Bill Text: NY A02129 | 2015-2016 | General Assembly | Introduced
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Bill Title: Establishes the New York end of life options act; authorizes the prescription of aid-in-dying medication to individuals with terminal illnesses; terminal illness means incurable and irreversible illness that has been medically confirmed that will result in death within six months; form must be signed by the qualified individual and by two witnesses; no liability or sanctions where the health care provider participates in good faith.
Spectrum: Moderate Partisan Bill (Democrat 8-1)
Status: (Introduced - Dead) 2016-01-06 - referred to health [A02129 Detail]
Download: New_York-2015-A02129-Introduced.html
Bill Title: Establishes the New York end of life options act; authorizes the prescription of aid-in-dying medication to individuals with terminal illnesses; terminal illness means incurable and irreversible illness that has been medically confirmed that will result in death within six months; form must be signed by the qualified individual and by two witnesses; no liability or sanctions where the health care provider participates in good faith.
Spectrum: Moderate Partisan Bill (Democrat 8-1)
Status: (Introduced - Dead) 2016-01-06 - referred to health [A02129 Detail]
Download: New_York-2015-A02129-Introduced.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 2129 2015-2016 Regular Sessions I N A S S E M B L Y January 15, 2015 ___________ Introduced by M. of A. ROSENTHAL -- read once and referred to the Committee on Health AN ACT to amend the public health law, in relation to establishing "the death with dignity act" 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 death with 2 dignity act." 3 S 2. The public health law is amended by adding a new article 28-F to 4 read as follows: 5 ARTICLE 28-F 6 DEATH WITH DIGNITY ACT 7 SECTION 2899-D. DEFINITIONS. 8 2899-E. WRITTEN REQUEST FOR MEDICATION. 9 2899-F. FORM OF THE WRITTEN REQUEST. 10 2899-G. ATTENDING PHYSICIAN RESPONSIBILITIES. 11 2899-H. CONSULTING PHYSICIAN CONFIRMATION. 12 2899-I. COUNSELING REFERRAL. 13 2899-J. INFORMED DECISION. 14 2899-K. FAMILY NOTIFICATION. 15 2899-L. WRITTEN AND ORAL REQUESTS. 16 2899-M. RIGHT TO RESCIND REQUEST. 17 2899-N. WAITING PERIODS. 18 2899-O. MEDICAL RECORD DOCUMENTATION REQUIREMENTS. 19 2899-P. RESIDENCY REQUIREMENT. 20 2899-Q. REPORTING REQUIREMENTS. 21 2899-R. EFFECT ON CONSTRUCTION OF WILLS, CONTRACTS AND STATUTES. 22 2899-S. INSURANCE OR ANNUITY POLICIES. 23 2899-T. CONSTRUCTION. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06100-01-5 A. 2129 2 1 2899-U. IMMUNITIES; BASIS FOR PROHIBITING HEALTH CARE PROVIDER 2 FROM PARTICIPATION; NOTIFICATION; PERMISSIBLE SANC- 3 TIONS. 4 2899-V. LIABILITIES. 5 2899-W. CLAIMS BY GOVERNMENTAL ENTITY FOR COSTS INCURRED. 6 2899-X. FORM OF THE REQUEST. 7 2899-Y. PENALTIES. 8 2899-Z. SEVERABILITY. 9 S 2899-D. DEFINITIONS. AS USED IN THIS ARTICLE, THE FOLLOWING WORDS 10 AND PHRASES SHALL HAVE THE FOLLOWING MEANINGS: 11 1. "ADULT" MEANS AN INDIVIDUAL WHO IS EIGHTEEN YEARS OF AGE OR OLDER. 12 2. "ATTENDING PHYSICIAN" MEANS THE PHYSICIAN WHO HAS PRIMARY RESPONSI- 13 BILITY FOR THE CARE OF THE PATIENT AND TREATMENT OF THE PATIENT'S TERMI- 14 NAL DISEASE. 15 3. "CAPABLE" MEANS THAT IN THE OPINION OF A COURT OR IN THE OPINION OF 16 THE PATIENT'S ATTENDING PHYSICIAN OR CONSULTING PHYSICIAN, PSYCHIATRIST 17 OR PSYCHOLOGIST, A PATIENT HAS THE ABILITY TO MAKE AND COMMUNICATE 18 HEALTH CARE DECISIONS TO HEALTH CARE PROVIDERS, INCLUDING COMMUNICATION 19 THROUGH PERSONS FAMILIAR WITH THE PATIENT'S MANNER OF COMMUNICATING IF 20 THOSE PERSONS ARE AVAILABLE. 21 4. "CONSULTING PHYSICIAN" MEANS A PHYSICIAN WHO IS QUALIFIED BY 22 SPECIALTY OR EXPERIENCE TO MAKE A PROFESSIONAL DIAGNOSIS AND PROGNOSIS 23 REGARDING THE PATIENT'S DISEASE. 