S T A T E O F N E W Y O R K ________________________________________________________________________ 9360 I N A S S E M B L Y February 22, 2012 ___________ Introduced by M. of A. STEVENSON -- 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. 24 2899-U. IMMUNITIES; BASIS FOR PROHIBITING HEALTH CARE PROVIDER 25 FROM PARTICIPATION; NOTIFICATION; PERMISSIBLE SANC- 26 TIONS. 27 2899-V. LIABILITIES. 28 2899-W. CLAIMS BY GOVERNMENTAL ENTITY FOR COSTS INCURRED. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD13067-02-2 A. 9360 2 1 2899-X. FORM OF THE REQUEST. 2 2899-Y. PENALTIES. 3 2899-Z. SEVERABILITY. 4 S 2899-D. DEFINITIONS. AS USED IN THIS ARTICLE, THE FOLLOWING WORDS 5 AND PHRASES SHALL HAVE THE FOLLOWING MEANINGS: 6 1. "ADULT" MEANS AN INDIVIDUAL WHO IS EIGHTEEN YEARS OF AGE OR OLDER. 7 2. "ATTENDING PHYSICIAN" MEANS THE PHYSICIAN WHO HAS PRIMARY RESPONSI- 8 BILITY FOR THE CARE OF THE PATIENT AND TREATMENT OF THE PATIENT'S TERMI- 9 NAL DISEASE. 10 3. "CAPABLE" MEANS THAT IN THE OPINION OF A COURT OR IN THE OPINION OF 11 THE PATIENT'S ATTENDING PHYSICIAN OR CONSULTING PHYSICIAN, PSYCHIATRIST 12 OR PSYCHOLOGIST, A PATIENT HAS THE ABILITY TO MAKE AND COMMUNICATE 13 HEALTH CARE DECISIONS TO HEALTH CARE PROVIDERS, INCLUDING COMMUNICATION 14 THROUGH PERSONS FAMILIAR WITH THE PATIENT'S MANNER OF COMMUNICATING IF 15 THOSE PERSONS ARE AVAILABLE. 16 4. "CONSULTING PHYSICIAN" MEANS A PHYSICIAN WHO IS QUALIFIED BY 17 SPECIALTY OR EXPERIENCE TO MAKE A PROFESSIONAL DIAGNOSIS AND PROGNOSIS 18 REGARDING THE PATIENT'S DISEASE. 19 5. "COUNSELING" MEANS ONE OR MORE CONSULTATIONS AS NECESSARY BETWEEN A 20 STATE LICENSED PSYCHIATRIST OR PSYCHOLOGIST AND A PATIENT FOR THE 21 PURPOSE OF DETERMINING THAT THE PATIENT IS CAPABLE AND NOT SUFFERING 22 FROM A PSYCHIATRIC OR PSYCHOLOGICAL DISORDER OR DEPRESSION CAUSING 23 IMPAIRED JUDGMENT. 24 6. "HEALTH CARE PROVIDER" MEANS A PERSON LICENSED, CERTIFIED OR OTHER- 25 WISE AUTHORIZED OR PERMITTED BY THE LAWS OF THIS STATE TO ADMINISTER 26 HEALTH CARE OR DISPENSE MEDICATION IN THE ORDINARY COURSE OF BUSINESS OR 27 PRACTICE OF A PROFESSION, AND INCLUDES A HEALTH CARE FACILITY. 28 7. "INFORMED DECISION" MEANS A DECISION BY A QUALIFIED PATIENT, TO 29 REQUEST AND OBTAIN A PRESCRIPTION TO END HIS OR HER LIFE IN A HUMANE AND 30 DIGNIFIED MANNER, THAT IS BASED ON AN APPRECIATION OF THE RELEVANT FACTS 31 AND AFTER BEING FULLY INFORMED BY THE ATTENDING PHYSICIAN OF: 32 (A) HIS OR HER MEDICAL DIAGNOSIS; 33 (B) HIS OR HER PROGNOSIS; 34 (C) THE POTENTIAL RISKS ASSOCIATED WITH TAKING THE MEDICATION TO BE 35 PRESCRIBED; 36 (D) THE PROBABLE RESULT OF TAKING THE MEDICATION TO BE PRESCRIBED; AND 37 (E) THE FEASIBLE ALTERNATIVES, INCLUDING, BUT NOT LIMITED TO, COMFORT 38 CARE, HOSPICE CARE AND PAIN CONTROL. 39 8. "MEDICALLY CONFIRMED" MEANS THE MEDICAL OPINION OF THE ATTENDING 40 PHYSICIAN HAS BEEN CONFIRMED BY A CONSULTING PHYSICIAN WHO HAS EXAMINED 41 THE PATIENT AND THE PATIENT'S RELEVANT MEDICAL RECORDS. 42 9. "PATIENT" MEANS A PERSON WHO IS UNDER THE CARE OF A PHYSICIAN. 43 10. "PHYSICIAN" MEANS A DOCTOR OF MEDICINE OR OSTEOPATHY LICENSED TO 44 PRACTICE MEDICINE BY THE STATE BOARD FOR MEDICINE PURSUANT TO ARTICLE 45 ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW. 46 11. "QUALIFIED PATIENT" MEANS A CAPABLE ADULT WHO IS A RESIDENT OF 47 THIS STATE AND HAS SATISFIED THE REQUIREMENTS OF THIS ARTICLE IN ORDER 48 TO OBTAIN A PRESCRIPTION FOR MEDICATION TO END HIS OR HER LIFE IN A 49 HUMANE AND DIGNIFIED MANNER. 