|SAME AS||SAME AS S03151-A|
|COSPNSR||Rosenthal L, Gottfried, Dinowitz, Galef, Hevesi, Steck, Blake, Lavine, Lupardo, Sepulveda, Abinanti, Rodriguez, Jaffee, Jones, D'Urso, Miller MG, Ortiz, Arroyo, Simotas, Vanel, Quart, Rivera, Miller ML, Thiele, Mosley|
|MLTSPNSR||Braunstein, Crouch, Lifton, Magee, Skartados|
|Add Art 28-F §§2899-d - 2899-s, Pub Health L|
|Relates to the medical aid in dying act; relates to a terminally ill patient's request for and use of medication for medical aid in dying.|
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STATE OF NEW YORK ________________________________________________________________________ 2383--A 2017-2018 Regular Sessions IN ASSEMBLY January 19, 2017 ___________ Introduced by M. of A. PAULIN, L. ROSENTHAL, GOTTFRIED, DINOWITZ, GALEF, HEVESI, STECK, BLAKE, LAVINE, LUPARDO, SEPULVEDA, HARRIS, ABINANTI, RODRIGUEZ, JAFFEE, JONES, D'URSO, M. G. MILLER, ORTIZ, ARROYO, SIMO- TAS, ERRIGO, VANEL, QUART -- Multi-Sponsored by -- M. of A. BRAUN- STEIN, CROUCH, MAGEE, SKARTADOS -- read once and referred to the Committee on Health -- recommitted to the Committee on Health in accordance with Assembly Rule 3, sec. 2 -- 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. 16 2899-l. Protection and immunities. 17 2899-m. Permissible refusals and prohibitions. 18 2899-n. Relation to other laws and contracts. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD01103-12-8A. 2383--A 2 1 2899-o. Safe disposal of unused medications. 2 2899-p. Death certificate. 3 2899-q. Reporting. 4 2899-r. Penalties. 5 2899-s. Severability. 6 § 2899-d. Definitions. As used in this article: 7 1. "Adult" means an individual who is eighteen years of age or older. 8 2. "Attending physician" means the physician who has primary responsi- 9 bility for the care of the patient and treatment of the patient's termi- 10 nal illness or condition. 11 3. "Capacity" means the ability to understand and appreciate the 12 nature and consequences of health care decisions, including the benefits 13 and risks of and alternatives to any proposed health care, and to reach 14 an informed decision. 15 4. "Consulting physician" means a physician who is qualified by 16 specialty or experience to make a professional diagnosis and prognosis 17 regarding a person's terminal illness or condition. 18 5. "Health care facility" means a general hospital, nursing home, or 19 residential health care facility as defined in section twenty-eight 20 hundred one of this chapter. 21 6. "Health care provider" means a person licensed, certified, or 22 authorized by law to administer health care or dispense medication in 23 the ordinary course of business or practice of a profession. 24 7. "Informed decision" means a decision by a patient who is suffering 25 from a terminal illness or condition to request and obtain a 26 prescription for medication that the patient may self-administer to end 27 the patient's life that is based on an understanding and acknowledgment 28 of the relevant facts and that is made voluntarily, of the patient's own 29 volition and without coercion, after being fully informed of: 30 (a) the patient's medical diagnosis and prognosis; 31 (b) the potential risks associated with taking the medication to be 32 prescribed; 33 (c) the probable result of taking the medication to be prescribed; 34 (d) the possibility that the patient may choose not to obtain the 35 medication, or may obtain the medication but may decide not to self-ad- 36 minister it; and 37 (e) the feasible alternatives and appropriate treatment options, 38 including but not limited to palliative care and hospice care. 39 8. "Medical aid in dying" means the medical practice of a physician 40 prescribing medication to a qualified individual that the individual may 41 choose to self-administer to bring about death. 42 9. "Medically confirmed" means the medical opinion of the attending 43 physician that a patient has a terminal illness or condition and has 44 made an informed decision which has been confirmed by a consulting 45 physician who has examined the patient and the patient's relevant 46 medical records. 47 10. "Medication" means medication prescribed by a physician under this 48 article. 49 11. "Mental health professional" means a physician, nurse practition- 50 er, physician assistant or psychologist, licensed or certified under the 51 education law acting within his or her scope of practice and who is 52 qualified, by training and experience, certification, or board certif- 53 ication or eligibility, to make a determination under section twenty- 54 eight hundred ninety-nine-i of this article; provided that in the case 55 of a nurse practitioner or physician assistant, the professional shallA. 2383--A 3 1 not have a collaborative agreement or collaborative relationship with or 2 be supervised by the attending physician or consulting physician. 