24 5. "COUNSELING" MEANS ONE OR MORE CONSULTATIONS AS NECESSARY BETWEEN A 25 STATE LICENSED PSYCHIATRIST OR PSYCHOLOGIST AND A PATIENT FOR THE 26 PURPOSE OF DETERMINING THAT THE PATIENT IS CAPABLE AND NOT SUFFERING 27 FROM A PSYCHIATRIC OR PSYCHOLOGICAL DISORDER OR DEPRESSION CAUSING 28 IMPAIRED JUDGMENT. 29 6. "HEALTH CARE PROVIDER" MEANS A PERSON LICENSED, CERTIFIED OR OTHER- 30 WISE AUTHORIZED OR PERMITTED BY THE LAWS OF THIS STATE TO ADMINISTER 31 HEALTH CARE OR DISPENSE MEDICATION IN THE ORDINARY COURSE OF BUSINESS OR 32 PRACTICE OF A PROFESSION, AND INCLUDES A HEALTH CARE FACILITY. 33 7. "INFORMED DECISION" MEANS A DECISION BY A QUALIFIED PATIENT, TO 34 REQUEST AND OBTAIN A PRESCRIPTION TO END HIS OR HER LIFE IN A HUMANE AND 35 DIGNIFIED MANNER, THAT IS BASED ON AN APPRECIATION OF THE RELEVANT FACTS 36 AND AFTER BEING FULLY INFORMED BY THE ATTENDING PHYSICIAN OF: 37 (A) HIS OR HER MEDICAL DIAGNOSIS; 38 (B) HIS OR HER PROGNOSIS; 39 (C) THE POTENTIAL RISKS ASSOCIATED WITH TAKING THE MEDICATION TO BE 40 PRESCRIBED; 41 (D) THE PROBABLE RESULT OF TAKING THE MEDICATION TO BE PRESCRIBED; AND 42 (E) THE FEASIBLE ALTERNATIVES, INCLUDING, BUT NOT LIMITED TO, COMFORT 43 CARE, HOSPICE CARE AND PAIN CONTROL. 44 8. "MEDICALLY CONFIRMED" MEANS THE MEDICAL OPINION OF THE ATTENDING 45 PHYSICIAN HAS BEEN CONFIRMED BY A CONSULTING PHYSICIAN WHO HAS EXAMINED 46 THE PATIENT AND THE PATIENT'S RELEVANT MEDICAL RECORDS. 47 9. "PATIENT" MEANS A PERSON WHO IS UNDER THE CARE OF A PHYSICIAN. 48 10. "PHYSICIAN" MEANS A DOCTOR OF MEDICINE OR OSTEOPATHY LICENSED TO 49 PRACTICE MEDICINE BY THE STATE BOARD FOR MEDICINE PURSUANT TO ARTICLE 50 ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW. 51 11. "QUALIFIED PATIENT" MEANS A CAPABLE ADULT WHO IS A RESIDENT OF 52 THIS STATE AND HAS SATISFIED THE REQUIREMENTS OF THIS ARTICLE IN ORDER 53 TO OBTAIN A PRESCRIPTION FOR MEDICATION TO END HIS OR HER LIFE IN A 54 HUMANE AND DIGNIFIED MANNER. A. 2129 3 1 12. "TERMINAL DISEASE" MEANS AN INCURABLE AND IRREVERSIBLE DISEASE 2 THAT HAS BEEN MEDICALLY CONFIRMED AND WILL, WITHIN REASONABLE MEDICAL 3 JUDGMENT, PRODUCE DEATH WITHIN SIX MONTHS. 4 S 2899-E. WRITTEN REQUEST FOR MEDICATION. 1. AN ADULT WHO IS CAPABLE, 5 IS A RESIDENT OF THIS STATE AND HAS BEEN DETERMINED BY THE ATTENDING 6 PHYSICIAN AND CONSULTING PHYSICIAN TO BE SUFFERING FROM A TERMINAL 7 DISEASE, AND WHO HAS VOLUNTARILY EXPRESSED HIS OR HER WISH TO DIE, MAY 8 MAKE A WRITTEN REQUEST FOR MEDICATION FOR THE PURPOSE OF ENDING HIS OR 9 HER LIFE IN A HUMANE AND DIGNIFIED MANNER IN ACCORDANCE WITH THE 10 PROVISIONS OF THIS ARTICLE. 11 2. NO PERSON SHALL QUALIFY UNDER THE PROVISIONS OF THIS ARTICLE SOLELY 12 BECAUSE OF AGE OR DISABILITY. 13 S 2899-F. FORM OF THE WRITTEN REQUEST. 1. A VALID REQUEST FOR MEDICA- 14 TION UNDER THE PROVISIONS OF THIS ARTICLE SHALL BE IN SUBSTANTIALLY THE 15 FORM DESCRIBED IN SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-X OF THIS 16 ARTICLE SIGNED AND DATED BY THE PATIENT AND WITNESSED BY AT LEAST TWO 17 INDIVIDUALS WHO, IN THE PRESENCE OF THE PATIENT, ATTEST THAT TO THE BEST 18 OF THEIR KNOWLEDGE AND BELIEF THE PATIENT IS CAPABLE, ACTING VOLUNTAR- 19 ILY, AND IS NOT BEING COERCED TO SIGN THE REQUEST. 20 2. ONE OF THE WITNESSES SHALL BE A PERSON WHO IS NOT: 21 (A) A RELATIVE OF THE PATIENT BY BLOOD, MARRIAGE OR ADOPTION; 22 (B) A PERSON WHO AT THE TIME THE REQUEST IS SIGNED WOULD BE ENTITLED 23 TO ANY PORTION OF THE ESTATE OF THE QUALIFIED PATIENT UPON DEATH UNDER 24 ANY WILL OR BY OPERATION OF LAW; OR 25 (C) AN OWNER, OPERATOR OR EMPLOYEE OF A HEALTH CARE FACILITY WHERE THE 26 QUALIFIED PATIENT IS RECEIVING MEDICAL TREATMENT OR IS A RESIDENT. 