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A00995 Summary:

BILL NOA00995A
 
SAME ASSAME AS S02445-A
 
SPONSORPaulin
 
COSPNSRRosenthal L, Dinowitz, Hevesi, Steck, Lavine, Lupardo, Rivera, Thiele, Epstein, Seawright, Woerner, Reyes, Fall, Darling, Cruz, Sayegh, Aubry, Davila, Dickens, Stern, Burdick, Gallagher, Kelles, Gonzalez-Rojas, Mitaynes, Mamdani, Clark, Burke, Anderson, Jean-Pierre, Sillitti, Jackson, Pretlow, Septimo, Glick, Gibbs, Tapia, Lunsford, Cunningham, Levenberg, Simone, Bores, Forrest, Shrestha, Shimsky, Raga, Rajkumar, Kim, Hunter, Stirpe, Chandler-Waterman, Ardila, Lee, Taylor, Meeks, Otis, Alvarez
 
MLTSPNSRBraunstein, Bronson, Burgos, Hyndman, Ramos, Zinerman
 
Add Art 28-F 2899-d - 2899-s, Pub Health L
 
Relates to the medical aid in dying act; relates to a terminally ill patient's request for and use of medication for medical aid in dying.
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A00995 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         995--A
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 12, 2023
                                       ___________
 
        Introduced  by  M.  of A. PAULIN, L. ROSENTHAL, DINOWITZ, HEVESI, STECK,
          LAVINE, LUPARDO, VANEL, RIVERA, THIELE, EPSTEIN,  SEAWRIGHT,  WOERNER,
          REYES,  FALL,  DARLING,  CRUZ,  SAYEGH, AUBRY, DAVILA, DICKENS, STERN,
          BURDICK, GALLAGHER, KELLES, GONZALEZ-ROJAS, MITAYNES, MAMDANI,  CLARK,
          BURKE,  ANDERSON,  JEAN-PIERRE,  SILLITTI,  JACKSON, PRETLOW, SEPTIMO,
          GLICK, GIBBS, TAPIA, LUNSFORD, CUNNINGHAM, LEVENBERG,  SIMONE,  BORES,
          FORREST, SHRESTHA, SHIMSKY, RAGA, RAJKUMAR, KIM, HUNTER, STIRPE, CHAN-
          DLER-WATERMAN,  ARDILA,  LEE -- Multi-Sponsored by -- M. of A.  BRAUN-
          STEIN, BRONSON, BURGOS, CARROLL, HYNDMAN, RAMOS, ZINERMAN -- read once
          and referred to the Committee on Health -- committee discharged,  bill
          amended,  ordered reprinted as amended and recommitted to said commit-
          tee
 
        AN ACT to amend the public health law, in relation to a  terminally  ill
          patient's request for and use of medication for medical aid in dying
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. This act shall be known and may be cited  as  the  "medical
     2  aid in dying act".
     3    §  2. The public health law is amended by adding a new article 28-F to
     4  read as follows:
     5                                ARTICLE 28-F
     6                            MEDICAL AID IN DYING
     7  Section 2899-d. Definitions.
     8          2899-e. Request process.
     9          2899-f. Attending physician responsibilities.
    10          2899-g. Right to rescind request; requirement to offer  opportu-
    11                    nity to rescind.
    12          2899-h. Consulting physician responsibilities.
    13          2899-i. Referral to mental health professional.
    14          2899-j. Medical record documentation requirements.
    15          2899-k. Form of written request and witness attestation.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02188-05-3