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 capacity, has made an informed decision, and has 14 satisfied the requirements of this article in order to obtain a 15 prescription for medication. 16 16. "Self-administer" means a qualified individual's affirmative, 17 conscious, and voluntary act of using medication under this article. 18 17. "Terminal illness or condition" means an incurable and irrevers- 19 ible illness or condition that has been medically confirmed and will, 20 within reasonable medical judgment, produce death within six months. 21 § 2899-e. Request process. 1. Oral and written request. A patient 22 wishing to request medication under this article shall make an oral 23 request and submit a written request to the patient's attending physi- 24 cian. 25 2. Making a written request. A patient may make a written request for 26 and consent to self-administer medication for the purpose of ending his 27 or her life in accordance with this article if the patient: 28 (a) has been determined by the attending physician to have a terminal 29 illness or condition and which has been medically confirmed by a 30 consulting physician; and 31 (b) based on an informed decision, expresses voluntarily, of the 32 patient's own volition and without coercion the request for medication 33 to end his or her life. 34 3. Written request signed and witnessed. (a) A written request for 35 medication under this article shall be signed and dated by the patient 36 and witnessed by at least two adults who, in the presence of the 37 patient, attest that to the best of his or her knowledge and belief the 38 patient has capacity, is acting voluntarily, is making the request for 39 medication of his or her own volition and is not being coerced to sign 40 the request. The written request shall be in substantially the form 41 described in section twenty-eight hundred ninety-nine-k of this article. 42 (b) One of the witnesses shall be an adult who is not: 43 (i) a relative of the patient by blood, marriage or adoption; 44 (ii) a person who at the time the request is signed would be entitled 45 to any portion of the estate of the patient upon death under any will or 46 by operation of law; or 47 (iii) an owner, operator, employee or independent contractor of a 48 health care facility where the patient is receiving treatment or is a 49 resident. 50 (c) The attending physician, consulting physician and, if applicable, 51 the mental health professional who provides a capacity determination of 52 the patient under this article shall not be a witness. 53 4. No person shall qualify for medical aid in dying under this article 54 solely because of age or disability.A. 2383--A 4 1 § 2899-f. Attending physician responsibilities. 1. The attending 2 physician shall examine the patient and his or her relevant medical 3 records and: 4 (a) make a determination of whether a patient has a terminal illness 5 or condition, has capacity, has made an informed decision and has made 6 the request voluntarily of the patient's own volition and without coer- 7 cion; 8 (b) inform the patient of the requirement under this article for 9 confirmation by a consulting physician, and refer the patient to a 10 consulting physician upon the patient's request; 11 (c) refer the patient to a mental health professional pursuant to 12 section twenty-eight hundred ninety-nine-i of this article if the 13 attending physician believes that the patient may lack capacity to make 14 an informed decision; 15 (d) provide information and counseling under section twenty-nine 16 hundred ninety-seven-c of this chapter; 17 (e) ensure that the patient is making an informed decision by discuss- 18 ing with the patient: (i) the patient's medical diagnosis and prognosis; 19 (ii) the potential risks associated with taking the medication to be 20 prescribed; (iii) the probable result of taking the medication to be 21 prescribed; (iv) the possibility that the patient may choose to obtain 22 the medication but not take it; and (v) the feasible alternatives and 23 appropriate treatment options, including but not limited to (1) informa- 24 tion and counseling regarding palliative and hospice care and end-of- 25 life options appropriate to the patient, including but not limited to: 26 the range of options appropriate to the patient; the prognosis, risks 27 and benefits of the various options; and the patient's legal rights to 28 comprehensive pain and symptom management at the end of life; and (2) 29 information regarding treatment options appropriate to the patient, 30 including the prognosis, risks and benefits of the various treatment 31 options; 32 (f) discuss with the patient the importance of: 33 (i) having another person present when the patient takes