If parental rights have been terminated for both parents, or the parents are deceased, and the attending physician recommends end-of-life care, the caseworker and supervisor must:
• obtain a written statement from the attending physician certifying that the child has a terminal or irreversible condition and that the physician recommends withholding or withdrawing life-sustaining treatment;
• request a second opinion or a review by a hospital medical or ethics review board if there are any concerns about the attending physician's recommendation. The hospital decides whether to convene a review committee;
• confirm that there is no relative, fictive kin, or other individual with possessory or custodial rights. If one is available, that person must be consulted for end-of-life decisions if possible;
• notify and discuss the recommendation with the program director, regional director, regional attorney, attorney representing DFPS, the child's attorney ad litem, guardian ad litem, CASA (if applicable), and any other legal party to the case; and
• notify and consult with the local court, according to the procedures explained below.
If the court … | The caseworker must… |
|---|---|
will rule on the decision… | • involve the attorney representing DFPS, the child's attorney ad litem, the child's guardian ad litem, any individual with possessory or custodial rights, and any other involved individuals in developing a recommendation for the court. (If there is no attorney ad litem, the caseworker must recommend that the court appoint one); and • comply with the court's directive or order. The commissioner must take any action necessary to carry out the court's decision. |
declines to rule on the decision… | • involve the attorney representing DFPS, the child's attorney ad litem, the child's guardian ad litem, any individual with possessory or custodial rights, and any other involved individuals in developing a recommendation about the child's care; • present the recommendation to the regional director; • the regional director must present the recommendation to the commissioner for the commissioner's decision; • notify the hospital or healthcare provider and the court of the commissioner's decision. The commissioner must take any action necessary to carry out the decision. |
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