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A04321 Summary:

BILL NOA04321A
 
SAME ASSAME AS S06471
 
SPONSORPaulin
 
COSPNSRRosenthal L, Gottfried, Dinowitz, Galef, Hevesi, Steck, Lavine, Lupardo, Abinanti, Rodriguez, Vanel, Quart, Rivera J, Miller M, Thiele, Epstein, Seawright, Woerner, Reyes, Frontus, Fernandez, Fall, Darling, Cruz, Sayegh, Pichardo, Aubry, Davila, Dickens, Stern, Burdick, Gallagher, Forrest, Kelles, Gonzalez-Rojas, Mitaynes, Mamdani, Clark, Burke, De La Rosa, Anderson, Jean-Pierre, Sillitti, Jackson, Pretlow, Septimo
 
MLTSPNSRBraunstein, Burgos, Carroll, Englebright, Hyndman, Ramos
 
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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A04321 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         4321--A
 
                               2021-2022 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 1, 2021
                                       ___________
 
        Introduced by M. of A. PAULIN, L. ROSENTHAL, GOTTFRIED, DINOWITZ, GALEF,
          HEVESI,  STECK,  LAVINE,  LUPARDO,  ABINANTI, RODRIGUEZ, VANEL, QUART,
          J. RIVERA, M. MILLER,  THIELE,  EPSTEIN,  SEAWRIGHT,  WOERNER,  REYES,
          FRONTUS,  FERNANDEZ,  FALL,  DARLING,  CRUZ,  SAYEGH, PICHARDO, AUBRY,
          DAVILA, DICKENS, STERN, BURDICK, GALLAGHER,  FORREST,  KELLES,  GONZA-
          LEZ-ROJAS,  JACKSON,  MITAYNES,  MAMDANI,  CLARK, BURKE, DE LA ROSA --
          Multi-Sponsored by -- M. of A.  BRAUNSTEIN,  BURGOS,  CARROLL,  ENGLE-
          BRIGHT,  HYNDMAN,  RAMOS -- read once and referred to the Committee on
          Health -- committee discharged, bill  amended,  ordered  reprinted  as
          amended and recommitted to said committee
 
        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.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01956-02-1

        A. 4321--A                          2
 
     1          2899-n. Relation to other laws and contracts.
     2          2899-o. Safe disposal of unused medications.
     3          2899-p. Death certificate.
     4          2899-q. Reporting.
     5          2899-r. Penalties.
     6          2899-s. Severability.
     7    § 2899-d. Definitions. As used in this article:
     8    1. "Adult" means an individual who is eighteen years of age or older.
     9    2. "Attending physician" means the physician who has primary responsi-
    10  bility for the care of the patient and treatment of the patient's termi-
    11  nal illness or condition.
    12    3.  "Capacity"  means  the  ability  to  understand and appreciate the
    13  nature and consequences of health care decisions, including the benefits
    14  and risks of and alternatives to any  proposed  health  care,  including
    15  medical aid in dying, and to reach an informed decision.
    16    4.    "Consulting  physician"  means  a  physician who is qualified by
    17  specialty or experience to make a professional diagnosis  and  prognosis
    18  regarding a person's terminal illness or condition.
    19    5.  "Health  care facility" means a general hospital, nursing home, or
    20  residential health care facility  as  defined  in  section  twenty-eight
    21  hundred  one  of  this  chapter, or a hospice as defined in section four
    22  thousand two of this chapter; provided that for the purposes of  section
    23  twenty  eight  hundred  ninety-nine-m  of  this article, "hospice" shall
    24  refer only to a facility providing in-patient hospice care or a  hospice
    25  residence.
    26    6.  "Health  care  provider"  means  a  person licensed, certified, or
    27  authorized by law to administer health care or  dispense  medication  in
    28  the ordinary course of business or practice of a profession.
    29    7.  "Informed decision" means a decision by a patient who is suffering
    30  from   a   terminal  illness  or  condition  to  request  and  obtain  a
    31  prescription for medication that the patient may self-administer to  end
    32  the  patient's life that is based on an understanding and acknowledgment
    33  of the relevant facts and that is made voluntarily, of the patient's own
    34  volition and without coercion, after being fully informed of:
    35    (a) the patient's medical diagnosis and prognosis;
    36    (b) the potential risks associated with taking the  medication  to  be
    37  prescribed;
    38    (c) the probable result of taking the medication to be prescribed;
    39    (d)  the  possibility  that  the  patient may choose not to obtain the
    40  medication, or may obtain the medication but may decide not to  self-ad-
    41  minister it; and
    42    (e)  the  feasible  alternatives  and  appropriate  treatment options,
    43  including but not limited to palliative care and hospice care.
    44    8. "Medical aid in dying" means the medical practice  of  a  physician
    45  prescribing medication to a qualified individual that the individual may
    46  choose to self-administer to bring about death.
    47    9.  "Medically  confirmed"  means the medical opinion of the attending
    48  physician that a patient has a terminal illness  or  condition  and  has
    49  made  an  informed  decision  which  has  been confirmed by a consulting
    50  physician who has  examined  the  patient  and  the  patient's  relevant
    51  medical records.
    52    10. "Medication" means medication prescribed by a physician under this
    53  article.
    54    11.  "Mental health professional" means a licensed physician, who is a
    55  diplomate or eligible to be certified by a national board of psychiatry,
    56  psychiatric nurse practitioner, or psychologist, licensed  or  certified

