Bill Text: NY S03947 | 2019-2020 | General Assembly | Introduced


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 8-0)

Status: (Introduced) 2019-02-21 - REFERRED TO HEALTH [S03947 Detail]

Download: New_York-2019-S03947-Introduced.html


                STATE OF NEW YORK
        ________________________________________________________________________
                                          3947
                               2019-2020 Regular Sessions
                    IN SENATE
                                    February 21, 2019
                                       ___________
        Introduced  by Sens. SAVINO, RIVERA, HOYLMAN, KRUEGER, SEPULVEDA -- read
          twice and ordered printed, and when printed to  be  committed  to  the
          Committee on Health
        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.
    22          2899-r. Penalties.
    23          2899-s. Severability.
    24    § 2899-d. Definitions. As used in this article:
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00626-02-9

        S. 3947                             2
     1    1. "Adult" means an individual who is eighteen years of age or older.
     2    2. "Attending physician" means the physician who has primary responsi-
     3  bility for the care of the patient and treatment of the patient's termi-
     4  nal illness or condition.
     5    3.  "Capacity"  means  the  ability  to  understand and appreciate the
     6  nature and consequences of health care decisions, including the benefits
     7  and risks of and alternatives to any  proposed  health  care,  including
     8  medical aid in dying, and to reach an informed decision.
     9    4.    "Consulting  physician"  means  a  physician who is qualified by
    10  specialty or experience to make a professional diagnosis  and  prognosis
    11  regarding a person's terminal illness or condition.
    12    5.  "Health  care facility" means a general hospital, nursing home, or
    13  residential health care facility  as  defined  in  section  twenty-eight
    14  hundred  one  of  this  chapter, or a hospice as defined in section four
    15  thousand two of this chapter; provided that for the purposes of  section
    16  twenty  eight  hundred  ninety-nine-m  of  this article, "hospice" shall
    17  refer only to a facility providing in-patient hospice care or a  hospice
    18  residence.
    19    6.  "Health  care  provider"  means  a  person licensed, certified, or
    20  authorized by law to administer health care or  dispense  medication  in
    21  the ordinary course of business or practice of a profession.
    22    7.  "Informed decision" means a decision by a patient who is suffering
    23  from   a   terminal  illness  or  condition  to  request  and  obtain  a
    24  prescription for medication that the patient may self-administer to  end
    25  the  patient's life that is based on an understanding and acknowledgment
    26  of the relevant facts and that is made voluntarily, of the patient's own
    27  volition and without coercion, after being fully informed of:
    28    (a) the patient's medical diagnosis and prognosis;
    29    (b) the potential risks associated with taking the  medication  to  be
    30  prescribed;
    31    (c) the probable result of taking the medication to be prescribed;
    32    (d)  the  possibility  that  the  patient may choose not to obtain the
    33  medication, or may obtain the medication but may decide not to  self-ad-
    34  minister it; and
    35    (e)  the  feasible  alternatives  and  appropriate  treatment options,
    36  including but not limited to palliative care and hospice care.
    37    8. "Medical aid in dying" means the medical practice  of  a  physician
    38  prescribing medication to a qualified individual that the individual may
    39  choose to self-administer to bring about death.
    40    9.  "Medically  confirmed"  means the medical opinion of the attending
    41  physician that a patient has a terminal illness  or  condition  and  has
    42  made  an  informed  decision  which  has  been confirmed by a consulting
    43  physician who has  examined  the  patient  and  the  patient's  relevant
    44  medical records.
    45    10. "Medication" means medication prescribed by a physician under this
    46  article.
    47    11.  "Mental health professional" means a licensed physician, who is a
    48  diplomate or eligible to be certified by a national board of psychiatry,
    49  psychiatric nurse practitioner, or psychologist, licensed  or  certified
    50  under  the  education law acting within his or her scope of practice and
    51  who is qualified, by training and experience,  certification,  or  board
    52  certification  or  eligibility,  to  make  a determination under section
    53  twenty-eight hundred ninety-nine-i of this article.
    54    12. "Palliative care" means health care treatment, including interdis-
    55  ciplinary end-of-life care, and consultation with  patients  and  family
    56  members,  to  prevent  or  relieve pain and suffering and to enhance the

