- Summary
- Actions
- Committee Votes
- Floor Votes
- Memo
- Text
- LFIN
- Chamber Video/Transcript
A00136 Summary:
| BILL NO | A00136 |
| SAME AS | SAME AS S00138 |
| SPONSOR | Paulin (MS) |
| COSPNSR | Rosenthal, Dinowitz, Hevesi, Steck, Lupardo, Rivera, Epstein, Seawright, Woerner, Reyes, Cruz, Sayegh, Davila, Stern, Burdick, Gallagher, Kelles, Gonzalez-Rojas, Mitaynes, Mamdani, Clark, Anderson, Jackson, Septimo, Glick, Gibbs, Tapia, Lunsford, Cunningham, Levenberg, Simone, Bores, Forrest, Shrestha, Shimsky, Raga, Rajkumar, Kim, Hunter, Stirpe, Chandler-Waterman, Lee, Taylor, Meeks, Otis, Alvarez, Lavine, Dais, Jacobson, Kay, Carroll P, Lasher, Schiavoni, Romero, Valdez, Burroughs, Hooks, O'Pharrow, Dilan, Torres, De Los Santos |
| MLTSPNSR | Braunstein, Bronson, 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. | |
A00136 Committee Votes:
| Paulin | Aye | Jensen | Nay | ||||||
| Dinowitz | Aye | Gandolfo | Nay | ||||||
| Rosenthal | Aye | Blumencranz | Nay | ||||||
| Hevesi | Aye | Gray | Nay | ||||||
| Steck | Aye | Maher | Nay | ||||||
| Braunstein | Aye | Slater | Nay | ||||||
| Solages | Nay | Chludzinski | Nay | ||||||
| Bichotte Hermel | Nay | Norber | Nay | ||||||
| Sayegh | Aye | ||||||||
| McDonald | Aye | ||||||||
| Reyes | Aye | ||||||||
| Gonzalez-Rojas | Aye | ||||||||
| Rajkumar | Aye | ||||||||
| Forrest | Aye | ||||||||
| Kelles | Aye | ||||||||
| Lucas | Absent | ||||||||
| Meeks | Aye | ||||||||
| Lunsford | Aye | ||||||||
| Dinowitz | Aye | Morinello | Nay | ||||||
| Cook | Nay | Reilly | Nay | ||||||
| Lavine | Aye | Mikulin | Nay | ||||||
| Weprin | Nay | Tannousis | Nay | ||||||
| Hevesi | Aye | Angelino | Nay | ||||||
| Seawright | Aye | Molitor | Nay | ||||||
| Rosenthal | Aye | ||||||||
| Walker | Nay | ||||||||
| Vanel | Excused | ||||||||
| Cruz | Aye | ||||||||
| Epstein | Aye | ||||||||
| Bores | Aye | ||||||||
| Reyes | Aye | ||||||||
| Cunningham | Aye | ||||||||
| Romero | Aye | ||||||||
| Bronson | Aye | ||||||||
| Heastie | Aye | Barclay | Excused | ||||||
| Pretlow | Aye | Hawley | Nay | ||||||
| Cook | Aye | Blankenbush | Nay | ||||||
| Glick | Aye | Ra | Nay | ||||||
| Dinowitz | Aye | Brabenec | Nay | ||||||
| Colton | Aye | Palmesano | Nay | ||||||
| Magnarelli | Aye | Reilly | Nay | ||||||
| Paulin | Aye | Smith | Nay | ||||||
| Peoples-Stokes | Aye | Jensen | Nay | ||||||
| Benedetto | Aye | ||||||||
| Lavine | Aye | ||||||||
| Lupardo | Aye | ||||||||
| Braunstein | Aye | ||||||||
| Davila | Aye | ||||||||
| Hyndman | Aye | ||||||||
| Rozic | Aye | ||||||||
| Bronson | Aye | ||||||||
| Hevesi | Aye | ||||||||
| Hunter | Aye | ||||||||
| Taylor | Aye | ||||||||
| Cruz | Aye | ||||||||
| Vanel | Excused | ||||||||
Go to top
A00136 Floor Votes:
Yes ‡
Alvarez
Yes
Carroll P
No
Friend
Yes
Lee
No
Peoples-Stokes
No
Slater
Yes
Anderson
Yes
Carroll RC
Yes
Gallagher
No
Lemondes
No
Pheffer Amato
No
Smith
No
Angelino
Yes
Chandler-Waterm
No
Gallahan
Yes
Levenberg
No
Pirozzolo
No
Smullen
No
Bailey
No
Chang
No
Gandolfo
No
Lucas
Yes
Pretlow
No
Solages
No
Barclay
No
Chludzinski
Yes
Gibbs
Yes
Lunsford
No
Ra
Yes
Steck
Yes
Barrett
Yes
Clark
No
Giglio
Yes
Lupardo
Yes
Raga
Yes
Stern
ER
Beephan
No
Colton
Yes
Glick
No
Magnarelli
ER
Rajkumar
Yes
Stirpe
No
Bendett
No
Conrad
Yes
Gonzalez-Rojas
No
Maher
Yes
Ramos
No
Tague
Yes
Benedetto
Yes
Cook
No
Gray
Yes ‡
Mamdani
No
Reilly
No
Tannousis
No
Berger
Yes
Cruz
Yes
Griffin
No
Manktelow
Yes
Reyes
Yes
Tapia
No
Bichotte Hermel
Yes
Cunningham
No
Hawley
Yes
McDonald
Yes
Rivera
Yes
Taylor
No
Blankenbush
Yes
Dais
Yes
Hevesi
No ‡
McDonough
Yes
Romero
Yes ‡
Torres
No
Blumencranz
Yes
Davila
Yes
Hooks
Yes
McMahon
Yes
Rosenthal
Yes
Valdez
No
Bologna
Yes
De Los Santos
Yes
Hunter
Yes
Meeks
No
Rozic
No
Vanel
Yes
Bores
No
DeStefano
Yes
Hyndman
No
Mikulin
No
Santabarbara
No
Walker
No
Brabenec
Yes
Dilan
Yes
Jackson
No
Miller
Yes
Sayegh
No
Walsh
Yes
Braunstein
Yes
Dinowitz
Yes
Jacobson
Yes
Mitaynes
Yes
Schiavoni
No
Weprin
Yes
Bronson
No ‡
DiPietro
No
Jensen
No
Molitor
Yes
Seawright
No
Wieder
No
Brook-Krasny
No
Durso
Yes
Jones
No
Morinello
No
Sempolinski
No
Williams
No
Brown EA
Yes
Eachus
Yes
Kassay
No
Norber
Yes
Septimo
Yes
Woerner
No
Brown K
No
Eichenstein
Yes
Kay
No
Novakhov
Yes
Shimsky
Yes
Wright
Yes
Burdick
Yes
Epstein
Yes
Kelles
Yes
O'Pharrow
Yes
Shrestha
No
Yeger
Yes
Burke
No
Fall
Yes
Kim
Yes
Otis
Yes
Simon
No
Zaccaro
Yes
Burroughs
No
Fitzpatrick
Yes
Lasher
No
Palmesano
Yes
Simone
Yes
Zinerman
No
Buttenschon
Yes
Forrest
Yes
Lavine
Yes
Paulin
No
Simpson
Yes
Mr. Speaker
‡ Indicates voting via videoconference
A00136 Memo:
Go to topNEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
TITLE OF BILL: 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 PURPOSE: To provide that a mentally competent, terminally ill adult with a prog- nosis of six months or less to live may request medication from their treating physician that they can decide to self-administer to hasten the patient's death provided the requirements set forth in the act are met, and to provide certain protection and immunities to health care provid- ers and other persons, including a physician who prescribes medication in compliance with the provisions of the article to the terminally ill patient to be self-administered by the patient. SUMMARY OF SPECIFIC PROVISIONS: Section 1 provides .that this act shall be known and may be cited as the "Medical Aid in Dying Act". Section 2 amends the Public Health Law by adding a new article 28-F, Medical Aid in Dying, comprised of the following sections: § 2899-d sets forth definitions. 2899-e sets forth the request process by which a patient may request medication for the purpose of ending his or her life in accordance with this article. The patient wishing to request such medication shall make an oral request and submit a written request, which shall be signed and dated by the patient and witnessed by at least two adults as provided in such section, identifying persons who shall not serve as witnesses. The patient's attending physician, consulting physician and, if applicable, the mental health professional who provides a capacity determination of the patient under the article shall not act as a witness. § 2899-f sets forth the responsibilities of the attending physician. 2899-g provides that a patient may at any time rescind a request for medication without regard to the patient's decision-making capacity, and that the attending physician may not write a prescription for medication without first offering the patient an opportunity to rescind the request. 2899-h sets forth the responsibilities of the consulting physician. 2899-i provides that if the attending physician or the consulting physi- cian determines that the patient may lack decision-making capacity to make an informed decision due to a condition, including, but not limited to, a psychiatric or psychological disorder, or other condition causing impaired judgment, such physician shall refer the patient to a mental health professional for a determination of whether the patient has deci- sion-making capacity. If the mental health professional determines that the patient lacks capacity to make an informed decision, the patient shall not be deemed a qualified individual and the attending physician shall not prescribe medication to the patient. A determination made pursuant to this section that an adult patient lacks decision-making capacity shall not be construed as a finding that the patient lacks decision-making capacity for any other purpose. § 2899-j sets forth the items that must be documented or filed in the patients medical record. 