27 3. THE PATIENT'S ATTENDING PHYSICIAN AT THE TIME THE REQUEST IS SIGNED 28 SHALL NOT BE A WITNESS. 29 4. IF THE PATIENT IS A PATIENT IN A LONG TERM CARE FACILITY AT THE 30 TIME THE WRITTEN REQUEST IS MADE, ONE OF THE WITNESSES SHALL BE AN INDI- 31 VIDUAL DESIGNATED BY THE FACILITY. 32 S 2899-G. ATTENDING PHYSICIAN RESPONSIBILITIES. 1. THE ATTENDING 33 PHYSICIAN SHALL: 34 (A) MAKE THE INITIAL DETERMINATION OF WHETHER A PATIENT HAS A TERMINAL 35 DISEASE, IS CAPABLE, AND HAS MADE THE REQUEST VOLUNTARILY; 36 (B) REQUEST THAT THE PATIENT DEMONSTRATE NEW YORK STATE RESIDENCY; 37 (C) TO ENSURE THAT THE PATIENT IS MAKING AN INFORMED DECISION, INFORM 38 THE PATIENT OF: 39 (I) HIS OR HER MEDICAL DIAGNOSIS; 40 (II) HIS OR HER PROGNOSIS; 41 (III) THE POTENTIAL RISKS ASSOCIATED WITH TAKING THE MEDICATION TO BE 42 PRESCRIBED; 43 (IV) THE PROBABLY RESULT OF TAKING THE MEDICATION TO BE PRESCRIBED; 44 AND 45 (V) THE FEASIBLE ALTERNATIVES, INCLUDING, BUT NOT LIMITED TO, COMFORT 46 CARE, HOSPICE CARE AND PAIN CONTROL; 47 (D) REFER THE PATIENT TO A CONSULTING PHYSICIAN FOR MEDICAL CONFIRMA- 48 TION OF THE DIAGNOSIS, AND FOR A DETERMINATION THAT THE PATIENT IS CAPA- 49 BLE AND ACTING VOLUNTARILY; 50 (E) REFER THE PATIENT FOR COUNSELING, IF APPROPRIATE, PURSUANT TO 51 SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-I OF THIS ARTICLE; 52 (F) RECOMMEND THAT THE PATIENT NOTIFY NEXT OF KIN; 53 (G) COUNSEL THE PATIENT ABOUT THE IMPORTANCE OF HAVING ANOTHER PERSON 54 PRESENT WHEN THE PATIENT TAKES THE MEDICATION PRESCRIBED PURSUANT TO THE 55 PROVISIONS OF THIS ARTICLE AND OF NOT TAKING THE MEDICATION IN A PUBLIC 56 PLACE; A. 2129 4 1 (H) INFORM THE PATIENT THAT HE OR SHE HAS AN OPPORTUNITY TO RESCIND 2 THE REQUEST AT ANY TIME AND IN ANY MANNER, AND OFFER THE PATIENT AN 3 OPPORTUNITY TO RESCIND AT THE END OF THE FIFTEEN DAY WAITING PERIOD 4 PURSUANT TO SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-L OF THIS ARTICLE; 5 (I) VERIFY, IMMEDIATELY PRIOR TO WRITING THE PRESCRIPTION FOR MEDICA- 6 TION UNDER THE PROVISIONS OF THIS ARTICLE, THAT THE PATIENT IS MAKING AN 7 INFORMED DECISION; 8 (J) FULFILL THE MEDICAL RECORD DOCUMENTATION REQUIREMENTS OF SECTION 9 TWENTY-EIGHT HUNDRED NINETY-NINE-O OF THIS ARTICLE; 10 (K) ENSURE THAT ALL APPROPRIATE STEPS ARE CARRIED OUT IN ACCORDANCE 11 WITH THE PROVISIONS OF THIS ARTICLE PRIOR TO WRITING A PRESCRIPTION FOR 12 MEDICATION TO ENABLE A QUALIFIED PATIENT TO END HIS OR HER LIFE IN A 13 HUMANE AND DIGNIFIED MANNER; AND 14 (L) (I) DISPENSE MEDICATIONS DIRECTLY, INCLUDING ANCILLARY MEDICATIONS 15 INTENDED TO FACILITATE THE DESIRED EFFECT TO MINIMIZE THE PATIENT'S 16 DISCOMFORT, PROVIDED THE ATTENDING PHYSICIAN, HAS A CURRENT DRUG 17 ENFORCEMENT ADMINISTRATION CERTIFICATE AND COMPLIES WITH ANY APPLICABLE 18 RULE OR REGULATION; OR 19 (II) WITH THE PATIENT'S WRITTEN CONSENT: 20 (A) CONTACT A PHARMACIST AND INFORM THE PHARMACIST OF THE 21 PRESCRIPTION; AND 22 (B) DELIVER THE WRITTEN PRESCRIPTION PERSONALLY OR BY MAIL TO THE 23 PHARMACIST, WHO WILL DISPENSE THE MEDICATIONS TO EITHER THE PATIENT, THE 24 ATTENDING PHYSICIAN OR AN EXPRESSLY IDENTIFIED AGENT OF THE PATIENT. 25 2. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, THE ATTENDING PHYSICIAN 26 MAY SIGN THE PATIENT'S DEATH CERTIFICATE. 27 S 2899-H. CONSULTING PHYSICIAN CONFIRMATION. BEFORE A PATIENT IS QUAL- 28 IFIED UNDER THE PROVISIONS OF THIS ARTICLE, A CONSULTING PHYSICIAN SHALL 29 EXAMINE THE PATIENT AND HIS OR HER RELEVANT MEDICAL RECORDS AND CONFIRM, 30 IN WRITING, THE ATTENDING PHYSICIAN'S DIAGNOSIS THAT THE PATIENT IS 31 SUFFERING FROM A TERMINAL DISEASE, AND VERIFY THAT THE PATIENT IS CAPA- 32 BLE, IS ACTING VOLUNTARILY AND HAS MADE AN INFORMED DECISION. 