50 12. "TERMINAL DISEASE" MEANS AN INCURABLE AND IRREVERSIBLE DISEASE 51 THAT HAS BEEN MEDICALLY CONFIRMED AND WILL, WITHIN REASONABLE MEDICAL 52 JUDGMENT, PRODUCE DEATH WITHIN SIX MONTHS. 53 S 2899-E. WRITTEN REQUEST FOR MEDICATION. 1. AN ADULT WHO IS CAPABLE, 54 IS A RESIDENT OF THIS STATE AND HAS BEEN DETERMINED BY THE ATTENDING 55 PHYSICIAN AND CONSULTING PHYSICIAN TO BE SUFFERING FROM A TERMINAL 56 DISEASE, AND WHO HAS VOLUNTARILY EXPRESSED HIS OR HER WISH TO DIE, MAY A. 9360 3 1 MAKE A WRITTEN REQUEST FOR MEDICATION FOR THE PURPOSE OF ENDING HIS OR 2 HER LIFE IN A HUMANE AND DIGNIFIED MANNER IN ACCORDANCE WITH THE 3 PROVISIONS OF THIS ARTICLE. 4 2. NO PERSON SHALL QUALIFY UNDER THE PROVISIONS OF THIS ARTICLE SOLELY 5 BECAUSE OF AGE OR DISABILITY. 6 S 2899-F. FORM OF THE WRITTEN REQUEST. 1. A VALID REQUEST FOR MEDICA- 7 TION UNDER THE PROVISIONS OF THIS ARTICLE SHALL BE IN SUBSTANTIALLY THE 8 FORM DESCRIBED IN SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-X OF THIS 9 ARTICLE SIGNED AND DATED BY THE PATIENT AND WITNESSED BY AT LEAST TWO 10 INDIVIDUALS WHO, IN THE PRESENCE OF THE PATIENT, ATTEST THAT TO THE BEST 11 OF THEIR KNOWLEDGE AND BELIEF THE PATIENT IS CAPABLE, ACTING VOLUNTAR- 12 ILY, AND IS NOT BEING COERCED TO SIGN THE REQUEST. 13 2. ONE OF THE WITNESSES SHALL BE A PERSON WHO IS NOT: 14 (A) A RELATIVE OF THE PATIENT BY BLOOD, MARRIAGE OR ADOPTION; 15 (B) A PERSON WHO AT THE TIME THE REQUEST IS SIGNED WOULD BE ENTITLED 16 TO ANY PORTION OF THE ESTATE OF THE QUALIFIED PATIENT UPON DEATH UNDER 17 ANY WILL OR BY OPERATION OF LAW; OR 18 (C) AN OWNER, OPERATOR OR EMPLOYEE OF A HEALTH CARE FACILITY WHERE THE 19 QUALIFIED PATIENT IS RECEIVING MEDICAL TREATMENT OR IS A RESIDENT. 20 3. THE PATIENT'S ATTENDING PHYSICIAN AT THE TIME THE REQUEST IS SIGNED 21 SHALL NOT BE A WITNESS. 22 4. IF THE PATIENT IS A PATIENT IN A LONG TERM CARE FACILITY AT THE 23 TIME THE WRITTEN REQUEST IS MADE, ONE OF THE WITNESSES SHALL BE AN INDI- 24 VIDUAL DESIGNATED BY THE FACILITY. 25 S 2899-G. ATTENDING PHYSICIAN RESPONSIBILITIES. 1. THE ATTENDING 26 PHYSICIAN SHALL: 27 (A) MAKE THE INITIAL DETERMINATION OF WHETHER A PATIENT HAS A TERMINAL 28 DISEASE, IS CAPABLE, AND HAS MADE THE REQUEST VOLUNTARILY; 29 (B) REQUEST THAT THE PATIENT DEMONSTRATE NEW YORK STATE RESIDENCY; 30 (C) TO ENSURE THAT THE PATIENT IS MAKING AN INFORMED DECISION, INFORM 31 THE PATIENT OF: 32 (I) HIS OR HER MEDICAL DIAGNOSIS; 33 (II) HIS OR HER PROGNOSIS; 34 (III) THE POTENTIAL RISKS ASSOCIATED WITH TAKING THE MEDICATION TO BE 35 PRESCRIBED; 36 (IV) THE PROBABLY RESULT OF TAKING THE MEDICATION TO BE PRESCRIBED; 37 AND 38 (V) THE FEASIBLE ALTERNATIVES, INCLUDING, BUT NOT LIMITED TO, COMFORT 39 CARE, HOSPICE CARE AND PAIN CONTROL; 40 (D) REFER THE PATIENT TO A CONSULTING PHYSICIAN FOR MEDICAL CONFIRMA- 41 TION OF THE DIAGNOSIS, AND FOR A DETERMINATION THAT THE PATIENT IS CAPA- 42 BLE AND ACTING VOLUNTARILY; 43 (E) REFER THE PATIENT FOR COUNSELING IF APPROPRIATE PURSUANT TO 44 SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-I OF THIS ARTICLE; 45 (F) RECOMMEND THAT THE PATIENT NOTIFY NEXT OF KIN; 46 (G) COUNSEL THE PATIENT ABOUT THE IMPORTANCE OF HAVING ANOTHER PERSON 47 PRESENT WHEN THE PATIENT TAKES THE MEDICATION PRESCRIBED PURSUANT TO THE 48 PROVISIONS OF THIS ARTICLE AND OF NOT TAKING THE MEDICATION IN A PUBLIC 49 PLACE; 50 (H) INFORM THE PATIENT THAT HE OR SHE HAS AN OPPORTUNITY TO RESCIND 51 THE REQUEST