the medica- 34 tion and the restriction that no person other than the patient may 35 administer the medication; 36 (ii) not taking the medication in a public place; and 37 (iii) informing the patient's family of the patient's decision to 38 request and take medication that will end the patient's life; a patient 39 who declines or is unable to notify family shall not have his or her 40 request for medication denied for that reason; 41 (g) inform the patient that he or she may rescind the request for 42 medication at any time and in any manner; 43 (h) fulfill the medical record documentation requirements of section 44 twenty-eight hundred ninety-nine-j of this article; and 45 (i) ensure that all appropriate steps are carried out in accordance 46 with this article before writing a prescription for medication. 47 2. Upon receiving confirmation from a consulting physician under 48 section twenty-eight hundred ninety-nine-h of this article and subject 49 to section twenty-eight hundred ninety-nine-i of this article, the 50 attending physician who determines that the patient has a terminal 51 illness or condition, has capacity and has made a voluntary request for 52 medication as provided in this article, may personally, or by referral 53 to another physician, prescribe or order appropriate medication in 54 accordance with the patient's request under this article, and at the 55 patient's request, facilitate the filling of the prescription and deliv- 56 ery of the medication to the patient.A. 2383--A 5 1 3. In accordance with the direction of the prescribing or ordering 2 physician and the consent of the patient, the patient may self-adminis- 3 ter the medication to himself or herself. A health care professional or 4 other person shall not administer the medication to the patient. 5 § 2899-g. Right to rescind request; requirement to offer opportunity 6 to rescind. 1. A patient may at any time rescind his or her request for 7 medication under this article without regard to the patient's capacity. 8 2. A prescription for medication may not be written without the 9 attending physician offering the qualified individual an opportunity to 10 rescind the request. 11 § 2899-h. Consulting physician responsibilities. Before a patient who 12 is requesting medication may receive a prescription for medication under 13 this article, a consulting physician must: 14 1. examine the patient and his or her relevant medical records; 15 2. confirm, in writing, to the attending physician and the patient, 16 whether: (a) the patient has a terminal illness or condition; (b) the 17 patient is making an informed decision; (c) the patient has capacity, or 18 provide documentation that the consulting physician has referred the 19 patient for a determination under section twenty-eight hundred ninety- 20 nine-i of this article; and (d) the patient is acting voluntarily, of 21 the patient's own volition and without coercion. 22 § 2899-i. Referral to mental health professional. 1. If the attending 23 physician or the consulting physician believes that the patient may lack 24 capacity, the attending physician or consulting physician shall refer 25 the patient to a mental health professional for a determination of 26 whether the patient has capacity to make an informed decision. The 27 referring physician shall advise the patient that the report of the 28 mental health professional will be provided to the attending physician 29 and the consulting physician. 30 2. A mental health professional who evaluates a patient under this 31 section shall report, in writing, to the attending physician and the 32 consulting physician, his or her independent conclusions about whether 33 the patient has capacity to make an informed decision, provided that if, 34 at the time of the report, the patient has not yet been referred to a 35 consulting physician, then upon referral the attending physician shall 36 provide the consulting physician with a copy of the mental health 37 professional's report. If the mental health professional determines that 38 the patient lacks capacity to make an informed decision, the patient 39 shall not be deemed a qualified individual, and the attending physician 40 shall not prescribe medication to the patient. 41 § 2899-j. Medical record documentation requirements. An attending 42 physician shall document or file the following in the patient's medical 43 record: 44 1. the dates of all oral requests by the patient for medication under 45 this article; 46 2. the written request by the patient for medication under this arti- 47 cle, including the declaration of witnesses and interpreter's declara- 48 tion, if applicable; 49 3. the attending physician's diagnosis and prognosis, determination of 50 capacity, and determination that the patient is acting voluntarily, of 51 the patient's own volition and without coercion, and has made an 52 informed decision; 53 4. if applicable, written confirmation of capacity under section twen- 54 ty-eight hundred ninety-nine-i of this article; and 55 5. a note by the attending physician indicating that all requirements 56 under this article have been met and indicating the steps taken to carryA. 