Bill Text: NY S02445 | 2023-2024 | General Assembly | Amended
Bill Title: 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.
Spectrum: Partisan Bill (Democrat 23-0)
Status: (Introduced) 2024-04-04 - PRINT NUMBER 2445B [S02445 Detail]
Download: New_York-2023-S02445-Amended.html
STATE OF NEW YORK ________________________________________________________________________ 2445--B 2023-2024 Regular Sessions IN SENATE January 20, 2023 ___________ Introduced by Sens. HOYLMAN-SIGAL, SCARCELLA-SPANTON, BRESLIN, BRISPORT, BROUK, COMRIE, COONEY, FERNANDEZ, GIANARIS, GONZALEZ, HARCKHAM, JACK- SON, KENNEDY, KRUEGER, MYRIE, RAMOS, RIVERA, RYAN, SALAZAR, SANDERS, SEPULVEDA, SERRANO, WEBB -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- recommitted to the Committee on Health in accord- ance with Senate Rule 6, sec. 8 -- 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. 18 2899-n. Relation to other laws and contracts. 19 2899-o. Safe disposal of unused medications. 20 2899-p. Death certificate. 21 2899-q. Reporting. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD02188-07-4S. 2445--B 2 1 2899-r. Penalties. 2 2899-s. Severability. 3 § 2899-d. Definitions. As used in this article: 4 1. "Adult" means an individual who is eighteen years of age or older. 5 2. "Attending physician" means the physician who has primary responsi- 6 bility for the care of the patient and treatment of the patient's termi- 7 nal illness or condition. 8 3. "Decision-making capacity" means the ability to understand and 9 appreciate the nature and consequences of health care decisions, includ- 10 ing the benefits and risks of and alternatives to any proposed health 11 care, including medical aid in dying, and to reach an informed decision. 12 4. "Consulting physician" means a physician who is qualified by 13 specialty or experience to make a professional diagnosis and prognosis 14 regarding a person's terminal illness or condition. 15 5. "Health care facility" means a general hospital, nursing home, or 16 residential health care facility as defined in section twenty-eight 17 hundred one of this chapter, or a hospice as defined in section four 18 thousand two of this chapter; provided that for the purposes of section 19 twenty eight hundred ninety-nine-m of this article, "hospice" shall 20 refer only to a facility providing in-patient hospice care or a hospice 21 residence. 22 6. "Health care provider" means a person licensed, certified, or 23 authorized by law to administer health care or dispense medication in 24 the ordinary course of business or practice of a profession. 25 7. "Informed decision" means a decision by a patient who is suffering 26 from a terminal illness or condition to request and obtain a 27 prescription for medication that the patient may self-administer to end 28 the patient's life that is based on an understanding and acknowledgment 29 of the relevant facts and that is made voluntarily, of the patient's own 30 volition and without coercion, after being fully informed of: 31 (a) the patient's medical diagnosis and prognosis; 32 (b) the potential risks associated with taking the medication to be 33 prescribed; 34 (c) the probable result of taking the medication to be prescribed; 35 (d) the possibility that the patient may choose not to obtain the 36 medication, or may obtain the medication but may decide not to self-ad- 37 minister it; and 38 (e) the feasible alternatives and appropriate treatment options, 39 including but not limited to palliative care and hospice care. 40 8. "Medical aid in dying" means the medical practice of a physician 41 prescribing medication to a qualified individual that the individual may 42 choose to self-administer to bring about death. 43 9. "Medically confirmed" means the medical opinion of the attending 44 physician that a patient has a terminal illness or condition and has 45 made an informed decision which has been confirmed by a consulting 46 physician who has examined the patient and the patient's relevant 47 medical records. 48 10. "Medication" means medication prescribed by a physician under this 49 article. 50 11. "Mental health professional" means a licensed physician, who is a 51 diplomate or eligible to be certified by a national board of psychiatry, 52 psychiatric nurse practitioner, or psychologist, licensed or certified 53 under the education law acting within such mental health professional's 54 scope of practice and who is qualified, by training and experience, 55 certification, or board certification or eligibility, to make a determi- 56 nation under section twenty-eight hundred ninety-nine-i of this article.S. 2445--B 3 1 12. "Palliative care" means health care treatment, including interdis- 2 ciplinary end-of-life care, and consultation with patients and family 3 members, to prevent or relieve pain and suffering and to enhance the 4 patient's quality of life, including hospice care under article forty of 5 this chapter. 