        A. 4321--A                          3
 
     1  under  the  education law acting within his or her scope of practice and
     2  who is qualified, by training and experience,  certification,  or  board
     3  certification  or  eligibility,  to  make  a determination under section
     4  twenty-eight hundred ninety-nine-i of this article.
     5    12. "Palliative care" means health care treatment, including interdis-
     6  ciplinary  end-of-life  care,  and consultation with patients and family
     7  members, to prevent or relieve pain and suffering  and  to  enhance  the
     8  patient's quality of life, including hospice care under article forty of
     9  this chapter.
    10    13.  "Patient"  means  a  person who is eighteen years of age or older
    11  under the care of a physician.
    12    14. "Physician" means an individual licensed to practice  medicine  in
    13  New York state.
    14    15.  "Qualified individual" means a patient with a terminal illness or
    15  condition, who has capacity, has made  an  informed  decision,  and  has
    16  satisfied  the  requirements  of  this  article  in  order  to  obtain a
    17  prescription for medication.
    18    16. "Self-administer"  means  a  qualified  individual's  affirmative,
    19  conscious,  and  voluntary  act to ingest medication under this article.
    20  Self-administration  does  not  include  lethal  injection   or   lethal
    21  infusion.
    22    17.  "Terminal  illness or condition" means an incurable and irrevers-
    23  ible illness or condition that has been medically  confirmed  and  will,
    24  within reasonable medical judgment, produce death within six months.
    25    § 2899-e. Request  process.    1.  Oral and written request. A patient
    26  wishing to request medication under this  article  shall  make  an  oral
    27  request  and  submit a written request to the patient's attending physi-
    28  cian.
    29    2. Making a written request. A patient may make a written request  for
    30  and  consent to self-administer medication for the purpose of ending his
    31  or her life in accordance with this article if the patient:
    32    (a) has been determined by the attending physician to have a  terminal
    33  illness  or  condition  and  which  has  been  medically  confirmed by a
    34  consulting physician; and
    35    (b) based on an  informed  decision,  expresses  voluntarily,  of  the
    36  patient's  own  volition and without coercion the request for medication
    37  to end his or her life.
    38    3. Written request signed and witnessed. (a)  A  written  request  for
    39  medication  under  this article shall be signed and dated by the patient
    40  and witnessed by at least  two  adults  who,  in  the  presence  of  the
    41  patient,  attest that to the best of his or her knowledge and belief the
    42  patient has capacity, is acting voluntarily, is making the  request  for
    43  medication  of  his or her own volition and is not being coerced to sign
    44  the request. The written request shall  be  in  substantially  the  form
    45  described in section twenty-eight hundred ninety-nine-k of this article.
    46    (b) One of the witnesses shall be an adult who is not:
    47    (i) a relative of the patient by blood, marriage or adoption;
    48    (ii)  a person who at the time the request is signed would be entitled
    49  to any portion of the estate of the patient upon death under any will or
    50  by operation of law; or
    51    (iii) an owner, operator, employee  or  independent  contractor  of  a
    52  health  care  facility  where the patient is receiving treatment or is a
    53  resident.
    54    (c) The attending physician, consulting physician and, if  applicable,
    55  the  mental health professional who provides a capacity determination of
    56  the patient under this article shall not be a witness.