2383--A 6 1 out the request, including a notation of the medication prescribed or 2 ordered. 3 § 2899-k. Form of written request and witness attestation. 1. A 4 request for medication under this article shall be in substantially the 5 following form: 6 REQUEST FOR MEDICATION TO END MY LIFE 7 I, _________________________________, am an adult who has capacity, 8 which means I understand and appreciate the nature and consequences of 9 health care decisions, including the benefits and risks of and alterna- 10 tives to any proposed health care, and to reach an informed decision and 11 to communicate health care decisions to a physician. 12 I have been diagnosed with ______________(insert diagnosis), which my 13 attending physician has determined is a terminal illness or condition, 14 which has been medically confirmed by a consulting physician. 15 I have been fully informed of my diagnosis and prognosis, the nature 16 of the medication to be prescribed and potential associated risks, the 17 expected result, and the feasible alternatives and treatment options 18 including but not limited to palliative care and hospice care. 19 I request that my attending physician prescribe medication that will 20 end my life if I choose to take it, and I authorize my attending physi- 21 cian to contact another physician or any pharmacist about my request. 22 INITIAL ONE: 23 ( ) I have informed or intend to inform one or more members of my 24 family of my decision. 25 ( ) I have decided not to inform any member of my family of my deci- 26 sion. 27 ( ) I have no family to inform of my decision. 28 I understand that I have the right to rescind this request or decline 29 to use the medication at any time. 30 I understand the importance of this request, and I expect to die if I 31 take the medication to be prescribed. I further understand that although 32 most deaths occur within three hours, my death may take longer, and my 33 attending physician has counseled me about this possibility. 34 I make this request voluntarily, of my own volition and without being 35 coerced, and I accept full responsibility for my actions. 36 Signed: __________________________ 37 Dated: ___________________________ 38 DECLARATION OF WITNESSES 39 I declare that the person signing this "Request for Medication to End 40 My Life": 41 (a) is personally known to me or has provided proof of identity; 42 (b) voluntarily signed the "Request for Medication to End My Life" in 43 my presence or acknowledged to me that he or she signed it; and 44 (c) to the best of my knowledge and belief, has capacity and is making 45 the "Request for Medication to End My Life" voluntarily, of his or her 46 own volition and is not being coerced to sign the "Request for Medica- 47 tion to End My Life". 48 I am not the attending physician or consulting physician of the person 49 signing the "Request for Medication to End My Life" or, if applicable, 50 the mental health professional who provides a capacity determination ofA. 2383--A 7 1 the person signing the "Request for Medication to End My Life" at the 2 time the "Request for Medication to End My Life" was signed. 3 I further declare under penalty of perjury that the statements made 4 herein are true and correct and false statements made herein are punish- 5 able. 6 __________________________ Witness 1, Date: ________________ 7 __________________________ (Printed name) 8 __________________________ (Address) 9 __________________________ (Telephone number) 10 I further declare that I am not (i) related to the above-named patient 11 by blood, marriage or adoption, (ii) entitled at the time the patient 12 signed the "Request for Medication to End My Life" to any portion of the 13 estate of the patient upon his/her death under any will or by operation 14 of law, or (iii) an owner, operator, employee or independent contractor 15 of a health care facility where the patient is receiving treatment or is 16 a resident. 17 __________________________ Witness 2, Date: _________________ 18 __________________________ (Printed name) 19 __________________________ (Address) 20 __________________________ (Telephone number) 21 NOTE: Only one of the two witnesses may (i) be a relative (by blood, 22 marriage or adoption) of the person signing the "Request for Medication 23 to End My Life", (ii) be entitled to any portion of the person's estate 24 upon death under any will or by operation of law, or (iii) own, operate, 25 be employed or be an independent contractor at a health care facility 26 where the person is receiving treatment or is a resident. 