6 13. "Patient" means a person who is eighteen years of age or older 7 under the care of a physician. 8 14. "Physician" means an individual licensed to practice medicine in 9 New York state. 10 15. "Qualified individual" means a patient with a terminal illness or 11 condition, who has decision-making capacity, has made an informed deci- 12 sion, and has satisfied the requirements of this article in order to 13 obtain a prescription for medication. 14 16. "Self-administer" means a qualified individual's affirmative, 15 conscious, and voluntary act to ingest medication under this article. 16 Self-administration does not include lethal injection or lethal 17 infusion. 18 17. "Terminal illness or condition" means an incurable and irrevers- 19 ible illness or condition that has been medically confirmed and will, 20 within reasonable medical judgment, produce death within six months. 21 18. "Third-party health care payer" has its ordinary meaning and 22 includes, but is not limited to, an insurer, organization or corporation 23 licensed or certified under article thirty-two, forty-three or forty- 24 seven of the insurance law, or article forty-four of the public health 25 law; or an entity such as a pharmacy benefits manager, fiscal adminis- 26 trator, or administrative services provider that participates in the 27 administration of a third-party health care payer system. 28 § 2899-e. Request process. 1. Oral and written request. A patient 29 wishing to request medication under this article shall make an oral 30 request and submit a written request to the patient's attending physi- 31 cian. 32 2. Making a written request. A patient may make a written request for 33 and consent to self-administer medication for the purpose of ending such 34 patient's life in accordance with this article if the patient: 35 (a) has been determined by the attending physician to have a terminal 36 illness or condition and which has been medically confirmed by a 37 consulting physician; and 38 (b) based on an informed decision, expresses voluntarily, of the 39 patient's own volition and without coercion the request for medication 40 to end such patient's life. 41 3. Written request signed and witnessed. (a) A written request for 42 medication under this article shall be signed and dated by the patient 43 and witnessed by at least two adults who, in the presence of the 44 patient, attest that to the best of the persons knowledge and belief the 45 patient has decision-making capacity, is acting voluntarily, is making 46 the request for medication of the patient's own volition and is not 47 being coerced to sign the request. The written request shall be in 48 substantially the form described in section twenty-eight hundred nine- 49 ty-nine-k of this article. 50 (b) Both witnesses shall be adults who are not: 51 (i) a relative of the patient by blood, marriage or adoption; 52 (ii) a person who at the time the request is signed would be entitled 53 to any portion of the estate of the patient upon death under any will or 54 by operation of law;S. 2445--B 4 1 (iii) an owner, operator, employee or independent contractor of a 2 health care facility where the patient is receiving treatment or is a 3 resident; 4 (iv) a domestic partner of the patient, as defined in subdivision 5 seven of section twenty-nine hundred ninety-four-a of this chapter; 6 (v) an agent under the patient's health care proxy as defined in 7 subdivision five of section twenty-nine hundred eighty of this chapter; 8 or 9 (vi) an agent acting under a power of attorney for the patient as 10 defined in section 5-1501 of the general obligations law. 11 (c) The attending physician, consulting physician and, if applicable, 12 the mental health professional who provides a decision-making capacity 13 determination of the patient under this article shall not be a witness. 14 4. No person shall qualify for medical aid in dying under this article 15 solely because of age or disability. 16 5. Requests for a medical aid-in-dying prescription must be made by 17 the qualified individual and may not be made by any other individual, 18 including the qualified individual's health care agent, or other agent 19 or surrogate, or via advance healthcare directive. 20 § 2899-f. Attending physician responsibilities. 