NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A995A
SPONSOR: Paulin PURPOSE:
To provide that a mentally competent, terminally ill patient may request
medication to be self-administered for the purpose of hastening 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
physician 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 decision-making capacity. If the mental health professional deter-
mines 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 ah adult patient lacks decision-mak-
ing capacity shall not be construed as a finding that the patient lacks
decision-making capacity for anyother purpose.
§ 2899-j sets forth the items that must be documented or filed in the
patient's medical record.
§ 2899-k sets forth the form of written request for medication and
declaration of witnesses. The section also provides that the written
request shall be written in the same language as any conversations or
consultations 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 or criminal
liability or professional disciplinary action by any government entity
for taking any reasonable good-faith action or refusing to act under the
article, including without limitation, 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 quali-
fied 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-
STATE OF NEW YORK
________________________________________________________________________
995--A
2023-2024 Regular Sessions
IN ASSEMBLY
January 12, 2023
___________
Introduced by M. of A. PAULIN, L. ROSENTHAL, DINOWITZ, HEVESI, STECK,
LAVINE, LUPARDO, VANEL, RIVERA, THIELE, EPSTEIN, SEAWRIGHT, WOERNER,
REYES, FALL, DARLING, CRUZ, SAYEGH, AUBRY, DAVILA, DICKENS, STERN,
BURDICK, GALLAGHER, KELLES, GONZALEZ-ROJAS, MITAYNES, MAMDANI, CLARK,
BURKE, ANDERSON, JEAN-PIERRE, SILLITTI, JACKSON, PRETLOW, SEPTIMO,
GLICK, GIBBS, TAPIA, LUNSFORD, CUNNINGHAM, LEVENBERG, SIMONE, BORES,
FORREST, SHRESTHA, SHIMSKY, RAGA, RAJKUMAR, KIM, HUNTER, STIRPE, CHAN-
DLER-WATERMAN, ARDILA, LEE -- Multi-Sponsored by -- M. of A. BRAUN-
STEIN, BRONSON, BURGOS, CARROLL, HYNDMAN, RAMOS, ZINERMAN -- read once
and referred to the Committee on Health -- committee discharged, bill
amended, ordered reprinted as amended and recommitted to said commit-
tee
AN ACT to amend the public health law, in relation to a terminally ill
patient's request for and use of medication for medical aid in dying
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. This act shall be known and may be cited as the "medical
2 aid in dying act".
3 § 2. The public health law is amended by adding a new article 28-F to
4 read as follows:
5 ARTICLE 28-F
6 MEDICAL AID IN DYING
7 Section 2899-d. Definitions.
8 2899-e. Request process.
9 2899-f. Attending physician responsibilities.
10 2899-g. Right to rescind request; requirement to offer opportu-
11 nity to rescind.
12 2899-h. Consulting physician responsibilities.
13 2899-i. Referral to mental health professional.
14 2899-j. Medical record documentation requirements.
15 2899-k. Form of written request and witness attestation.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02188-05-3
A. 995--A 2
1 2899-l. Protection and immunities.
2 2899-m. Permissible refusals and prohibitions.
3 2899-n. Relation to other laws and contracts.
4 2899-o. Safe disposal of unused medications.
5 2899-p. Death certificate.
6 2899-q. Reporting.
7 2899-r. Penalties.
8 2899-s. Severability.
9 § 2899-d. Definitions. As used in this article:
10 1. "Adult" means an individual who is eighteen years of age or older.
11 2. "Attending physician" means the physician who has primary responsi-
12 bility for the care of the patient and treatment of the patient's termi-
13 nal illness or condition.
14 3. "Decision-making capacity" means the ability to understand and
15 appreciate the nature and consequences of health care decisions, includ-
16 ing the benefits and risks of and alternatives to any proposed health
17 care, including medical aid in dying, and to reach an informed decision.
18 4. "Consulting physician" means a physician who is qualified by
19 specialty or experience to make a professional diagnosis and prognosis
20 regarding a person's terminal illness or condition.