27 2. (a) The "Request for Medication to End My Life" shall be written in 28 the same language as any conversations, consultations, or interpreted 29 conversations or consultations between a patient and at least one of his 30 or her attending or consulting physicians. 31 (b) Notwithstanding paragraph (a) of this subdivision, the written 32 "Request for Medication to End My Life" may be prepared in English even 33 when the conversations or consultations or interpreted conversations or 34 consultations were conducted in a language other than English or with 35 auxiliary aids or hearing, speech or visual aids, if the English 36 language form includes an attached declaration by the interpreter of the 37 conversation or consultation, which shall be in substantially the 38 following form: 39 INTERPRETER'S DECLARATION 40 I, ___________ (insert name of interpreter)_____ ,(mark as applica- 41 ble): 42 ( ) for a patient whose conversations or consultations or interpreted 43 conversations or consultations were conducted in a language other than 44 English and the "Request for Medication to End My Life" is in English: IA. 2383--A 8 1 declare that I am fluent in English and (insert target language). I have 2 the requisite language and interpreter skills to be able to interpret 3 effectively, accurately and impartially information shared and communi- 4 cations between the attending or consulting physician and (name of 5 patient). 6 I certify that on (insert date), at approximately (insert time), I 7 interpreted the communications and information conveyed between the 8 physician and (name of patient) as accurately and completely to the best 9 of my knowledge and ability and read the "Request for Medication to End 10 My Life" to (name of patient) in (insert target language). 11 (Name of patient) affirmed to me his/her desire to sign the "Request 12 for Medication to End My Life" voluntarily, of (name of patient)'s own 13 volition and without coercion. 14 ( ) for a patient with a speech, hearing or vision disability: I 15 declare that I have the requisite language, reading and/or interpreter 16 skills to communicate with the patient and to be able to read and/or 17 interpret effectively, accurately and impartially information shared and 18 communications that occurred on (insert date) between the attending or 19 consulting physician and (name of patient). 20 I certify that on (insert date), at approximately (insert time), I 21 read and/or interpreted the communications and information conveyed 22 between the physician and (name of patient) impartially and as accurate- 23 ly and completely to the best of my knowledge and ability and, where 24 needed for effective communication, read or interpreted the "Request for 25 Medication to End my Life" to (name of patient). 26 (Name of patient) affirmed to me his/her desire to sign the "Request 27 for Medication to End My Life" voluntarily, of (name of patient)'s own 28 volition and without coercion. 29 I further declare under penalty of perjury that (i) the foregoing is 30 true and correct; (ii) I am not (A) related to (name of patient) by 31 blood, marriage or adoption, (B) entitled at the time (name of patient) 32 signed the "Request for Medication to End My Life" to any portion of the 33 estate of (name of patient) upon his/her death under any will or by 34 operation of law, or (C) an owner, operator, employee or independent 35 contractor of a health care facility where (name of patient) is receiv- 36 ing treatment or is a resident, except that if I am an employee or inde- 37 pendent contractor at such health care facility, providing interpreter 38 services is part of my job description at such health care facility or I 39 have been trained to provide interpreter services and (name of patient) 40 requested that I provide interpreter services to him/her for the 41 purposes stated in this Declaration; and (iii) false statements made 42 herein are punishable. 43 Executed at (insert city, county and state) on this (insert day of 44 month) of (insert month), (insert year). 45 __________________________ (Signature of Interpreter) 46 __________________________ (Printed name of Interpreter) 47 __________________________ (ID # or Agency Name) 48 __________________________ (Address of Interpreter) 49 __________________________ (Language Spoken by Interpreter)A. 2383--A 9 1 (c) An interpreter whose services are provided under paragraph (b) of 2 this subdivision shall not (i) be related to the patient who signs the 3 "Request for Medication to End My Life" by blood, marriage or adoption, 4 (ii) be entitled at the time the "Request for Medication to End My Life" 5 is signed by the patient to any portion of the estate of the patient 6 upon death under any will or by operation of law, or (iii) be an owner, 7 operator, employee or independent contractor of a health care facility 8 where the patient is receiving treatment or is a resident; provided that 9 an employee or independent contractor whose job description at the 10 health care facility includes interpreter services or who is trained to 11 provide interpreter services and who has been requested by the patient 12 to serve as an interpreter under this article shall not be prohibited 13 from serving as a witness under this article. 