1. The attending 21 physician shall examine the patient and the patient's relevant medical 22 records and: 23 (a) make a determination of whether a patient has a terminal illness 24 or condition, has decision-making capacity, has made an informed deci- 25 sion and has made the request voluntarily of the patient's own volition 26 and without coercion; 27 (b) inform the patient of the requirement under this article for 28 confirmation by a consulting physician, and refer the patient to a 29 consulting physician upon the patient's request; 30 (c) refer the patient to a mental health professional pursuant to 31 section twenty-eight hundred ninety-nine-i of this article if the 32 attending physician believes that the patient may lack decision-making 33 capacity to make an informed decision; 34 (d) provide information and counseling under section twenty-nine 35 hundred ninety-seven-c of this chapter; 36 (e) ensure that the patient is making an informed decision by discuss- 37 ing with the patient: (i) the patient's medical diagnosis and prognosis; 38 (ii) the potential risks associated with taking the medication to be 39 prescribed; (iii) the probable result of taking the medication to be 40 prescribed; (iv) the possibility that the patient may choose to obtain 41 the medication but not take it; (v) the feasible alternatives and appro- 42 priate treatment options, including but not limited to (1) information 43 and counseling regarding palliative and hospice care and end-of-life 44 options appropriate to the patient, including but not limited to: the 45 range of options appropriate to the patient; the prognosis, risks and 46 benefits of the various options; and the patient's legal rights to 47 comprehensive pain and symptom management at the end of life; and (2) 48 information regarding treatment options appropriate to the patient, 49 including the prognosis, risks and benefits of the various treatment 50 options; 51 (f) offer to refer the patient for other appropriate treatment 52 options, including but not limited to palliative care and hospice care; 53 (g) provide health literate and culturally appropriate educational 54 material regarding hospice and palliative care that has been prepared by 55 the department in consultation with representatives of hospice and 56 palliative care providers from all regions of New York state, and thatS. 2445--B 5 1 is available on the department's website for access and download, 2 provided, however, an otherwise eligible patient cannot be denied care 3 under this article if these materials are not developed by the effective 4 date of this article; 5 (h) discuss with the patient the importance of: 6 (i) having another person present when the patient takes the medica- 7 tion and the restriction that no person other than the patient may 8 administer the medication; 9 (ii) not taking the medication in a public place; and 10 (iii) informing the patient's family of the patient's decision to 11 request and take medication that will end the patient's life; a patient 12 who declines or is unable to notify family shall not have such patient's 13 request for medication denied for that reason; 14 (i) inform the patient that such patient may rescind the request for 15 medication at any time and in any manner; 16 (j) fulfill the medical record documentation requirements of section 17 twenty-eight hundred ninety-nine-j of this article; and 18 (k) ensure that all appropriate steps are carried out in accordance 19 with this article before writing a prescription for medication. 20 2. Upon receiving confirmation from a consulting physician under 21 section twenty-eight hundred ninety-nine-h of this article and subject 22 to section twenty-eight hundred ninety-nine-i of this article, the 23 attending physician who determines that the patient has a terminal 24 illness or condition, has decision-making capacity and has made a volun- 25 tary request for medication as provided in this article, may personally, 26 or by referral to another physician, prescribe or order appropriate 27 medication in accordance with the patient's request under this article, 28 and at the patient's request, facilitate the filling of the prescription 29 and delivery of the medication to the patient. 30 3. In accordance with the direction of the prescribing or ordering 31 physician and the consent of the patient, the patient may self-adminis- 32 ter the medication to themselves. A health care professional or other 33 person shall not administer the medication to the patient. 34 § 2899-g. Right to rescind request; requirement to offer opportunity 35 to rescind. 1. A patient may at any time rescind the request for medi- 36 cation under this article without regard to the patient's decision-mak- 37 ing capacity. 38 2. A prescription for medication may not be written without the 39 attending physician offering the qualified individual an opportunity to 40 rescind the request. 41 § 2899-h. Consulting physician responsibilities. Before a patient who 42 is requesting medication may receive a prescription for medication under 43 this article, a consulting physician must: 44 1. examine the patient and such patient's relevant medical records; 45 2. confirm, in writing, to the attending physician and the patient, 46 whether: (a) the patient has a terminal illness or condition; (b) the 47 patient is making an informed decision; (c) the patient has decision- 48 making capacity, or provide documentation that the consulting physician 49 has referred the patient for a determination under section twenty-eight 50 hundred ninety-nine-i of this article; and (d) the patient is acting 51 voluntarily, of the patient's own volition and without coercion. 