AT ANY TIME AND IN ANY MANNER, AND OFFER THE PATIENT AN 52 OPPORTUNITY TO RESCIND AT THE END OF THE FIFTEEN DAY WAITING PERIOD 53 PURSUANT TO SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-L OF THIS ARTICLE; 54 (I) VERIFY, IMMEDIATELY PRIOR TO WRITING THE PRESCRIPTION FOR MEDICA- 55 TION UNDER THE PROVISIONS OF THIS ARTICLE, THAT THE PATIENT IS MAKING AN 56 INFORMED DECISION; A. 9360 4 1 (J) FULFILL THE MEDICAL RECORD DOCUMENTATION REQUIREMENTS OF SECTION 2 TWENTY-EIGHT HUNDRED NINETY-NINE-O OF THIS ARTICLE; 3 (K) ENSURE THAT ALL APPROPRIATE STEPS ARE CARRIED OUT IN ACCORDANCE 4 WITH THE PROVISIONS OF THIS ARTICLE PRIOR TO WRITING A PRESCRIPTION FOR 5 MEDICATION TO ENABLE A QUALIFIED PATIENT TO END HIS OR HER LIFE IN A 6 HUMANE AND DIGNIFIED MANNER; AND 7 (L) (I) DISPENSE MEDICATIONS DIRECTLY, INCLUDING ANCILLARY MEDICATIONS 8 INTENDED TO FACILITATE THE DESIRED EFFECT TO MINIMIZE THE PATIENT'S 9 DISCOMFORT, PROVIDED THE ATTENDING PHYSICIAN, HAS A CURRENT DRUG 10 ENFORCEMENT ADMINISTRATION CERTIFICATE AND COMPLIES WITH ANY APPLICABLE 11 RULE OR REGULATION; OR 12 (II) WITH THE PATIENT'S WRITTEN CONSENT: 13 (A) CONTACT A PHARMACIST AND INFORM THE PHARMACIST OF THE 14 PRESCRIPTION; AND 15 (B) DELIVER THE WRITTEN PRESCRIPTION PERSONALLY OR BY MAIL TO THE 16 PHARMACIST, WHO WILL DISPENSE THE MEDICATIONS TO EITHER THE PATIENT, THE 17 ATTENDING PHYSICIAN OR AN EXPRESSLY IDENTIFIED AGENT OF THE PATIENT. 18 2. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, THE ATTENDING PHYSICIAN 19 MAY SIGN THE PATIENT'S DEATH CERTIFICATE. 20 S 2899-H. CONSULTING PHYSICIAN CONFIRMATION. BEFORE A PATIENT IS QUAL- 21 IFIED UNDER THE PROVISIONS OF THIS ARTICLE, A CONSULTING PHYSICIAN SHALL 22 EXAMINE THE PATIENT AND HIS OR HER RELEVANT MEDICAL RECORDS AND CONFIRM, 23 IN WRITING, THE ATTENDING PHYSICIAN'S DIAGNOSIS THAT THE PATIENT IS 24 SUFFERING FROM A TERMINAL DISEASE, AND VERIFY THAT THE PATIENT IS CAPA- 25 BLE, IS ACTING VOLUNTARILY AND HAS MADE AN INFORMED DECISION. 26 S 2899-I. COUNSELING REFERRAL. IF IN THE OPINION OF THE ATTENDING 27 PHYSICIAN OR THE CONSULTING PHYSICIAN A PATIENT MAY BE SUFFERING FROM A 28 PSYCHIATRIC OR PSYCHOLOGICAL DISORDER OR DEPRESSION CAUSING IMPAIRED 29 JUDGMENT, EITHER PHYSICIAN SHALL REFER THE PATIENT FOR COUNSELING. NO 30 MEDICATION TO END A PATIENT'S LIFE IN A HUMANE AND DIGNIFIED MANNER 31 SHALL BE PRESCRIBED UNTIL THE PERSON PERFORMING THE COUNSELING DETER- 32 MINES THAT THE PATIENT IS NOT SUFFERING FROM A PSYCHIATRIC OR PSYCHOLOG- 33 ICAL DISORDER OR DEPRESSION CAUSING IMPAIRED JUDGMENT. 34 S 2899-J. INFORMED DECISION. NO PERSON SHALL RECEIVE A PRESCRIPTION 35 FOR MEDICATION TO END HIS OR HER LIFE IN A HUMANE AND DIGNIFIED MANNER 36 UNLESS HE OR SHE HAS MADE AN INFORMED DECISION AS DEFINED IN SUBDIVISION 37 SEVEN OF SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-D OF THIS ARTICLE. 38 IMMEDIATELY PRIOR TO WRITING A PRESCRIPTION FOR MEDICATION UNDER THE 39 PROVISIONS OF THIS ARTICLE, THE ATTENDING PHYSICIAN SHALL VERIFY THAT 40 THE PATIENT IS MAKING AN INFORMED DECISION. 41 S 2899-K. FAMILY NOTIFICATION. THE ATTENDING PHYSICIAN SHALL RECOMMEND 42 THAT THE PATIENT NOTIFY THE NEXT OF KIN OF HIS OR HER REQUEST FOR MEDI- 43 CATION PURSUANT TO THE PROVISIONS OF THIS ARTICLE. A PATIENT WHO 44 DECLINES OR IS UNABLE TO NOTIFY NEXT OF KIN SHALL NOT HAVE HIS OR HER 45 REQUEST DENIED FOR THAT REASON. 