21 5. "Health care facility" means a general hospital, nursing home, or
22 residential health care facility as defined in section twenty-eight
23 hundred one of this chapter, or a hospice as defined in section four
24 thousand two of this chapter; provided that for the purposes of section
25 twenty eight hundred ninety-nine-m of this article, "hospice" shall
26 refer only to a facility providing in-patient hospice care or a hospice
27 residence.
28 6. "Health care provider" means a person licensed, certified, or
29 authorized by law to administer health care or dispense medication in
30 the ordinary course of business or practice of a profession.
31 7. "Informed decision" means a decision by a patient who is suffering
32 from a terminal illness or condition to request and obtain a
33 prescription for medication that the patient may self-administer to end
34 the patient's life that is based on an understanding and acknowledgment
35 of the relevant facts and that is made voluntarily, of the patient's own
36 volition and without coercion, after being fully informed of:
37 (a) the patient's medical diagnosis and prognosis;
38 (b) the potential risks associated with taking the medication to be
39 prescribed;
40 (c) the probable result of taking the medication to be prescribed;
41 (d) the possibility that the patient may choose not to obtain the
42 medication, or may obtain the medication but may decide not to self-ad-
43 minister it; and
44 (e) the feasible alternatives and appropriate treatment options,
45 including but not limited to palliative care and hospice care.
46 8. "Medical aid in dying" means the medical practice of a physician
47 prescribing medication to a qualified individual that the individual may
48 choose to self-administer to bring about death.
49 9. "Medically confirmed" means the medical opinion of the attending
50 physician that a patient has a terminal illness or condition and has
51 made an informed decision which has been confirmed by a consulting
52 physician who has examined the patient and the patient's relevant
53 medical records.
54 10. "Medication" means medication prescribed by a physician under this
55 article.
A. 995--A 3
1 11. "Mental health professional" means a licensed physician, who is a
2 diplomate or eligible to be certified by a national board of psychiatry,
3 psychiatric nurse practitioner, or psychologist, licensed or certified
4 under the education law acting within his or her scope of practice and
5 who is qualified, by training and experience, certification, or board
6 certification or eligibility, to make a determination under section
7 twenty-eight hundred ninety-nine-i of this article.
8 12. "Palliative care" means health care treatment, including interdis-
9 ciplinary end-of-life care, and consultation with patients and family
10 members, to prevent or relieve pain and suffering and to enhance the
11 patient's quality of life, including hospice care under article forty of
12 this chapter.
13 13. "Patient" means a person who is eighteen years of age or older
14 under the care of a physician.
15 14. "Physician" means an individual licensed to practice medicine in
16 New York state.
17 15. "Qualified individual" means a patient with a terminal illness or
18 condition, who has decision-making capacity, has made an informed deci-
19 sion, and has satisfied the requirements of this article in order to
20 obtain a prescription for medication.
21 16. "Self-administer" means a qualified individual's affirmative,
22 conscious, and voluntary act to ingest medication under this article.
23 Self-administration does not include lethal injection or lethal
24 infusion.
25 17. "Terminal illness or condition" means an incurable and irrevers-
26 ible illness or condition that has been medically confirmed and will,
27 within reasonable medical judgment, produce death within six months.
28 § 2899-e. Request process. 1. Oral and written request. A patient
29 wishing to request medication under this article shall make an oral
30 request and submit a written request to the patient's attending physi-
31 cian.
32 2. Making a written request. A patient may make a written request for
33 and consent to self-administer medication for the purpose of ending his
34 or her life in accordance with this article if the patient:
35 (a) has been determined by the attending physician to have a terminal
36 illness or condition and which has been medically confirmed by a
37 consulting physician; and
38 (b) based on an informed decision, expresses voluntarily, of the
39 patient's own volition and without coercion the request for medication
40 to end his or her life.