        A. 4321--A                          4
 
     1    4. No person shall qualify for medical aid in dying under this article
     2  solely because of age or disability.
     3    5.  Requests  for  a medical aid-in-dying prescription must be made by
     4  the qualified individual and may not be made by  any  other  individual,
     5  including  the  qualified individual's health care agent, or other agent
     6  or surrogate, or via advance healthcare directive.
     7    § 2899-f. Attending  physician  responsibilities.  1.  The   attending
     8  physician  shall  examine  the  patient  and his or her relevant medical
     9  records and:
    10    (a) make a determination of whether a patient has a  terminal  illness
    11  or  condition,  has capacity, has made an informed decision and has made
    12  the request voluntarily of the patient's own volition and without  coer-
    13  cion;
    14    (b)  inform  the  patient  of  the  requirement under this article for
    15  confirmation by a consulting physician,  and  refer  the  patient  to  a
    16  consulting physician upon the patient's request;
    17    (c)  refer  the  patient  to  a mental health professional pursuant to
    18  section twenty-eight  hundred  ninety-nine-i  of  this  article  if  the
    19  attending  physician believes that the patient may lack capacity to make
    20  an informed decision;
    21    (d) provide  information  and  counseling  under  section  twenty-nine
    22  hundred ninety-seven-c of this chapter;
    23    (e) ensure that the patient is making an informed decision by discuss-
    24  ing with the patient: (i) the patient's medical diagnosis and prognosis;
    25  (ii)  the  potential  risks  associated with taking the medication to be
    26  prescribed; (iii) the probable result of taking  the  medication  to  be
    27  prescribed;  (iv)  the possibility that the patient may choose to obtain
    28  the medication but not take it; (v) the feasible alternatives and appro-
    29  priate treatment options, including but not limited to  (1)  information
    30  and  counseling  regarding  palliative  and hospice care and end-of-life
    31  options appropriate to the patient, including but not  limited  to:  the
    32  range  of  options  appropriate to the patient; the prognosis, risks and
    33  benefits of the various options;  and  the  patient's  legal  rights  to
    34  comprehensive  pain  and  symptom management at the end of life; and (2)
    35  information regarding treatment  options  appropriate  to  the  patient,
    36  including  the  prognosis,  risks  and benefits of the various treatment
    37  options;
    38    (f) offer  to  refer  the  patient  for  other  appropriate  treatment
    39  options, including but not limited to palliative care and hospice care;
    40    (g) discuss with the patient the importance of:
    41    (i)  having  another person present when the patient takes the medica-
    42  tion and the restriction that no  person  other  than  the  patient  may
    43  administer the medication;
    44    (ii) not taking the medication in a public place; and
    45    (iii)  informing  the  patient's  family  of the patient's decision to
    46  request and take medication that will end the patient's life; a  patient
    47  who  declines  or  is  unable to notify family shall not have his or her
    48  request for medication denied for that reason;
    49    (h) inform the patient that he or she  may  rescind  the  request  for
    50  medication at any time and in any manner;
    51    (i)  fulfill  the medical record documentation requirements of section
    52  twenty-eight hundred ninety-nine-j of this article; and
    53    (j) ensure that all appropriate steps are carried  out  in  accordance
    54  with this article before writing a prescription for medication.
    55    2.  Upon  receiving  confirmation  from  a  consulting physician under
    56  section twenty-eight hundred ninety-nine-h of this article  and  subject