46 S 2899-L. WRITTEN AND ORAL REQUESTS. IN ORDER TO RECEIVE A 47 PRESCRIPTION FOR MEDICATION TO END HIS OR HER LIFE IN A HUMANE AND 48 DIGNIFIED MANNER, A QUALIFIED PATIENT SHALL HAVE MADE AN ORAL REQUEST 49 AND A WRITTEN REQUEST, AND REITERATE THE ORAL REQUEST TO HIS OR HER 50 ATTENDING PHYSICIAN NO LESS THAN FIFTEEN DAYS AFTER MAKING THE INITIAL 51 ORAL REQUEST. AT THE TIME THE QUALIFIED PATIENT MAKES HIS OR HER SECOND 52 ORAL REQUEST, THE ATTENDING PHYSICIAN SHALL OFFER THE PATIENT AN OPPOR- 53 TUNITY TO RESCIND THE REQUEST. 54 S 2899-M. RIGHT TO RESCIND REQUEST. A PATIENT MAY RESCIND HIS OR HER 55 REQUEST AT ANY TIME AND IN ANY MANNER WITHOUT REGARD TO HIS OR HER 56 MENTAL STATE. NO PRESCRIPTION FOR MEDICATION UNDER THE PROVISIONS OF A. 9360 5 1 THIS ARTICLE MAY BE WRITTEN WITHOUT THE ATTENDING PHYSICIAN OFFERING THE 2 QUALIFIED PATIENT AN OPPORTUNITY TO RESCIND THE REQUEST. 3 S 2899-N. WAITING PERIODS. NO LESS THAN FIFTEEN DAYS SHALL ELAPSE 4 BETWEEN THE PATIENT'S INITIAL ORAL REQUEST AND THE WRITING OF A 5 PRESCRIPTION UNDER THE PROVISIONS OF THIS ARTICLE. NO LESS THAN 6 FORTY-EIGHT HOURS SHALL ELAPSE BETWEEN THE PATIENT'S WRITTEN REQUEST AND 7 THE WRITING OF A PRESCRIPTION UNDER THE PROVISIONS OF THIS ARTICLE. 8 S 2899-O. MEDICAL RECORD DOCUMENTATION REQUIREMENTS. THE FOLLOWING 9 SHALL BE DOCUMENTED OR FILED IN THE PATIENT'S MEDICAL RECORD: 10 1. ALL ORAL REQUESTS BY A PATIENT FOR MEDICATION TO END HIS OR HER 11 LIFE IN A HUMANE AND DIGNIFIED MANNER; 12 2. ALL WRITTEN REQUESTS BY A PATIENT FOR MEDICATION TO END HIS OR HER 13 LIFE IN A HUMANE AND DIGNIFIED MANNER; 14 3. THE ATTENDING PHYSICIAN'S DIAGNOSIS AND PROGNOSIS, DETERMINATION 15 THAT THE PATIENT IS CAPABLE, ACTING VOLUNTARILY AND HAS MADE AN INFORMED 16 DECISION; 17 4. THE CONSULTING PHYSICIAN'S DIAGNOSIS AND PROGNOSIS, AND VERIFICA- 18 TION THAT THE PATIENT IS CAPABLE, ACTING VOLUNTARILY AND HAS MADE AN 19 INFORMED DECISION; 20 5. A REPORT OF THE OUTCOME AND DETERMINATIONS MADE DURING COUNSELING, 21 IF PERFORMED; 22 6. THE ATTENDING PHYSICIAN'S OFFER TO THE PATIENT TO RESCIND HIS OR 23 HER REQUEST AT THE TIME OF THE PATIENT'S SECOND ORAL REQUEST PURSUANT TO 24 SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-I OF THIS ARTICLE; AND 25 7. A NOTE BY THE ATTENDING PHYSICIAN INDICATING THAT ALL REQUIREMENTS 26 UNDER THE PROVISIONS OF THIS ARTICLE HAVE BEEN MET AND INDICATING THE 27 STEPS TAKEN TO CARRY OUT THE REQUEST, INCLUDING A NOTATION OF THE MEDI- 28 CATION PRESCRIBED. 29 S 2899-P. RESIDENCY REQUIREMENT. ONLY REQUESTS MADE BY NEW YORK STATE 30 RESIDENTS UNDER THE PROVISIONS OF THIS ARTICLE SHALL BE GRANTED. FACTORS 31 DEMONSTRATING NEW YORK STATE RESIDENCY SHALL INCLUDE BUT SHALL NOT BE 32 LIMITED TO: 33 1. POSSESSION OF A NEW YORK STATE DRIVER'S LICENSE; 34 2. REGISTRATION TO VOTE IN NEW YORK STATE; 35 3. EVIDENCE THAT THE PERSON OWNS OR LEASES PROPERTY IN NEW YORK STATE; 36 OR 37 4. FILING OF A NEW YORK STATE TAX RETURN FOR THE MOST RECENT TAX YEAR. 38 S 2899-Q. REPORTING REQUIREMENTS. 1. (A) THE STATE BOARD FOR MEDICINE 39 SHALL ANNUALLY REVIEW A SAMPLE OF RECORDS MAINTAINED PURSUANT TO THE 40 PROVISIONS OF THIS ARTICLE. 41 (B) THE STATE BOARD FOR MEDICINE SHALL REQUIRE ANY HEALTH CARE PROVID- 42 ER UPON DISPENSING MEDICATION PURSUANT TO THE PROVISIONS OF THIS ARTICLE 43 TO FILE A COPY OF THE DISPENSING RECORD WITH THE STATE BOARD FOR MEDI- 44 CINE. 45 2. THE STATE BOARD FOR MEDICINE SHALL MAKE RULES TO FACILITATE THE 46 COLLECTION OF INFORMATION REGARDING COMPLIANCE WITH THE PROVISIONS OF 47 THIS ARTICLE. EXCEPT AS OTHERWISE REQUIRED BY LAW, THE INFORMATION 48 COLLECTED SHALL NOT BE A PUBLIC RECORD AND MAY NOT BE MADE AVAILABLE FOR 49 INSPECTION BY THE PUBLIC. 