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A02694 Summary:

BILL NOA02694
 
SAME ASSAME AS S03947
 
SPONSORPaulin (MS)
 
COSPNSRRosenthal L, Gottfried, Dinowitz, Galef, Hevesi, Steck, Blake, Lavine, Lupardo, Abinanti, Rodriguez, Jaffee, D'Urso, Miller MG, Ortiz, Arroyo, Simotas, Vanel, Quart, Rivera, Miller ML, Thiele, Mosley, Epstein, Seawright, Woerner, Reyes, Frontus, Fernandez, Griffin, Fall, Raynor
 
MLTSPNSRBraunstein, Crouch, Lifton
 
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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A02694 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          2694
 
                               2019-2020 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 25, 2019
                                       ___________
 
        Introduced by M. of A. PAULIN, L. ROSENTHAL, GOTTFRIED, DINOWITZ, GALEF,
          HEVESI,  STECK,  BLAKE,  LAVINE, LUPARDO, ABINANTI, RODRIGUEZ, JAFFEE,
          JONES, D'URSO, M. G. MILLER, ORTIZ,  ARROYO,  SIMOTAS,  VANEL,  QUART,
          RIVERA,  M. L. MILLER,  THIELE, MOSLEY, EPSTEIN, SEAWRIGHT, WOERNER --
          Multi-Sponsored by -- M. of A. BRAUNSTEIN, CROUCH, LIFTON -- read once
          and referred to the Committee on Health
 
        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.
    16          2899-l. Protection and immunities.
    17          2899-m. Permissible refusals and prohibitions.
    18          2899-n. Relation to other laws and contracts.
    19          2899-o. Safe disposal of unused medications.
    20          2899-p. Death certificate.
    21          2899-q. Reporting.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00626-02-9

        A. 2694                             2
 
     1          2899-r. Penalties.
     2          2899-s. Severability.
     3    § 2899-d. Definitions. As used in this article:
     4    1. "Adult" means an individual who is eighteen years of age or older.
     5    2. "Attending physician" means the physician who has primary responsi-
     6  bility for the care of the patient and treatment of the patient's termi-
     7  nal illness or condition.
     8    3.  "Capacity"  means  the  ability  to  understand and appreciate the
     9  nature and consequences of health care decisions, including the benefits
    10  and risks of and alternatives to any  proposed  health  care,  including
    11  medical aid in dying, and to reach an informed decision.
    12    4.    "Consulting  physician"  means  a  physician who is qualified by
    13  specialty or experience to make a professional diagnosis  and  prognosis
    14  regarding a person's terminal illness or condition.
    15    5.  "Health  care facility" means a general hospital, nursing home, or
    16  residential health care facility  as  defined  in  section  twenty-eight
    17  hundred  one  of  this  chapter, or a hospice as defined in section four
    18  thousand two of this chapter; provided that for the purposes of  section
    19  twenty  eight  hundred  ninety-nine-m  of  this article, "hospice" shall
    20  refer only to a facility providing in-patient hospice care or a  hospice
    21  residence.
    22    6.  "Health  care  provider"  means  a  person licensed, certified, or
    23  authorized by law to administer health care or  dispense  medication  in
    24  the ordinary course of business or practice of a profession.
    25    7.  "Informed decision" means a decision by a patient who is suffering
    26  from   a   terminal  illness  or  condition  to  request  and  obtain  a
    27  prescription for medication that the patient may self-administer to  end
    28  the  patient's life that is based on an understanding and acknowledgment
    29  of the relevant facts and that is made voluntarily, of the patient's own
    30  volition and without coercion, after being fully informed of:
    31    (a) the patient's medical diagnosis and prognosis;
    32    (b) the potential risks associated with taking the  medication  to  be
    33  prescribed;
    34    (c) the probable result of taking the medication to be prescribed;
    35    (d)  the  possibility  that  the  patient may choose not to obtain the
    36  medication, or may obtain the medication but may decide not to  self-ad-
    37  minister it; and
    38    (e)  the  feasible  alternatives  and  appropriate  treatment options,
    39  including but not limited to palliative care and hospice care.
    40    8. "Medical aid in dying" means the medical practice  of  a  physician
    41  prescribing medication to a qualified individual that the individual may
    42  choose to self-administer to bring about death.
    43    9.  "Medically  confirmed"  means the medical opinion of the attending
    44  physician that a patient has a terminal illness  or  condition  and  has
    45  made  an  informed  decision  which  has  been confirmed by a consulting
    46  physician who has  examined  the  patient  and  the  patient's  relevant
    47  medical records.
    48    10. "Medication" means medication prescribed by a physician under this
    49  article.
    50    11.  "Mental health professional" means a licensed physician, who is a
    51  diplomate or eligible to be certified by a national board of psychiatry,
    52  psychiatric nurse practitioner, or psychologist, licensed  or  certified
    53  under  the  education law acting within his or her scope of practice and
    54  who is qualified, by training and experience,  certification,  or  board
    55  certification  or  eligibility,  to  make  a determination under section
    56  twenty-eight hundred ninety-nine-i of this article.

