A medical form targeting the elderly and chronically ill is being heavily pushed in Kansas by the Center for Practical Bioethics (more on this group in this post).
However, a new formal opinion from the Kansas Attorney General, Derek Schmidt, verifies that in two distinct areas the form contravenes current statutes that protect patients!
At a press conference Wednesday hosted by Kansans for Life, (see press release here) Rep. John Rubin (R-Shawnee), who had requested the A.G. opinion,
labeled the TPOPP form “misleading” and “deficient” and asked that it be recalled.
TPOPP is the acronym for “Transportable Physician Orders for Patient Preferences.” Its stated objective is to “improve the quality of care people receive at the end of life by translating patient/resident goals into medical orders.” TPOPP is printed on ‘hot-pink’ paper and is designed to be a permanent part of the patient file in all settings.
TPOPP is a form aligned with similar documents in other states supervised by a private entity, the National POLST Paradigm Task Force. These forms use a series of check boxes to indicate:
- whether the patient should be resuscitated (DNR),
- which of three basic levels of medical care a patient should receive, and
- whether the patient will get medically administered food and water.
It is items 1 and 3 where TPOPP runs afoul of Kansas law.
Under Kansas law, a directive for DNR (Do Not Resuscitate) requires a witnessed and signed document excluding those who might financially gain by the death of the patient (K,S,A, 65-4943). TPOPP skirts these patient protections as well as eliminating the physician’s immunity from liability for not resuscitating–provided by a legal DNR under K.S.A. 65-4944.
Also, under Kansas law at K.S.A. 59-3075 (e)7), specific prerequisites are needed before guardians may withhold or withdraw life sustaining care. TPOPP ignores this statute.
In essence, TPOPP purports to be physician orders, but it crosses over into legal areas– putting patients’ lives, and physicians’ careers, at risk.
Unfortunately, significant medical groups and facilities across the state that should have been more vigilant and responsible, have already become partners and promoters in implementing TPOPP. (See list) Kansans for Life is notifying hospitals, medical facilities and physician groups about this new Attorney General opinion.
If you or someone you know has filled out a TPOPP form, you should seek counsel immediately on the legal effectiveness of this form. Patients, doctors and other health care professionals should be aware of the legal uncertainty that TPOPP presents.