        A. 995--A                           2
 
     1          2899-l. Protection and immunities.
     2          2899-m. Permissible refusals and prohibitions.
     3          2899-n. Relation to other laws and contracts.
     4          2899-o. Safe disposal of unused medications.
     5          2899-p. Death certificate.
     6          2899-q. Reporting.
     7          2899-r. Penalties.
     8          2899-s. Severability.
     9    § 2899-d. Definitions. As used in this article:
    10    1. "Adult" means an individual who is eighteen years of age or older.
    11    2. "Attending physician" means the physician who has primary responsi-
    12  bility for the care of the patient and treatment of the patient's termi-
    13  nal illness or condition.
    14    3.  "Decision-making  capacity"  means  the  ability to understand and
    15  appreciate the nature and consequences of health care decisions, includ-
    16  ing the benefits and risks of and alternatives to  any  proposed  health
    17  care, including medical aid in dying, and to reach an informed decision.
    18    4.    "Consulting  physician"  means  a  physician who is qualified by
    19  specialty or experience to make a professional diagnosis  and  prognosis
    20  regarding a person's terminal illness or condition.
    21    5.  "Health  care facility" means a general hospital, nursing home, or
    22  residential health care facility  as  defined  in  section  twenty-eight
    23  hundred  one  of  this  chapter, or a hospice as defined in section four
    24  thousand two of this chapter; provided that for the purposes of  section
    25  twenty  eight  hundred  ninety-nine-m  of  this article, "hospice" shall
    26  refer only to a facility providing in-patient hospice care or a  hospice
    27  residence.
    28    6.  "Health  care  provider"  means  a  person licensed, certified, or
    29  authorized by law to administer health care or  dispense  medication  in
    30  the ordinary course of business or practice of a profession.
    31    7.  "Informed decision" means a decision by a patient who is suffering
    32  from   a   terminal  illness  or  condition  to  request  and  obtain  a
    33  prescription for medication that the patient may self-administer to  end
    34  the  patient's life that is based on an understanding and acknowledgment
    35  of the relevant facts and that is made voluntarily, of the patient's own
    36  volition and without coercion, after being fully informed of:
    37    (a) the patient's medical diagnosis and prognosis;
    38    (b) the potential risks associated with taking the  medication  to  be
    39  prescribed;
    40    (c) the probable result of taking the medication to be prescribed;
    41    (d)  the  possibility  that  the  patient may choose not to obtain the
    42  medication, or may obtain the medication but may decide not to  self-ad-
    43  minister it; and
    44    (e)  the  feasible  alternatives  and  appropriate  treatment options,
    45  including but not limited to palliative care and hospice care.
    46    8. "Medical aid in dying" means the medical practice  of  a  physician
    47  prescribing medication to a qualified individual that the individual may
    48  choose to self-administer to bring about death.
    49    9.  "Medically  confirmed"  means the medical opinion of the attending
    50  physician that a patient has a terminal illness  or  condition  and  has
    51  made  an  informed  decision  which  has  been confirmed by a consulting
    52  physician who has  examined  the  patient  and  the  patient's  relevant
    53  medical records.
    54    10. "Medication" means medication prescribed by a physician under this
    55  article.

        A. 995--A                           3

     1    11.  "Mental health professional" means a licensed physician, who is a
     2  diplomate or eligible to be certified by a national board of psychiatry,
     3  psychiatric nurse practitioner, or psychologist, licensed  or  certified
     4  under  the  education law acting within his or her scope of practice and
     5  who  is  qualified,  by training and experience, certification, or board
     6  certification or eligibility, to  make  a  determination  under  section
     7  twenty-eight hundred ninety-nine-i of this article.
     8    12. "Palliative care" means health care treatment, including interdis-
     9  ciplinary  end-of-life  care,  and consultation with patients and family
    10  members, to prevent or relieve pain and suffering  and  to  enhance  the
    11  patient's quality of life, including hospice care under article forty of
    12  this chapter.
    13    13.  "Patient"  means  a  person who is eighteen years of age or older
    14  under the care of a physician.
    15    14. "Physician" means an individual licensed to practice  medicine  in
    16  New York state.
    17    15.  "Qualified individual" means a patient with a terminal illness or
    18  condition, who has decision-making capacity, has made an informed  deci-
    19  sion,  and  has  satisfied  the requirements of this article in order to
    20  obtain a prescription for medication.
    21    16. "Self-administer"  means  a  qualified  individual's  affirmative,
    22  conscious,  and  voluntary  act to ingest medication under this article.
    23  Self-administration  does  not  include  lethal  injection   or   lethal
    24  infusion.
    25    17.  "Terminal  illness or condition" means an incurable and irrevers-
    26  ible illness or condition that has been medically  confirmed  and  will,
    27  within reasonable medical judgment, produce death within six months.
    28    § 2899-e. Request  process.    1.  Oral and written request. A patient
    29  wishing to request medication under this  article  shall  make  an  oral
    30  request  and  submit a written request to the patient's attending physi-
    31  cian.
    32    2. Making a written request. A patient may make a written request  for
    33  and  consent to self-administer medication for the purpose of ending his
    34  or her life in accordance with this article if the patient:
    35    (a) has been determined by the attending physician to have a  terminal
    36  illness  or  condition  and  which  has  been  medically  confirmed by a
    37  consulting physician; and
    38    (b) based on an  informed  decision,  expresses  voluntarily,  of  the
    39  patient's  own  volition and without coercion the request for medication
    40  to end his or her life.
    41    3. Written request signed and witnessed. (a)  A  written  request  for
    42  medication  under  this article shall be signed and dated by the patient
    43  and witnessed by at least  two  adults  who,  in  the  presence  of  the
    44  patient,  attest that to the best of his or her knowledge and belief the
    45  patient has decision-making capacity, is acting voluntarily,  is  making
    46  the  request  for medication of his or her own volition and is not being
    47  coerced to sign the request. The written request shall  be  in  substan-
    48  tially  the form described in section twenty-eight hundred ninety-nine-k
    49  of this article.
    50    (b) Both witnesses shall be adults who are not:
    51    (i) a relative of the patient by blood, marriage or adoption;
    52    (ii) a person who at the time the request is signed would be  entitled
    53  to any portion of the estate of the patient upon death under any will or
    54  by operation of law; or