        A. 2694                             3
 
     1    12. "Palliative care" means health care treatment, including interdis-
     2  ciplinary end-of-life care, and consultation with  patients  and  family
     3  members,  to  prevent  or  relieve pain and suffering and to enhance the
     4  patient's quality of life, including hospice care under article forty of
     5  this chapter.
     6    13.  "Patient"  means  a  person who is eighteen years of age or older
     7  under the care of a physician.
     8    14. "Physician" means an individual licensed to practice  medicine  in
     9  New York state.
    10    15.  "Qualified individual" means a patient with a terminal illness or
    11  condition, who has capacity, has made  an  informed  decision,  and  has
    12  satisfied  the  requirements  of  this  article  in  order  to  obtain a
    13  prescription for medication.
    14    16. "Self-administer"  means  a  qualified  individual's  affirmative,
    15  conscious, and voluntary act of using medication under this article.
    16    17.  "Terminal  illness or condition" means an incurable and irrevers-
    17  ible illness or condition that has been medically  confirmed  and  will,
    18  within reasonable medical judgment, produce death within six months.
    19    § 2899-e. Request  process.    1.  Oral and written request. A patient
    20  wishing to request medication under this  article  shall  make  an  oral
    21  request  and  submit a written request to the patient's attending physi-
    22  cian.
    23    2. Making a written request. A patient may make a written request  for
    24  and  consent to self-administer medication for the purpose of ending his
    25  or her life in accordance with this article if the patient:
    26    (a) has been determined by the attending physician to have a  terminal
    27  illness  or  condition  and  which  has  been  medically  confirmed by a
    28  consulting physician; and
    29    (b) based on an  informed  decision,  expresses  voluntarily,  of  the
    30  patient's  own  volition and without coercion the request for medication
    31  to end his or her life.
    32    3. Written request signed and witnessed. (a)  A  written  request  for
    33  medication  under  this article shall be signed and dated by the patient
    34  and witnessed by at least  two  adults  who,  in  the  presence  of  the
    35  patient,  attest that to the best of his or her knowledge and belief the
    36  patient has capacity, is acting voluntarily, is making the  request  for
    37  medication  of  his or her own volition and is not being coerced to sign
    38  the request. The written request shall  be  in  substantially  the  form
    39  described in section twenty-eight hundred ninety-nine-k of this article.
    40    (b) One of the witnesses shall be an adult who is not:
    41    (i) a relative of the patient by blood, marriage or adoption;
    42    (ii)  a person who at the time the request is signed would be entitled
    43  to any portion of the estate of the patient upon death under any will or
    44  by operation of law; or
    45    (iii) an owner, operator, employee  or  independent  contractor  of  a
    46  health  care  facility  where the patient is receiving treatment or is a
    47  resident.
    48    (c) The attending physician, consulting physician and, if  applicable,
    49  the  mental health professional who provides a capacity determination of
    50  the patient under this article shall not be a witness.
    51    4. No person shall qualify for medical aid in dying under this article
    52  solely because of age or disability.
    53    5. Requests for a medical aid-in-dying prescription must  be  made  by
    54  the  qualified  individual  and may not be made by any other individual,
    55  including the qualified individual's health care agent, or  other  agent
    56  or surrogate, or via advance healthcare directive.