2899-k sets forth the form of written request for medication and decla- ration of witnesses. The section also provides that the written request shall be written in the same language as any conversations or consulta- tions between a patient and at least one of his or her attending or consulting physicians, provided that the written request may be in English, even if the conversations or consultations were conducted in a language other than English, if the form of written request includes the form of interpreter's declaration set forth in the section. § 2899-1 provides that a physician, pharmacist, other health care professional or other person shall not be subject to civil, administra- tive or criminal liability or penalty or professional disciplinary action by any government entity for taking any reasonable good- faith action or refusing to act under the article, including without limita- tion, engaging in discussions with a patient relating to the risks and benefits of end-of-life options in the circumstances described in the article and being present when a qualified individual self-administers medication. The section further provides that nothing in the section shall limit civil or criminal liability for negligence, recklessness or intentional misconduct. § 2899-m provides that a physician, nurse, pharmacist, other health care provider or other person shall not be under any duty by law or contract to participate in the provision of medication to a patient. If a health care provider is unable or unwilling to participate in the provision of medication to a patient and the patient transfers care to a new health care provider, the prior health care provider shall transfer or arrange for the transfer, upon request, of a copy of the patient's relevant medical records to the new health care provider. A private health care facility may prohibit the prescribing,.dispensing, ordering or self-ad- ministering of medication under the article while the patient is being treated in or while the patient is residing in such facility if the requirements set forth in the section have been met. In addition, where a health care facility has adopted a prohibition under the subdivision, if a patient who wishes to use medication under the article requests, the patient shall be transferred promptly to another health care facili- ty that is reasonably accessible under the circumstances and willing to permit the prescribing, dispensing, ordering or self-administering of medication with respect to the patient. Where a health care facility has adopted a prohibition under the subdivision, any health care provider or employee of the facility who violates the prohibition may be subject to sanctions otherwise available to the facility, provided the facility has previously notified the health care provider or employee of the prohibi- tion in writing. § 2899-n provides that (i) a patient who requests medication under the article will not, because of that request, be considered a person who is suicidal, and self-administering medication under the article shall not be deemed to be suicide for any purpose, (ii) action taken in accordance with the article shall not be construed for any purpose to constitute suicide, assisted suicide, attempted suicide, promoting a suicide attempt, mercy killing, or homicide under the law, including as an accomplice or accessory or otherwise, (iii) no provision in a contract, will or other agreement, whether written or oral, to the extent the provision would affect whether a person may make or rescind a request for medication or take any other action under the article, shall be valid, (iv) no obligation owing under any contract will be conditioned upon or affected by the making or rescinding of a request by a person for medication or taking any other action under the article, (v) a person and his or her beneficiaries shall not be denied benefits under a life insurance policy for actions taken in accordance with the article, and the sale, procurement or issuance of a life or health insurance or annuity policy or the rate charged for the policy shall not be condi- tioned upon or affected by the patient pinking or rescinding a request for medication under the article, (vi) an insurer shall not provide any information in communications made to a patient about the availability of medication under the article absent a request by the patient or by his or her attending physician upon the request of such patient, and any communication shall not include both the denial of coverage for treat- ment and information as to the availability of medication under the article, and (vii) the sale, procurement or issue of any professional malpractice insurance policy or the rate charged for the policy shall not be conditioned upon or affected by whether the insured does or does not take or participate in any action under he article. § 2899-o provides that the department of health shall make regulations providing for the safe disposal of unused medications prescribed, dispensed or ordered under the article. § 2899-p provides that if otherwise authorized by law, the attending physician may sign the qualified individual's death certificate. The cause of death listed on a qualified individual's death certificate who dies after self-administering medication under the article will be the underlying terminal illness. § 2899-q provides for the annual review by the commissioner of health of a sample of the records maintained under section twenty-eight hundred ninety-nine-j and twenty-eight hundred ninety-nine-p of the article. The commissioner shall adopt regulations establishing reporting requirements for physicians taking action under the article to determine utilization and compliance with the article. The information collected under the section shall not constitute a public record available for public inspection and shall be confidential and shall be collected and main- tained in a manner that protects the privacy of the patient, his or her family, and any health care provider acting in connection with such patient under the article, except that such information may be disclosed to a governmental agency as authorized or required by law relating to professional discipline, protection of public health or law enforcement. The commissioner shall prepare a report annually containing relevant data regarding utilization and compliance with the article and shall send such report to the legislature and post such report on its website. § 2899-r provides that nothing in the article shall be construed to limit professional discipline or civil liability resulting from conduct in violation of the article, negligent conduct, or intentional miscon- duct by any person. Conduct in violation of the articles hall be subject to applicable criminal liability under state law, including where appro- priate and without limitation, offenses constituting homicide, forgery, coercion, and related offenses, or federal law. § 2899-s provides the severability clause. Section 3 sets forth the effective date. JUSTIFICATION: Faced with a terminal