        S. 3947                             3
     1  patient's quality of life, including hospice care under article forty of
     2  this chapter.
     3    13.  "Patient"  means  a  person who is eighteen years of age or older
     4  under the care of a physician.
     5    14. "Physician" means an individual licensed to practice  medicine  in
     6  New York state.
     7    15.  "Qualified individual" means a patient with a terminal illness or
     8  condition, who has capacity, has made  an  informed  decision,  and  has
     9  satisfied  the  requirements  of  this  article  in  order  to  obtain a
    10  prescription for medication.
    11    16. "Self-administer"  means  a  qualified  individual's  affirmative,
    12  conscious, and voluntary act of using medication under this article.
    13    17.  "Terminal  illness or condition" means an incurable and irrevers-
    14  ible illness or condition that has been medically  confirmed  and  will,
    15  within reasonable medical judgment, produce death within six months.
    16    § 2899-e. Request  process.    1.  Oral and written request. A patient
    17  wishing to request medication under this  article  shall  make  an  oral
    18  request  and  submit a written request to the patient's attending physi-
    19  cian.
    20    2. Making a written request. A patient may make a written request  for
    21  and  consent to self-administer medication for the purpose of ending his
    22  or her life in accordance with this article if the patient:
    23    (a) has been determined by the attending physician to have a  terminal
    24  illness  or  condition  and  which  has  been  medically  confirmed by a
    25  consulting physician; and
    26    (b) based on an  informed  decision,  expresses  voluntarily,  of  the
    27  patient's  own  volition and without coercion the request for medication
    28  to end his or her life.
    29    3. Written request signed and witnessed. (a)  A  written  request  for
    30  medication  under  this article shall be signed and dated by the patient
    31  and witnessed by at least  two  adults  who,  in  the  presence  of  the
    32  patient,  attest that to the best of his or her knowledge and belief the
    33  patient has capacity, is acting voluntarily, is making the  request  for
    34  medication  of  his or her own volition and is not being coerced to sign
    35  the request. The written request shall  be  in  substantially  the  form
    36  described in section twenty-eight hundred ninety-nine-k of this article.
    37    (b) One of the witnesses shall be an adult who is not:
    38    (i) a relative of the patient by blood, marriage or adoption;
    39    (ii)  a person who at the time the request is signed would be entitled
    40  to any portion of the estate of the patient upon death under any will or
    41  by operation of law; or
    42    (iii) an owner, operator, employee  or  independent  contractor  of  a
    43  health  care  facility  where the patient is receiving treatment or is a
    44  resident.
    45    (c) The attending physician, consulting physician and, if  applicable,
    46  the  mental health professional who provides a capacity determination of
    47  the patient under this article shall not be a witness.
    48    4. No person shall qualify for medical aid in dying under this article
    49  solely because of age or disability.
    50    5. Requests for a medical aid-in-dying prescription must  be  made  by
    51  the  qualified  individual  and may not be made by any other individual,
    52  including the qualified individual's health care agent, or  other  agent
    53  or surrogate, or via advance healthcare directive.
    54    § 2899-f. Attending   physician  responsibilities.  1.  The  attending
    55  physician shall examine the patient and  his  or  her  relevant  medical
    56  records and:

        S. 3947                             4
     1    (a)  make  a determination of whether a patient has a terminal illness
     2  or condition, has capacity, has made an informed decision and  has  made
     3  the  request voluntarily of the patient's own volition and without coer-
     4  cion;
     5    (b)  inform  the  patient  of  the  requirement under this article for
     6  confirmation by a consulting physician,  and  refer  the  patient  to  a
     7  consulting physician upon the patient's request;
     8    (c)  refer  the  patient  to  a mental health professional pursuant to
     9  section twenty-eight  hundred  ninety-nine-i  of  this  article  if  the
    10  attending  physician believes that the patient may lack capacity to make
    11  an informed decision;
    12    (d) provide  information  and  counseling  under  section  twenty-nine
    13  hundred ninety-seven-c of this chapter;
    14    (e) ensure that the patient is making an informed decision by discuss-
    15  ing with the patient: (i) the patient's medical diagnosis and prognosis;
    16  (ii)  the  potential  risks  associated with taking the medication to be
    17  prescribed; (iii) the probable result of taking  the  medication  to  be
    18  prescribed;  (iv)  the possibility that the patient may choose to obtain
    19  the medication but not take it; (v) the feasible alternatives and appro-
    20  priate treatment options, including but not limited to  (1)  information
    21  and  counseling  regarding  palliative  and hospice care and end-of-life
    22  options appropriate to the patient, including but not  limited  to:  the
    23  range  of  options  appropriate to the patient; the prognosis, risks and
    24  benefits of the various options;  and  the  patient's  legal  rights  to
    25  comprehensive  pain  and  symptom management at the end of life; and (2)
    26  information regarding treatment  options  appropriate  to  the  patient,
    27  including  the  prognosis,  risks  and benefits of the various treatment
    28  options;
    29    (f) offer  to  refer  the  patient  for  other  appropriate  treatment
    30  options, including but not limited to palliative care and hospice care;
    31    (g) discuss with the patient the importance of:
    32    (i)  having  another person present when the patient takes the medica-
    33  tion and the restriction that no  person  other  than  the  patient  may
    34  administer the medication;
    35    (ii) not taking the medication in a public place; and
    36    (iii)  informing  the  patient's  family  of the patient's decision to
    37  request and take medication that will end the patient's life; a  patient
    38  who  declines  or  is  unable to notify family shall not have his or her
    39  request for medication denied for that reason;
    40    (h) inform the patient that he or she  may  rescind  the  request  for
    41  medication at any time and in any manner;
    42    (i)  fulfill  the medical record documentation requirements of section
    43  twenty-eight hundred ninety-nine-j of this article; and
    44    (j) ensure that all appropriate steps are carried  out  in  accordance
    45  with this article before writing a prescription for medication.
    46    2.  Upon  receiving  confirmation  from  a  consulting physician under
    47  section twenty-eight hundred ninety-nine-h of this article  and  subject
    48  to  section  twenty-eight  hundred  ninety-nine-i  of  this article, the
    49  attending physician who determines  that  the  patient  has  a  terminal
    50  illness  or condition, has capacity and has made a voluntary request for
    51  medication as provided in this article, may personally, or  by  referral
    52  to  another  physician,  prescribe  or  order  appropriate medication in
    53  accordance with the patient's request under this  article,  and  at  the
    54  patient's request, facilitate the filling of the prescription and deliv-
    55  ery of the medication to the patient.