41 3. Written request signed and witnessed. (a) A written request for
42 medication under this article shall be signed and dated by the patient
43 and witnessed by at least two adults who, in the presence of the
44 patient, attest that to the best of his or her knowledge and belief the
45 patient has decision-making capacity, is acting voluntarily, is making
46 the request for medication of his or her own volition and is not being
47 coerced to sign the request. The written request shall be in substan-
48 tially the form described in section twenty-eight hundred ninety-nine-k
49 of this article.
50 (b) Both witnesses shall be adults who are not:
51 (i) a relative of the patient by blood, marriage or adoption;
52 (ii) a person who at the time the request is signed would be entitled
53 to any portion of the estate of the patient upon death under any will or
54 by operation of law; or
A. 995--A 4
1 (iii) an owner, operator, employee or independent contractor of a
2 health care facility where the patient is receiving treatment or is a
3 resident.
4 (c) The attending physician, consulting physician and, if applicable,
5 the mental health professional who provides a decision-making capacity
6 determination of the patient under this article shall not be a witness.
7 4. No person shall qualify for medical aid in dying under this article
8 solely because of age or disability.
9 5. Requests for a medical aid-in-dying prescription must be made by
10 the qualified individual and may not be made by any other individual,
11 including the qualified individual's health care agent, or other agent
12 or surrogate, or via advance healthcare directive.
13 § 2899-f. Attending physician responsibilities. 1. The attending
14 physician shall examine the patient and his or her relevant medical
15 records and:
16 (a) make a determination of whether a patient has a terminal illness
17 or condition, has decision-making capacity, has made an informed deci-
18 sion and has made the request voluntarily of the patient's own volition
19 and without coercion;
20 (b) inform the patient of the requirement under this article for
21 confirmation by a consulting physician, and refer the patient to a
22 consulting physician upon the patient's request;
23 (c) refer the patient to a mental health professional pursuant to
24 section twenty-eight hundred ninety-nine-i of this article if the
25 attending physician believes that the patient may lack decision-making
26 capacity to make an informed decision;
27 (d) provide information and counseling under section twenty-nine
28 hundred ninety-seven-c of this chapter;
29 (e) ensure that the patient is making an informed decision by discuss-
30 ing with the patient: (i) the patient's medical diagnosis and prognosis;
31 (ii) the potential risks associated with taking the medication to be
32 prescribed; (iii) the probable result of taking the medication to be
33 prescribed; (iv) the possibility that the patient may choose to obtain
34 the medication but not take it; (v) the feasible alternatives and appro-
35 priate treatment options, including but not limited to (1) information
36 and counseling regarding palliative and hospice care and end-of-life
37 options appropriate to the patient, including but not limited to: the
38 range of options appropriate to the patient; the prognosis, risks and
39 benefits of the various options; and the patient's legal rights to
40 comprehensive pain and symptom management at the end of life; and (2)
41 information regarding treatment options appropriate to the patient,
42 including the prognosis, risks and benefits of the various treatment
43 options;
44 (f) offer to refer the patient for other appropriate treatment
45 options, including but not limited to palliative care and hospice care;
46 (g) provide health literate and culturally appropriate educational
47 material regarding hospice and palliative care that has been prepared by
48 the department in consultation with representatives of hospice and
49 palliative care providers from all regions of New York state, and that
50 is available on the department's website for access and download,
51 provided, however, an otherwise eligible patient cannot be denied care
52 under this article if these materials are not developed by the effective
53 date of this article;
54 (h) discuss with the patient the importance of:
A. 995--A 5
1 (i) having another person present when the patient takes the medica-
2 tion and the restriction that no person other than the patient may
3 administer the medication;
4 (ii) not taking the medication in a public place; and
5 (iii) informing the patient's family of the patient's decision to
6 request and take medication that will end the patient's life; a patient
7 who declines or is unable to notify family shall not have his or her
8 request for medication denied for that reason;
9 (i) inform the patient that he or she may rescind the request for
10 medication at any time and in any manner;
11 (j) fulfill the medical record documentation requirements of section
12 twenty-eight hundred ninety-nine-j of this article; and
13 (k) ensure that all appropriate steps are carried out in accordance
14 with this article before writing a prescription for medication.