diagnosis, when no curative treatment options exist, New Yorkers deserve the full range of options for care at the end of life. The law would authorize medical aid in dying for terminally ill adults with less than six months to live who have been determined by two doctors to be mentally capable to make an informed decision. Medical aid in dying allows a mentally capable, terminally ill adult to request a prescription from their healthcare provider for a medication that they can choose to ingest to die peacefully. The multi-step request process, strict eligibility criteria, and other safeguards embedded in this legislation ensure that patients pursuing the option, healthcare providers who deliver care pursuant to the law, and those who refrain from participating in medical aid in dying are all protected. Authorizing the full range of end-of-life options, including medical aid in dying, allows people to engage in open conversations with their healthcare providers, their loved ones and their faith leaders about the end of life experience they want. Nearly 30 years ago, Oregon passed the nation's first law allowing terminally ill, mentally capable adults with a prognosis of six months or less to request a prescription for medication they can take to die peacefully. Currently, 10 states and Washington, D.C., have authorized the option of medical aid in dying. These laws have worked in states that have adopted them, without any of the ill-effects predicted by opponents. There has not been a single substantiated incident of coercion or abuse associated with medical aid in dying laws. With more than a quarter century of data since Oregon implemented its law, and years of experience in 10 other authorized jurisdictions, we no longer have to hypothesize about what will happen if this medical practice is authorized in New York. We know: Medical aid in dying protects patients, affords dying people autonomy, and improves care across the end-of-life spectrum. Support for medical aid in dying is growing. Each year since 1996, Gall- up has issued results of a survey on opinions related to end-of- life options.The latest data from Gallup shows that the vast majority of adults surveyed believe in expanded end-of-life options, and that support has grown steadily over the past three decades. Polling conducted by Susquehanna Polling & Research reported that 68% of voters support medical aid in dying as an end-of-life care option. When respondents were asked if they want the option of medical aid in dying personally for themselves, 67% said yes. Additionally, nearly 8 out of 10 U.S. residents (79%) who self-identify as having a disability agree that medical aid in dying "should be legal for terminally ill, mentally capable adults who chose to self-ingest medication to die peacefully." New York voters overwhelmingly support the option of medical aid in dying. In a YouGov poll conducted January 18-31, 2024, 72% of New York voters, including 73% of voters with disabilities, said they support the Medical Aid in Dying Act. Majority support is consistent across the state (with support ranging from 64% to 76%), the political spectrum (Democrats: 78%; Republicans: 59%), the racial spectrum (white voters: 73%, Black voters: 66%, Hispanic voters: 69%, Asian voters: 76%, and other races: 54%) and religious spectrum (Catholic: 65%, Protestant: 61%, other religions: 76%, and no religion: 87%). Healthcare providers in New York support this option. The Medical Society of the State of New York (MSSNY) support this legislation, as does the New York State Acade- my of Family Physicians. A 2018 Medscape survey of New York physicians found that 56 percent of doctors support medical aid in dying. Their support increased to 67 percent when physicians learned about the bill provisions. The New York State Nurses Union (NYSNA) also supports the bill. So too, do lawyers in New York. The New York State Bar Association convened a Task Force on Medical Aid in Dying and conducted a thorough 6-month investigation in 2023; the Task Force concluded by recommending support for the Medical Aid in Dying Act, and the NYSBA House of Deleg- ates voted to support the bill in 2024. Medical aid in dying and hospice is not an either/or proposition. In 2023, 87% of patients who utilized medical aid in dying in Oregon were enrolled in hospice care, and were able to die at home. Oregon leads the nation in hospice care, with double the utilization rate of the national average; New York ranks last among states, and second-to-last, just ahead of Puerto Rico, in terms of appropriate hospice utilization according to the latest report from the National Hospice & Palliative Care Organization. Close to 60 organizations that represent many aspects of civil society across New York State support medical aid in dying. They include: 1 in 9 Long Island Breast Cancer Action Coalition, AIDS Coalition to Unleash Power (ACT UP NY), ALS United Greater New York, The Arc New York, Adel- phi NY Statewide Breast Cancer Program, Adirondack Voters for Change, Black Nonbelievers of NYC, Breast Cancer Coalition of Rochester, Buffalo Unitarian United Church, Capital District Humanist Society, Catholics Vote Common Good, CCoHope Indivisible, Completed Life Initiative, Congregation B'nai Yisrael, Death with Dignity Albany, End of Life Choices New York, Four Freedoms Democratic Club, Gay Men's Health Crisis (GMHC), Harlem United, Hispanic Health Network, Housing Works, Indivis- ible Scarsdale, Indivisible Westchester, Indivisible Westchester Districts 6 & 7, Indivisible Yorktown, Jim Owles Liberal Democratic Club, Larchmont Mamaroneck Indivisible, Latino Commission on AIDS, Lati- nos for Healthcare Equity, League of Women Voters of NYS, Medical Socie- ty of the State of New York (MSSNY), Mobilizing Preachers & Communities (MPAC), New York Civil Liberties Union (NYCLU), New York Unitarian Univ- ersalist Justice, New York Society for Ethical Culture, New York State Academy of Family Physicians, New York State Association of Counties, New York State Bar Association, New York State Council of Churches, New York State Nurses Association, New York State Public Health Association, NOW-NY, NYCD16 Indivisible, New York State Nurses Association (NYSNA), Planned Parenthood Empire State Acts (PPESA), Rainbow Seniors ROC, SAGE - NY (Advocacy & Services for LGBT Elders), Sadhana: Coalition of Progressive Hindus, Secular Coalition of America--New York Chapter, SHARE Cancer Support, StateWide Senior Action Council, St. Francis Community of Faith, Tompkins County Legislature, United University Professors- Committee on Active Retiree, Membership & New Paltz chapter, Up2Us, Village Independent Democrats, West chester Coalition for Legal Abortion/Choice Matters, Women's Bar Association of the State of New York, WESPAC Foundation. LEGISLATIVE HISTORY: 2023-24: A.995c, referred to Health / Same as S. 2445c, referred to Health. 2022: A.4321a, referred to Health / Same as S.6471, referred to Health. 2020-21:A.4331,Referred to Health/S.6471,Referred to Health 2019-20:A.2694,Referred to Health /S.3947,Referred to Health 2017-18:A.2383-A, Referred to Health / S.3151-A, Referred to Health 2016: A.10059, Referred to Codes / S.7579, Referred to Health FISCAL IMPLICATIONS: None to the State. EFFECTIVE DATE: This act shall take effect immediately.