33 S 2899-I. COUNSELING REFERRAL. IF IN THE OPINION OF THE ATTENDING 34 PHYSICIAN OR THE CONSULTING PHYSICIAN A PATIENT MAY BE SUFFERING FROM A 35 PSYCHIATRIC OR PSYCHOLOGICAL DISORDER OR DEPRESSION CAUSING IMPAIRED 36 JUDGMENT, EITHER PHYSICIAN SHALL REFER THE PATIENT FOR COUNSELING. NO 37 MEDICATION TO END A PATIENT'S LIFE IN A HUMANE AND DIGNIFIED MANNER 38 SHALL BE PRESCRIBED UNTIL THE PERSON PERFORMING THE COUNSELING DETER- 39 MINES THAT THE PATIENT IS NOT SUFFERING FROM A PSYCHIATRIC OR PSYCHOLOG- 40 ICAL DISORDER OR DEPRESSION CAUSING IMPAIRED JUDGMENT. 41 S 2899-J. INFORMED DECISION. NO PERSON SHALL RECEIVE A PRESCRIPTION 42 FOR MEDICATION TO END HIS OR HER LIFE IN A HUMANE AND DIGNIFIED MANNER 43 UNLESS HE OR SHE HAS MADE AN INFORMED DECISION AS DEFINED IN SUBDIVISION 44 SEVEN OF SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-D OF THIS ARTICLE. 45 IMMEDIATELY PRIOR TO WRITING A PRESCRIPTION FOR MEDICATION UNDER THE 46 PROVISIONS OF THIS ARTICLE, THE ATTENDING PHYSICIAN SHALL VERIFY THAT 47 THE PATIENT IS MAKING AN INFORMED DECISION. 48 S 2899-K. FAMILY NOTIFICATION. THE ATTENDING PHYSICIAN SHALL RECOMMEND 49 THAT THE PATIENT NOTIFY THE NEXT OF KIN OF HIS OR HER REQUEST FOR MEDI- 50 CATION PURSUANT TO THE PROVISIONS OF THIS ARTICLE. A PATIENT WHO 51 DECLINES OR IS UNABLE TO NOTIFY NEXT OF KIN SHALL NOT HAVE HIS OR HER 52 REQUEST DENIED FOR THAT REASON. 53 S 2899-L. WRITTEN AND ORAL REQUESTS. IN ORDER TO RECEIVE A 54 PRESCRIPTION FOR MEDICATION TO END HIS OR HER LIFE IN A HUMANE AND 55 DIGNIFIED MANNER, A QUALIFIED PATIENT SHALL HAVE MADE AN ORAL REQUEST 56 AND A WRITTEN REQUEST, AND REITERATE THE ORAL REQUEST TO HIS OR HER A. 2129 5 1 ATTENDING PHYSICIAN NO LESS THAN FIFTEEN DAYS AFTER MAKING THE INITIAL 2 ORAL REQUEST. AT THE TIME THE QUALIFIED PATIENT MAKES HIS OR HER SECOND 3 ORAL REQUEST, THE ATTENDING PHYSICIAN SHALL OFFER THE PATIENT AN OPPOR- 4 TUNITY TO RESCIND THE REQUEST. 5 S 2899-M. RIGHT TO RESCIND REQUEST. A PATIENT MAY RESCIND HIS OR HER 6 REQUEST AT ANY TIME AND IN ANY MANNER WITHOUT REGARD TO HIS OR HER 7 MENTAL STATE. NO PRESCRIPTION FOR MEDICATION UNDER THE PROVISIONS OF 8 THIS ARTICLE MAY BE WRITTEN WITHOUT THE ATTENDING PHYSICIAN OFFERING THE 9 QUALIFIED PATIENT AN OPPORTUNITY TO RESCIND THE REQUEST. 10 S 2899-N. WAITING PERIODS. NO LESS THAN FIFTEEN DAYS SHALL ELAPSE 11 BETWEEN THE PATIENT'S INITIAL ORAL REQUEST AND THE WRITING OF A 12 PRESCRIPTION UNDER THE PROVISIONS OF THIS ARTICLE. NO LESS THAN 13 FORTY-EIGHT HOURS SHALL ELAPSE BETWEEN THE PATIENT'S WRITTEN REQUEST AND 14 THE WRITING OF A PRESCRIPTION UNDER THE PROVISIONS OF THIS ARTICLE. 15 S 2899-O. MEDICAL RECORD DOCUMENTATION REQUIREMENTS. THE FOLLOWING 16 SHALL BE DOCUMENTED OR FILED IN THE PATIENT'S MEDICAL RECORD: 17 1. ALL ORAL REQUESTS BY A PATIENT FOR MEDICATION TO END HIS OR HER 18 LIFE IN A HUMANE AND DIGNIFIED MANNER; 19 2. ALL WRITTEN REQUESTS BY A PATIENT FOR MEDICATION TO END HIS OR HER 20 LIFE IN A HUMANE AND DIGNIFIED MANNER; 21 3. THE ATTENDING PHYSICIAN'S DIAGNOSIS AND PROGNOSIS, DETERMINATION 22 THAT THE PATIENT IS CAPABLE, ACTING VOLUNTARILY AND HAS MADE AN INFORMED 23 DECISION; 24 4. THE CONSULTING PHYSICIAN'S DIAGNOSIS AND PROGNOSIS, AND VERIFICA- 25 TION THAT THE PATIENT IS CAPABLE, ACTING VOLUNTARILY AND HAS MADE AN 26 INFORMED DECISION; 27 5. A REPORT OF THE OUTCOME AND DETERMINATIONS MADE DURING COUNSELING, 28 IF PERFORMED; 29 6. THE ATTENDING PHYSICIAN'S OFFER TO THE PATIENT TO RESCIND HIS OR 30 HER REQUEST AT THE TIME OF THE PATIENT'S SECOND ORAL REQUEST PURSUANT TO 31 SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-I OF THIS ARTICLE; AND 32 7. A NOTE BY THE ATTENDING PHYSICIAN INDICATING THAT ALL REQUIREMENTS 33 UNDER THE PROVISIONS OF THIS ARTICLE HAVE BEEN MET AND INDICATING THE 34 STEPS TAKEN TO CARRY OUT THE REQUEST, INCLUDING A NOTATION OF THE MEDI- 35 CATION PRESCRIBED. 