        A. 4321--A                          5
 
     1  to  section  twenty-eight  hundred  ninety-nine-i  of  this article, the
     2  attending physician who determines  that  the  patient  has  a  terminal
     3  illness  or condition, has capacity and has made a voluntary request for
     4  medication  as  provided in this article, may personally, or by referral
     5  to another physician,  prescribe  or  order  appropriate  medication  in
     6  accordance  with  the  patient's  request under this article, and at the
     7  patient's request, facilitate the filling of the prescription and deliv-
     8  ery of the medication to the patient.
     9    3. In accordance with the direction of  the  prescribing  or  ordering
    10  physician  and the consent of the patient, the patient may self-adminis-
    11  ter the medication to himself or herself. A health care professional  or
    12  other person shall not administer the medication to the patient.
    13    § 2899-g. Right  to  rescind request; requirement to offer opportunity
    14  to rescind.  1. A patient may at any time rescind his or her request for
    15  medication under this article without regard to the patient's capacity.
    16    2. A prescription for  medication  may  not  be  written  without  the
    17  attending  physician offering the qualified individual an opportunity to
    18  rescind the request.
    19    § 2899-h. Consulting physician responsibilities. Before a patient  who
    20  is requesting medication may receive a prescription for medication under
    21  this article, a consulting physician must:
    22    1. examine the patient and his or her relevant medical records;
    23    2.  confirm,  in  writing, to the attending physician and the patient,
    24  whether: (a) the patient has a terminal illness or  condition;  (b)  the
    25  patient is making an informed decision; (c) the patient has capacity, or
    26  provide  documentation  that  the  consulting physician has referred the
    27  patient for a determination under section twenty-eight  hundred  ninety-
    28  nine-i  of  this  article; and (d) the patient is acting voluntarily, of
    29  the patient's own volition and without coercion.
    30    § 2899-i. Referral to mental health professional. 1. If the  attending
    31  physician  or  the  consulting physician determines that the patient may
    32  lack capacity to make an informed decision due to a  condition,  includ-
    33  ing,  but  not  limited  to, a psychiatric or psychological disorder, or
    34  other condition causing impaired judgement, the attending  physician  or
    35  consulting  physician shall refer the patient to a mental health profes-
    36  sional for a determination of whether the patient has capacity  to  make
    37  an  informed  decision. The referring physician shall advise the patient
    38  that the report of the mental health professional will  be  provided  to
    39  the attending physician and the consulting physician.
    40    2.  A  mental  health  professional who evaluates a patient under this
    41  section shall report, in writing, to the  attending  physician  and  the
    42  consulting  physician,  his or her independent conclusions about whether
    43  the patient has capacity to make an informed decision, provided that if,
    44  at the time of the report, the patient has not yet been  referred  to  a
    45  consulting  physician,  then upon referral the attending physician shall
    46  provide the consulting physician  with  a  copy  of  the  mental  health
    47  professional's report. If the mental health professional determines that
    48  the  patient  lacks  capacity  to make an informed decision, the patient
    49  shall not be deemed a qualified individual, and the attending  physician
    50  shall not prescribe medication to the patient.
    51    3. A determination made pursuant to this section that an adult patient
    52  lacks  decision-making capacity shall not be construed as a finding that
    53  the patient lacks capacity for any other purpose.
    54    § 2899-j. Medical  record  documentation  requirements.  An  attending
    55  physician  shall document or file the following in the patient's medical
    56  record:

        A. 4321--A                          6
 
     1    1. the dates of all oral requests by the patient for medication  under
     2  this article;
     3    2.  the written request by the patient for medication under this arti-
     4  cle, including the declaration of witnesses and  interpreter's  declara-
     5  tion, if applicable;
     6    3. the attending physician's diagnosis and prognosis, determination of
     7  capacity,  and  determination that the patient is acting voluntarily, of
     8  the patient's own  volition  and  without  coercion,  and  has  made  an
     9  informed decision;
    10    4. if applicable, written confirmation of capacity under section twen-
    11  ty-eight hundred ninety-nine-i of this article; and
    12    5.  a note by the attending physician indicating that all requirements
    13  under this article have been met and indicating the steps taken to carry
    14  out the request, including a notation of the  medication  prescribed  or
    15  ordered.
    16    § 2899-k. Form  of  written  request  and  witness  attestation.  1. A
    17  request for medication under this article shall be in substantially  the
    18  following form:
    19                    REQUEST FOR MEDICATION TO END MY LIFE
 
    20    I,  _________________________________,  am  an adult who has capacity,
    21  which means I understand and appreciate the nature and  consequences  of
    22  health  care decisions, including the benefits and risks of and alterna-
    23  tives to any proposed health care, and to reach an informed decision and
    24  to communicate health care decisions to a physician.
    25    I have been diagnosed with ______________(insert diagnosis), which  my
    26  attending  physician  has determined is a terminal illness or condition,
    27  which has been medically confirmed by a consulting physician.
    28    I have been fully informed of my diagnosis and prognosis,  the  nature
    29  of  the  medication to be prescribed and potential associated risks, the
    30  expected result, and the feasible  alternatives  and  treatment  options
    31  including but not limited to palliative care and hospice care.
    32    I  request  that my attending physician prescribe medication that will
    33  end my life if I choose to take it, and I authorize my attending  physi-
    34  cian to contact another physician or any pharmacist about my request.
 
    35    INITIAL ONE:
    36    (    )  I  have informed or intend to inform one or more members of my
    37  family of my decision.
    38    (  ) I have decided not to inform any member of my family of my  deci-
    39  sion.
    40    (  ) I have no family to inform of my decision.
    41    I  understand that I have the right to rescind this request or decline
    42  to use the medication at any time.
    43    I understand the importance of this request, and I expect to die if  I
    44  take the medication to be prescribed. I further understand that although
    45  most  deaths  occur within three hours, my death may take longer, and my
    46  attending physician has counseled me about this possibility.
    47    I make this request voluntarily, of my own volition and without  being
    48  coerced, and I accept full responsibility for my actions.
 
    49  Signed: __________________________
 
    50  Dated: ___________________________
 
    51                          DECLARATION OF WITNESSES

        A. 4321--A                          7
 
     1    I  declare that the person signing this "Request for Medication to End
     2  My Life":
     3    (a) is personally known to me or has provided proof of identity;
     4    (b)  voluntarily signed the "Request for Medication to End My Life" in
     5  my presence or acknowledged to me that he or she signed it; and
     6    (c) to the best of my knowledge and belief, has capacity and is making
     7  the "Request for Medication to End My Life" voluntarily, of his  or  her
     8  own  volition  and is not being coerced to sign the "Request for Medica-
     9  tion to End My Life".
    10    I am not the attending physician or consulting physician of the person
    11  signing the "Request for Medication to End My Life" or,  if  applicable,
    12  the  mental health professional who provides a capacity determination of
    13  the person signing the "Request for Medication to End My  Life"  at  the
    14  time the "Request for Medication to End My Life" was signed.
    15    I  further  declare  under penalty of perjury that the statements made
    16  herein are true and correct and false statements made herein are punish-
    17  able.
 