A00136 Text:
Go to topSTATE OF NEW YORK ________________________________________________________________________ 136 2025-2026 Regular Sessions IN ASSEMBLY (Prefiled) January 8, 2025 ___________ Introduced by M. of A. PAULIN, ROSENTHAL, DINOWITZ, HEVESI, STECK, LUPARDO, RIVERA, EPSTEIN, SEAWRIGHT, WOERNER, REYES, CRUZ, SAYEGH, DAVILA, STERN, BURDICK, GALLAGHER, KELLES, GONZALEZ-ROJAS, MITAYNES, MAMDANI, CLARK, ANDERSON, JACKSON, SEPTIMO, GLICK, GIBBS, TAPIA, LUNS- FORD, CUNNINGHAM, LEVENBERG, SIMONE, BORES, FORREST, SHRESTHA, SHIM- SKY, RAGA, RAJKUMAR, KIM, HUNTER, STIRPE, CHANDLER-WATERMAN, LEE, TAYLOR, MEEKS, OTIS, ALVAREZ, LAVINE, DAIS, JACOBSON -- Multi-Spon- sored by -- M. of A. BRAUNSTEIN, BRONSON, HYNDMAN, RAMOS, ZINERMAN -- 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. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD00320-01-5A. 136 2 1 2899-q. Reporting. 2 2899-r. Penalties. 3 2899-s. Severability. 4 § 2899-d. Definitions. As used in this article: 5 1. "Adult" means an individual who is eighteen years of age or older. 6 2. "Attending physician" means the physician who has primary responsi- 7 bility for the care of the patient and treatment of the patient's termi- 8 nal illness or condition. 9 3. "Decision-making capacity" means the ability to understand and 10 appreciate the nature and consequences of health care decisions, includ- 11 ing the benefits and risks of and alternatives to any proposed health 12 care, including medical aid in dying, and to reach an informed decision. 13 4. "Consulting physician" means a physician who is qualified by 14 specialty or experience to make a professional diagnosis and prognosis 15 regarding a person's terminal illness or condition. 16 5. "Health care facility" means a general hospital, nursing home, or 17 residential health care facility as defined in section twenty-eight 18 hundred one of this chapter, or a hospice as defined in section four 19 thousand two of this chapter; provided that for the purposes of section 20 twenty eight hundred ninety-nine-m of this article, "hospice" shall 21 refer only to a facility providing in-patient hospice care or a hospice 22 residence. 23 6. "Health care provider" means an individual licensed, certified, or 24 authorized by law to administer health care or dispense medication in 25 the ordinary course of business or practice of a profession. 26 7. "Informed decision" means a decision by a patient who is suffering 27 from a terminal illness or condition to request and obtain a 28 prescription for medication that the patient may self-administer to end 29 the patient's life that is based on an understanding and acknowledgment 30 of the relevant facts and that is made voluntarily, of the patient's own 31 volition and without coercion, after being fully informed of: 32 (a) the patient's medical diagnosis and prognosis; 33 (b) the potential risks associated with taking the medication to be 34 prescribed; 35 (c) the probable result of taking the medication to be prescribed; 36 (d) the possibility that the patient may choose not to obtain the 37 medication, or may obtain the medication but may decide not to self-ad- 38 minister it; and 39 (e) the feasible alternatives and appropriate treatment options, 40 including but not limited to palliative care and hospice care. 41 8. "Medical aid in dying" means the medical practice of a physician 42 prescribing medication to a qualified individual that the individual may 43 choose to self-administer to bring about death. 44 9. "Medically confirmed" means the medical opinion of the attending 45 physician that a patient has a terminal illness or condition and has 46 made an informed decision which has been confirmed by a consulting 47 physician who has examined the patient and the patient's relevant 48 medical records. 49 10. "Medication" means medication prescribed by a physician under this 50 article. 51 11. "Mental health professional" means a licensed physician, who is a 52 diplomate or eligible to be certified by a national board of psychiatry, 53 psychiatric nurse practitioner, or psychologist, licensed or certified 54 under the education law acting within such mental health professional's 55 scope of practice and who is qualified, by training and experience,A. 136 3 1 certification, or board certification or eligibility, to make a determi- 2 nation under section twenty-eight hundred ninety-nine-i of this article. 3 12. "Palliative care" means health care treatment, including interdis- 4 ciplinary end-of-life care, and consultation with patients and family 5 members, to prevent or relieve pain and suffering and to enhance the 6 patient's quality of life, including hospice care under article forty of 7 this chapter. 8 13. "Patient" means a person who is eighteen years of age or older 9 under the care of a physician. 10 14. "Physician" means an individual licensed to practice medicine in 11 New York state. 12 15. "Qualified individual" means a patient with a terminal illness or 13 condition, who has decision-making capacity, has made an informed deci- 14 sion, and has satisfied the requirements of this article in order to 15 obtain a prescription for medication. 16 16. "Self-administer" means a qualified individual's affirmative, 17 conscious, and voluntary act to ingest medication under this article. 18 Self-administration does not include lethal injection or lethal 19 infusion. 20 17. "Terminal illness or condition" means an incurable and irrevers- 21 ible illness or condition that has been medically confirmed and will, 22 within reasonable medical judgment, produce death within six months. 23 18. "Third-party health care payer" has its ordinary meaning and 24 includes, but is not limited to, an insurer, organization or corporation 25 licensed or certified under article thirty-two, forty-three or forty- 26 seven of the insurance law, or article forty-four of the public health 27 law; or an entity such as a pharmacy benefits manager, fiscal adminis- 28 trator, or administrative services provider that participates in the 29 administration of a third-party health care payer system. 30 § 2899-e. Request process. 1. Oral and written request. A patient 31 wishing to request medication under this article shall make an oral 32 request and submit a written request to the patient's attending physi- 33 cian. 34 2. Making a written request. A patient may make a written request for 35 and consent to self-administer medication for the purpose of ending such 36 patient's life in accordance with this article if the patient: 37 (a) has been determined by the attending physician to have a terminal 38 illness or condition and which has been medically confirmed by a 39 consulting physician; and 40 (b) based on an informed decision, expresses voluntarily, of the 41 patient's own volition and without coercion the request for medication 42 to end such patient's life. 43 3. Written request signed and witnessed. (a) A written request for 44 medication under this article shall be signed and dated by the patient 45 and witnessed by at least two adults who, in the presence of the 46 patient, attest that to the best of the persons knowledge and belief the 47 patient has decision-making capacity, is acting voluntarily, is making 48 the request for medication of the patient's own volition and is not 49 being coerced to sign the request. The written request shall be in 50 substantially the form described in section twenty-eight hundred nine- 51 ty-nine-k of this article. 