        A. 2694                             4
 
     1    § 2899-f. Attending   physician  responsibilities.  1.  The  attending
     2  physician shall examine the patient and  his  or  her  relevant  medical
     3  records and:
     4    (a)  make  a determination of whether a patient has a terminal illness
     5  or condition, has capacity, has made an informed decision and  has  made
     6  the  request voluntarily of the patient's own volition and without coer-
     7  cion;
     8    (b) inform the patient of  the  requirement  under  this  article  for
     9  confirmation  by  a  consulting  physician,  and  refer the patient to a
    10  consulting physician upon the patient's request;
    11    (c) refer the patient to a  mental  health  professional  pursuant  to
    12  section  twenty-eight  hundred  ninety-nine-i  of  this  article  if the
    13  attending physician believes that the patient may lack capacity to  make
    14  an informed decision;
    15    (d)  provide  information  and  counseling  under  section twenty-nine
    16  hundred ninety-seven-c of this chapter;
    17    (e) ensure that the patient is making an informed decision by discuss-
    18  ing with the patient: (i) the patient's medical diagnosis and prognosis;
    19  (ii) the potential risks associated with taking  the  medication  to  be
    20  prescribed;  (iii)  the  probable  result of taking the medication to be
    21  prescribed; (iv) the possibility that the patient may choose  to  obtain
    22  the medication but not take it; (v) the feasible alternatives and appro-
    23  priate  treatment  options, including but not limited to (1) information
    24  and counseling regarding palliative and  hospice  care  and  end-of-life
    25  options  appropriate  to  the patient, including but not limited to: the
    26  range of options appropriate to the patient; the  prognosis,  risks  and
    27  benefits  of  the  various  options;  and  the patient's legal rights to
    28  comprehensive pain and symptom management at the end of  life;  and  (2)
    29  information  regarding  treatment  options  appropriate  to the patient,
    30  including the prognosis, risks and benefits  of  the  various  treatment
    31  options;
    32    (f)  offer  to  refer  the  patient  for  other  appropriate treatment
    33  options, including but not limited to palliative care and hospice care;
    34    (g) discuss with the patient the importance of:
    35    (i) having another person present when the patient takes  the  medica-
    36  tion  and  the  restriction  that  no  person other than the patient may
    37  administer the medication;
    38    (ii) not taking the medication in a public place; and
    39    (iii) informing the patient's family  of  the  patient's  decision  to
    40  request  and take medication that will end the patient's life; a patient
    41  who declines or is unable to notify family shall not  have  his  or  her
    42  request for medication denied for that reason;
    43    (h)  inform  the  patient  that  he or she may rescind the request for
    44  medication at any time and in any manner;
    45    (i) fulfill the medical record documentation requirements  of  section
    46  twenty-eight hundred ninety-nine-j of this article; and
    47    (j)  ensure  that  all appropriate steps are carried out in accordance
    48  with this article before writing a prescription for medication.
    49    2. Upon receiving  confirmation  from  a  consulting  physician  under
    50  section  twenty-eight  hundred ninety-nine-h of this article and subject
    51  to section twenty-eight  hundred  ninety-nine-i  of  this  article,  the
    52  attending  physician  who  determines  that  the  patient has a terminal
    53  illness or condition, has capacity and has made a voluntary request  for
    54  medication  as  provided in this article, may personally, or by referral
    55  to another physician,  prescribe  or  order  appropriate  medication  in
    56  accordance  with  the  patient's  request under this article, and at the