        A. 995--A                           4
 
     1    (iii)  an  owner,  operator,  employee  or independent contractor of a
     2  health care facility where the patient is receiving treatment  or  is  a
     3  resident.
     4    (c)  The attending physician, consulting physician and, if applicable,
     5  the mental health professional who provides a  decision-making  capacity
     6  determination of the patient under this article shall not be a witness.
     7    4. No person shall qualify for medical aid in dying under this article
     8  solely because of age or disability.
     9    5.  Requests  for  a medical aid-in-dying prescription must be made by
    10  the qualified individual and may not be made by  any  other  individual,
    11  including  the  qualified individual's health care agent, or other agent
    12  or surrogate, or via advance healthcare directive.
    13    § 2899-f. Attending  physician  responsibilities.  1.  The   attending
    14  physician  shall  examine  the  patient  and his or her relevant medical
    15  records and:
    16    (a) make a determination of whether a patient has a  terminal  illness
    17  or  condition,  has decision-making capacity, has made an informed deci-
    18  sion and has made the request voluntarily of the patient's own  volition
    19  and without coercion;
    20    (b)  inform  the  patient  of  the  requirement under this article for
    21  confirmation by a consulting physician,  and  refer  the  patient  to  a
    22  consulting physician upon the patient's request;
    23    (c)  refer  the  patient  to  a mental health professional pursuant to
    24  section twenty-eight  hundred  ninety-nine-i  of  this  article  if  the
    25  attending  physician  believes that the patient may lack decision-making
    26  capacity to make an informed decision;
    27    (d) provide  information  and  counseling  under  section  twenty-nine
    28  hundred ninety-seven-c of this chapter;
    29    (e) ensure that the patient is making an informed decision by discuss-
    30  ing with the patient: (i) the patient's medical diagnosis and prognosis;
    31  (ii)  the  potential  risks  associated with taking the medication to be
    32  prescribed; (iii) the probable result of taking  the  medication  to  be
    33  prescribed;  (iv)  the possibility that the patient may choose to obtain
    34  the medication but not take it; (v) the feasible alternatives and appro-
    35  priate treatment options, including but not limited to  (1)  information
    36  and  counseling  regarding  palliative  and hospice care and end-of-life
    37  options appropriate to the patient, including but not  limited  to:  the
    38  range  of  options  appropriate to the patient; the prognosis, risks and
    39  benefits of the various options;  and  the  patient's  legal  rights  to
    40  comprehensive  pain  and  symptom management at the end of life; and (2)
    41  information regarding treatment  options  appropriate  to  the  patient,
    42  including  the  prognosis,  risks  and benefits of the various treatment
    43  options;
    44    (f) offer  to  refer  the  patient  for  other  appropriate  treatment
    45  options, including but not limited to palliative care and hospice care;
    46    (g)  provide  health  literate  and culturally appropriate educational
    47  material regarding hospice and palliative care that has been prepared by
    48  the department in  consultation  with  representatives  of  hospice  and
    49  palliative  care  providers from all regions of New York state, and that
    50  is available on  the  department's  website  for  access  and  download,
    51  provided,  however,  an otherwise eligible patient cannot be denied care
    52  under this article if these materials are not developed by the effective
    53  date of this article;
    54    (h) discuss with the patient the importance of:

        A. 995--A                           5
 
     1    (i) having another person present when the patient takes  the  medica-
     2  tion  and  the  restriction  that  no  person other than the patient may
     3  administer the medication;
     4    (ii) not taking the medication in a public place; and
     5    (iii)  informing  the  patient's  family  of the patient's decision to
     6  request and take medication that will end the patient's life; a  patient
     7  who  declines  or  is  unable to notify family shall not have his or her
     8  request for medication denied for that reason;
     9    (i) inform the patient that he or she  may  rescind  the  request  for
    10  medication at any time and in any manner;
    11    (j)  fulfill  the medical record documentation requirements of section
    12  twenty-eight hundred ninety-nine-j of this article; and
    13    (k) ensure that all appropriate steps are carried  out  in  accordance
    14  with this article before writing a prescription for medication.
    15    2.  Upon  receiving  confirmation  from  a  consulting physician under
    16  section twenty-eight hundred ninety-nine-h of this article  and  subject
    17  to  section  twenty-eight  hundred  ninety-nine-i  of  this article, the
    18  attending physician who determines  that  the  patient  has  a  terminal
    19  illness or condition, has decision-making capacity and has made a volun-
    20  tary request for medication as provided in this article, may personally,
    21  or  by  referral  to  another  physician, prescribe or order appropriate
    22  medication in accordance with the patient's request under this  article,
    23  and at the patient's request, facilitate the filling of the prescription
    24  and delivery of the medication to the patient.
    25    3.  In  accordance  with  the direction of the prescribing or ordering
    26  physician and the consent of the patient, the patient may  self-adminis-
    27  ter  the medication to himself or herself. A health care professional or
    28  other person shall not administer the medication to the patient.
    29    § 2899-g. Right to rescind request; requirement to  offer  opportunity
    30  to rescind.  1. A patient may at any time rescind his or her request for
    31  medication  under this article without regard to the patient's decision-
    32  making capacity.
    33    2. A prescription for  medication  may  not  be  written  without  the
    34  attending  physician offering the qualified individual an opportunity to
    35  rescind the request.
    36    § 2899-h. Consulting physician responsibilities. Before a patient  who
    37  is requesting medication may receive a prescription for medication under
    38  this article, a consulting physician must:
    39    1. examine the patient and his or her relevant medical records;
    40    2.  confirm,  in  writing, to the attending physician and the patient,
    41  whether: (a) the patient has a terminal illness or  condition;  (b)  the
    42  patient  is  making  an informed decision; (c) the patient has decision-
    43  making capacity, or provide documentation that the consulting  physician
    44  has  referred the patient for a determination under section twenty-eight
    45  hundred ninety-nine-i of this article; and (d)  the  patient  is  acting
    46  voluntarily, of the patient's own volition and without coercion.
    47    § 2899-i. Referral  to mental health professional. 1. If the attending
    48  physician or the consulting physician determines that  the  patient  may
    49  lack  decision-making  capacity  to  make  an informed decision due to a
    50  condition, including, but not limited to, a psychiatric or psychological
    51  disorder, or other condition causing impaired judgement,  the  attending
    52  physician  or  consulting  physician shall refer the patient to a mental
    53  health professional for a determination of whether the patient has deci-
    54  sion-making capacity to make an informed decision. The referring  physi-
    55  cian  shall  advise  the  patient  that  the report of the mental health

        A. 995--A                           6
 
     1  professional will  be  provided  to  the  attending  physician  and  the
     2  consulting physician.
     3    2.  A  mental  health  professional who evaluates a patient under this
     4  section shall report, in writing, to the  attending  physician  and  the
     5  consulting  physician,  his or her independent conclusions about whether
     6  the patient has decision-making capacity to make an  informed  decision,
     7  provided  that  if,  at  the time of the report, the patient has not yet
     8  been referred to a consulting physician, then upon referral the  attend-
     9  ing  physician shall provide the consulting physician with a copy of the
    10  mental health professional's report. If the mental  health  professional
    11  determines  that  the  patient lacks decision-making capacity to make an
    12  informed decision, the patient shall not be deemed a qualified  individ-
    13  ual,  and  the attending physician shall not prescribe medication to the
    14  patient.
    15    3. A determination made pursuant to this section that an adult patient
    16  lacks decision-making capacity shall not be construed as a finding  that
    17  the patient lacks decision-making capacity for any other purpose.
    18    § 2899-j. Medical  record  documentation  requirements.  An  attending
    19  physician shall document or file the following in the patient's  medical
    20  record:
    21    1.  the dates of all oral requests by the patient for medication under
    22  this article;
    23    2. the written request by the patient for medication under this  arti-
    24  cle,  including  the declaration of witnesses and interpreter's declara-
    25  tion, if applicable;
    26    3. the attending physician's diagnosis and prognosis, determination of
    27  decision-making capacity, and determination that the patient  is  acting
    28  voluntarily, of the patient's own volition and without coercion, and has
    29  made an informed decision;
    30    4.  if  applicable,  written  confirmation of decision-making capacity
    31  under section twenty-eight hundred ninety-nine-i of this article; and
    32    5. a note by the attending physician indicating that all  requirements
    33  under this article have been met and indicating the steps taken to carry
    34  out  the  request,  including a notation of the medication prescribed or
    35  ordered.
    36    § 2899-k. Form of  written  request  and  witness  attestation.  1.  A
    37  request  for medication under this article shall be in substantially the
    38  following form:
    39                    REQUEST FOR MEDICATION TO END MY LIFE
 