    18  __________________________ Witness 1, Date: ________________
 
    19  __________________________ (Printed name)
 
    20  __________________________ (Address)
 
    21  __________________________ (Telephone number)
 
    22    I further declare that I am not (i) related to the above-named patient
    23  by blood, marriage or adoption, (ii) entitled at the  time  the  patient
    24  signed the "Request for Medication to End My Life" to any portion of the
    25  estate  of the patient upon his/her death under any will or by operation
    26  of law, or (iii) an owner, operator, employee or independent  contractor
    27  of a health care facility where the patient is receiving treatment or is
    28  a resident.
 
    29  __________________________ Witness 2, Date: _________________
 
    30  __________________________ (Printed name)
 
    31  __________________________ (Address)
 
    32  __________________________ (Telephone number)
 
    33    NOTE:  Only  one of the two witnesses may (i) be a relative (by blood,
    34  marriage or adoption) of the person signing the "Request for  Medication
    35  to  End My Life", (ii) be entitled to any portion of the person's estate
    36  upon death under any will or by operation of law, or (iii) own, operate,
    37  be employed or be an independent contractor at a  health  care  facility
    38  where the person is receiving treatment or is a resident.
    39    2. (a) The "Request for Medication to End My Life" shall be written in
    40  the  same  language  as any conversations, consultations, or interpreted
    41  conversations or consultations between a patient and at least one of his
    42  or her attending or consulting physicians.
    43    (b) Notwithstanding paragraph (a) of  this  subdivision,  the  written
    44  "Request  for Medication to End My Life" may be prepared in English even
    45  when the conversations or consultations or interpreted conversations  or
    46  consultations  were  conducted  in a language other than English or with

        A. 4321--A                          8
 
     1  auxiliary aids or  hearing,  speech  or  visual  aids,  if  the  English
     2  language form includes an attached declaration by the interpreter of the
     3  conversation  or  consultation,  which  shall  be  in  substantially the
     4  following form:
 
     5                          INTERPRETER'S DECLARATION
 
     6    I,  ___________  (insert  name of interpreter)_____ ,(mark as applica-
     7  ble):
     8    (  ) for a patient whose conversations or consultations or interpreted
     9  conversations or consultations were conducted in a language  other  than
    10  English and the "Request for Medication to End My Life" is in English: I
    11  declare that I am fluent in English and (insert target language). I have
    12  the  requisite  language  and interpreter skills to be able to interpret
    13  effectively, accurately and impartially information shared and  communi-
    14  cations  between  the  attending  or  consulting  physician and (name of
    15  patient).
    16    I certify that on (insert date), at  approximately  (insert  time),  I
    17  interpreted  the  communications  and  information  conveyed between the
    18  physician and (name of patient) as accurately and completely to the best
    19  of my knowledge and ability and read the "Request for Medication to  End
    20  My Life" to (name of patient) in (insert target language).
    21    (Name  of  patient) affirmed to me his/her desire to sign the "Request
    22  for Medication to End My Life" voluntarily, of (name of  patient)'s  own
    23  volition and without coercion.
    24    (  )  for  a  patient  with  a speech, hearing or vision disability: I
    25  declare that I have the requisite language, reading  and/or  interpreter
    26  skills  to  communicate  with  the patient and to be able to read and/or
    27  interpret effectively, accurately and impartially information shared and
    28  communications that occurred on (insert date) between the  attending  or
    29  consulting physician and (name of patient).
    30    I  certify  that  on  (insert date), at approximately (insert time), I
    31  read and/or interpreted  the  communications  and  information  conveyed
    32  between the physician and (name of patient) impartially and as accurate-
    33  ly  and  completely  to  the best of my knowledge and ability and, where
    34  needed for effective communication, read or interpreted the "Request for
    35  Medication to End my Life" to (name of patient).
    36    (Name of patient) affirmed to me his/her desire to sign  the  "Request
    37  for  Medication  to End My Life" voluntarily, of (name of patient)'s own
    38  volition and without coercion.
    39    I further declare under penalty of perjury that (i) the  foregoing  is
    40  true  and  correct;  (ii)  I  am not (A) related to (name of patient) by
    41  blood, marriage or adoption, (B) entitled at the time (name of  patient)
    42  signed the "Request for Medication to End My Life" to any portion of the
    43  estate  of  (name  of  patient)  upon his/her death under any will or by
    44  operation of law, or (C) an owner,  operator,  employee  or  independent
    45  contractor  of a health care facility where (name of patient) is receiv-
    46  ing treatment or is a resident, except that if I am an employee or inde-
    47  pendent contractor at such health care facility,  providing  interpreter
    48  services is part of my job description at such health care facility or I
    49  have  been trained to provide interpreter services and (name of patient)
    50  requested that  I  provide  interpreter  services  to  him/her  for  the
    51  purposes  stated  in  this  Declaration; and (iii) false statements made
    52  herein are punishable.