        A. 2694                             5
 
     1  patient's request, facilitate the filling of the prescription and deliv-
     2  ery of the medication to the patient.
     3    3.  In  accordance  with  the direction of the prescribing or ordering
     4  physician and the consent of the patient, the patient may  self-adminis-
     5  ter  the medication to himself or herself. A health care professional or
     6  other person shall not administer the medication to the patient.
     7    § 2899-g. Right to rescind request; requirement to  offer  opportunity
     8  to rescind.  1. A patient may at any time rescind his or her request for
     9  medication under this article without regard to the patient's capacity.
    10    2.  A  prescription  for  medication  may  not  be written without the
    11  attending physician offering the qualified individual an opportunity  to
    12  rescind the request.
    13    § 2899-h. Consulting  physician responsibilities. Before a patient who
    14  is requesting medication may receive a prescription for medication under
    15  this article, a consulting physician must:
    16    1. examine the patient and his or her relevant medical records;
    17    2. confirm, in writing, to the attending physician  and  the  patient,
    18  whether:  (a)  the  patient has a terminal illness or condition; (b) the
    19  patient is making an informed decision; (c) the patient has capacity, or
    20  provide documentation that the consulting  physician  has  referred  the
    21  patient  for  a determination under section twenty-eight hundred ninety-
    22  nine-i of this article; and (d) the patient is  acting  voluntarily,  of
    23  the patient's own volition and without coercion.
    24    § 2899-i. Referral  to mental health professional. 1. If the attending
    25  physician or the consulting physician determines that  the  patient  may
    26  lack  capacity  to make an informed decision due to a condition, includ-
    27  ing, but not limited to, a psychiatric  or  psychological  disorder,  or
    28  other  condition  causing impaired judgement, the attending physician or
    29  consulting physician shall refer the patient to a mental health  profes-
    30  sional  for  a determination of whether the patient has capacity to make
    31  an informed decision. The referring physician shall advise  the  patient
    32  that  the  report  of the mental health professional will be provided to
    33  the attending physician and the consulting physician.
    34    2. A mental health professional who evaluates  a  patient  under  this
    35  section  shall  report,  in  writing, to the attending physician and the
    36  consulting physician, his or her independent conclusions  about  whether
    37  the patient has capacity to make an informed decision, provided that if,
    38  at  the  time  of the report, the patient has not yet been referred to a
    39  consulting physician, then upon referral the attending  physician  shall
    40  provide  the  consulting  physician  with  a  copy  of the mental health
    41  professional's report. If the mental health professional determines that
    42  the patient lacks capacity to make an  informed  decision,  the  patient
    43  shall  not be deemed a qualified individual, and the attending physician
    44  shall not prescribe medication to the patient.
    45    3. A determination made pursuant to this section that an adult patient
    46  lacks decision-making capacity shall not be construed as a finding  that
    47  the patient lacks capacity for any other purpose.
    48    § 2899-j. Medical  record  documentation  requirements.  An  attending
    49  physician shall document or file the following in the patient's  medical
    50  record:
    51    1.  the dates of all oral requests by the patient for medication under
    52  this article;
    53    2. the written request by the patient for medication under this  arti-
    54  cle,  including  the declaration of witnesses and interpreter's declara-
    55  tion, if applicable;

        A. 2694                             6
 
     1    3. the attending physician's diagnosis and prognosis, determination of
     2  capacity, and determination that the patient is acting  voluntarily,  of
     3  the  patient's  own  volition  and  without  coercion,  and  has made an
     4  informed decision;
     5    4. if applicable, written confirmation of capacity under section twen-
     6  ty-eight hundred ninety-nine-i of this article; and
     7    5.  a note by the attending physician indicating that all requirements
     8  under this article have been met and indicating the steps taken to carry
     9  out the request, including a notation of the  medication  prescribed  or
    10  ordered.
    11    § 2899-k. Form  of  written  request  and  witness  attestation.  1. A
    12  request for medication under this article shall be in substantially  the
    13  following form:
    14                    REQUEST FOR MEDICATION TO END MY LIFE
 
    15    I,  _________________________________,  am  an adult who has capacity,
    16  which means I understand and appreciate the nature and  consequences  of
    17  health  care decisions, including the benefits and risks of and alterna-
    18  tives to any proposed health care, and to reach an informed decision and
    19  to communicate health care decisions to a physician.
    20    I have been diagnosed with ______________(insert diagnosis), which  my
    21  attending  physician  has determined is a terminal illness or condition,
    22  which has been medically confirmed by a consulting physician.
    23    I have been fully informed of my diagnosis and prognosis,  the  nature
    24  of  the  medication to be prescribed and potential associated risks, the
    25  expected result, and the feasible  alternatives  and  treatment  options
    26  including but not limited to palliative care and hospice care.
    27    I  request  that my attending physician prescribe medication that will
    28  end my life if I choose to take it, and I authorize my attending  physi-
    29  cian to contact another physician or any pharmacist about my request.
 