52 (b) Both witnesses shall be adults who are not: 53 (i) a relative of the patient by blood, marriage or adoption; 54 (ii) a person who at the time the request is signed would be entitled 55 to any portion of the estate of the patient upon death under any will or 56 by operation of law;A. 136 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 (iv) a domestic partner of the patient, as defined in subdivision 5 seven of section twenty-nine hundred ninety-four-a of this chapter; 6 (v) an agent under the patient's health care proxy as defined in 7 subdivision five of section twenty-nine hundred eighty of this chapter; 8 or 9 (vi) an agent acting under a power of attorney for the patient as 10 defined in section 5-1501 of the general obligations law. 11 (c) The attending physician, consulting physician and, if applicable, 12 the mental health professional who provides a decision-making capacity 13 determination of the patient under this article shall not be a witness. 14 4. No person shall qualify for medical aid in dying under this article 15 solely because of age or disability. 16 5. Requests for a medical aid-in-dying prescription must be made by 17 the qualified individual and may not be made by any other individual, 18 including the qualified individual's health care agent, or other agent 19 or surrogate, or via advance healthcare directive. 20 § 2899-f. Attending physician responsibilities. 1. The attending 21 physician shall examine the patient and the patient's relevant medical 22 records and: 23 (a) make a determination of whether a patient has a terminal illness 24 or condition, has decision-making capacity, has made an informed deci- 25 sion and has made the request voluntarily of the patient's own volition 26 and without coercion; 27 (b) inform the patient of the requirement under this article for 28 confirmation by a consulting physician, and refer the patient to a 29 consulting physician upon the patient's request; 30 (c) refer the patient to a mental health professional pursuant to 31 section twenty-eight hundred ninety-nine-i of this article if the 32 attending physician believes that the patient may lack decision-making 33 capacity to make an informed decision; 34 (d) provide information and counseling under section twenty-nine 35 hundred ninety-seven-c of this chapter; 36 (e) ensure that the patient is making an informed decision by discuss- 37 ing with the patient: (i) the patient's medical diagnosis and prognosis; 38 (ii) the potential risks associated with taking the medication to be 39 prescribed; (iii) the probable result of taking the medication to be 40 prescribed; (iv) the possibility that the patient may choose to obtain 41 the medication but not take it; (v) the feasible alternatives and appro- 42 priate treatment options, including but not limited to (1) information 43 and counseling regarding palliative and hospice care and end-of-life 44 options appropriate to the patient, including but not limited to: the 45 range of options appropriate to the patient; the prognosis, risks and 46 benefits of the various options; and the patient's legal rights to 47 comprehensive pain and symptom management at the end of life; and (2) 48 information regarding treatment options appropriate to the patient, 49 including the prognosis, risks and benefits of the various treatment 50 options; 51 (f) offer to refer the patient for other appropriate treatment 52 options, including but not limited to palliative care and hospice care; 53 (g) provide health literate and culturally appropriate educational 54 material regarding hospice and palliative care that has been prepared by 55 the department in consultation with representatives of hospice and 56 palliative care providers from all regions of New York state, and thatA. 136 5 1 is available on the department's website for access and download, 2 provided, however, an otherwise eligible patient cannot be denied care 3 under this article if these materials are not developed by the effective 4 date of this article; 5 (h) discuss with the patient the importance of: 6 (i) having another person present when the patient takes the medica- 7 tion and the restriction that no person other than the patient may 8 administer the medication; 9 (ii) not taking the medication in a public place; and 10 (iii) informing the patient's family of the patient's decision to 11 request and take medication that will end the patient's life; a patient 12 who declines or is unable to notify family shall not have such patient's 13 request for medication denied for that reason; 14 (i) inform the patient that such patient may rescind the request for 15 medication at any time and in any manner; 16 (j) fulfill the medical record documentation requirements of section 17 twenty-eight hundred ninety-nine-j of this article; and 18 (k) ensure that all appropriate steps are carried out in accordance 19 with this article before writing a prescription for medication. 20 2. Upon receiving confirmation from a consulting physician under 21 section twenty-eight hundred ninety-nine-h of this article and subject 22 to section twenty-eight hundred ninety-nine-i of this article, the 23 attending physician who determines that the patient has a terminal 24 illness or condition, has decision-making capacity and has made a volun- 25 tary request for medication as provided in this article, may personally, 26 or by referral to another physician, prescribe or order appropriate 27 medication in accordance with the patient's request under this article, 28 and at the patient's request, facilitate the filling of the prescription 29 and delivery of the medication to the patient. 30 3. In accordance with the direction of the prescribing or ordering 31 physician and the consent of the patient, the patient may self-adminis- 32 ter the medication to themselves. A health care professional or other 33 person shall not administer the medication to the patient. 34 § 2899-g. Right to rescind request; requirement to offer opportunity 35 to rescind. 1. A patient may at any time rescind the request for medi- 36 cation under this article without regard to the patient's decision-mak- 37 ing capacity. 38 2. A prescription for medication may not be written without the 39 attending physician offering the qualified individual an opportunity to 40 rescind the request. 41 § 2899-h. Consulting physician responsibilities. Before a patient who 42 is requesting medication may receive a prescription for medication under 43 this article, a consulting physician must: 44 1. examine the patient and such patient's relevant medical records; 45 2. confirm, in writing, to the attending physician and the patient, 46 whether: (a) the patient has a terminal illness or condition; (b) the 47 patient is making an informed decision; (c) the patient has decision- 48 making capacity, or provide documentation that the consulting physician 49 has referred the patient for a determination under section twenty-eight 50 hundred ninety-nine-i of this article; and (d) the patient is acting 51 voluntarily, of the patient's own volition and without coercion. 52 § 2899-i. Referral to mental health professional. 1. If the attending 53 physician or the consulting physician determines that the patient may 54 lack decision-making capacity to make an informed decision due to a 55 condition, including, but not limited to, a psychiatric or psychological 56 disorder, or other condition causing impaired judgement, the attendingA. 