36 S 2899-P. RESIDENCY REQUIREMENT. ONLY REQUESTS MADE BY NEW YORK STATE 37 RESIDENTS UNDER THE PROVISIONS OF THIS ARTICLE SHALL BE GRANTED. FACTORS 38 DEMONSTRATING NEW YORK STATE RESIDENCY SHALL INCLUDE BUT SHALL NOT BE 39 LIMITED TO: 40 1. POSSESSION OF A NEW YORK STATE DRIVER'S LICENSE; 41 2. REGISTRATION TO VOTE IN NEW YORK STATE; 42 3. EVIDENCE THAT THE PERSON OWNS OR LEASES PROPERTY IN NEW YORK STATE; 43 OR 44 4. FILING OF A NEW YORK STATE TAX RETURN FOR THE MOST RECENT TAX YEAR. 45 S 2899-Q. REPORTING REQUIREMENTS. 1. (A) THE STATE BOARD FOR MEDICINE 46 SHALL ANNUALLY REVIEW A SAMPLE OF RECORDS MAINTAINED PURSUANT TO THE 47 PROVISIONS OF THIS ARTICLE. 48 (B) THE STATE BOARD FOR MEDICINE SHALL REQUIRE ANY HEALTH CARE PROVID- 49 ER UPON DISPENSING MEDICATION PURSUANT TO THE PROVISIONS OF THIS ARTICLE 50 TO FILE A COPY OF THE DISPENSING RECORD WITH THE STATE BOARD FOR MEDI- 51 CINE. 52 2. THE STATE BOARD FOR MEDICINE SHALL MAKE RULES TO FACILITATE THE 53 COLLECTION OF INFORMATION REGARDING COMPLIANCE WITH THE PROVISIONS OF 54 THIS ARTICLE. EXCEPT AS OTHERWISE REQUIRED BY LAW, THE INFORMATION 55 COLLECTED SHALL NOT BE A PUBLIC RECORD AND MAY NOT BE MADE AVAILABLE FOR 56 INSPECTION BY THE PUBLIC. A. 2129 6 1 3. THE STATE BOARD FOR MEDICINE SHALL GENERATE AND MAKE AVAILABLE TO 2 THE PUBLIC AN ANNUAL STATISTICAL REPORT OF INFORMATION COLLECTED UNDER 3 SUBDIVISION TWO OF THIS SECTION. 4 S 2899-R. EFFECT ON CONSTRUCTION OF WILLS, CONTRACTS AND STATUTES. 1. 5 NO PROVISION IN A CONTRACT, WILL OR OTHER AGREEMENT, WHETHER WRITTEN OR 6 ORAL, TO THE EXTENT THE PROVISION WOULD AFFECT WHETHER A PERSON MAY MAKE 7 OR RESCIND A REQUEST FOR MEDICATION TO END HIS OR HER LIFE IN A HUMANE 8 AND DIGNIFIED MANNER, SHALL BE VALID. 9 2. NO OBLIGATION OWING UNDER ANY CURRENTLY EXISTING CONTRACT SHALL BE 10 CONDITIONED OR AFFECTED BY THE MAKING OR RESCINDING OF A REQUEST, BY A 11 PERSON, FOR MEDICATION TO END HIS OR HER LIFE IN A HUMANE AND DIGNIFIED 12 MANNER. 13 S 2899-S. INSURANCE OR ANNUITY POLICIES. THE SALE, PROCUREMENT, OR 14 ISSUANCE OF ANY LIFE, HEALTH, OR ACCIDENT INSURANCE OR ANNUITY POLICY OR 15 THE RATE CHARGED FOR ANY POLICY SHALL NOT BE CONDITIONED UPON OR 16 AFFECTED BY THE MAKING OR RESCINDING OF A REQUEST, BY A PERSON, FOR 17 MEDICATION TO END HIS OR HER LIFE IN A HUMANE AND DIGNIFIED MANNER. 18 NEITHER SHALL A QUALIFIED PATIENT'S ACT OF INGESTING MEDICATION TO END 19 HIS OR HER LIFE IN A HUMANE AND DIGNIFIED MANNER HAVE AN EFFECT UPON A 20 LIFE, HEALTH, OR ACCIDENT INSURANCE OR ANNUITY POLICY. 21 S 2899-T. CONSTRUCTION. THE PROVISIONS OF THIS ARTICLE SHALL NOT BE 22 CONSTRUED TO AUTHORIZE A PHYSICIAN OR ANY OTHER PERSON TO END A 23 PATIENT'S LIFE BY LETHAL INJECTION, MERCY KILLING OR ACTIVE EUTHANASIA. 24 ACTIONS TAKEN IN ACCORDANCE WITH THE PROVISIONS OF THIS ARTICLE SHALL 25 NOT, FOR ANY PURPOSE, CONSTITUTE SUICIDE, ASSISTED SUICIDE, MANSLAUGHT- 26 ER, MURDER OR HOMICIDE, UNDER THE LAW. 27 S 2899-U. IMMUNITIES; BASIS FOR PROHIBITING HEALTH CARE PROVIDER FROM 28 PARTICIPATION; NOTIFICATION; PERMISSIBLE SANCTIONS. 1. NO PERSON SHALL 29 BE SUBJECT TO CIVIL OR CRIMINAL LIABILITY OR PROFESSIONAL DISCIPLINARY 30 ACTION FOR PARTICIPATING IN GOOD FAITH COMPLIANCE WITH THE PROVISIONS OF 31 THIS ARTICLE. THIS INCLUDES BEING PRESENT WHEN A QUALIFIED PATIENT TAKES 32 THE PRESCRIBED MEDICATION TO END HIS OR HER LIFE IN A HUMANE AND DIGNI- 33 FIED MANNER. 34 2. NO PROFESSIONAL ORGANIZATION OR ASSOCIATION, OR HEALTH CARE PROVID- 35 ER, MAY SUBJECT A PERSON TO CENSURE, DISCIPLINE, SUSPENSION, LOSS OF 36 LICENSE, LOSS OF PRIVILEGES, LOSS OF MEMBERSHIP OR OTHER PENALTY FOR 37 PARTICIPATING OR REFUSING TO PARTICIPATE IN GOOD FAITH COMPLIANCE WITH 38 THE PROVISIONS OF THIS ARTICLE. 