50 3. THE STATE BOARD FOR MEDICINE SHALL GENERATE AND MAKE AVAILABLE TO 51 THE PUBLIC AN ANNUAL STATISTICAL REPORT OF INFORMATION COLLECTED UNDER 52 SUBDIVISION TWO OF THIS SECTION. 53 S 2899-R. EFFECT ON CONSTRUCTION OF WILLS, CONTRACTS AND STATUTES. 1. 54 NO PROVISION IN A CONTRACT, WILL OR OTHER AGREEMENT, WHETHER WRITTEN OR 55 ORAL, TO THE EXTENT THE PROVISION WOULD AFFECT WHETHER A PERSON MAY MAKE A. 9360 6 1 OR RESCIND A REQUEST FOR MEDICATION TO END HIS OR HER LIFE IN A HUMANE 2 AND DIGNIFIED MANNER, SHALL BE VALID. 3 2. NO OBLIGATION OWING UNDER ANY CURRENTLY EXISTING CONTRACT SHALL BE 4 CONDITIONED OR AFFECTED BY THE MAKING OR RESCINDING OF A REQUEST, BY A 5 PERSON, FOR MEDICATION TO END HIS OR HER LIFE IN A HUMANE AND DIGNIFIED 6 MANNER. 7 S 2899-S. INSURANCE OR ANNUITY POLICIES. THE SALE, PROCUREMENT, OR 8 ISSUANCE OF ANY LIFE, HEALTH, OR ACCIDENT INSURANCE OR ANNUITY POLICY OR 9 THE RATE CHARGED FOR ANY POLICY SHALL NOT BE CONDITIONED UPON OR 10 AFFECTED BY THE MAKING OR RESCINDING OF A REQUEST, BY A PERSON, FOR 11 MEDICATION TO END HIS OR HER LIFE IN A HUMANE AND DIGNIFIED MANNER. 12 NEITHER SHALL A QUALIFIED PATIENT'S ACT OF INGESTING MEDICATION TO END 13 HIS OR HER LIFE IN A HUMANE AND DIGNIFIED MANNER HAVE AN EFFECT UPON A 14 LIFE, HEALTH, OR ACCIDENT INSURANCE OR ANNUITY POLICY. 15 S 2899-T. CONSTRUCTION. THE PROVISIONS OF THIS ARTICLE SHALL NOT BE 16 CONSTRUED TO AUTHORIZE A PHYSICIAN OR ANY OTHER PERSON TO END A 17 PATIENT'S LIFE BY LETHAL INJECTION, MERCY KILLING OR ACTIVE EUTHANASIA. 18 ACTIONS TAKEN IN ACCORDANCE WITH THE PROVISIONS OF THIS ARTICLE SHALL 19 NOT, FOR ANY PURPOSE, CONSTITUTE SUICIDE, ASSISTED SUICIDE, MERCY KILL- 20 ING OR HOMICIDE, UNDER THE LAW. 21 S 2899-U. IMMUNITIES; BASIS FOR PROHIBITING HEALTH CARE PROVIDER FROM 22 PARTICIPATION; NOTIFICATION; PERMISSIBLE SANCTIONS. 1. NO PERSON SHALL 23 BE SUBJECT TO CIVIL OR CRIMINAL LIABILITY OR PROFESSIONAL DISCIPLINARY 24 ACTION FOR PARTICIPATING IN GOOD FAITH COMPLIANCE WITH THE PROVISIONS OF 25 THIS ARTICLE. THIS INCLUDES BEING PRESENT WHEN A QUALIFIED PATIENT TAKES 26 THE PRESCRIBED MEDICATION TO END HIS OR HER LIFE IN A HUMANE AND DIGNI- 27 FIED MANNER. 28 2. NO PROFESSIONAL ORGANIZATION OR ASSOCIATION, OR HEALTH CARE PROVID- 29 ER, MAY SUBJECT A PERSON TO CENSURE, DISCIPLINE, SUSPENSION, LOSS OF 30 LICENSE, LOSS OF PRIVILEGES, LOSS OF MEMBERSHIP OR OTHER PENALTY FOR 31 PARTICIPATING OR REFUSING TO PARTICIPATE IN GOOD FAITH COMPLIANCE WITH 32 THE PROVISIONS OF THIS ARTICLE. 33 3. NO REQUEST BY A PATIENT FOR OR PROVISION BY AN ATTENDING PHYSICIAN 34 OF MEDICATION IN GOOD FAITH COMPLIANCE WITH THE PROVISIONS OF THIS ARTI- 35 CLE SHALL CONSTITUTE NEGLECT FOR ANY PURPOSE OF LAW OR PROVIDE THE SOLE 36 BASIS FOR THE APPOINTMENT OF A GUARDIAN OR CONSERVATOR. 37 4. NO HEALTH CARE PROVIDER SHALL BE UNDER ANY DUTY, WHETHER BY 38 CONTRACT, BY STATUTE OR BY ANY OTHER LEGAL REQUIREMENT TO PARTICIPATE IN 39 THE PROVISION TO A QUALIFIED PATIENT OF MEDICATION TO END HIS OR HER 40 LIFE IN A HUMANE AND DIGNIFIED MANNER. IF A HEALTH CARE PROVIDER IS 41 UNABLE OR UNWILLING TO CARRY OUT A PATIENT'S REQUEST UNDER THE 42 PROVISIONS OF THIS ARTICLE, AND THE PATIENT TRANSFERS HIS OR HER CARE TO 43 A NEW HEALTH CARE PROVIDER, THE PRIOR HEALTH CARE PROVIDER SHALL TRANS- 44 FER, UPON REQUEST, A COPY OF THE PATIENT'S RELEVANT MEDICAL RECORDS TO 45 THE NEW HEALTH CARE PROVIDER. 