52 § 2899-i. Referral to mental health professional. 1. If the attending 53 physician or the consulting physician determines that the patient may 54 lack decision-making capacity to make an informed decision due to a 55 condition, including, but not limited to, a psychiatric or psychological 56 disorder, or other condition causing impaired judgement, the attendingS. 2445--B 6 1 physician or consulting physician shall refer the patient to a mental 2 health professional for a determination of whether the patient has deci- 3 sion-making capacity to make an informed decision. The referring physi- 4 cian shall advise the patient that the report of the mental health 5 professional will be provided to the attending physician and the 6 consulting physician. 7 2. A mental health professional who evaluates a patient under this 8 section shall report, in writing, to the attending physician and the 9 consulting physician, the mental health professional's independent 10 conclusions about whether the patient has decision-making capacity to 11 make an informed decision, provided that if, at the time of the report, 12 the patient has not yet been referred to a consulting physician, then 13 upon referral the attending physician shall provide the consulting 14 physician with a copy of the mental health professional's report. If the 15 mental health professional determines that the patient lacks decision- 16 making capacity to make an informed decision, the patient shall not be 17 deemed a qualified individual, and the attending physician shall not 18 prescribe medication to the patient. 19 3. A determination made pursuant to this section that an adult patient 20 lacks decision-making capacity shall not be construed as a finding that 21 the patient lacks decision-making capacity for any other purpose. 22 § 2899-j. Medical record documentation requirements. An attending 23 physician shall document or file the following in the patient's medical 24 record: 25 1. the dates of all oral requests by the patient for medication under 26 this article; 27 2. the written request by the patient for medication under this arti- 28 cle, including the declaration of witnesses and interpreter's declara- 29 tion, if applicable; 30 3. the attending physician's diagnosis and prognosis, determination of 31 decision-making capacity, and determination that the patient is acting 32 voluntarily, of the patient's own volition and without coercion, and has 33 made an informed decision; 34 4. if applicable, written confirmation of decision-making capacity 35 under section twenty-eight hundred ninety-nine-i of this article; and 36 5. a note by the attending physician indicating that all requirements 37 under this article have been met and indicating the steps taken to carry 38 out the request, including a notation of the medication prescribed or 39 ordered. 40 § 2899-k. Form of written request and witness attestation. 1. A 41 request for medication under this article shall be in substantially the 42 following form: 43 REQUEST FOR MEDICATION TO END MY LIFE 44 I, _________________________________, am an adult who has decision- 45 making capacity, which means I understand and appreciate the nature and 46 consequences of health care decisions, including the benefits and risks 47 of and alternatives to any proposed health care, and to reach an 48 informed decision and to communicate health care decisions to a physi- 49 cian. 50 I have been diagnosed with (insert diagnosis), which my attending 51 physician has determined is a terminal illness or condition, which has 52 been medically confirmed by a consulting physician. 53 I have been fully informed of my diagnosis and prognosis, the nature 54 of the medication to be prescribed and potential associated risks, theS. 2445--B 7 1 expected result, and the feasible alternatives and treatment options 2 including but not limited to palliative care and hospice care. 3 I request that my attending physician prescribe medication that will 4 end my life if I choose to take it, and I authorize my attending physi- 5 cian to contact another physician or any pharmacist about my request. 6 INITIAL ONE: 7 ( ) I have informed or intend to inform one or more members of my 8 family of my decision. 9 ( ) I have decided not to inform any member of my family of my deci- 10 sion. 11 ( ) I have no family to inform of my decision. 12 I understand that I have the right to rescind this request or decline 13 to use the medication at any time. 14 I understand the importance of this request, and I expect to die if I 15 take the medication to be prescribed. I further understand that although 16 most deaths occur within three hours, my death may take longer, and my 17 attending physician has counseled me about this possibility. 18 I make this request voluntarily, of my own volition and without being 19 coerced, and I accept full responsibility for my actions. 