    40    I, _________________________________, am an adult  who  has  decision-
    41  making  capacity, which means I understand and appreciate the nature and
    42  consequences of health care decisions, including the benefits and  risks
    43  of  and  alternatives  to  any  proposed  health  care,  and to reach an
    44  informed decision and to communicate health care decisions to  a  physi-
    45  cian.
    46    I  have been diagnosed with ______________(insert diagnosis), which my
    47  attending physician has determined is a terminal illness  or  condition,
    48  which has been medically confirmed by a consulting physician.
    49    I  have  been fully informed of my diagnosis and prognosis, the nature
    50  of the medication to be prescribed and potential associated  risks,  the
    51  expected  result,  and  the  feasible alternatives and treatment options
    52  including but not limited to palliative care and hospice care.
    53    I request that my attending physician prescribe medication  that  will
    54  end  my life if I choose to take it, and I authorize my attending physi-
    55  cian to contact another physician or any pharmacist about my request.

        A. 995--A                           7
 
     1    INITIAL ONE:
     2    (    )  I  have informed or intend to inform one or more members of my
     3  family of my decision.
     4    (  ) I have decided not to inform any member of my family of my  deci-
     5  sion.
     6    (  ) I have no family to inform of my decision.
     7    I  understand that I have the right to rescind this request or decline
     8  to use the medication at any time.
     9    I understand the importance of this request, and I expect to die if  I
    10  take the medication to be prescribed. I further understand that although
    11  most  deaths  occur within three hours, my death may take longer, and my
    12  attending physician has counseled me about this possibility.
    13    I make this request voluntarily, of my own volition and without  being
    14  coerced, and I accept full responsibility for my actions.
 
    15  Signed: __________________________
 
    16  Dated: ___________________________
 
    17                          DECLARATION OF WITNESSES
 
    18    I  declare that the person signing this "Request for Medication to End
    19  My Life":
    20    (a) is personally known to me or has provided proof of identity;
    21    (b) voluntarily signed the "Request for Medication to End My Life"  in
    22  my presence or acknowledged to me that he or she signed it; and
    23    (c) to the best of my knowledge and belief, has decision-making capac-
    24  ity  and is making the "Request for Medication to End My Life" voluntar-
    25  ily, of his or her own volition and is not being  coerced  to  sign  the
    26  "Request for Medication to End My Life".
    27    I am not the attending physician or consulting physician of the person
    28  signing  the  "Request for Medication to End My Life" or, if applicable,
    29  the mental health professional who provides a  decision-making  capacity
    30  determination  of  the person signing the "Request for Medication to End
    31  My Life" at the time the "Request for Medication to  End  My  Life"  was
    32  signed.
    33    I  further  declare  under penalty of perjury that the statements made
    34  herein are true and correct and false statements made herein are punish-
    35  able.
 
    36  __________________________ Witness 1, Date: ________________

    37  __________________________ (Printed name)
 
    38  __________________________ (Address)
 
    39  __________________________ (Telephone number)
 
    40    I further declare that I am not (i) related to the above-named patient
    41  by blood, marriage or adoption, (ii) entitled at the  time  the  patient
    42  signed the "Request for Medication to End My Life" to any portion of the
    43  estate  of the patient upon his/her death under any will or by operation
    44  of law, or (iii) an owner, operator, employee or independent  contractor
    45  of a health care facility where the patient is receiving treatment or is
    46  a resident.