    30    INITIAL ONE:
    31    (    )  I  have informed or intend to inform one or more members of my
    32  family of my decision.
    33    (  ) I have decided not to inform any member of my family of my  deci-
    34  sion.
    35    (  ) I have no family to inform of my decision.
    36    I  understand that I have the right to rescind this request or decline
    37  to use the medication at any time.
    38    I understand the importance of this request, and I expect to die if  I
    39  take the medication to be prescribed. I further understand that although
    40  most  deaths  occur within three hours, my death may take longer, and my
    41  attending physician has counseled me about this possibility.
    42    I make this request voluntarily, of my own volition and without  being
    43  coerced, and I accept full responsibility for my actions.
 
    44  Signed: __________________________
 
    45  Dated: ___________________________
 
    46                          DECLARATION OF WITNESSES
 
    47    I  declare that the person signing this "Request for Medication to End
    48  My Life":
    49    (a) is personally known to me or has provided proof of identity;

        A. 2694                             7
 
     1    (b) voluntarily signed the "Request for Medication to End My Life"  in
     2  my presence or acknowledged to me that he or she signed it; and
     3    (c) to the best of my knowledge and belief, has capacity and is making
     4  the  "Request  for Medication to End My Life" voluntarily, of his or her
     5  own volition and is not being coerced to sign the "Request  for  Medica-
     6  tion to End My Life".
     7    I am not the attending physician or consulting physician of the person
     8  signing  the  "Request for Medication to End My Life" or, if applicable,
     9  the mental health professional who provides a capacity determination  of
    10  the  person  signing  the "Request for Medication to End My Life" at the
    11  time the "Request for Medication to End My Life" was signed.
    12    I further declare under penalty of perjury that  the  statements  made
    13  herein are true and correct and false statements made herein are punish-
    14  able.
 
    15  __________________________ Witness 1, Date: ________________
 
    16  __________________________ (Printed name)
 
    17  __________________________ (Address)
 
    18  __________________________ (Telephone number)
 
    19    I further declare that I am not (i) related to the above-named patient
    20  by  blood,  marriage  or adoption, (ii) entitled at the time the patient
    21  signed the "Request for Medication to End My Life" to any portion of the
    22  estate of the patient upon his/her death under any will or by  operation
    23  of  law, or (iii) an owner, operator, employee or independent contractor
    24  of a health care facility where the patient is receiving treatment or is
    25  a resident.

    26  __________________________ Witness 2, Date: _________________
 
    27  __________________________ (Printed name)
 
    28  __________________________ (Address)
 
    29  __________________________ (Telephone number)
 
    30    NOTE: Only one of the two witnesses may (i) be a relative  (by  blood,
    31  marriage  or adoption) of the person signing the "Request for Medication
    32  to End My Life", (ii) be entitled to any portion of the person's  estate
    33  upon death under any will or by operation of law, or (iii) own, operate,
    34  be  employed  or  be an independent contractor at a health care facility
    35  where the person is receiving treatment or is a resident.
    36    2. (a) The "Request for Medication to End My Life" shall be written in
    37  the same language as any conversations,  consultations,  or  interpreted
    38  conversations or consultations between a patient and at least one of his
    39  or her attending or consulting physicians.
    40    (b)  Notwithstanding  paragraph  (a)  of this subdivision, the written
    41  "Request for Medication to End My Life" may be prepared in English  even
    42  when  the conversations or consultations or interpreted conversations or
    43  consultations were conducted in a language other than  English  or  with
    44  auxiliary  aids  or  hearing,  speech  or  visual  aids,  if the English
    45  language form includes an attached declaration by the interpreter of the

        A. 2694                             8

     1  conversation or  consultation,  which  shall  be  in  substantially  the
     2  following form:
 