20 Signed: __________________________ 21 Dated: ___________________________ 22 DECLARATION OF WITNESSES 23 I declare that the person signing this "Request for Medication to End 24 My Life": 25 (a) is personally known to me or has provided proof of identity; 26 (b) voluntarily signed the "Request for Medication to End My Life" in 27 my presence or acknowledged to me that the person signed it; and 28 (c) to the best of my knowledge and belief, has decision-making capac- 29 ity and is making the "Request for Medication to End My Life" voluntar- 30 ily, of the person's own volition and is not being coerced to sign the 31 "Request for Medication to End My Life". 32 I am not the attending physician or consulting physician of the person 33 signing the "Request for Medication to End My Life" or, if applicable, 34 the mental health professional who provides a decision-making capacity 35 determination of the person signing the "Request for Medication to End 36 My Life" at the time the "Request for Medication to End My Life" was 37 signed. 38 I further declare under penalty of perjury that the statements made 39 herein are true and correct and false statements made herein are punish- 40 able. 41 Witness 1, Date: 42 (Printed name) 43 (Address) 44 (Telephone number) 45 I further declare that I am not (i) related to the above-named patient 46 by blood, marriage or adoption, (ii) entitled at the time the patientS. 2445--B 8 1 signed the "Request for Medication to End My Life" to any portion of the 2 estate of the patient upon such patient's death under any will or by 3 operation of law, or (iii) an owner, operator, employee or independent 4 contractor of a health care facility where the patient is receiving 5 treatment or is a resident. 6 Witness 2, Date: 7 (Printed name) 8 (Address) 9 (Telephone number) 10 I further declare that I am not (i) related to the above-named patient 11 by blood, marriage or adoption, (ii) entitled at the time the patient 12 signed the "Request for Medication to End My Life" to any portion of the 13 estate of the patient upon such patient's death under any will or by 14 operation of law, or (iii) an owner, operator, employee or independent 15 contractor of a health care facility where the patient is receiving 16 treatment or is a resident. 17 2. (a) The "Request for Medication to End My Life" shall be written in 18 the same language as any conversations, consultations, or interpreted 19 conversations or consultations between a patient and at least one of the 20 patient's attending or consulting physicians. 21 (b) Notwithstanding paragraph (a) of this subdivision, the written 22 "Request for Medication to End My Life" may be prepared in English even 23 when the conversations or consultations or interpreted conversations or 24 consultations were conducted in a language other than English or with 25 auxiliary aids or hearing, speech or visual aids, if the English 26 language form includes an attached declaration by the interpreter of the 27 conversation or consultation, which shall be in substantially the 28 following form: 29 INTERPRETER'S DECLARATION 30 I, (insert name of interpreter), (mark as applicable): 31 ( ) for a patient whose conversations or consultations or interpreted 32 conversations or consultations were conducted in a language other than 33 English and the "Request for Medication to End My Life" is in English: I 34 declare that I am fluent in English and (insert target language). I have 35 the requisite language and interpreter skills to be able to interpret 36 effectively, accurately and impartially information shared and communi- 37 cations between the attending or consulting physician and (name of 38 patient). 39 I certify that on (insert date), at approximately (insert time), I 40 interpreted the communications and information conveyed between the 41 physician and (name of patient) as accurately and completely to the best 42 of my knowledge and ability and read the "Request for Medication to End 43 My Life" to (name of patient) in (insert target language). 44 (Name of patient) affirmed to me such patient's desire to sign the 45 "Request for Medication to End My Life" voluntarily, of (name of 46 patient)'s own volition and without coercion. 47 ( ) for a patient with a speech, hearing or vision disability: I 48 declare that I have the requisite language, reading and/or interpreter 49 skills to communicate with the patient and to be able to read and/orS. 2445--B 9 1 interpret effectively, accurately and impartially information shared and 2 communications that occurred on (insert date) between the attending or 3 consulting physician and (name of patient). 4 I certify that on (insert date), at approximately (insert time), I 5 read and/or interpreted the communications and information conveyed 6 between the physician and (name of patient) impartially and as accurate- 7 ly and completely to the best of my knowledge and ability and, where 8 needed for effective communication, read or interpreted the "Request for 9 Medication to End my Life" to (name of patient). 