        A. 995--A                           8
 
     1  __________________________ Witness 2, Date: _________________

     2  __________________________ (Printed name)
 
     3  __________________________ (Address)
 
     4  __________________________ (Telephone number)
 
     5    I further declare that I am not (i) related to the above-named patient
     6  by  blood,  marriage  or adoption, (ii) entitled at the time the patient
     7  signed the "Request for Medication to End My Life" to any portion of the
     8  estate of the patient upon his/her death under any will or by  operation
     9  of  law, or (iii) an owner, operator, employee or independent contractor
    10  of a health care facility where the patient is receiving treatment or is
    11  a resident.
    12    2. (a) The "Request for Medication to End My Life" shall be written in
    13  the same language as any conversations,  consultations,  or  interpreted
    14  conversations or consultations between a patient and at least one of his
    15  or her attending or consulting physicians.
    16    (b)  Notwithstanding  paragraph  (a)  of this subdivision, the written
    17  "Request for Medication to End My Life" may be prepared in English  even
    18  when  the conversations or consultations or interpreted conversations or
    19  consultations were conducted in a language other than  English  or  with
    20  auxiliary  aids  or  hearing,  speech  or  visual  aids,  if the English
    21  language form includes an attached declaration by the interpreter of the
    22  conversation or  consultation,  which  shall  be  in  substantially  the
    23  following form:
 
    24                          INTERPRETER'S DECLARATION

    25    I,  ___________  (insert  name of interpreter)_____ ,(mark as applica-
    26  ble):
    27    (  ) for a patient whose conversations or consultations or interpreted
    28  conversations or consultations were conducted in a language  other  than
    29  English and the "Request for Medication to End My Life" is in English: I
    30  declare that I am fluent in English and (insert target language). I have
    31  the  requisite  language  and interpreter skills to be able to interpret
    32  effectively, accurately and impartially information shared and  communi-
    33  cations  between  the  attending  or  consulting  physician and (name of
    34  patient).
    35    I certify that on (insert date), at  approximately  (insert  time),  I
    36  interpreted  the  communications  and  information  conveyed between the
    37  physician and (name of patient) as accurately and completely to the best
    38  of my knowledge and ability and read the "Request for Medication to  End
    39  My Life" to (name of patient) in (insert target language).
    40    (Name  of  patient) affirmed to me his/her desire to sign the "Request
    41  for Medication to End My Life" voluntarily, of (name of  patient)'s  own
    42  volition and without coercion.
    43    (  )  for  a  patient  with  a speech, hearing or vision disability: I
    44  declare that I have the requisite language, reading  and/or  interpreter
    45  skills  to  communicate  with  the patient and to be able to read and/or
    46  interpret effectively, accurately and impartially information shared and
    47  communications that occurred on (insert date) between the  attending  or
    48  consulting physician and (name of patient).
    49    I  certify  that  on  (insert date), at approximately (insert time), I
    50  read and/or interpreted  the  communications  and  information  conveyed

        A. 995--A                           9
 
     1  between the physician and (name of patient) impartially and as accurate-
     2  ly  and  completely  to  the best of my knowledge and ability and, where
     3  needed for effective communication, read or interpreted the "Request for
     4  Medication to End my Life" to (name of patient).
     5    (Name  of  patient) affirmed to me his/her desire to sign the "Request
     6  for Medication to End My Life" voluntarily, of (name of  patient)'s  own
     7  volition and without coercion.
     8    I  further  declare under penalty of perjury that (i) the foregoing is
     9  true and correct; (ii) I am not (A) related  to  (name  of  patient)  by
    10  blood,  marriage or adoption, (B) entitled at the time (name of patient)
    11  signed the "Request for Medication to End My Life" to any portion of the
    12  estate of (name of patient) upon his/her death  under  any  will  or  by
    13  operation  of  law,  or  (C) an owner, operator, employee or independent
    14  contractor of a health care facility where (name of patient) is  receiv-
    15  ing treatment or is a resident, except that if I am an employee or inde-
    16  pendent  contractor  at such health care facility, providing interpreter
    17  services is part of my job description at such health care facility or I
    18  have been trained to provide interpreter services and (name of  patient)
    19  requested  that  I  provide  interpreter  services  to  him/her  for the
    20  purposes stated in this Declaration; and  (iii)  false  statements  made
    21  herein are punishable.
 
    22  Executed  at  (insert  city,  county  and  state) on this (insert day of
    23  month) of (insert month), (insert year).
 
