Senate Bill 1265 of 2002 (Printer’s No. 1682) amends Title 20 of the Pennsylvania Consolidated Statutes by revising the advance directive provisions for health care and providing a comprehensive framework for health care powers of attorney. This senate bill is the product of many discussions over the last three legislative sessions. Therefore, a historical perspective on the provisions contained in the bill, as well as those excluded from the bill, is helpful to understand the purpose of the legislation.

In March 1998, the Joint State Government Commission Task Force and Advisory Committee on Decedents’ Estates Laws recommended a health care decision-making proposal, which included the following recommendations.

• Amend and restructure Chapter 54 of Title 20
• Provide a comprehensive statutory framework for health care powers of attorney
• Permit a principal to provide in a health care power of attorney for a health care agent to make all health care decisions for the principal, including those concerning life-sustaining treatment
• Provide a statutory framework for health care representatives who may make health care decisions for certain individuals who lack the ability to make or communicate health care decisions
• Establish who may act as a health care representative in descending order of priority
• Ensure that any life-sustaining treatment decision made by a health care agent or health care representative complies with the applicable provisions for advance directives
• Repeal the optional advance directive form
• Amend and clarify the definitions relating to advance directives, health care powers of attorney and health care representatives

Senate Bill 1357 of 1998 incorporated the recommendations of the task force and advisory committee into legislation. The bill was later amended in the Senate Public Health and Welfare Committee to add provisions relating to out-of-hospital do-not-resuscitate orders. However, the bill was not enacted during the 1997-1998 legislative session.

On January 21, 1999, the provisions contained in Senate Bill 1357 of 1998 were introduced as Senate Bill 172 of 1999. Senate Bill 172, later amended to remove the out-of- hospital do-not-resuscitate provisions, passed the Senate on May 15, 2000. The bill was then referred to the House Judiciary Committee where it remained until the end of the 1999-2000 legislative session.

In early 2001, Senator Stewart J. Greenleaf, chair of the task force and prime sponsor of Senate Bill 1357 of 1998 and Senate Bill 172 of 1999, convened an ad hoc group to consider issues raised during the preceding several years concerning advance directives, health care powers of attorney, health care representatives and out-of- hospital do-not-resuscitate orders. The ad hoc group included legislative staff and representatives from the Department of PublicWelfare, the Pennsylvania Medical Society, the Pennsylvania Bar Association, the Pennsylvania Catholic Conference and the Advisory Committee on Decedents’ Estates Laws.

As a result of the discussions of the ad hoc group, the provisions contained in Senate Bill 172 of 1999 were introduced as Senate Bill 1265 of 2002. However, because the ad hoc group could not reach consensus on the concept of health care representatives, Senate Bill 1265 does not incorporate that concept. It also excludes the provisions concerning out-of- hospital do-not-resuscitate orders, which are addressed instead in House Bill 96 of 2001.

The following pages contain the legislation and official comments. The official comments are derived from the relevant comments that appeared in the March 1998 Joint State Government Commission report, with technical amendments reflecting the proposed statutory changes that occurred after the issuance of the report and before the introduction of Senate Bill 1265 of 2002. The official comments may be used to determine the intent of the General Assembly.