136 6 1 physician or consulting physician shall refer the patient to a mental 2 health professional for a determination of whether the patient has deci- 3 sion-making capacity to make an informed decision. The referring physi- 4 cian shall advise the patient that the report of the mental health 5 professional will be provided to the attending physician and the 6 consulting physician. 7 2. A mental health professional who evaluates a patient under this 8 section shall report, in writing, to the attending physician and the 9 consulting physician, the mental health professional's independent 10 conclusions about whether the patient has decision-making capacity to 11 make an informed decision, provided that if, at the time of the report, 12 the patient has not yet been referred to a consulting physician, then 13 upon referral the attending physician shall provide the consulting 14 physician with a copy of the mental health professional's report. If the 15 mental health professional determines that the patient lacks decision- 16 making capacity to make an informed decision, the patient shall not be 17 deemed a qualified individual, and the attending physician shall not 18 prescribe medication to the patient. 19 3. A determination made pursuant to this section that an adult patient 20 lacks decision-making capacity shall not be construed as a finding that 21 the patient lacks decision-making capacity for any other purpose. 22 § 2899-j. Medical record documentation requirements. An attending 23 physician shall document or file the following in the patient's medical 24 record: 25 1. the dates of all oral requests by the patient for medication under 26 this article; 27 2. the written request by the patient for medication under this arti- 28 cle, including the declaration of witnesses and interpreter's declara- 29 tion, if applicable; 30 3. the attending physician's diagnosis and prognosis, determination of 31 decision-making capacity, and determination that the patient is acting 32 voluntarily, of the patient's own volition and without coercion, and has 33 made an informed decision; 34 4. if applicable, written confirmation of decision-making capacity 35 under section twenty-eight hundred ninety-nine-i of this article; and 36 5. a note by the attending physician indicating that all requirements 37 under this article have been met and indicating the steps taken to carry 38 out the request, including a notation of the medication prescribed or 39 ordered. 40 § 2899-k. Form of written request and witness attestation. 1. A 41 request for medication under this article shall be in substantially the 42 following form: 43 REQUEST FOR MEDICATION TO END MY LIFE 44 I, _________________________________, am an adult who has decision- 45 making capacity, which means I understand and appreciate the nature and 46 consequences of health care decisions, including the benefits and risks 47 of and alternatives to any proposed health care, and to reach an 48 informed decision and to communicate health care decisions to a physi- 49 cian. 50 I have been diagnosed with (insert diagnosis), which my attending 51 physician has determined is a terminal illness or condition, which has 52 been medically confirmed by a consulting physician. 53 I have been fully informed of my diagnosis and prognosis, the nature 54 of the medication to be prescribed and potential associated risks, theA. 136 7 1 expected result, and the feasible alternatives and treatment options 2 including but not limited to palliative care and hospice care. 3 I request that my attending physician prescribe medication that will 4 end my life if I choose to take it, and I authorize my attending physi- 5 cian to contact another physician or any pharmacist about my request. 6 INITIAL ONE: 7 ( ) I have informed or intend to inform one or more members of my 8 family of my decision. 9 ( ) I have decided not to inform any member of my family of my deci- 10 sion. 11 ( ) I have no family to inform of my decision. 12 I understand that I have the right to rescind this request or decline 13 to use the medication at any time. 14 I understand the importance of this request, and I expect to die if I 15 take the medication to be prescribed. I further understand that although 16 most deaths occur within three hours, my death may take longer, and my 17 attending physician has counseled me about this possibility. 18 I make this request voluntarily, of my own volition and without being 19 coerced, and I accept full responsibility for my actions. 20 Signed: __________________________ 21 Dated: ___________________________ 22 DECLARATION OF WITNESSES 23 I declare that the person signing this "Request for Medication to End 24 My Life": 25 (a) is personally known to me or has provided proof of identity; 26 (b) voluntarily signed the "Request for Medication to End My Life" in 27 my presence or acknowledged to me that the person signed it; and 28 (c) to the best of my knowledge and belief, has decision-making capac- 29 ity and is making the "Request for Medication to End My Life" voluntar- 30 ily, of the person's own volition and is not being coerced to sign the 31 "Request for Medication to End My Life". 32 I am not the attending physician or consulting physician of the person 33 signing the "Request for Medication to End My Life" or, if applicable, 34 the mental health professional who provides a decision-making capacity 35 determination of the person signing the "Request for Medication to End 36 My Life" at the time the "Request for Medication to End My Life" was 37 signed. 38 I further declare under penalty of perjury that the statements made 39 herein are true and correct and false statements made herein are punish- 40 able. 41 I further declare that I am not (i) related to the above-named patient 42 by blood, marriage or adoption, (ii) entitled at the time the patient 43 signed the "Request for Medication to End My Life" to any portion of the 44 estate of the patient upon such patient's death under any will or by 45 operation of law, or (iii) an owner, operator, employee or independent 46 contractor of a health care facility where the patient is receiving 47 treatment or is a resident. 48 Witness 1, Date: 49 (Printed name)A. 136 8 1 (Address) 2 (Telephone number) 3 Witness 2, Date: 4 (Printed name) 5 (Address) 6 (Telephone number) 7 2. (a) The "Request for Medication to End My Life" shall be written in 8 the same language as any conversations, consultations, or interpreted 9 conversations or consultations between a patient and at least one of the 10 patient's attending or consulting physicians. 11 (b) Notwithstanding paragraph (a) of this subdivision, the written 12 "Request for Medication to End My Life" may be prepared in English even 13 when the conversations or consultations or interpreted conversations or 14 consultations were conducted in a language other than English or with 15 auxiliary aids or hearing, speech or visual aids, if the English 16 language form includes an attached declaration by the interpreter of the 17 conversation or consultation, which shall be in substantially the 18 following form: 19 INTERPRETER'S DECLARATION 20 I, (insert name of interpreter), (mark as applicable): 21 ( ) for a patient whose conversations or consultations or interpreted 22 conversations or consultations were conducted in a language other than 23 English and the "Request for Medication to End My Life" is in English: I 24 declare that I am fluent in English and (insert target language). I have 25 the requisite language and interpreter skills to be able to interpret 26 effectively, accurately and impartially information shared and communi- 27 cations between the attending or consulting physician and (name of 28 patient). 