     3                          INTERPRETER'S DECLARATION
 
     4    I,  ___________  (insert  name of interpreter)_____ ,(mark as applica-
     5  ble):
     6    (  ) for a patient whose conversations or consultations or interpreted
     7  conversations or consultations were conducted in a language  other  than
     8  English and the "Request for Medication to End My Life" is in English: I
     9  declare that I am fluent in English and (insert target language). I have
    10  the  requisite  language  and interpreter skills to be able to interpret
    11  effectively, accurately and impartially information shared and  communi-
    12  cations  between  the  attending  or  consulting  physician and (name of
    13  patient).
    14    I certify that on (insert date), at  approximately  (insert  time),  I
    15  interpreted  the  communications  and  information  conveyed between the
    16  physician and (name of patient) as accurately and completely to the best
    17  of my knowledge and ability and read the "Request for Medication to  End
    18  My Life" to (name of patient) in (insert target language).
    19    (Name  of  patient) affirmed to me his/her desire to sign the "Request
    20  for Medication to End My Life" voluntarily, of (name of  patient)'s  own
    21  volition and without coercion.
    22    (  )  for  a  patient  with  a speech, hearing or vision disability: I
    23  declare that I have the requisite language, reading  and/or  interpreter
    24  skills  to  communicate  with  the patient and to be able to read and/or
    25  interpret effectively, accurately and impartially information shared and
    26  communications that occurred on (insert date) between the  attending  or
    27  consulting physician and (name of patient).
    28    I  certify  that  on  (insert date), at approximately (insert time), I
    29  read and/or interpreted  the  communications  and  information  conveyed
    30  between the physician and (name of patient) impartially and as accurate-
    31  ly  and  completely  to  the best of my knowledge and ability and, where
    32  needed for effective communication, read or interpreted the "Request for
    33  Medication to End my Life" to (name of patient).
    34    (Name of patient) affirmed to me his/her desire to sign  the  "Request
    35  for  Medication  to End My Life" voluntarily, of (name of patient)'s own
    36  volition and without coercion.
    37    I further declare under penalty of perjury that (i) the  foregoing  is
    38  true  and  correct;  (ii)  I  am not (A) related to (name of patient) by
    39  blood, marriage or adoption, (B) entitled at the time (name of  patient)
    40  signed the "Request for Medication to End My Life" to any portion of the
    41  estate  of  (name  of  patient)  upon his/her death under any will or by
    42  operation of law, or (C) an owner,  operator,  employee  or  independent
    43  contractor  of a health care facility where (name of patient) is receiv-
    44  ing treatment or is a resident, except that if I am an employee or inde-
    45  pendent contractor at such health care facility,  providing  interpreter
    46  services is part of my job description at such health care facility or I
    47  have  been trained to provide interpreter services and (name of patient)
    48  requested that  I  provide  interpreter  services  to  him/her  for  the
    49  purposes  stated  in  this  Declaration; and (iii) false statements made
    50  herein are punishable.
 
    51  Executed at (insert city, county and  state)  on  this  (insert  day  of
    52  month) of (insert month), (insert year).

        A. 2694                             9
 
     1  __________________________ (Signature of Interpreter)
 
     2  __________________________ (Printed name of Interpreter)
 
     3  __________________________ (ID # or Agency Name)

     4  __________________________ (Address of Interpreter)
 
     5  __________________________ (Language Spoken by Interpreter)
 