    24  __________________________ (Signature of Interpreter)
 
    25  __________________________ (Printed name of Interpreter)
 
    26  __________________________ (ID # or Agency Name)
 
    27  __________________________ (Address of Interpreter)
 
    28  __________________________ (Language Spoken by Interpreter)

    29    (c) An interpreter whose services are provided under paragraph (b)  of
    30  this  subdivision  shall not (i) be related to the patient who signs the
    31  "Request for Medication to End My Life" by blood, marriage or  adoption,
    32  (ii) be entitled at the time the "Request for Medication to End My Life"
    33  is  signed  by  the  patient to any portion of the estate of the patient
    34  upon death under any will or by operation of law, or (iii) be an  owner,
    35  operator,  employee  or independent contractor of a health care facility
    36  where the patient is receiving treatment or is a resident; provided that
    37  an employee or independent  contractor  whose  job  description  at  the
    38  health  care facility includes interpreter services or who is trained to
    39  provide interpreter services and who has been requested by  the  patient
    40  to  serve  as  an interpreter under this article shall not be prohibited
    41  from serving as a witness under this article.
    42    § 2899-l. Protection and immunities. 1. A physician, pharmacist, other
    43  health care professional or other person shall not be subject  to  civil
    44  or criminal liability or professional disciplinary action by any govern-
    45  ment  entity  for taking any reasonable good-faith action or refusing to
    46  act under this article, including, but not limited to:  (a) engaging  in
    47  discussions with a patient relating to the risks and benefits of end-of-
    48  life options in the circumstances described in this article, (b) provid-
    49  ing  a  patient,  upon  request,  with a referral to another health care

        A. 995--A                          10
 
     1  provider, (c) being present when a qualified individual self-administers
     2  medication, (d) refraining from acting to prevent the qualified individ-
     3  ual from self-administering such  medication,  or  (e)  refraining  from
     4  acting  to resuscitate the qualified individual after he or she self-ad-
     5  ministers such medication.
     6    2. Nothing in this section shall limit civil or criminal liability for
     7  negligence, recklessness or intentional misconduct.
     8    § 2899-m. Permissible refusals and prohibitions. 1. (a)  A  physician,
     9  nurse,  pharmacist, other health care provider or other person shall not
    10  be under any duty, by law or contract, to participate in  the  provision
    11  of medication to a patient under this article.
    12    (b) If a health care provider is unable or unwilling to participate in
    13  the  provision  of  medication  to  a patient under this article and the
    14  patient transfers care to a new health care provider, the  prior  health
    15  care  provider shall transfer or arrange for the transfer, upon request,
    16  of a copy of the patient's relevant medical records to  the  new  health
    17  care provider.
    18    2.  (a)  A  private health care facility may prohibit the prescribing,
    19  dispensing, ordering or  self-administering  of  medication  under  this
    20  article  while  the  patient is being treated in or while the patient is
    21  residing in the health care facility if:
    22    (i) the prescribing, dispensing,  ordering  or  self-administering  is
    23  contrary  to a formally adopted policy of the facility that is expressly
    24  based on sincerely held religious beliefs or moral  convictions  central
    25  to the facility's operating principles; and
    26    (ii)  the  facility  has  informed the patient of such policy prior to
    27  admission or as soon as reasonably possible.
    28    (b) Where a facility has adopted a prohibition under this subdivision,
    29  if a patient who wishes to use medication under this  article  requests,
    30  the patient shall be transferred promptly to another health care facili-
    31  ty  that is reasonably accessible under the circumstances and willing to
    32  permit the prescribing, dispensing, ordering and  self-administering  of
    33  medication under this article with respect to the patient.
    34    3.  Where  a health care facility has adopted a prohibition under this
    35  subdivision,  any  health  care  provider  or  employee  or  independent
    36  contractor  of  the facility who violates the prohibition may be subject
    37  to sanctions otherwise available to the facility, provided the  facility
    38  has  previously notified the health care provider, employee or independ-
    39  ent contractor of the prohibition in writing.
    40    § 2899-n. Relation to other laws and contracts. 1. (a) A  patient  who
    41  requests  medication  under  this  article  shall  not,  because of that
    42  request, be considered to be a person who is suicidal, and self-adminis-
    43  tering medication under this article shall not be deemed to be  suicide,
    44  for any purpose.
    45    (b)  Action  taken  in  accordance  with  this  article  shall  not be
    46  construed for any  purpose  to  constitute  suicide,  assisted  suicide,
    47  attempted  suicide, promoting a suicide attempt, euthanasia, mercy kill-
    48  ing, or homicide under the law, including as an accomplice or  accessory
    49  or otherwise.
    50    2.  (a)  No  provision in a contract, will or other agreement, whether
    51  written or oral, to the extent the  provision  would  affect  whether  a
    52  person  may  make  or rescind a request for medication or take any other
    53  action under this article, shall be valid.
    54    (b) No obligation owing under any contract  shall  be  conditioned  or
    55  affected  by the making or rescinding of a request by a person for medi-
    56  cation or taking any other action under this article.