46 5. (A) NOTWITHSTANDING ANY OTHER PROVISION OF LAW, A HEALTH CARE 47 PROVIDER MAY PROHIBIT ANOTHER HEALTH CARE PROVIDER FROM PARTICIPATING IN 48 THE PROVISIONS OF THIS ARTICLE ON THE PREMISES OF THE PROHIBITING 49 PROVIDER IF THE PROHIBITING PROVIDER HAS NOTIFIED THE HEALTH CARE 50 PROVIDER OF THE PROHIBITING PROVIDER'S POLICY REGARDING PARTICIPATING IN 51 THE PROVISIONS OF THIS ARTICLE. NOTHING IN THIS SUBDIVISION PREVENTS A 52 HEALTH CARE PROVIDER FROM PROVIDING HEALTH CARE SERVICES TO A PATIENT 53 THAT DO NOT CONSTITUTE PARTICIPATION IN THE PROVISIONS OF THIS ARTICLE. 54 (B) NOTWITHSTANDING THE PROVISIONS OF SUBDIVISIONS ONE, TWO, THREE AND 55 FOUR OF THIS SECTION, A HEALTH CARE PROVIDER MAY SUBJECT ANOTHER HEALTH 56 CARE PROVIDER TO THE SANCTIONS STATED IN THIS SUBDIVISION IF THE SANC- A. 9360 7 1 TIONING HEALTH CARE PROVIDER HAS NOTIFIED THE SANCTIONED PROVIDER PRIOR 2 TO PARTICIPATION IN THE PROVISIONS OF THIS ARTICLE THAT IT PROHIBITS 3 PARTICIPATION IN THE PROVISIONS OF THIS ARTICLE. 4 (I) LOSS OF PRIVILEGES, LOSS OF MEMBERSHIP OR OTHER SANCTION PROVIDED 5 PURSUANT TO THE MEDICAL STAFF BYLAWS, POLICIES AND PROCEDURES OF THE 6 SANCTIONING HEALTH CARE PROVIDER IF THE SANCTIONED PROVIDER IS A MEMBER 7 OF THE SANCTIONING PROVIDER'S MEDICAL STAFF AND PARTICIPATES IN THE 8 PROVISIONS OF THIS ARTICLE WHILE ON THE HEALTH CARE FACILITY PREMISES, 9 OF THE SANCTIONING HEALTH CARE PROVIDER, BUT NOT INCLUDING THE PRIVATE 10 MEDICAL OFFICE OF A PHYSICIAN OR OTHER PROVIDER; 11 (II) TERMINATION OF LEASE OR OTHER PROPERTY CONTRACT OR OTHER NONMONE- 12 TARY REMEDIES PROVIDED BY LEASE CONTRACT, NOT INCLUDING LOSS OR 13 RESTRICTION OF MEDICAL STAFF PRIVILEGES OR EXCLUSION FROM A PROVIDER 14 PANEL, IF THE SANCTIONED PROVIDER PARTICIPATES IN THE PROVISIONS OF THIS 15 ARTICLE WHILE ON THE PREMISES OF THE SANCTIONING HEALTH CARE PROVIDER OR 16 ON PROPERTY THAT IS OWNED BY OR UNDER THE DIRECT CONTROL OF THE SANC- 17 TIONING HEALTH CARE PROVIDER; OR 18 (III) TERMINATION OF CONTRACT OR OTHER NONMONETARY REMEDIES PROVIDED 19 BY CONTRACT IF THE SANCTIONED PROVIDER PARTICIPATES IN THE PROVISIONS OF 20 THIS ARTICLE WHILE ACTING IN THE COURSE AND SCOPE OF THE SANCTIONED 21 PROVIDER'S CAPACITY AS AN EMPLOYEE OR INDEPENDENT CONTRACTOR OF THE 22 SANCTIONING HEALTH CARE PROVIDER. NOTHING IN THIS PARAGRAPH SHALL BE 23 CONSTRUED TO PREVENT: 24 (A) A HEALTH CARE PROVIDER FROM PARTICIPATING IN THE PROVISIONS OF 25 THIS ARTICLE WHILE ACTING OUTSIDE THE COURSE AND SCOPE OF THE PROVIDER'S 26 CAPACITY AS AN EMPLOYEE OR INDEPENDENT CONTRACTOR; OR 27 (B) A PATIENT FROM CONTRACTING WITH HIS OR HER ATTENDING PHYSICIAN AND 28 CONSULTING PHYSICIAN TO ACT OUTSIDE THE COURSE AND SCOPE OF THE PROVID- 29 ER'S CAPACITY AS AN EMPLOYEE OR INDEPENDENT CONTRACTOR OF THE SANCTION- 30 ING HEALTH CARE PROVIDER. 31 (C) A HEALTH CARE PROVIDER THAT IMPOSES SANCTIONS PURSUANT TO PARA- 32 GRAPH (B) OF THIS SUBDIVISION MUST FOLLOW ALL DUE PROCESS AND OTHER 33 PROCEDURES THE SANCTIONING HEALTH CARE PROVIDER MAY HAVE THAT ARE 34 RELATED TO THE IMPOSITION OF SANCTIONS ON ANOTHER HEALTH CARE PROVIDER. 35 (D) FOR PURPOSES OF THIS SUBDIVISION: 36 (I) "NOTIFY" MEANS A SEPARATE STATEMENT IN WRITING TO THE HEALTH CARE 37 PROVIDER SPECIFICALLY INFORMING THE HEALTH CARE PROVIDER PRIOR TO THE 38 PROVIDER'S PARTICIPATION IN THE PROVISIONS OF THIS ARTICLE OF THE SANC- 39 TIONING HEALTH CARE PROVIDER'S POLICY ABOUT PARTICIPATION IN ACTIVITIES 40 COVERED BY THE PROVISIONS OF THIS ARTICLE. 