 2005; amended 2011, No. 60, § 10, eff. June 1, 2011; 2011, No. 76 (Adj. Sess.), § 1, eff. March 7, 2012; 2013, No. 50, § E.312.3; 2013, No. 127 (Adj. Sess.), §§ 2, 5, eff. May 10, 2014; 2015, No. 136 (Adj. Sess.), § 1, eff. Jan. 1, 2018; 2017, No. 121 (Adj. Sess.), § 3, eff. May 3, 2018; 2023, No. 6, § 244, eff. July 1, 2023.)