15 2. Upon receiving confirmation from a consulting physician under
16 section twenty-eight hundred ninety-nine-h of this article and subject
17 to section twenty-eight hundred ninety-nine-i of this article, the
18 attending physician who determines that the patient has a terminal
19 illness or condition, has decision-making capacity and has made a volun-
20 tary request for medication as provided in this article, may personally,
21 or by referral to another physician, prescribe or order appropriate
22 medication in accordance with the patient's request under this article,
23 and at the patient's request, facilitate the filling of the prescription
24 and delivery of the medication to the patient.
25 3. In accordance with the direction of the prescribing or ordering
26 physician and the consent of the patient, the patient may self-adminis-
27 ter the medication to himself or herself. A health care professional or
28 other person shall not administer the medication to the patient.
29 § 2899-g. Right to rescind request; requirement to offer opportunity
30 to rescind. 1. A patient may at any time rescind his or her request for
31 medication under this article without regard to the patient's decision-
32 making capacity.
33 2. A prescription for medication may not be written without the
34 attending physician offering the qualified individual an opportunity to
35 rescind the request.
36 § 2899-h. Consulting physician responsibilities. Before a patient who
37 is requesting medication may receive a prescription for medication under
38 this article, a consulting physician must:
39 1. examine the patient and his or her relevant medical records;
40 2. confirm, in writing, to the attending physician and the patient,
41 whether: (a) the patient has a terminal illness or condition; (b) the
42 patient is making an informed decision; (c) the patient has decision-
43 making capacity, or provide documentation that the consulting physician
44 has referred the patient for a determination under section twenty-eight
45 hundred ninety-nine-i of this article; and (d) the patient is acting
46 voluntarily, of the patient's own volition and without coercion.
47 § 2899-i. Referral to mental health professional. 1. If the attending
48 physician or the consulting physician determines that the patient may
49 lack decision-making capacity to make an informed decision due to a
50 condition, including, but not limited to, a psychiatric or psychological
51 disorder, or other condition causing impaired judgement, the attending
52 physician or consulting physician shall refer the patient to a mental
53 health professional for a determination of whether the patient has deci-
54 sion-making capacity to make an informed decision. The referring physi-
55 cian shall advise the patient that the report of the mental health
A. 995--A 6
1 professional will be provided to the attending physician and the
2 consulting physician.
3 2. A mental health professional who evaluates a patient under this
4 section shall report, in writing, to the attending physician and the
5 consulting physician, his or her independent conclusions about whether
6 the patient has decision-making capacity to make an informed decision,
7 provided that if, at the time of the report, the patient has not yet
8 been referred to a consulting physician, then upon referral the attend-
9 ing physician shall provide the consulting physician with a copy of the
10 mental health professional's report. If the mental health professional
11 determines that the patient lacks decision-making capacity to make an
12 informed decision, the patient shall not be deemed a qualified individ-
13 ual, and the attending physician shall not prescribe medication to the
14 patient.
15 3. A determination made pursuant to this section that an adult patient
16 lacks decision-making capacity shall not be construed as a finding that
17 the patient lacks decision-making capacity for any other purpose.
18 § 2899-j. Medical record documentation requirements. An attending
19 physician shall document or file the following in the patient's medical
20 record:
21 1. the dates of all oral requests by the patient for medication under
22 this article;
23 2. the written request by the patient for medication under this arti-
24 cle, including the declaration of witnesses and interpreter's declara-
25 tion, if applicable;
26 3. the attending physician's diagnosis and prognosis, determination of
27 decision-making capacity, and determination that the patient is acting
28 voluntarily, of the patient's own volition and without coercion, and has
29 made an informed decision;
30 4. if applicable, written confirmation of decision-making capacity
31 under section twenty-eight hundred ninety-nine-i of this article; and
32 5. a note by the attending physician indicating that all requirements
33 under this article have been met and indicating the steps taken to carry
34 out the request, including a notation of the medication prescribed or
35 ordered.