39 3. NO REQUEST BY A PATIENT FOR OR PROVISION BY AN ATTENDING PHYSICIAN 40 OF MEDICATION IN GOOD FAITH COMPLIANCE WITH THE PROVISIONS OF THIS ARTI- 41 CLE SHALL CONSTITUTE NEGLECT FOR ANY PURPOSE OF LAW OR PROVIDE THE SOLE 42 BASIS FOR THE APPOINTMENT OF A GUARDIAN OR CONSERVATOR. 43 4. NO HEALTH CARE PROVIDER SHALL BE UNDER ANY DUTY, WHETHER BY 44 CONTRACT, BY STATUTE OR BY ANY OTHER LEGAL REQUIREMENT TO PARTICIPATE IN 45 THE PROVISION TO A QUALIFIED PATIENT OF MEDICATION TO END HIS OR HER 46 LIFE IN A HUMANE AND DIGNIFIED MANNER. IF A HEALTH CARE PROVIDER IS 47 UNABLE OR UNWILLING TO CARRY OUT A PATIENT'S REQUEST UNDER THE 48 PROVISIONS OF THIS ARTICLE, AND THE PATIENT TRANSFERS HIS OR HER CARE TO 49 A NEW HEALTH CARE PROVIDER, THE PRIOR HEALTH CARE PROVIDER SHALL TRANS- 50 FER, UPON REQUEST, A COPY OF THE PATIENT'S RELEVANT MEDICAL RECORDS TO 51 THE NEW HEALTH CARE PROVIDER. 52 5. (A) NOTWITHSTANDING ANY OTHER PROVISION OF LAW, A HEALTH CARE 53 PROVIDER MAY PROHIBIT ANOTHER HEALTH CARE PROVIDER FROM PARTICIPATING IN 54 THE PROVISIONS OF THIS ARTICLE ON THE PREMISES OF THE PROHIBITING 55 PROVIDER IF THE PROHIBITING PROVIDER HAS NOTIFIED THE HEALTH CARE 56 PROVIDER OF THE PROHIBITING PROVIDER'S POLICY REGARDING PARTICIPATING IN A. 2129 7 1 THE PROVISIONS OF THIS ARTICLE. NOTHING IN THIS SUBDIVISION PREVENTS A 2 HEALTH CARE PROVIDER FROM PROVIDING TO A PATIENT, HEALTH CARE SERVICES 3 THAT DO NOT CONSTITUTE PARTICIPATION IN THE PROVISIONS OF THIS ARTICLE. 4 (B) NOTWITHSTANDING THE PROVISIONS OF SUBDIVISIONS ONE, TWO, THREE AND 5 FOUR OF THIS SECTION, A HEALTH CARE PROVIDER MAY SUBJECT ANOTHER HEALTH 6 CARE PROVIDER TO THE SANCTIONS STATED IN THIS SUBDIVISION IF THE SANC- 7 TIONING HEALTH CARE PROVIDER HAS NOTIFIED THE SANCTIONED PROVIDER PRIOR 8 TO PARTICIPATION IN THE PROVISIONS OF THIS ARTICLE THAT IT PROHIBITS 9 PARTICIPATION IN THE PROVISIONS OF THIS ARTICLE. 10 (I) LOSS OF PRIVILEGES, LOSS OF MEMBERSHIP OR OTHER SANCTION PROVIDED 11 PURSUANT TO THE MEDICAL STAFF BYLAWS, POLICIES AND PROCEDURES OF THE 12 SANCTIONING HEALTH CARE PROVIDER IF THE SANCTIONED PROVIDER IS A MEMBER 13 OF THE SANCTIONING PROVIDER'S MEDICAL STAFF AND PARTICIPATES IN THE 14 PROVISIONS OF THIS ARTICLE WHILE ON THE HEALTH CARE FACILITY PREMISES, 15 OF THE SANCTIONING HEALTH CARE PROVIDER, BUT NOT INCLUDING THE PRIVATE 16 MEDICAL OFFICE OF A PHYSICIAN OR OTHER PROVIDER; 17 (II) TERMINATION OF LEASE OR OTHER PROPERTY CONTRACT OR OTHER NONMONE- 18 TARY REMEDIES PROVIDED BY LEASE CONTRACT, NOT INCLUDING LOSS OR 19 RESTRICTION OF MEDICAL STAFF PRIVILEGES OR EXCLUSION FROM A PROVIDER 20 PANEL, IF THE SANCTIONED PROVIDER PARTICIPATES IN THE PROVISIONS OF THIS 21 ARTICLE WHILE ON THE PREMISES OF THE SANCTIONING HEALTH CARE PROVIDER OR 22 ON PROPERTY THAT IS OWNED BY OR UNDER THE DIRECT CONTROL OF THE SANC- 23 TIONING HEALTH CARE PROVIDER; OR 24 (III) TERMINATION OF CONTRACT OR OTHER NONMONETARY REMEDIES PROVIDED 25 BY CONTRACT IF THE SANCTIONED PROVIDER PARTICIPATES IN THE PROVISIONS OF 26 THIS ARTICLE WHILE ACTING IN THE COURSE AND SCOPE OF THE SANCTIONED 27 PROVIDER'S CAPACITY AS AN EMPLOYEE OR INDEPENDENT CONTRACTOR OF THE 28 SANCTIONING HEALTH CARE PROVIDER. NOTHING IN THIS PARAGRAPH SHALL BE 29 CONSTRUED TO PREVENT: 30 (A) A HEALTH CARE PROVIDER FROM PARTICIPATING IN THE PROVISIONS OF 31 THIS ARTICLE WHILE ACTING OUTSIDE THE COURSE AND SCOPE OF THE PROVIDER'S 32 CAPACITY AS AN EMPLOYEE OR INDEPENDENT CONTRACTOR; OR 33 (B) A PATIENT FROM CONTRACTING WITH HIS OR HER ATTENDING PHYSICIAN AND 34 CONSULTING PHYSICIAN TO ACT OUTSIDE THE COURSE AND SCOPE OF THE PROVID- 35 ER'S CAPACITY AS AN EMPLOYEE OR INDEPENDENT CONTRACTOR OF THE SANCTION- 36 ING HEALTH CARE PROVIDER. 