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HB 1254

An Act amending Title 20 (Decedents, Estates and Fiduciaries) of the Pennsylvania Consolidated Statutes, in health care, further providing for applicability, for definitions, for criminal penalties, for definitions, for orders, bracelets and necklaces, for revocation, for absence of order, bracelet or necklace and for emergency medical services, repealing provisions relating to advisory committee and providing for discontinuance and for Pennsylvania orders for life-sustaining treatment; and making an editorial change.

2025-2026 Regular Session Introduced by Johanny Cepeda-Freytiz and 15 co-sponsors

Pennsylvania replaces DNR orders with comprehensive life-sustaining treatment orders, requiring new definitions, procedures, and emergency responder protocols to govern end-of-life medical decisions.

Referred to Judiciary
0
WeVote Research Nonpartisan
Bill Summary · HB 1254

Legislative bill overview

HB 1254 comprehensively reforms Pennsylvania's end-of-life medical decision-making framework by replacing the existing "do not resuscitate" (DNR) order system with a new "Pennsylvania Orders for Life-Sustaining Treatment" (POLST) system. The bill updates definitions, criminal penalties, and procedures for how patients can communicate their healthcare preferences regarding life-sustaining treatments, while eliminating the previous advisory committee structure.

Why is this important

End-of-life care decisions directly affect how Pennsylvanians receive medical treatment during critical moments and how their final wishes are honored. The shift from DNR orders to POLST orders represents a broader national trend toward more comprehensive advance directive systems that address multiple types of life-sustaining treatments (not just resuscitation), potentially giving patients more nuanced control over their care and reducing medical interventions that may conflict with their values.

Potential points of contention

  • Scope expansion: Moving beyond simple DNR orders to comprehensive life-sustaining treatment decisions may create confusion about what patients are actually authorizing or refusing, requiring clear education and implementation protocols
  • Vulnerable population safeguards: Broader end-of-life authority requires robust protections against coercion or undue influence on patients with cognitive impairment, dementia, or limited health literacy
  • Emergency responder compliance: EMS personnel must quickly interpret and honor POLST orders in high-stress situations; inconsistent application across jurisdictions could create liability and patient safety concerns

Compiled from official sources — confirm details with the bill’s official record.

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