36 § 2899-k. Form of written request and witness attestation. 1. A
37 request for medication under this article shall be in substantially the
38 following form:
39 REQUEST FOR MEDICATION TO END MY LIFE
40 I, _________________________________, am an adult who has decision-
41 making capacity, which means I understand and appreciate the nature and
42 consequences of health care decisions, including the benefits and risks
43 of and alternatives to any proposed health care, and to reach an
44 informed decision and to communicate health care decisions to a physi-
45 cian.
46 I have been diagnosed with ______________(insert diagnosis), which my
47 attending physician has determined is a terminal illness or condition,
48 which has been medically confirmed by a consulting physician.
49 I have been fully informed of my diagnosis and prognosis, the nature
50 of the medication to be prescribed and potential associated risks, the
51 expected result, and the feasible alternatives and treatment options
52 including but not limited to palliative care and hospice care.
53 I request that my attending physician prescribe medication that will
54 end my life if I choose to take it, and I authorize my attending physi-
55 cian to contact another physician or any pharmacist about my request.
A. 995--A 7
1 INITIAL ONE:
2 ( ) I have informed or intend to inform one or more members of my
3 family of my decision.
4 ( ) I have decided not to inform any member of my family of my deci-
5 sion.
6 ( ) I have no family to inform of my decision.
7 I understand that I have the right to rescind this request or decline
8 to use the medication at any time.
9 I understand the importance of this request, and I expect to die if I
10 take the medication to be prescribed. I further understand that although
11 most deaths occur within three hours, my death may take longer, and my
12 attending physician has counseled me about this possibility.
13 I make this request voluntarily, of my own volition and without being
14 coerced, and I accept full responsibility for my actions.
15 Signed: __________________________
16 Dated: ___________________________
17 DECLARATION OF WITNESSES
18 I declare that the person signing this "Request for Medication to End
19 My Life":
20 (a) is personally known to me or has provided proof of identity;
21 (b) voluntarily signed the "Request for Medication to End My Life" in
22 my presence or acknowledged to me that he or she signed it; and
23 (c) to the best of my knowledge and belief, has decision-making capac-
24 ity and is making the "Request for Medication to End My Life" voluntar-
25 ily, of his or her own volition and is not being coerced to sign the
26 "Request for Medication to End My Life".
27 I am not the attending physician or consulting physician of the person
28 signing the "Request for Medication to End My Life" or, if applicable,
29 the mental health professional who provides a decision-making capacity
30 determination of the person signing the "Request for Medication to End
31 My Life" at the time the "Request for Medication to End My Life" was
32 signed.
33 I further declare under penalty of perjury that the statements made
34 herein are true and correct and false statements made herein are punish-
35 able.
36 __________________________ Witness 1, Date: ________________
37 __________________________ (Printed name)
38 __________________________ (Address)
39 __________________________ (Telephone number)
40 I further declare that I am not (i) related to the above-named patient
41 by blood, marriage or adoption, (ii) entitled at the time the patient
42 signed the "Request for Medication to End My Life" to any portion of the
43 estate of the patient upon his/her death under any will or by operation
44 of law, or (iii) an owner, operator, employee or independent contractor
45 of a health care facility where the patient is receiving treatment or is
46 a resident.
A. 995--A 8
1 __________________________ Witness 2, Date: _________________
2 __________________________ (Printed name)
3 __________________________ (Address)
4 __________________________ (Telephone number)
5 I further declare that I am not (i) related to the above-named patient
6 by blood, marriage or adoption, (ii) entitled at the time the patient
7 signed the "Request for Medication to End My Life" to any portion of the
8 estate of the patient upon his/her death under any will or by operation
9 of law, or (iii) an owner, operator, employee or independent contractor
10 of a health care facility where the patient is receiving treatment or is
11 a resident.