10 (Name of patient) affirmed to me such patient's desire to sign the 11 "Request for Medication to End My Life" voluntarily, of (name of 12 patient)'s own volition and without coercion. 13 I further declare under penalty of perjury that (i) the foregoing is 14 true and correct; (ii) I am not (A) related to (name of patient) by 15 blood, marriage or adoption, (B) entitled at the time (name of patient) 16 signed the "Request for Medication to End My Life" to any portion of the 17 estate of (name of patient) upon such patient's death under any will or 18 by operation of law, or (C) an owner, operator, employee or independent 19 contractor of a health care facility where (name of patient) is receiv- 20 ing treatment or is a resident, except that if I am an employee or inde- 21 pendent contractor at such health care facility, providing interpreter 22 services is part of my job description at such health care facility or I 23 have been trained to provide interpreter services and (name of patient) 24 requested that I provide interpreter services to such patient for the 25 purposes stated in this Declaration; and (iii) false statements made 26 herein are punishable. 27 Executed at (insert city, county and state) on this (insert day of 28 month) of (insert month), (insert year). 29 (Signature of Interpreter) 30 (Printed name of Interpreter) 31 (ID # or Agency Name) 32 (Address of Interpreter) 33 (Language Spoken by Interpreter) 34 (c) An interpreter whose services are provided under paragraph (b) of 35 this subdivision shall not (i) be related to the patient who signs the 36 "Request for Medication to End My Life" by blood, marriage or adoption, 37 (ii) be entitled at the time the "Request for Medication to End My Life" 38 is signed by the patient to any portion of the estate of the patient 39 upon death under any will or by operation of law, or (iii) be an owner, 40 operator, employee or independent contractor of a health care facility 41 where the patient is receiving treatment or is a resident; provided that 42 an employee or independent contractor whose job description at the 43 health care facility includes interpreter services or who is trained to 44 provide interpreter services and who has been requested by the patient 45 to serve as an interpreter under this article shall not be prohibited 46 from serving as an interpreter under this article. 47 § 2899-l. Protection and immunities. 1. A physician, pharmacist, other 48 health care provider or other person shall not be subject to civil, 49 administrative, or criminal liability or penalty or professional disci-S. 2445--B 10 1 plinary action by any government entity for taking any reasonable good- 2 faith action or refusing to act under this article, including, but not 3 limited to: (a) engaging in discussions with a patient relating to the 4 risks and benefits of end-of-life options in the circumstances described 5 in this article, (b) providing a patient, upon request, with a referral 6 to another health care provider, (c) being present when a qualified 7 individual self-administers medication, (d) refraining from acting to 8 prevent the qualified individual from self-administering such medica- 9 tion, or (e) refraining from acting to resuscitate the qualified indi- 10 vidual after the qualified individual self-administers such medication. 11 2. A health care provider or other person shall not be subject to 12 employment, credentialing, or contractual liability or penalty for any 13 reasonable good-faith action or refusing to act under this article, 14 including, but not limited to: 15 (a) engaging in discussions with a patient relating to the risks and 16 benefits of end-of-life options in the circumstances described in this 17 article; 18 (b) providing a patient, upon request, with a referral to another 19 health care provider; 20 (c) being present when a qualified individual self-administers medica- 21 tion; 22 (d) refraining from acting to prevent the qualified individual from 23 self-administering such medication; or 24 (e) refraining from acting to resuscitate the qualified individual 25 after the qualified individual self-administers such medication. Howev- 26 er, this subdivision does not bar a health care facility from acting 27 under paragraph (c) of subdivision two of section twenty-eight hundred 28 ninety-nine-m of this article. 29 3. Nothing in this section shall limit civil, administrative, or crim- 30 inal liability or penalty or any professional disciplinary action, or 31 employment, credentialing, or contractual liability or penalty for 32 negligence, recklessness or intentional misconduct. 33 § 2899-m. Permissible refusals and prohibitions. 