     6    (c)  An interpreter whose services are provided under paragraph (b) of
     7  this subdivision shall not (i) be related to the patient who  signs  the
     8  "Request  for Medication to End My Life" by blood, marriage or adoption,
     9  (ii) be entitled at the time the "Request for Medication to End My Life"
    10  is signed by the patient to any portion of the  estate  of  the  patient
    11  upon  death under any will or by operation of law, or (iii) be an owner,
    12  operator, employee or independent contractor of a health  care  facility
    13  where the patient is receiving treatment or is a resident; provided that
    14  an  employee  or  independent  contractor  whose  job description at the
    15  health care facility includes interpreter services or who is trained  to
    16  provide  interpreter  services and who has been requested by the patient
    17  to serve as an interpreter under this article shall  not  be  prohibited
    18  from serving as a witness under this article.
    19    § 2899-l. Protection and immunities. 1. A physician, pharmacist, other
    20  health  care  professional or other person shall not be subject to civil
    21  or criminal liability or professional disciplinary action by any govern-
    22  ment entity for taking any reasonable good-faith action or  refusing  to
    23  act  under this article, including, but not limited to:  (a) engaging in
    24  discussions with a patient relating to the risks and benefits of end-of-
    25  life options in the circumstances described in this article, (b) provid-
    26  ing a patient, upon request, with a  referral  to  another  health  care
    27  provider, (c) being present when a qualified individual self-administers
    28  medication, (d) refraining from acting to prevent the qualified individ-
    29  ual  from  self-administering  such  medication,  or (e) refraining from
    30  acting to resuscitate the qualified individual after he or she  self-ad-
    31  ministers such medication.
    32    2. Nothing in this section shall limit civil or criminal liability for
    33  negligence, recklessness or intentional misconduct.
    34    § 2899-m. Permissible  refusals  and prohibitions. 1. (a) A physician,
    35  nurse, pharmacist, other health care provider or other person shall  not
    36  be  under  any duty, by law or contract, to participate in the provision
    37  of medication to a patient under this article.
    38    (b) If a health care provider is unable or unwilling to participate in
    39  the provision of medication to a patient  under  this  article  and  the
    40  patient  transfers  care to a new health care provider, the prior health
    41  care provider shall transfer or arrange for the transfer, upon  request,
    42  of  a  copy  of the patient's relevant medical records to the new health
    43  care provider.
    44    2. (a) A private health care facility may  prohibit  the  prescribing,
    45  dispensing,  ordering  or  self-administering  of  medication under this
    46  article while the patient is being treated in or while  the  patient  is
    47  residing in the health care facility if:
    48    (i)  the  prescribing,  dispensing,  ordering or self-administering is
    49  contrary to a formally adopted policy of the facility that is  expressly
    50  based  on  sincerely held religious beliefs or moral convictions central
    51  to the facility's operating principles; and

        A. 2694                            10
 
     1    (ii) the facility has informed the patient of  such  policy  prior  to
     2  admission or as soon as reasonably possible.
     3    (b) Where a facility has adopted a prohibition under this subdivision,
     4  if  a  patient who wishes to use medication under this article requests,
     5  the patient shall be transferred promptly to another health care facili-
     6  ty that is reasonably accessible under the circumstances and willing  to
     7  permit  the  prescribing, dispensing, ordering and self-administering of
     8  medication under this article with respect to the patient.
     9    3. Where a health care facility has adopted a prohibition  under  this
    10  subdivision,  any  health  care  provider  or  employee  or  independent
    11  contractor of the facility who violates the prohibition may  be  subject
    12  to  sanctions otherwise available to the facility, provided the facility
    13  has previously notified the health care provider, employee or  independ-
    14  ent contractor of the prohibition in writing.
    15    § 2899-n. Relation  to  other laws and contracts. 1. (a) A patient who
    16  requests medication under  this  article  shall  not,  because  of  that
    17  request, be considered to be a person who is suicidal, and self-adminis-
    18  tering  medication under this article shall not be deemed to be suicide,
    19  for any purpose.
    20    (b) Action  taken  in  accordance  with  this  article  shall  not  be
    21  construed  for  any  purpose  to  constitute  suicide, assisted suicide,
    22  attempted suicide, promoting a suicide attempt, euthanasia, mercy  kill-
    23  ing,  or homicide under the law, including as an accomplice or accessory
    24  or otherwise.
    25    2. (a) No provision in a contract, will or  other  agreement,  whether
    26  written  or  oral,  to  the  extent the provision would affect whether a
    27  person may make or rescind a request for medication or  take  any  other
    28  action under this article, shall be valid.
    29    (b)  No  obligation  owing  under any contract shall be conditioned or
    30  affected by the making or rescinding of a request by a person for  medi-
    31  cation or taking any other action under this article.
    32    3. (a) A person and his or her beneficiaries shall not be denied bene-
    33  fits  under a life insurance policy for actions taken in accordance with
    34  this article.
    35    (b) Notwithstanding the provisions of any law or contract,  the  sale,
    36  procurement or issuance of a life or health insurance or annuity policy,
    37  or  the  rate  charged  for  a  policy, shall not be conditioned upon or
    38  affected by a patient making or  rescinding  a  request  for  medication
    39  under this article.
    40    4. An insurer shall not provide any information in communications made
    41  to  a  patient  about  the availability of medication under this article
    42  absent a request by the patient or by his  or  her  attending  physician
    43  upon  the  request  of such patient. Any communication shall not include
    44  both the denial of coverage for treatment  and  information  as  to  the
    45  availability of medication under this article.
    46    5.  The  sale,  procurement,  or issue of any professional malpractice
    47  insurance policy or the rate charged for the policy shall not be  condi-
    48  tioned  upon or affected by whether the insured does or does not take or
    49  participate in any action under this article.
    50    § 2899-o. Safe disposal of unused  medications.    A  person  who  has
    51  custody  or control of any unused medication prescribed under this arti-
    52  cle after the death of the qualified individual shall personally deliver
    53  the unused medication for disposal to  the  nearest  qualified  facility
    54  that  properly  disposes of controlled substances or shall dispose of it
    55  by lawful means in accordance with regulations made by the commissioner,
    56  regulations made by or guidelines of the commissioner of  education,  or