        S. 3947                             5
     1    3.  In  accordance  with  the direction of the prescribing or ordering
     2  physician and the consent of the patient, the patient may  self-adminis-
     3  ter  the medication to himself or herself. A health care professional or
     4  other person shall not administer the medication to the patient.
     5    § 2899-g. Right  to  rescind request; requirement to offer opportunity
     6  to rescind.  1. A patient may at any time rescind his or her request for
     7  medication under this article without regard to the patient's capacity.
     8    2. A prescription for  medication  may  not  be  written  without  the
     9  attending  physician offering the qualified individual an opportunity to
    10  rescind the request.
    11    § 2899-h. Consulting physician responsibilities. Before a patient  who
    12  is requesting medication may receive a prescription for medication under
    13  this article, a consulting physician must:
    14    1. examine the patient and his or her relevant medical records;
    15    2.  confirm,  in  writing, to the attending physician and the patient,
    16  whether: (a) the patient has a terminal illness or  condition;  (b)  the
    17  patient is making an informed decision; (c) the patient has capacity, or
    18  provide  documentation  that  the  consulting physician has referred the
    19  patient for a determination under section twenty-eight  hundred  ninety-
    20  nine-i  of  this  article; and (d) the patient is acting voluntarily, of
    21  the patient's own volition and without coercion.
    22    § 2899-i. Referral to mental health professional. 1. If the  attending
    23  physician  or  the  consulting physician determines that the patient may
    24  lack capacity to make an informed decision due to a  condition,  includ-
    25  ing,  but  not  limited  to, a psychiatric or psychological disorder, or
    26  other condition causing impaired judgement, the attending  physician  or
    27  consulting  physician shall refer the patient to a mental health profes-
    28  sional for a determination of whether the patient has capacity  to  make
    29  an  informed  decision. The referring physician shall advise the patient
    30  that the report of the mental health professional will  be  provided  to
    31  the attending physician and the consulting physician.
    32    2.  A  mental  health  professional who evaluates a patient under this
    33  section shall report, in writing, to the  attending  physician  and  the
    34  consulting  physician,  his or her independent conclusions about whether
    35  the patient has capacity to make an informed decision, provided that if,
    36  at the time of the report, the patient has not yet been  referred  to  a
    37  consulting  physician,  then upon referral the attending physician shall
    38  provide the consulting physician  with  a  copy  of  the  mental  health
    39  professional's report. If the mental health professional determines that
    40  the  patient  lacks  capacity  to make an informed decision, the patient
    41  shall not be deemed a qualified individual, and the attending  physician
    42  shall not prescribe medication to the patient.
    43    3. A determination made pursuant to this section that an adult patient
    44  lacks  decision-making capacity shall not be construed as a finding that
    45  the patient lacks capacity for any other purpose.
    46    § 2899-j. Medical  record  documentation  requirements.  An  attending
    47  physician  shall document or file the following in the patient's medical
    48  record:
    49    1. the dates of all oral requests by the patient for medication  under
    50  this article;
    51    2.  the written request by the patient for medication under this arti-
    52  cle, including the declaration of witnesses and  interpreter's  declara-
    53  tion, if applicable;
    54    3. the attending physician's diagnosis and prognosis, determination of
    55  capacity,  and  determination that the patient is acting voluntarily, of

        S. 3947                             6
     1  the patient's own  volition  and  without  coercion,  and  has  made  an
     2  informed decision;
     3    4. if applicable, written confirmation of capacity under section twen-
     4  ty-eight hundred ninety-nine-i of this article; and
     5    5.  a note by the attending physician indicating that all requirements
     6  under this article have been met and indicating the steps taken to carry
     7  out the request, including a notation of the  medication  prescribed  or
     8  ordered.
     9    § 2899-k. Form  of  written  request  and  witness  attestation.  1. A
    10  request for medication under this article shall be in substantially  the
    11  following form:
    12                    REQUEST FOR MEDICATION TO END MY LIFE
    13    I,  _________________________________,  am  an adult who has capacity,
    14  which means I understand and appreciate the nature and  consequences  of
    15  health  care decisions, including the benefits and risks of and alterna-
    16  tives to any proposed health care, and to reach an informed decision and
    17  to communicate health care decisions to a physician.
    18    I have been diagnosed with ______________(insert diagnosis), which  my
    19  attending  physician  has determined is a terminal illness or condition,
    20  which has been medically confirmed by a consulting physician.
    21    I have been fully informed of my diagnosis and prognosis,  the  nature
    22  of  the  medication to be prescribed and potential associated risks, the
    23  expected result, and the feasible  alternatives  and  treatment  options
    24  including but not limited to palliative care and hospice care.
    25    I  request  that my attending physician prescribe medication that will
    26  end my life if I choose to take it, and I authorize my attending  physi-
    27  cian to contact another physician or any pharmacist about my request.
    28    INITIAL ONE:
    29    (    )  I  have informed or intend to inform one or more members of my
    30  family of my decision.
    31    (  ) I have decided not to inform any member of my family of my  deci-
    32  sion.
    33    (  ) I have no family to inform of my decision.
    34    I  understand that I have the right to rescind this request or decline
    35  to use the medication at any time.
    36    I understand the importance of this request, and I expect to die if  I
    37  take the medication to be prescribed. I further understand that although
    38  most  deaths  occur within three hours, my death may take longer, and my
    39  attending physician has counseled me about this possibility.
    40    I make this request voluntarily, of my own volition and without  being
    41  coerced, and I accept full responsibility for my actions.
    42  Signed: __________________________
    43  Dated: ___________________________
    44                          DECLARATION OF WITNESSES
    45    I  declare that the person signing this "Request for Medication to End
    46  My Life":
    47    (a) is personally known to me or has provided proof of identity;
    48    (b) voluntarily signed the "Request for Medication to End My Life"  in
    49  my presence or acknowledged to me that he or she signed it; and