12 2. (a) The "Request for Medication to End My Life" shall be written in
13 the same language as any conversations, consultations, or interpreted
14 conversations or consultations between a patient and at least one of his
15 or her attending or consulting physicians.
16 (b) Notwithstanding paragraph (a) of this subdivision, the written
17 "Request for Medication to End My Life" may be prepared in English even
18 when the conversations or consultations or interpreted conversations or
19 consultations were conducted in a language other than English or with
20 auxiliary aids or hearing, speech or visual aids, if the English
21 language form includes an attached declaration by the interpreter of the
22 conversation or consultation, which shall be in substantially the
23 following form:
24 INTERPRETER'S DECLARATION
25 I, ___________ (insert name of interpreter)_____ ,(mark as applica-
26 ble):
27 ( ) for a patient whose conversations or consultations or interpreted
28 conversations or consultations were conducted in a language other than
29 English and the "Request for Medication to End My Life" is in English: I
30 declare that I am fluent in English and (insert target language). I have
31 the requisite language and interpreter skills to be able to interpret
32 effectively, accurately and impartially information shared and communi-
33 cations between the attending or consulting physician and (name of
34 patient).
35 I certify that on (insert date), at approximately (insert time), I
36 interpreted the communications and information conveyed between the
37 physician and (name of patient) as accurately and completely to the best
38 of my knowledge and ability and read the "Request for Medication to End
39 My Life" to (name of patient) in (insert target language).
40 (Name of patient) affirmed to me his/her desire to sign the "Request
41 for Medication to End My Life" voluntarily, of (name of patient)'s own
42 volition and without coercion.
43 ( ) for a patient with a speech, hearing or vision disability: I
44 declare that I have the requisite language, reading and/or interpreter
45 skills to communicate with the patient and to be able to read and/or
46 interpret effectively, accurately and impartially information shared and
47 communications that occurred on (insert date) between the attending or
48 consulting physician and (name of patient).
49 I certify that on (insert date), at approximately (insert time), I
50 read and/or interpreted the communications and information conveyed
A. 995--A 9
1 between the physician and (name of patient) impartially and as accurate-
2 ly and completely to the best of my knowledge and ability and, where
3 needed for effective communication, read or interpreted the "Request for
4 Medication to End my Life" to (name of patient).
5 (Name of patient) affirmed to me his/her desire to sign the "Request
6 for Medication to End My Life" voluntarily, of (name of patient)'s own
7 volition and without coercion.
8 I further declare under penalty of perjury that (i) the foregoing is
9 true and correct; (ii) I am not (A) related to (name of patient) by
10 blood, marriage or adoption, (B) entitled at the time (name of patient)
11 signed the "Request for Medication to End My Life" to any portion of the
12 estate of (name of patient) upon his/her death under any will or by
13 operation of law, or (C) an owner, operator, employee or independent
14 contractor of a health care facility where (name of patient) is receiv-
15 ing treatment or is a resident, except that if I am an employee or inde-
16 pendent contractor at such health care facility, providing interpreter
17 services is part of my job description at such health care facility or I
18 have been trained to provide interpreter services and (name of patient)
19 requested that I provide interpreter services to him/her for the
20 purposes stated in this Declaration; and (iii) false statements made
21 herein are punishable.
22 Executed at (insert city, county and state) on this (insert day of
23 month) of (insert month), (insert year).