        A. 2694                            11

     1  guidelines  of  a federal drug enforcement administration approved take-
     2  back program. A qualified facility that properly disposes of  controlled
     3  substances shall accept and dispose of any medication delivered to it as
     4  provided hereunder regardless of whether such medication is a controlled
     5  substance.  The  commissioner may make regulations as may be appropriate
     6  for the safe disposal of unused  medications  prescribed,  dispensed  or
     7  ordered under this article as provided in this section.
     8    § 2899-p. Death  certificate.   1. If otherwise authorized by law, the
     9  attending physician may sign the qualified  individual's  death  certif-
    10  icate.
    11    2. The cause of death listed on a qualified individual's death certif-
    12  icate  who  dies  after self-administering medication under this article
    13  will be the underlying terminal illness or condition.
    14    § 2899-q. Reporting. 1.  The  commissioner  shall  annually  review  a
    15  sample  of  the  records  maintained under sections twenty-eight hundred
    16  ninety-nine-j and twenty-eight hundred ninety-nine-p  of  this  article.
    17  The commissioner shall adopt regulations establishing reporting require-
    18  ments  for  physicians  taking  action  under  this article to determine
    19  utilization and compliance with this article. The information  collected
    20  under  this  subdivision  shall not constitute a public record available
    21  for public inspection and shall be confidential and collected and  main-
    22  tained  in a manner that protects the privacy of the patient, his or her
    23  family, and any health care provider  acting  in  connection  with  such
    24  patient  under  this  article,  except  that  such  information  may  be
    25  disclosed to a governmental agency as  authorized  or  required  by  law
    26  relating  to professional discipline, protection of public health or law
    27  enforcement.
    28    2. The commissioner shall prepare a report annually  containing  rele-
    29  vant  data  regarding  utilization  and compliance with this article and
    30  shall send such report to the legislature, and post such report  on  the
    31  department's website.
    32    § 2899-r. Penalties.  1. Nothing in this article shall be construed to
    33  limit professional discipline or civil liability resulting from  conduct
    34  in  violation of this article, negligent conduct, or intentional miscon-
    35  duct by any person.
    36    2. Conduct in violation of this article shall be subject to applicable
    37  criminal liability under state law,  including,  where  appropriate  and
    38  without  limitation,  offenses constituting homicide, forgery, coercion,
    39  and related offenses, or federal law.
    40    § 2899-s. Severability. If any provision of this article or any appli-
    41  cation of any provision of this article, is held to be  invalid,  or  to
    42  violate  or  be  inconsistent  with  any federal law or regulation, that
    43  shall not affect the validity or effectiveness of any other provision of
    44  this article, or of any other application of any provision of this arti-
    45  cle, which can be given effect without that  provision  or  application;
    46  and  to  that  end,  the provisions and applications of this article are
    47  severable.
    48    § 3. This act shall take effect immediately.
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