29 I certify that on (insert date), at approximately (insert time), I 30 interpreted the communications and information conveyed between the 31 physician and (name of patient) as accurately and completely to the best 32 of my knowledge and ability and read the "Request for Medication to End 33 My Life" to (name of patient) in (insert target language). 34 (Name of patient) affirmed to me such patient's desire to sign the 35 "Request for Medication to End My Life" voluntarily, of (name of 36 patient)'s own volition and without coercion. 37 ( ) for a patient with a speech, hearing or vision disability: I 38 declare that I have the requisite language, reading and/or interpreter 39 skills to communicate with the patient and to be able to read and/or 40 interpret effectively, accurately and impartially information shared and 41 communications that occurred on (insert date) between the attending or 42 consulting physician and (name of patient). 43 I certify that on (insert date), at approximately (insert time), I 44 read and/or interpreted the communications and information conveyed 45 between the physician and (name of patient) impartially and as accurate- 46 ly and completely to the best of my knowledge and ability and, where 47 needed for effective communication, read or interpreted the "Request for 48 Medication to End my Life" to (name of patient).A. 136 9 1 (Name of patient) affirmed to me such patient's desire to sign the 2 "Request for Medication to End My Life" voluntarily, of (name of 3 patient)'s own volition and without coercion. 4 I further declare under penalty of perjury that (i) the foregoing is 5 true and correct; (ii) I am not (A) related to (name of patient) by 6 blood, marriage or adoption, (B) entitled at the time (name of patient) 7 signed the "Request for Medication to End My Life" to any portion of the 8 estate of (name of patient) upon such patient's death under any will or 9 by operation of law, or (C) an owner, operator, employee or independent 10 contractor of a health care facility where (name of patient) is receiv- 11 ing treatment or is a resident, except that if I am an employee or inde- 12 pendent contractor at such health care facility, providing interpreter 13 services is part of my job description at such health care facility or I 14 have been trained to provide interpreter services and (name of patient) 15 requested that I provide interpreter services to such patient for the 16 purposes stated in this Declaration; and (iii) false statements made 17 herein are punishable. 18 Executed at (insert city, county and state) on this (insert day of 19 month) of (insert month), (insert year). 20 (Signature of Interpreter) 21 (Printed name of Interpreter) 22 (ID # or Agency Name) 23 (Address of Interpreter) 24 (Language Spoken by Interpreter) 25 (c) An interpreter whose services are provided under paragraph (b) of 26 this subdivision shall not (i) be related to the patient who signs the 27 "Request for Medication to End My Life" by blood, marriage or adoption, 28 (ii) be entitled at the time the "Request for Medication to End My Life" 29 is signed by the patient to any portion of the estate of the patient 30 upon death under any will or by operation of law, or (iii) be an owner, 31 operator, employee or independent contractor of a health care facility 32 where the patient is receiving treatment or is a resident; provided that 33 an employee or independent contractor whose job description at the 34 health care facility includes interpreter services or who is trained to 35 provide interpreter services and who has been requested by the patient 36 to serve as an interpreter under this article shall not be prohibited 37 from serving as an interpreter under this article. 38 § 2899-l. Protection and immunities. 1. A physician, pharmacist, other 39 health care provider or other person shall not be subject to civil, 40 administrative, or criminal liability or penalty or professional disci- 41 plinary action by any government entity for taking any reasonable good- 42 faith action or refusing to act under this article, including, but not 43 limited to: (a) engaging in discussions with a patient relating to the 44 risks and benefits of end-of-life options in the circumstances described 45 in this article, (b) providing a patient, upon request, with a referral 46 to another health care provider, (c) being present when a qualified 47 individual self-administers medication, (d) refraining from acting to 48 prevent the qualified individual from self-administering such medica-A. 136 10 1 tion, or (e) refraining from acting to resuscitate the qualified indi- 2 vidual after the qualified individual self-administers such medication. 3 2. A health care provider or other person shall not be subject to 4 employment, credentialing, or contractual liability or penalty for any 5 reasonable good-faith action or refusing to act under this article, 6 including, but not limited to: 7 (a) engaging in discussions with a patient relating to the risks and 8 benefits of end-of-life options in the circumstances described in this 9 article; 10 (b) providing a patient, upon request, with a referral to another 11 health care provider; 12 (c) being present when a qualified individual self-administers medica- 13 tion; 14 (d) refraining from acting to prevent the qualified individual from 15 self-administering such medication; or 16 (e) refraining from acting to resuscitate the qualified individual 17 after the qualified individual self-administers such medication. Howev- 18 er, this subdivision does not bar a health care facility from acting 19 under paragraph (c) of subdivision two of section twenty-eight hundred 20 ninety-nine-m of this article. 21 3. Nothing in this section shall limit civil, administrative, or crim- 22 inal liability or penalty or any professional disciplinary action, or 23 employment, credentialing, or contractual liability or penalty for 24 negligence, recklessness or intentional misconduct. 25 § 2899-m. Permissible refusals and prohibitions. 1. (a) A physician, 26 nurse, pharmacist, other health care provider or other person shall not 27 be under any duty, by law or contract, to participate in the provision 28 of medication to a patient under this article. 29 (b) If a health care provider is unable or unwilling to participate in 30 the provision of medication to a patient under this article and the 31 patient transfers care to a new health care provider, the prior health 32 care provider shall transfer or arrange for the transfer, upon request, 33 of a copy of the patient's relevant medical records to the new health 34 care provider. 35 2. (a) A private health care facility may prohibit the prescribing, 36 dispensing, ordering or self-administering of medication under this 37 article while the patient is being treated in or while the patient is 38 residing in the health care facility if: 39 (i) the prescribing, dispensing, ordering or self-administering is 40 contrary to a formally adopted policy of the facility that is expressly 41 based on sincerely held religious beliefs or moral convictions central 42 to the facility's operating principles; and 43 (ii) the facility has informed the patient of such policy prior to 44 admission or as soon as reasonably possible. 