24 __________________________ (Signature of Interpreter)
25 __________________________ (Printed name of Interpreter)
26 __________________________ (ID # or Agency Name)
27 __________________________ (Address of Interpreter)
28 __________________________ (Language Spoken by Interpreter)
29 (c) An interpreter whose services are provided under paragraph (b) of
30 this subdivision shall not (i) be related to the patient who signs the
31 "Request for Medication to End My Life" by blood, marriage or adoption,
32 (ii) be entitled at the time the "Request for Medication to End My Life"
33 is signed by the patient to any portion of the estate of the patient
34 upon death under any will or by operation of law, or (iii) be an owner,
35 operator, employee or independent contractor of a health care facility
36 where the patient is receiving treatment or is a resident; provided that
37 an employee or independent contractor whose job description at the
38 health care facility includes interpreter services or who is trained to
39 provide interpreter services and who has been requested by the patient
40 to serve as an interpreter under this article shall not be prohibited
41 from serving as a witness under this article.
42 § 2899-l. Protection and immunities. 1. A physician, pharmacist, other
43 health care professional or other person shall not be subject to civil
44 or criminal liability or professional disciplinary action by any govern-
45 ment entity for taking any reasonable good-faith action or refusing to
46 act under this article, including, but not limited to: (a) engaging in
47 discussions with a patient relating to the risks and benefits of end-of-
48 life options in the circumstances described in this article, (b) provid-
49 ing a patient, upon request, with a referral to another health care
A. 995--A 10
1 provider, (c) being present when a qualified individual self-administers
2 medication, (d) refraining from acting to prevent the qualified individ-
3 ual from self-administering such medication, or (e) refraining from
4 acting to resuscitate the qualified individual after he or she self-ad-
5 ministers such medication.
6 2. Nothing in this section shall limit civil or criminal liability for
7 negligence, recklessness or intentional misconduct.
8 § 2899-m. Permissible refusals and prohibitions. 1. (a) A physician,
9 nurse, pharmacist, other health care provider or other person shall not
10 be under any duty, by law or contract, to participate in the provision
11 of medication to a patient under this article.
12 (b) If a health care provider is unable or unwilling to participate in
13 the provision of medication to a patient under this article and the
14 patient transfers care to a new health care provider, the prior health
15 care provider shall transfer or arrange for the transfer, upon request,
16 of a copy of the patient's relevant medical records to the new health
17 care provider.
18 2. (a) A private health care facility may prohibit the prescribing,
19 dispensing, ordering or self-administering of medication under this
20 article while the patient is being treated in or while the patient is
21 residing in the health care facility if:
22 (i) the prescribing, dispensing, ordering or self-administering is
23 contrary to a formally adopted policy of the facility that is expressly
24 based on sincerely held religious beliefs or moral convictions central
25 to the facility's operating principles; and
26 (ii) the facility has informed the patient of such policy prior to
27 admission or as soon as reasonably possible.
28 (b) Where a facility has adopted a prohibition under this subdivision,
29 if a patient who wishes to use medication under this article requests,
30 the patient shall be transferred promptly to another health care facili-
31 ty that is reasonably accessible under the circumstances and willing to
32 permit the prescribing, dispensing, ordering and self-administering of
33 medication under this article with respect to the patient.
34 3. Where a health care facility has adopted a prohibition under this
35 subdivision, any health care provider or employee or independent
36 contractor of the facility who violates the prohibition may be subject
37 to sanctions otherwise available to the facility, provided the facility
38 has previously notified the health care provider, employee or independ-
39 ent contractor of the prohibition in writing.
40 § 2899-n. Relation to other laws and contracts. 1. (a) A patient who
41 requests medication under this article shall not, because of that
42 request, be considered to be a person who is suicidal, and self-adminis-
43 tering medication under this article shall not be deemed to be suicide,
44 for any purpose.
45 (b) Action taken in accordance with this article shall not be
46 construed for any purpose to constitute suicide, assisted suicide,
47 attempted suicide, promoting a suicide attempt, euthanasia, mercy kill-
48 ing, or homicide under the law, including as an accomplice or accessory
49 or otherwise.
50 2. (a) No provision in a contract, will or other agreement, whether
51 written or oral, to the extent the provision would affect whether a
52 person may make or rescind a request for medication or take any other
53 action under this article, shall be valid.