37 (C) A HEALTH CARE PROVIDER THAT IMPOSES SANCTIONS PURSUANT TO PARA- 38 GRAPH (B) OF THIS SUBDIVISION MUST FOLLOW ALL DUE PROCESS AND OTHER 39 PROCEDURES THE SANCTIONING HEALTH CARE PROVIDER MAY HAVE THAT ARE 40 RELATED TO THE IMPOSITION OF SANCTIONS ON ANOTHER HEALTH CARE PROVIDER. 41 (D) FOR PURPOSES OF THIS SUBDIVISION: 42 (I) "NOTIFY" MEANS A SEPARATE STATEMENT IN WRITING TO THE HEALTH CARE 43 PROVIDER SPECIFICALLY INFORMING THE HEALTH CARE PROVIDER PRIOR TO THE 44 PROVIDER'S PARTICIPATION IN THE PROVISIONS OF THIS ARTICLE OF THE SANC- 45 TIONING HEALTH CARE PROVIDER'S POLICY ABOUT PARTICIPATION IN ACTIVITIES 46 COVERED BY THE PROVISIONS OF THIS ARTICLE. 47 (II) "PARTICIPATE IN THE PROVISIONS OF THIS ARTICLE" MEANS TO PERFORM 48 THE DUTIES OF AN ATTENDING PHYSICIAN PURSUANT TO SECTION TWENTY-EIGHT 49 HUNDRED NINETY-NINE-G OF THIS ARTICLE; THE CONSULTING PHYSICIAN FUNCTION 50 PURSUANT TO SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-H OF THIS ARTICLE, 51 OR THE COUNSELING FUNCTION PURSUANT TO SECTION TWENTY-EIGHT HUNDRED 52 NINETY-NINE-I OF THIS ARTICLE. "PARTICIPATE IN THE PROVISIONS OF THIS 53 ARTICLE" DOES NOT INCLUDE: 54 (A) MAKING AN INITIAL DETERMINATION THAT A PATIENT HAS A TERMINAL 55 DISEASE AND INFORMING THE PATIENT OF THE MEDICAL PROGNOSIS; A. 2129 8 1 (B) PROVIDING INFORMATION ABOUT THE DEATH WITH DIGNITY ACT TO A 2 PATIENT UPON THE REQUEST OF THE PATIENT; 3 (C) PROVIDING A PATIENT, UPON THE REQUEST OF THE PATIENT, WITH A 4 REFERRAL TO ANOTHER PHYSICIAN; OR 5 (D) A PATIENT CONTRACTING WITH HIS OR HER ATTENDING PHYSICIAN AND 6 CONSULTING PHYSICIAN TO ACT OUTSIDE OF THE COURSE AND SCOPE OF THE 7 PROVIDER'S CAPACITY AS AN EMPLOYEE OR INDEPENDENT CONTRACTOR OF THE 8 SANCTIONING HEALTH CARE PROVIDER. 9 6. ACTION TAKEN PURSUANT TO SECTION TWENTY-EIGHT HUNDRED 10 NINETY-NINE-F, TWENTY-EIGHT HUNDRED NINETY-NINE-G, TWENTY-EIGHT HUNDRED 11 NINETY-NINE-H, OR TWENTY-EIGHT HUNDRED NINETY-NINE-I SHALL NOT BE THE 12 SOLE BASIS FOR A REPORT OF UNPROFESSIONAL OR DISHONORABLE CONDUCT UNDER 13 ARTICLE ONE HUNDRED THIRTY-ONE-A OF THE EDUCATION LAW. 14 7. NO PROVISION OF THE PROVISIONS OF THIS ARTICLE SHALL BE CONSTRUED 15 TO ALLOW A LOWER STANDARD OF CARE FOR PATIENTS IN THE COMMUNITY WHERE 16 THE PATIENT IS TREATED OR A SIMILAR COMMUNITY. 17 S 2899-V. LIABILITIES. 1. A PERSON WHO WITHOUT AUTHORIZATION OF THE 18 PATIENT WILLFULLY ALTERS OR FORGES A REQUEST FOR MEDICATION OR CONCEALS 19 OR DESTROYS A RESCISSION OF THAT REQUEST WITH THE INTENT OR EFFECT OF 20 CAUSING THE PATIENT'S DEATH SHALL BE GUILTY OF A CLASS A FELONY. 21 2. A PERSON WHO COERCES OR EXERTS UNDUE INFLUENCE ON A PATIENT TO 22 REQUEST MEDICATION FOR THE PURPOSE OF ENDING THE PATIENT'S LIFE, OR TO 23 DESTROY A RESCISSION OF SUCH A REQUEST, SHALL BE GUILTY OF A CLASS A 24 FELONY. 25 3. NOTHING IN THE PROVISIONS OF THIS ARTICLE LIMITS FURTHER LIABILITY 26 FOR CIVIL DAMAGES RESULTING FROM OTHER NEGLIGENT CONDUCT OR INTENTIONAL 27 MISCONDUCT BY ANY PERSON. 28 4. THE PENALTIES IN THE PROVISIONS OF THIS ARTICLE DO NOT PRECLUDE 29 CRIMINAL PENALTIES APPLICABLE UNDER OTHER LAW FOR CONDUCT WHICH IS 30 INCONSISTENT WITH THE PROVISIONS OF THIS ARTICLE. 31 S 2899-W. CLAIMS BY GOVERNMENTAL ENTITY FOR COSTS INCURRED. ANY 32 GOVERNMENTAL ENTITY THAT INCURS COSTS RESULTING FROM A PERSON TERMINAT- 33 ING HIS OR HER LIFE PURSUANT TO THE PROVISIONS OF THIS ARTICLE IN A 34 PUBLIC PLACE SHALL HAVE A CLAIM AGAINST THE ESTATE OF THE PERSON TO 35 RECOVER SUCH COSTS AND REASONABLE ATTORNEY FEES RELATED TO ENFORCING THE 36 CLAIM. 