14 § 2899-l. Protection and immunities. 1. A physician, pharmacist, other 15 health care professional or other person shall not be subject to civil 16 or criminal liability or professional disciplinary action by any govern- 17 ment entity for taking any reasonable good-faith action or refusing to 18 act under this article, including, but not limited to: (a) engaging in 19 discussions with a patient relating to the risks and benefits of end-of- 20 life options in the circumstances described in this article, (b) provid- 21 ing a patient, upon request, with a referral to another health care 22 provider, (c) being present when a qualified individual self-administers 23 medication, (d) refraining from acting to prevent the qualified individ- 24 ual from self-administering such medication, or (e) refraining from 25 acting to resuscitate the qualified individual after he or she self-ad- 26 ministers such medication. 27 2. Nothing in this section shall limit civil or criminal liability for 28 negligence, recklessness or intentional misconduct. 29 § 2899-m. Permissible refusals and prohibitions. 1. (a) A physician, 30 nurse, pharmacist, other health care provider or other person shall not 31 be under any duty, by law or contract, to participate in the provision 32 of medication to a patient under this article. 33 (b) If a health care provider is unable or unwilling to participate in 34 the provision of medication to a patient under this article and the 35 patient transfers care to a new health care provider, the prior health 36 care provider shall transfer or arrange for the transfer, upon request, 37 of a copy of the patient's relevant medical records to the new health 38 care provider. 39 2. (a) A private health care facility may prohibit the prescribing, 40 dispensing, ordering or self-administering of medication under this 41 article while the patient is being treated in or while the patient is 42 residing in the health care facility if: 43 (i) the prescribing, dispensing, ordering or self-administering is 44 contrary to a formally adopted policy of the facility that is expressly 45 based on sincerely held religious beliefs or moral convictions central 46 to the facility's operating principles; and 47 (ii) the facility has informed the patient of such policy prior to 48 admission or as soon as reasonably possible. 49 (b) Where a facility has adopted a prohibition under this subdivision, 50 if a patient who wishes to use medication under this article requests, 51 the patient shall be transferred promptly to another health care facili- 52 ty that is reasonably accessible under the circumstances and willing to 53 permit the prescribing, dispensing, ordering and self-administering of 54 medication under this article with respect to the patient. 55 3. Where a health care facility has adopted a prohibition under this 56 subdivision, any health care provider or employee or independentA. 2383--A 10 1 contractor of the facility who violates the prohibition may be subject 2 to sanctions otherwise available to the facility, provided the facility 3 has previously notified the health care provider, employee or independ- 4 ent contractor of the prohibition in writing. 5 § 2899-n. Relation to other laws and contracts. 1. (a) A patient who 6 requests medication under this article shall not, because of that 7 request, be considered to be a person who is suicidal, and self-adminis- 8 tering medication under this article shall not be deemed to be suicide, 9 for any purpose. 10 (b) Action taken in accordance with this article shall not be 11 construed for any purpose to constitute suicide, assisted suicide, 12 attempted suicide, promoting a suicide attempt, euthanasia, mercy kill- 13 ing, or homicide under the law, including as an accomplice or accessory 14 or otherwise. 15 2. (a) No provision in a contract, will or other agreement, whether 16 written or oral, to the extent the provision would affect whether a 17 person may make or rescind a request for medication or take any other 18 action under this article, shall be valid. 19 (b) No obligation owing under any contract shall be conditioned or 20 affected by the making or rescinding of a request by a person for medi- 21 cation or taking any other action under this article. 