1. (a) A physician, 34 nurse, pharmacist, other health care provider or other person shall not 35 be under any duty, by law or contract, to participate in the provision 36 of medication to a patient under this article. 37 (b) If a health care provider is unable or unwilling to participate in 38 the provision of medication to a patient under this article and the 39 patient transfers care to a new health care provider, the prior health 40 care provider shall transfer or arrange for the transfer, upon request, 41 of a copy of the patient's relevant medical records to the new health 42 care provider. 43 2. (a) A private health care facility may prohibit the prescribing, 44 dispensing, ordering or self-administering of medication under this 45 article while the patient is being treated in or while the patient is 46 residing in the health care facility if: 47 (i) the prescribing, dispensing, ordering or self-administering is 48 contrary to a formally adopted policy of the facility that is expressly 49 based on sincerely held religious beliefs or moral convictions central 50 to the facility's operating principles; and 51 (ii) the facility has informed the patient of such policy prior to 52 admission or as soon as reasonably possible. 53 (b) Where a facility has adopted a prohibition under this subdivision, 54 if a patient who wishes to use medication under this article requests, 55 the patient shall be transferred promptly to another health care facili- 56 ty that is reasonably accessible under the circumstances and willing toS. 2445--B 11 1 permit the prescribing, dispensing, ordering and self-administering of 2 medication under this article with respect to the patient. 3 (c) Where a health care facility has adopted a prohibition under this 4 subdivision, any health care provider or employee or independent 5 contractor of the facility who violates the prohibition may be subject 6 to sanctions otherwise available to the facility, provided the facility 7 has previously notified the health care provider, employee or independ- 8 ent contractor of the prohibition in writing. 9 § 2899-n. Relation to other laws and contracts. 1. (a) A patient who 10 requests medication under this article shall not, because of that 11 request, be considered to be a person who is suicidal, and self-adminis- 12 tering medication under this article shall not be deemed to be suicide, 13 for any purpose. 14 (b) Action taken in accordance with this article shall not be 15 construed for any purpose to constitute suicide, assisted suicide, 16 attempted suicide, promoting a suicide attempt, euthanasia, mercy kill- 17 ing, or homicide under the law, including as an accomplice or accessory 18 or otherwise. 19 2. (a) No provision in a contract, other agreement or testamentary 20 instrument, whether written or oral, to the extent the provision would 21 affect whether a person may make or rescind a request for medication or 22 take any other action under this article, shall be valid. 23 (b) No obligation owing under any contract, other agreement or testa- 24 mentary instrument shall be conditioned or affected by the making or 25 rescinding of a request by a person for medication or taking any other 26 action under this article. 27 3. (a) A person and such person's beneficiaries shall not be denied 28 benefits under a life insurance policy for actions taken in accordance 29 with this article. 30 (b) The sale, procurement or issuance of a life insurance or annuity 31 policy or third-party health care payer policy or coverage, or the rate 32 charged for a policy or coverage, shall not be conditioned upon or 33 affected by a patient making or rescinding a request for medication 34 under this article. 35 (c) No third-party health care payer may deny coverage for any service 36 or item that would otherwise be covered by the policy because the 37 patient has or has not chosen to request or use medication under this 38 article. 39 4. An insurer or third-party health care payer shall not provide any 40 information in communications made to a patient about the availability 41 of medication under this article absent a request by the patient or by 42 such patient's attending physician upon the request of such patient. Any 43 communication shall not include both the denial of coverage for treat- 44 ment and information as to the availability of medication under this 45 article. This subdivision does not bar the inclusion of information as 46 to the coverage of medication and professional services under this arti- 47 cle in information generally stating what is covered by a third-party 48 health care payer or provided in response to a request by the patient or 49 by such patient's attending physician upon the request of the patient. 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 deliverS. 2445--B 12 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, the 27 patient's family, and any health care provider acting in connection with 28 such 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.