54 (b) No obligation owing under any contract shall be conditioned or
55 affected by the making or rescinding of a request by a person for medi-
56 cation or taking any other action under this article.
A. 995--A 11
1 3. (a) A person and his or her beneficiaries shall not be denied bene-
2 fits under a life insurance policy for actions taken in accordance with
3 this article.
4 (b) Notwithstanding the provisions of any law or contract, the sale,
5 procurement or issuance of a life or health insurance or annuity policy,
6 or the rate charged for a policy, shall not be conditioned upon or
7 affected by a patient making or rescinding a request for medication
8 under this article.
9 4. An insurer shall not provide any information in communications made
10 to a patient about the availability of medication under this article
11 absent a request by the patient or by his or her attending physician
12 upon the request of such patient. Any communication shall not include
13 both the denial of coverage for treatment and information as to the
14 availability of medication under this article.
15 5. The sale, procurement, or issue of any professional malpractice
16 insurance policy or the rate charged for the policy shall not be condi-
17 tioned upon or affected by whether the insured does or does not take or
18 participate in any action under this article.
19 § 2899-o. Safe disposal of unused medications. A person who has
20 custody or control of any unused medication prescribed under this arti-
21 cle after the death of the qualified individual shall personally deliver
22 the unused medication for disposal to the nearest qualified facility
23 that properly disposes of controlled substances or shall dispose of it
24 by lawful means in accordance with regulations made by the commissioner,
25 regulations made by or guidelines of the commissioner of education, or
26 guidelines of a federal drug enforcement administration approved take-
27 back program. A qualified facility that properly disposes of controlled
28 substances shall accept and dispose of any medication delivered to it as
29 provided hereunder regardless of whether such medication is a controlled
30 substance. The commissioner may make regulations as may be appropriate
31 for the safe disposal of unused medications prescribed, dispensed or
32 ordered under this article as provided in this section.
33 § 2899-p. Death certificate. 1. If otherwise authorized by law, the
34 attending physician may sign the qualified individual's death certif-
35 icate.
36 2. The cause of death listed on a qualified individual's death certif-
37 icate who dies after self-administering medication under this article
38 will be the underlying terminal illness or condition.
39 § 2899-q. Reporting. 1. The commissioner shall annually review a
40 sample of the records maintained under sections twenty-eight hundred
41 ninety-nine-j and twenty-eight hundred ninety-nine-p of this article.
42 The commissioner shall adopt regulations establishing reporting require-
43 ments for physicians taking action under this article to determine
44 utilization and compliance with this article. The information collected
45 under this subdivision shall not constitute a public record available
46 for public inspection and shall be confidential and collected and main-
47 tained in a manner that protects the privacy of the patient, his or her
48 family, and any health care provider acting in connection with such
49 patient under this article, except that such information may be
50 disclosed to a governmental agency as authorized or required by law
51 relating to professional discipline, protection of public health or law
52 enforcement.
53 2. The commissioner shall prepare a report annually containing rele-
54 vant data regarding utilization and compliance with this article and
55 shall send such report to the legislature, and post such report on the
56 department's website.
A. 995--A 12
1 § 2899-r. Penalties. 1. Nothing in this article shall be construed to
2 limit professional discipline or civil liability resulting from conduct
3 in violation of this article, negligent conduct, or intentional miscon-
4 duct by any person.
5 2. Conduct in violation of this article shall be subject to applicable
6 criminal liability under state law, including, where appropriate and
7 without limitation, offenses constituting homicide, forgery, coercion,
8 and related offenses, or federal law.
9 § 2899-s. Severability. If any provision of this article or any appli-
10 cation of any provision of this article, is held to be invalid, or to
11 violate or be inconsistent with any federal law or regulation, that
12 shall not affect the validity or effectiveness of any other provision of
13 this article, or of any other application of any provision of this arti-
14 cle, which can be given effect without that provision or application;
15 and to that end, the provisions and applications of this article are
16 severable.
17 § 3. This act shall take effect immediately.