45 (b) Where a facility has adopted a prohibition under this subdivision, 46 if a patient who wishes to use medication under this article requests, 47 the patient shall be transferred promptly to another health care facili- 48 ty that is reasonably accessible under the circumstances and willing to 49 permit the prescribing, dispensing, ordering and self-administering of 50 medication under this article with respect to the patient. 51 (c) Where a health care facility has adopted a prohibition under this 52 subdivision, any health care provider or employee or independent 53 contractor of the facility who violates the prohibition may be subject 54 to sanctions otherwise available to the facility, provided the facility 55 has previously notified the health care provider, employee or independ- 56 ent contractor of the prohibition in writing.A. 136 11 1 § 2899-n. Relation to other laws and contracts. 1. (a) A patient who 2 requests medication under this article shall not, because of that 3 request, be considered to be a person who is suicidal, and self-adminis- 4 tering medication under this article shall not be deemed to be suicide, 5 for any purpose. 6 (b) Action taken in accordance with this article shall not be 7 construed for any purpose to constitute suicide, assisted suicide, 8 attempted suicide, promoting a suicide attempt, euthanasia, mercy kill- 9 ing, or homicide under the law, including as an accomplice or accessory 10 or otherwise. 11 2. (a) No provision in a contract, other agreement or testamentary 12 instrument, whether written or oral, to the extent the provision would 13 affect whether a person may make or rescind a request for medication or 14 take any other action under this article, shall be valid. 15 (b) No obligation owing under any contract, other agreement or testa- 16 mentary instrument shall be conditioned or affected by the making or 17 rescinding of a request by a person for medication or taking any other 18 action under this article. 19 3. (a) A person and such person's beneficiaries shall not be denied 20 benefits under a life insurance policy for actions taken in accordance 21 with this article. 22 (b) The sale, procurement or issuance of a life insurance or annuity 23 policy or third-party health care payer policy or coverage, or the rate 24 charged for a policy or coverage, shall not be conditioned upon or 25 affected by a patient making or rescinding a request for medication 26 under this article. 27 (c) This article shall not limit the effect of a life insurance policy 28 provision concerning incontestability pursuant to article thirty-two of 29 the insurance law or any rights or obligations concerning a material 30 misrepresentation in accordance with article thirty-one of the insurance 31 law. 32 (d) No third-party health care payer may deny coverage for any service 33 or item that would otherwise be covered by the policy because the 34 patient has or has not chosen to request or use medication under this 35 article. 36 4. An insurer or third-party health care payer shall not provide any 37 information in communications made to a patient about the availability 38 of medication under this article absent a request by the patient or by 39 such patient's attending physician upon the request of such patient. Any 40 communication shall not include both the denial of coverage for treat- 41 ment and information as to the availability of medication under this 42 article. This subdivision does not bar the inclusion of information as 43 to the coverage of medication and professional services under this arti- 44 cle in information generally stating what is covered by a third-party 45 health care payer or provided in response to a request by the patient or 46 by such patient's attending physician upon the request of the patient. 47 5. The sale, procurement, or issue of any professional malpractice 48 insurance policy or the rate charged for the policy shall not be condi- 49 tioned upon or affected by whether the insured does or does not take or 50 participate in any action under this article. 51 § 2899-o. Safe disposal of unused medications. A person who has 52 custody or control of any unused medication prescribed under this arti- 53 cle after the death of the qualified individual shall personally deliver 54 the unused medication for disposal to the nearest qualified facility 55 that properly disposes of controlled substances or shall dispose of it 56 by lawful means in accordance with regulations made by the commissioner,A. 136 12 1 regulations made by or guidelines of the commissioner of education, or 2 guidelines of a federal drug enforcement administration approved take- 3 back program. A qualified facility that properly disposes of controlled 4 substances shall accept and dispose of any medication delivered to it as 5 provided hereunder regardless of whether such medication is a controlled 6 substance. The commissioner may make regulations as may be appropriate 7 for the safe disposal of unused medications prescribed, dispensed or 8 ordered under this article as provided in this section. 9 § 2899-p. Death certificate. 1. If otherwise authorized by law, the 10 attending physician may sign the qualified individual's death certif- 11 icate. 12 2. The cause of death listed on a qualified individual's death certif- 13 icate who dies after self-administering medication under this article 14 will be the underlying terminal illness or condition. 15 § 2899-q. Reporting. 1. The commissioner shall annually review a 16 sample of the records maintained under sections twenty-eight hundred 17 ninety-nine-j and twenty-eight hundred ninety-nine-p of this article. 18 The commissioner shall adopt regulations establishing reporting require- 19 ments for physicians taking action under this article to determine 20 utilization and compliance with this article. The information collected 21 under this subdivision shall not constitute a public record available 22 for public inspection and shall be confidential and collected and main- 23 tained in a manner that protects the privacy of the patient, the 24 patient's family, and any health care provider acting in connection with 25 such patient under this article, except that such information may be 26 disclosed to a governmental agency as authorized or required by law 27 relating to professional discipline, protection of public health or law 28 enforcement. 29 2. The commissioner shall prepare a report annually containing rele- 30 vant data regarding utilization and compliance with this article and 31 shall send such report to the legislature, and post such report on the 32 department's website. 33 § 2899-r. Penalties. 1. Nothing in this article shall be construed to 34 limit professional discipline or civil liability resulting from conduct 35 in violation of this article, negligent conduct, or intentional miscon- 36 duct by any person. 37 2. Conduct in violation of this article shall be subject to applicable 38 criminal liability under state law, including, where appropriate and 39 without limitation, offenses constituting homicide, forgery, coercion, 40 and related offenses, or federal law. 41 § 2899-s. Severability. If any provision of this article or any appli- 42 cation of any provision of this article, is held to be invalid, or to 43 violate or be inconsistent with any federal law or regulation, that 44 shall not affect the validity or effectiveness of any other provision of 45 this article, or of any other application of any provision of this arti- 46 cle, which can be given effect without that provision or application; 47 and to that end, the provisions and applications of this article are 48 severable. 49 § 3. This act shall take effect immediately.