110 CMR 11.12 - No Code Orders

(1) "No code" order means a medical order regarding a terminally ill patient directing a hospital and its staff not to use heroic medical efforts in the event of cardiac or respiratory failure. Heroic medical efforts include invasive and traumatic life-saving techniques such as intracardial medication, intracardial massage and electric shock treatment. No code orders include "do not resuscitate" orders or orders stated in different language attempting to accomplish substantially the same result as a "no code" order. See Custody of a Minor, 385 Mass. 697, 434 N.E.2d 601 (1982).

(2) No Consent by Department. Department staff shall not consent to the entry of a "no code" order for any ward or child in its care or custody. See Custody of a Minor, 434 N.E.2d 601 (1982).

(3) Consent by Parents.

(a) With respect to a child who is in the care of the Department, the right to consent or to refuse to consent to the entry of a "no code" order shall remain with the child's parents, unless otherwise limited by court order. If the Department has reason to believe that the parents are guilty of medical neglect by their consent to a "no code" order, the Department shall seek custody through a court proceeding which alleges medical neglect.

(b) With respect to a child who is a ward of the Department or is in Department custody, when a medical provider seeks the Department's consent to the entry of a "no code" order, the Department shall not consent unless it seeks and receives prior judicial approval for the entry of a "no code" order, even if the child's biological parents have consented to the entry of such order. See Custody of a Minor, 434 N.E.2d 601, 608 (1982). When seeking prior judicial approval, the Department shall file a Motion for Appointment of a Guardian ad Litem to investigate whether such order should enter.

Notes

110 CMR 11.12

Amended by Mass Register Issue 1475, eff. 8/5/2022.