37 S 2899-X. FORM OF THE REQUEST. A REQUEST FOR A MEDICATION AS AUTHOR- 38 IZED BY THE PROVISIONS OF THIS ARTICLE SHALL BE IN SUBSTANTIALLY THE 39 FOLLOWING FORM: 40 REQUEST FOR MEDICATION 41 TO END MY LIFE IN A HUMANE 42 AND DIGNIFIED MANNER 43 I, ______________________, AM AN ADULT OF SOUND MIND. 44 I AM SUFFERING FROM _____________, WHICH MY ATTENDING PHYSICIAN HAS 45 DETERMINED IS A TERMINAL DISEASE AND WHICH HAS BEEN MEDICALLY CONFIRMED 46 BY A CONSULTING PHYSICIAN. 47 I HAVE BEEN FULLY INFORMED OF MY DIAGNOSIS, PROGNOSIS, THE NATURE OF 48 MEDICATION TO BE PRESCRIBED AND POTENTIAL ASSOCIATED RISKS, THE EXPECTED 49 RESULT, AND THE FEASIBLE ALTERNATIVES, INCLUDING COMFORT CARE, HOSPICE 50 CARE AND PAIN CONTROL. 51 I REQUEST THAT MY ATTENDING PHYSICIAN PRESCRIBE MEDICATION THAT WILL END 52 MY LIFE IN A HUMANE AND DIGNIFIED MANNER. 53 INITIAL ONE: A. 2129 9 1 ___ I HAVE INFORMED MY FAMILY OF MY DECISION AND TAKEN THEIR OPINIONS 2 INTO CONSIDERATION. 3 ___ I HAVE DECIDED NOT TO INFORM MY FAMILY OF MY DECISION. 4 ___ I HAVE NO FAMILY TO INFORM OF MY DECISION. 5 I UNDERSTAND THAT I HAVE THE RIGHT TO RESCIND THIS REQUEST AT ANY TIME. 6 I UNDERSTAND THE FULL IMPORT OF THIS REQUEST AND I EXPECT TO DIE WHEN I 7 TAKE THE MEDICATION TO BE PRESCRIBED. I FURTHER UNDERSTAND THAT ALTHOUGH 8 MOST DEATHS OCCUR WITHIN THREE HOURS, MY DEATH MAY TAKE LONGER AND MY 9 PHYSICIAN HAS COUNSELED ME ABOUT THIS POSSIBILITY. 10 I MAKE THIS REQUEST VOLUNTARILY AND WITHOUT RESERVATION, AND I ACCEPT 11 FULL MORAL RESPONSIBILITY FOR MY ACTIONS. 12 SIGNED: __________ 13 DATED: __________ 14 DECLARATION OF WITNESSES 15 WE DECLARE THAT THE PERSON SIGNING THIS REQUEST: 16 (A) IS PERSONALLY KNOWN TO US OR HAS PROVIDED PROOF OF IDENTIFY; 17 (B) SIGNED THIS REQUEST IN OUR PRESENCE; 18 (C) APPEARS TO BE OF SOUND MIND AND NOT UNDER DURESS, FRAUD OR UNDUE 19 INFLUENCE; 20 (D) IS NOT A PATIENT FOR WHOM EITHER OF US IS ATTENDING PHYSICIAN. 21 __________ WITNESS 1/DATE 22 __________ WITNESS 2/DATE 23 NOTE: ONE WITNESS SHALL NOT BE A RELATIVE (BY BLOOD, MARRIAGE OR 24 ADOPTION) OF THE PERSON SIGNING THIS REQUEST, SHALL NOT BE ENTITLED TO 25 ANY PORTION OF THE PERSON'S ESTATE UPON DEATH AND SHALL NOT OWN, OPERATE 26 OR BE EMPLOYED AT A HEALTH CARE FACILITY WHERE THE PERSON IS A PATIENT 27 OR RESIDENT. IF THE PATIENT IS AN INPATIENT AT A HEALTH CARE FACILITY, 28 ONE OF THE WITNESSES SHALL BE AN INDIVIDUAL DESIGNATED BY THE FACILITY. 29 S 2899-Y. PENALTIES. 1. IT SHALL BE A CLASS A FELONY FOR A PERSON 30 WITHOUT AUTHORIZATION OF THE PRINCIPAL TO WILLFULLY ALTER, FORGE, 31 CONCEAL OR DESTROY AN INSTRUMENT, THE REINSTATEMENT OR REVOCATION OF AN 32 INSTRUMENT OR ANY OTHER EVIDENCE OR DOCUMENT REFLECTING THE PRINCIPAL'S 33 DESIRES AND INTERESTS, WITH THE INTENT AND EFFECT OF CAUSING A WITHHOLD- 34 ING OR WITHDRAWAL OF LIFE-SUSTAINING PROCEDURES OR OF ARTIFICIALLY 35 ADMINISTERED NUTRITION AND HYDRATION WHICH HASTENS THE DEATH OF THE 36 PRINCIPAL. 37 2. EXCEPT AS PROVIDED IN SUBDIVISION ONE OF THIS SECTION, IT SHALL BE 38 A CLASS A MISDEMEANOR FOR A PERSON WITHOUT AUTHORIZATION OF THE PRINCI- 39 PAL TO WILLFULLY ALTER, FORGE, CONCEAL OR DESTROY AN INSTRUMENT, THE 40 REINSTATEMENT OR REVOCATION OF AN INSTRUMENT, OR ANY OTHER EVIDENCE OR 41 DOCUMENT REFLECTING THE PRINCIPAL'S DESIRES AND INTERESTS WITH THE 42 INTENT OR EFFECT OF AFFECTING A HEALTH CARE DECISION. 43 S 2899-Z. SEVERABILITY. IF ANY CLAUSE, SENTENCE, PARAGRAPH, SECTION OR 44 PART OF THIS ARTICLE SHALL BE ADJUDGED BY ANY COURT OF COMPETENT JURIS- 45 DICTION TO BE INVALID, SUCH JUDGMENT SHALL NOT AFFECT, IMPAIR OR INVALI- 46 DATE THE REMAINDER THEREOF, BUT SHALL BE CONFINED IN ITS OPERATION TO 47 THE CLAUSE, SENTENCE, PARAGRAPH, SECTION OR PART THEREOF, DIRECTLY 48 INVOLVED IN THE CONTROVERSY IN WHICH SUCH JUDGEMENT SHALL HAVE BEEN 49 RENDERED. 50 S 3. This act shall take effect on the first of November next succeed- 51 ing the date on which it shall have become a law.