22 3. (a) A person and his or her beneficiaries shall not be denied bene- 23 fits under a life insurance policy for actions taken in accordance with 24 this article. 25 (b) Notwithstanding the provisions of any law or contract, the sale, 26 procurement or issuance of a life or health insurance or annuity policy, 27 or the rate charged for a policy, shall not be conditioned upon or 28 affected by a patient making or rescinding a request for medication 29 under this article. 30 4. An insurer shall not provide any information in communications made 31 to a patient about the availability of medication under this article 32 absent a request by the patient or by his or her attending physician 33 upon the request of such patient. Any communication shall not include 34 both the denial of coverage for treatment and information as to the 35 availability of medication under this article. 36 5. The sale, procurement, or issue of any professional malpractice 37 insurance policy or the rate charged for the policy shall not be condi- 38 tioned upon or affected by whether the insured does or does not take or 39 participate in any action under this article. 40 § 2899-o. Safe disposal of unused medications. A person who has 41 custody or control of any unused medication prescribed under this arti- 42 cle after the death of the qualified individual shall personally deliver 43 the unused medication for disposal to the nearest qualified facility 44 that properly disposes of controlled substances or shall dispose of it 45 by lawful means in accordance with regulations made by the commissioner, 46 regulations made by or guidelines of the commissioner of education, or 47 guidelines of a federal drug enforcement administration approved take- 48 back program. A qualified facility that properly disposes of controlled 49 substances shall accept and dispose of any medication delivered to it as 50 provided hereunder regardless of whether such medication is a controlled 51 substance. The commissioner may make regulations as may be appropriate 52 for the safe disposal of unused medications prescribed, dispensed or 53 ordered under this article as provided in this section. 54 § 2899-p. Death certificate. 1. If otherwise authorized by law, the 55 attending physician may sign the qualified individual's death certif- 56 icate.A. 2383--A 11 1 2. The cause of death listed on a qualified individual's death certif- 2 icate who dies after self-administering medication under this article 3 will be the underlying terminal illness or condition. 4 § 2899-q. Reporting. 1. The commissioner shall annually review a 5 sample of the records maintained under sections twenty-eight hundred 6 ninety-nine-j and twenty-eight hundred ninety-nine-p of this article. 7 The commissioner shall adopt regulations establishing reporting require- 8 ments for physicians taking action under this article to determine 9 utilization and compliance with this article. The information collected 10 under this subdivision shall not constitute a public record available 11 for public inspection and shall be confidential and collected and main- 12 tained in a manner that protects the privacy of the patient, his or her 13 family, and any health care provider acting in connection with such 14 patient under this article, except that such information may be 15 disclosed to a governmental agency as authorized or required by law 16 relating to professional discipline, protection of public health or law 17 enforcement. 18 2. The commissioner shall prepare a report annually containing rele- 19 vant data regarding utilization and compliance with this article and 20 shall post such report on the department's website. 21 § 2899-r. Penalties. 1. Nothing in this article shall be construed to 22 limit professional discipline or civil liability resulting from conduct 23 in violation of this article, negligent conduct, or intentional miscon- 24 duct by any person. 25 2. Conduct in violation of this article shall be subject to applicable 26 criminal liability under state law, including, where appropriate and 27 without limitation, offenses constituting homicide, forgery, coercion, 28 and related offenses, or federal law. 29 § 2899-s. Severability. If any provision of this article or any appli- 30 cation of any provision of this article, is held to be invalid, or to 31 violate or be inconsistent with any federal law or regulation, that 32 shall not affect the validity or effectiveness of any other provision of 33 this article, or of any other application of any provision of this arti- 34 cle, which can be given effect without that provision or application; 35 and to that end, the provisions and applications of this article are 36 severable. 37 § 3. This act shall take effect immediately.