        A. 995--A                          11
 
     1    3. (a) A person and his or her beneficiaries shall not be denied bene-
     2  fits under a life insurance policy for actions taken in accordance  with
     3  this article.
     4    (b)  Notwithstanding  the provisions of any law or contract, the sale,
     5  procurement or issuance of a life or health insurance or annuity policy,
     6  or the rate charged for a policy,  shall  not  be  conditioned  upon  or
     7  affected  by  a  patient  making  or rescinding a request for medication
     8  under this article.
     9    4. An insurer shall not provide any information in communications made
    10  to a patient about the availability of  medication  under  this  article
    11  absent  a  request  by  the patient or by his or her attending physician
    12  upon the request of such patient. Any communication  shall  not  include
    13  both  the  denial  of  coverage  for treatment and information as to the
    14  availability of medication under this article.
    15    5. The sale, procurement, or issue  of  any  professional  malpractice
    16  insurance  policy or the rate charged for the policy shall not be condi-
    17  tioned upon or affected by whether the insured does or does not take  or
    18  participate in any action under this article.
    19    § 2899-o. Safe  disposal  of  unused  medications.    A person who has
    20  custody or control of any unused medication prescribed under this  arti-
    21  cle after the death of the qualified individual shall personally deliver
    22  the  unused  medication  for  disposal to the nearest qualified facility
    23  that properly disposes of controlled substances or shall dispose  of  it
    24  by lawful means in accordance with regulations made by the commissioner,
    25  regulations  made  by or guidelines of the commissioner of education, or
    26  guidelines of a federal drug enforcement administration  approved  take-
    27  back  program. A qualified facility that properly disposes of controlled
    28  substances shall accept and dispose of any medication delivered to it as
    29  provided hereunder regardless of whether such medication is a controlled
    30  substance. The commissioner may make regulations as may  be  appropriate
    31  for  the  safe  disposal  of unused medications prescribed, dispensed or
    32  ordered under this article as provided in this section.
    33    § 2899-p. Death certificate.  1. If otherwise authorized by  law,  the
    34  attending  physician  may  sign the qualified individual's death certif-
    35  icate.
    36    2. The cause of death listed on a qualified individual's death certif-
    37  icate who dies after self-administering medication  under  this  article
    38  will be the underlying terminal illness or condition.
    39    § 2899-q. Reporting.  1.  The  commissioner  shall  annually  review a
    40  sample of the records maintained  under  sections  twenty-eight  hundred
    41  ninety-nine-j  and  twenty-eight  hundred ninety-nine-p of this article.
    42  The commissioner shall adopt regulations establishing reporting require-
    43  ments for physicians taking  action  under  this  article  to  determine
    44  utilization  and compliance with this article. The information collected
    45  under this subdivision shall not constitute a  public  record  available
    46  for  public inspection and shall be confidential and collected and main-
    47  tained in a manner that protects the privacy of the patient, his or  her
    48  family,  and  any  health  care  provider acting in connection with such
    49  patient  under  this  article,  except  that  such  information  may  be
    50  disclosed  to  a  governmental  agency  as authorized or required by law
    51  relating to professional discipline, protection of public health or  law
    52  enforcement.
    53    2.  The  commissioner shall prepare a report annually containing rele-
    54  vant data regarding utilization and compliance  with  this  article  and
    55  shall  send  such report to the legislature, and post such report on the
    56  department's website.

        A. 995--A                          12
 
     1    § 2899-r. Penalties. 1. Nothing in this article shall be construed  to
     2  limit  professional discipline or civil liability resulting from conduct
     3  in violation of this article, negligent conduct, or intentional  miscon-
     4  duct by any person.
     5    2. Conduct in violation of this article shall be subject to applicable
     6  criminal  liability  under  state  law, including, where appropriate and
     7  without limitation, offenses constituting homicide,  forgery,  coercion,
     8  and related offenses, or federal law.
     9    § 2899-s. Severability. If any provision of this article or any appli-
    10  cation  of  any  provision of this article, is held to be invalid, or to
    11  violate or be inconsistent with any  federal  law  or  regulation,  that
    12  shall not affect the validity or effectiveness of any other provision of
    13  this article, or of any other application of any provision of this arti-
    14  cle,  which  can  be given effect without that provision or application;
    15  and to that end, the provisions and applications  of  this  article  are
    16  severable.
    17    § 3. This act shall take effect immediately.
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