41 (II) "PARTICIPATE IN DEATH WITH DIGNITY ACT" MEANS TO PERFORM THE 42 DUTIES OF AN ATTENDING PHYSICIAN PURSUANT TO SECTION TWENTY-EIGHT 43 HUNDRED NINETY-NINE-G OF THIS ARTICLE; THE CONSULTING PHYSICIAN FUNCTION 44 PURSUANT TO SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-H OF THIS ARTICLE, 45 OR THE COUNSELING FUNCTION PURSUANT TO SECTION TWENTY-EIGHT HUNDRED 46 NINETY-NINE-I OF THIS ARTICLE. "PARTICIPATE IN DEATH WITH DIGNITY ACT" 47 DOES NOT INCLUDE: 48 (A) MAKING AN INITIAL DETERMINATION THAT A PATIENT HAS A TERMINAL 49 DISEASE AND INFORMING THE PATIENT OF THE MEDICAL PROGNOSIS; 50 (B) PROVIDING INFORMATION ABOUT THE DEATH WITH DIGNITY ACT TO A 51 PATIENT UPON THE REQUEST OF THE PATIENT; 52 (C) PROVIDING A PATIENT, UPON THE REQUEST OF THE PATIENT, WITH A 53 REFERRAL TO ANOTHER PHYSICIAN; OR 54 (D) A PATIENT CONTRACTING WITH HIS OR HER ATTENDING PHYSICIAN AND 55 CONSULTING PHYSICIAN TO ACT OUTSIDE OF THE COURSE AND SCOPE OF THE A. 9360 8 1 PROVIDER'S CAPACITY AS AN EMPLOYEE OR INDEPENDENT CONTRACTOR OF THE 2 SANCTIONING HEALTH CARE PROVIDER. 3 6. ACTION TAKEN PURSUANT TO SECTION TWENTY-EIGHT HUNDRED 4 NINETY-NINE-F, TWENTY-EIGHT HUNDRED NINETY-NINE-G, TWENTY-EIGHT HUNDRED 5 NINETY-NINE-H, OR TWENTY-EIGHT HUNDRED NINETY-NINE-I SHALL NOT BE THE 6 SOLE BASIS FOR A REPORT OF UNPROFESSIONAL OR DISHONORABLE CONDUCT UNDER 7 ARTICLE ONE HUNDRED THIRTY-ONE-A OF THE EDUCATION LAW. 8 7. NO PROVISION OF THE PROVISIONS OF THIS ARTICLE SHALL BE CONSTRUED 9 TO ALLOW A LOWER STANDARD OF CARE FOR PATIENTS IN THE COMMUNITY WHERE 10 THE PATIENT IS TREATED OR A SIMILAR COMMUNITY. 11 S 2899-V. LIABILITIES. 1. A PERSON WHO WITHOUT AUTHORIZATION OF THE 12 PATIENT WILLFULLY ALTERS OR FORGES A REQUEST FOR MEDICATION OR CONCEALS 13 OR DESTROYS A RESCISSION OF THAT REQUEST WITH THE INTENT OR EFFECT OF 14 CAUSING THE PATIENT'S DEATH SHALL BE GUILTY OF A CLASS A FELONY. 15 2. A PERSON WHO COERCES OR EXERTS UNDUE INFLUENCE ON A PATIENT TO 16 REQUEST MEDICATION FOR THE PURPOSE OF ENDING THE PATIENT'S LIFE, OR TO 17 DESTROY A RESCISSION OF SUCH A REQUEST, SHALL BE GUILTY OF A CLASS A 18 FELONY. 19 3. NOTHING IN THE PROVISIONS OF THIS ARTICLE LIMITS FURTHER LIABILITY 20 FOR CIVIL DAMAGES RESULTING FROM OTHER NEGLIGENT CONDUCT OR INTENTIONAL 21 MISCONDUCT BY ANY PERSON. 22 4. THE PENALTIES IN THE PROVISIONS OF THIS ARTICLE DO NOT PRECLUDE 23 CRIMINAL PENALTIES APPLICABLE UNDER OTHER LAW FOR CONDUCT WHICH IS 24 INCONSISTENT WITH THE PROVISIONS OF THIS ARTICLE. 25 S 2899-W. CLAIMS BY GOVERNMENTAL ENTITY FOR COSTS INCURRED. ANY 26 GOVERNMENTAL ENTITY THAT INCURS COSTS RESULTING FROM A PERSON TERMINAT- 27 ING HIS OR HER LIFE PURSUANT TO THE PROVISIONS OF THIS ARTICLE IN A 28 PUBLIC PLACE SHALL HAVE A CLAIM AGAINST THE ESTATE OF THE PERSON TO 29 RECOVER SUCH COSTS AND REASONABLE ATTORNEY FEES RELATED TO ENFORCING THE 30 CLAIM. 31 S 2899-X. FORM OF THE REQUEST. A REQUEST FOR A MEDICATION AS AUTHOR- 32 IZED BY THE PROVISIONS OF THIS ARTICLE SHALL BE IN SUBSTANTIALLY THE 33 FOLLOWING FORM: 34 REQUEST FOR MEDICATION 35 TO END MY LIFE IN A HUMANE 36 AND DIGNIFIED MANNER 37 I, ______________________, AM AN ADULT OF SOUND MIND. 38 I AM SUFFERING FROM _____________, WHICH MY ATTENDING PHYSICIAN HAS 39 DETERMINED IS A TERMINAL DISEASE AND WHICH HAS BEEN MEDICALLY CONFIRMED 40 BY A CONSULTING PHYSICIAN. 