Pennsylvania defines regulations for out-of-hospital DNR orders and emergency medical services

Pennsylvania's House Bill 1254, introduced on April 17, 2025, aims to tighten regulations surrounding advance health care directives and out-of-hospital do-not-resuscitate (OOH-DNR) orders. The bill seeks to address critical issues of fraud and coercion in the creation and alteration of these vital documents, which dictate patient care preferences in emergencies.

At the heart of the legislation is a provision that criminalizes the falsification or forgery of advance health care directives, OOH-DNR orders, and related identifiers such as bracelets and necklaces. This move is designed to protect vulnerable patients from potential exploitation and ensure that their health care wishes are honored without undue influence.

The bill has sparked significant debate among lawmakers and health care advocates. Proponents argue that it is essential for safeguarding patient autonomy and preventing abuse, particularly among elderly or incapacitated individuals. Critics, however, express concerns about the potential for overreach and the implications for health care providers who may inadvertently find themselves in legal jeopardy.

Economic implications are also at play, as the bill could lead to increased administrative burdens for health care providers who must ensure compliance with the new regulations. Additionally, the legislation may prompt discussions about the adequacy of current training for emergency medical services (EMS) personnel regarding the handling of OOH-DNR orders.

As the bill moves through the legislative process, experts predict that it could set a precedent for similar measures in other states, reflecting a growing national focus on patient rights and ethical health care practices. The outcome of House Bill 1254 will likely influence how health care directives are managed in Pennsylvania and beyond, shaping the landscape of patient care for years to come.