        A. 4321--A                          9
 
     1  Executed at (insert city, county and  state)  on  this  (insert  day  of
     2  month) of (insert month), (insert year).
 
     3  __________________________ (Signature of Interpreter)

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

        A. 4321--A                         10
 
     1    (i)  the  prescribing,  dispensing,  ordering or self-administering is
     2  contrary to a formally adopted policy of the facility that is  expressly
     3  based  on  sincerely held religious beliefs or moral convictions central
     4  to the facility's operating principles; and
     5    (ii)  the  facility  has  informed the patient of such policy prior to
     6  admission or as soon as reasonably possible.
     7    (b) Where a facility has adopted a prohibition under this subdivision,
     8  if a patient who wishes to use medication under this  article  requests,
     9  the patient shall be transferred promptly to another health care facili-
    10  ty  that is reasonably accessible under the circumstances and willing to
    11  permit the prescribing, dispensing, ordering and  self-administering  of
    12  medication under this article with respect to the patient.
    13    3.  Where  a health care facility has adopted a prohibition under this
    14  subdivision,  any  health  care  provider  or  employee  or  independent
    15  contractor  of  the facility who violates the prohibition may be subject
    16  to sanctions otherwise available to the facility, provided the  facility
    17  has  previously notified the health care provider, employee or independ-
    18  ent contractor of the prohibition in writing.
    19    § 2899-n. Relation to other laws and contracts. 1. (a) A  patient  who
    20  requests  medication  under  this  article  shall  not,  because of that
    21  request, be considered to be a person who is suicidal, and self-adminis-
    22  tering medication under this article shall not be deemed to be  suicide,
    23  for any purpose.
    24    (b)  Action  taken  in  accordance  with  this  article  shall  not be
    25  construed for any  purpose  to  constitute  suicide,  assisted  suicide,
    26  attempted  suicide, promoting a suicide attempt, euthanasia, mercy kill-
    27  ing, or homicide under the law, including as an accomplice or  accessory
    28  or otherwise.
    29    2.  (a)  No  provision in a contract, will or other agreement, whether
    30  written or oral, to the extent the  provision  would  affect  whether  a
    31  person  may  make  or rescind a request for medication or take any other
    32  action under this article, shall be valid.
    33    (b) No obligation owing under any contract  shall  be  conditioned  or
    34  affected  by the making or rescinding of a request by a person for medi-
    35  cation or taking any other action under this article.
    36    3. (a) A person and his or her beneficiaries shall not be denied bene-
    37  fits under a life insurance policy for actions taken in accordance  with
    38  this article.
    39    (b)  Notwithstanding  the provisions of any law or contract, the sale,
    40  procurement or issuance of a life or health insurance or annuity policy,
    41  or the rate charged for a policy,  shall  not  be  conditioned  upon  or
    42  affected  by  a  patient  making  or rescinding a request for medication
    43  under this article.
    44    4. An insurer shall not provide any information in communications made
    45  to a patient about the availability of  medication  under  this  article
    46  absent  a  request  by  the patient or by his or her attending physician
    47  upon the request of such patient. Any communication  shall  not  include
    48  both  the  denial  of  coverage  for treatment and information as to the
    49  availability of medication under this article.
    50    5. The sale, procurement, or issue  of  any  professional  malpractice
    51  insurance  policy or the rate charged for the policy shall not be condi-
    52  tioned upon or affected by whether the insured does or does not take  or
    53  participate in any action under this article.
    54    § 2899-o. Safe  disposal  of  unused  medications.    A person who has
    55  custody or control of any unused medication prescribed under this  arti-
    56  cle after the death of the qualified individual shall personally deliver