41 I HAVE BEEN FULLY INFORMED OF MY DIAGNOSIS, PROGNOSIS, THE NATURE OF 42 MEDICATION TO BE PRESCRIBED AND POTENTIAL ASSOCIATED RISKS, THE EXPECTED 43 RESULT, AND THE FEASIBLE ALTERNATIVES, INCLUDING COMFORT CARE, HOSPICE 44 CARE AND PAIN CONTROL. 45 I REQUEST THAT MY ATTENDING PHYSICIAN PRESCRIBE MEDICATION THAT WILL END 46 MY LIFE IN A HUMANE AND DIGNIFIED MANNER. 47 INITIAL ONE: 48 ___ I HAVE INFORMED MY FAMILY OF MY DECISION AND TAKEN THEIR OPINIONS 49 INTO CONSIDERATION. 50 ___ I HAVE DECIDED NOT TO INFORM MY FAMILY OF MY DECISION. 51 ___ I HAVE NO FAMILY TO INFORM OF MY DECISION. 52 I UNDERSTAND THAT I HAVE THE RIGHT TO RESCIND THIS REQUEST AT ANY TIME. A. 9360 9 1 I UNDERSTAND THE FULL IMPORT OF THIS REQUEST AND I EXPECT TO DIE WHEN I 2 TAKE THE MEDICATION TO BE PRESCRIBED. I FURTHER UNDERSTAND THAT ALTHOUGH 3 MOST DEATHS OCCUR WITHIN THREE HOURS, MY DEATH MAY TAKE LONGER AND MY 4 PHYSICIAN HAS COUNSELED ME ABOUT THIS POSSIBILITY. 5 I MAKE THIS REQUEST VOLUNTARILY AND WITHOUT RESERVATION, AND I ACCEPT 6 FULL MORAL RESPONSIBILITY FOR MY ACTIONS. 7 SIGNED: __________ 8 DATED: __________ 9 DECLARATION OF WITNESSES 10 WE DECLARE THAT THE PERSON SIGNING THIS REQUEST: 11 (A) IS PERSONALLY KNOWN TO US OR HAS PROVIDED PROOF OF IDENTIFY; 12 (B) SIGNED THIS REQUEST IN OUR PRESENCE; 13 (C) APPEARS TO BE OF SOUND MIND AND NOT UNDER DURESS, FRAUD OR UNDUE 14 INFLUENCE; 15 (D) IS NOT A PATIENT FOR WHOM EITHER OF US IS ATTENDING PHYSICIAN. 16 __________ WITNESS 1/DATE 17 __________ WITNESS 2/DATE 18 NOTE: ONE WITNESS SHALL NOT BE A RELATIVE (BY BLOOD, MARRIAGE OR 19 ADOPTION) OF THE PERSON SIGNING THIS REQUEST, SHALL NOT BE ENTITLED TO 20 ANY PORTION OF THE PERSON'S ESTATE UPON DEATH AND SHALL NOT OWN, OPERATE 21 OR BE EMPLOYED AT A HEALTH CARE FACILITY WHERE THE PERSON IS A PATIENT 22 OR RESIDENT. IF THE PATIENT IS AN INPATIENT AT A HEALTH CARE FACILITY, 23 ONE OF THE WITNESSES SHALL BE AN INDIVIDUAL DESIGNATED BY THE FACILITY. 24 S 2899-Y. PENALTIES. 1. IT SHALL BE A CLASS A FELONY FOR A PERSON 25 WITHOUT AUTHORIZATION OF THE PRINCIPAL TO WILLFULLY ALTER, FORGE, 26 CONCEAL OR DESTROY AN INSTRUMENT, THE REINSTATEMENT OR REVOCATION OF AN 27 INSTRUMENT OR ANY OTHER EVIDENCE OR DOCUMENT REFLECTING THE PRINCIPAL'S 28 DESIRES AND INTERESTS, WITH THE INTENT AND EFFECT OF CAUSING A WITHHOLD- 29 ING OR WITHDRAWAL OF LIFE-SUSTAINING PROCEDURES OR OF ARTIFICIALLY 30 ADMINISTERED NUTRITION AND HYDRATION WHICH HASTENS THE DEATH OF THE 31 PRINCIPAL. 32 2. EXCEPT AS PROVIDED IN SUBDIVISION ONE OF THIS SECTION, IT SHALL BE 33 A CLASS A MISDEMEANOR FOR A PERSON WITHOUT AUTHORIZATION OF THE PRINCI- 34 PAL TO WILLFULLY ALTER, FORGE, CONCEAL OR DESTROY AN INSTRUMENT, THE 35 REINSTATEMENT OR REVOCATION OF AN INSTRUMENT, OR ANY OTHER EVIDENCE OR 36 DOCUMENT REFLECTING THE PRINCIPAL'S DESIRES AND INTERESTS WITH THE 37 INTENT OR EFFECT OF AFFECTING A HEALTH CARE DECISION. 38 S 2899-Z. SEVERABILITY. IF ANY CLAUSE, SENTENCE, PARAGRAPH, SECTION OR 39 PART OF THIS ARTICLE SHALL BE ADJUDGED BY ANY COURT OF COMPETENT JURIS- 40 DICTION TO BE INVALID, SUCH JUDGMENT SHALL NOT AFFECT, IMPAIR OR INVALI- 41 DATE THE REMAINDER THEREOF, BUT SHALL BE CONFINED IN ITS OPERATION TO 42 THE CLAUSE, SENTENCE, PARAGRAPH, SECTION OR PART THEREOF, DIRECTLY 43 INVOLVED IN THE CONTROVERSY IN WHICH SUCH JUDGEMENT SHALL HAVE BEEN 44 RENDERED. 45 S 3. This act shall take effect on the first of November next succeed- 46 ing the date on which it shall have become a law.