        A. 4321--A                         11
 
     1  the  unused  medication  for  disposal to the nearest qualified facility
     2  that properly disposes of controlled substances or shall dispose  of  it
     3  by lawful means in accordance with regulations made by the commissioner,
     4  regulations  made  by or guidelines of the commissioner of education, or
     5  guidelines of a federal drug enforcement administration  approved  take-
     6  back  program. A qualified facility that properly disposes of controlled
     7  substances shall accept and dispose of any medication delivered to it as
     8  provided hereunder regardless of whether such medication is a controlled
     9  substance. The commissioner may make regulations as may  be  appropriate
    10  for  the  safe  disposal  of unused medications prescribed, dispensed or
    11  ordered under this article as provided in this section.
    12    § 2899-p. Death certificate.  1. If otherwise authorized by  law,  the
    13  attending  physician  may  sign the qualified individual's death certif-
    14  icate.
    15    2. The cause of death listed on a qualified individual's death certif-
    16  icate who dies after self-administering medication  under  this  article
    17  will be the underlying terminal illness or condition.
    18    § 2899-q. Reporting.  1.  The  commissioner  shall  annually  review a
    19  sample of the records maintained  under  sections  twenty-eight  hundred
    20  ninety-nine-j  and  twenty-eight  hundred ninety-nine-p of this article.
    21  The commissioner shall adopt regulations establishing reporting require-
    22  ments for physicians taking  action  under  this  article  to  determine
    23  utilization  and compliance with this article. The information collected
    24  under this subdivision shall not constitute a  public  record  available
    25  for  public inspection and shall be confidential and collected and main-
    26  tained in a manner that protects the privacy of the patient, his or  her
    27  family,  and  any  health  care  provider acting in connection with such
    28  patient  under  this  article,  except  that  such  information  may  be
    29  disclosed  to  a  governmental  agency  as authorized or required by law
    30  relating to professional discipline, protection of public health or  law
    31  enforcement.
    32    2.  The  commissioner shall prepare a report annually containing rele-
    33  vant data regarding utilization and compliance  with  this  article  and
    34  shall  send  such report to the legislature, and post such report on the
    35  department's website.
    36    § 2899-r. Penalties. 1. Nothing in this article shall be construed  to
    37  limit  professional discipline or civil liability resulting from conduct
    38  in violation of this article, negligent conduct, or intentional  miscon-
    39  duct by any person.
    40    2. Conduct in violation of this article shall be subject to applicable
    41  criminal  liability  under  state  law, including, where appropriate and
    42  without limitation, offenses constituting homicide,  forgery,  coercion,
    43  and related offenses, or federal law.
    44    § 2899-s. Severability. If any provision of this article or any appli-
    45  cation  of  any  provision of this article, is held to be invalid, or to
    46  violate or be inconsistent with any  federal  law  or  regulation,  that
    47  shall not affect the validity or effectiveness of any other provision of
    48  this article, or of any other application of any provision of this arti-
    49  cle,  which  can  be given effect without that provision or application;
    50  and to that end, the provisions and applications  of  this  article  are
    51  severable.
    52    § 3. This act shall take effect immediately.
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