        S. 3947                             7
     1    (c) to the best of my knowledge and belief, has capacity and is making
     2  the  "Request  for Medication to End My Life" voluntarily, of his or her
     3  own volition and is not being coerced to sign the "Request  for  Medica-
     4  tion to End My Life".
     5    I am not the attending physician or consulting physician of the person
     6  signing  the  "Request for Medication to End My Life" or, if applicable,
     7  the mental health professional who provides a capacity determination  of
     8  the  person  signing  the "Request for Medication to End My Life" at the
     9  time the "Request for Medication to End My Life" was signed.
    10    I further declare under penalty of perjury that  the  statements  made
    11  herein are true and correct and false statements made herein are punish-
    12  able.
    13  __________________________ Witness 1, Date: ________________
    14  __________________________ (Printed name)
    15  __________________________ (Address)
    16  __________________________ (Telephone number)
    17    I further declare that I am not (i) related to the above-named patient
    18  by  blood,  marriage  or adoption, (ii) entitled at the time the patient
    19  signed the "Request for Medication to End My Life" to any portion of the
    20  estate of the patient upon his/her death under any will or by  operation
    21  of  law, or (iii) an owner, operator, employee or independent contractor
    22  of a health care facility where the patient is receiving treatment or is
    23  a resident.
    24  __________________________ Witness 2, Date: _________________
    25  __________________________ (Printed name)
    26  __________________________ (Address)
    27  __________________________ (Telephone number)
    28    NOTE: Only one of the two witnesses may (i) be a relative  (by  blood,
    29  marriage  or adoption) of the person signing the "Request for Medication
    30  to End My Life", (ii) be entitled to any portion of the person's  estate
    31  upon death under any will or by operation of law, or (iii) own, operate,
    32  be  employed  or  be an independent contractor at a health care facility
    33  where the person is receiving treatment or is a resident.
    34    2. (a) The "Request for Medication to End My Life" shall be written in
    35  the same language as any conversations,  consultations,  or  interpreted
    36  conversations or consultations between a patient and at least one of his
    37  or her attending or consulting physicians.
    38    (b)  Notwithstanding  paragraph  (a)  of this subdivision, the written
    39  "Request for Medication to End My Life" may be prepared in English  even
    40  when  the conversations or consultations or interpreted conversations or
    41  consultations were conducted in a language other than  English  or  with
    42  auxiliary  aids  or  hearing,  speech  or  visual  aids,  if the English
    43  language form includes an attached declaration by the interpreter of the
    44  conversation or  consultation,  which  shall  be  in  substantially  the
    45  following form:

        S. 3947                             8
     1                          INTERPRETER'S DECLARATION
     2    I,  ___________  (insert  name of interpreter)_____ ,(mark as applica-
     3  ble):
     4    (  ) for a patient whose conversations or consultations or interpreted
     5  conversations or consultations were conducted in a language  other  than
     6  English and the "Request for Medication to End My Life" is in English: I
     7  declare that I am fluent in English and (insert target language). I have
     8  the  requisite  language  and interpreter skills to be able to interpret
     9  effectively, accurately and impartially information shared and  communi-
    10  cations  between  the  attending  or  consulting  physician and (name of
    11  patient).
    12    I certify that on (insert date), at  approximately  (insert  time),  I
    13  interpreted  the  communications  and  information  conveyed between the
    14  physician and (name of patient) as accurately and completely to the best
    15  of my knowledge and ability and read the "Request for Medication to  End
    16  My Life" to (name of patient) in (insert target language).
    17    (Name  of  patient) affirmed to me his/her desire to sign the "Request
    18  for Medication to End My Life" voluntarily, of (name of  patient)'s  own
    19  volition and without coercion.
    20    (  )  for  a  patient  with  a speech, hearing or vision disability: I
    21  declare that I have the requisite language, reading  and/or  interpreter
    22  skills  to  communicate  with  the patient and to be able to read and/or
    23  interpret effectively, accurately and impartially information shared and
    24  communications that occurred on (insert date) between the  attending  or
    25  consulting physician and (name of patient).
    26    I  certify  that  on  (insert date), at approximately (insert time), I
    27  read and/or interpreted  the  communications  and  information  conveyed
    28  between the physician and (name of patient) impartially and as accurate-
    29  ly  and  completely  to  the best of my knowledge and ability and, where
    30  needed for effective communication, read or interpreted the "Request for
    31  Medication to End my Life" to (name of patient).
    32    (Name of patient) affirmed to me his/her desire to sign  the  "Request
    33  for  Medication  to End My Life" voluntarily, of (name of patient)'s own
    34  volition and without coercion.
    35    I further declare under penalty of perjury that (i) the  foregoing  is
    36  true  and  correct;  (ii)  I  am not (A) related to (name of patient) by
    37  blood, marriage or adoption, (B) entitled at the time (name of  patient)
    38  signed the "Request for Medication to End My Life" to any portion of the
    39  estate  of  (name  of  patient)  upon his/her death under any will or by
    40  operation of law, or (C) an owner,  operator,  employee  or  independent
    41  contractor  of a health care facility where (name of patient) is receiv-
    42  ing treatment or is a resident, except that if I am an employee or inde-
    43  pendent contractor at such health care facility,  providing  interpreter
    44  services is part of my job description at such health care facility or I
    45  have  been trained to provide interpreter services and (name of patient)
    46  requested that  I  provide  interpreter  services  to  him/her  for  the
    47  purposes  stated  in  this  Declaration; and (iii) false statements made
    48  herein are punishable.
    49  Executed at (insert city, county and  state)  on  this  (insert  day  of
    50  month) of (insert month), (insert year).
    51  __________________________ (Signature of Interpreter)
    52  __________________________ (Printed name of Interpreter)

        S. 3947                             9
     1  __________________________ (ID # or Agency Name)
     2  __________________________ (Address of Interpreter)
     3  __________________________ (Language Spoken by Interpreter)
     4    (c)  An interpreter whose services are provided under paragraph (b) of
     5  this subdivision shall not (i) be related to the patient who  signs  the
     6  "Request  for Medication to End My Life" by blood, marriage or adoption,
     7  (ii) be entitled at the time the "Request for Medication to End My Life"
     8  is signed by the patient to any portion of the  estate  of  the  patient
     9  upon  death under any will or by operation of law, or (iii) be an owner,
    10  operator, employee or independent contractor of a health  care  facility
    11  where the patient is receiving treatment or is a resident; provided that
    12  an  employee  or  independent  contractor  whose  job description at the
    13  health care facility includes interpreter services or who is trained  to
    14  provide  interpreter  services and who has been requested by the patient
    15  to serve as an interpreter under this article shall  not  be  prohibited
    16  from serving as a witness under this article.
    17    § 2899-l. Protection and immunities. 1. A physician, pharmacist, other
    18  health  care  professional or other person shall not be subject to civil
    19  or criminal liability or professional disciplinary action by any govern-
    20  ment entity for taking any reasonable good-faith action or  refusing  to
    21  act  under this article, including, but not limited to:  (a) engaging in
    22  discussions with a patient relating to the risks and benefits of end-of-
    23  life options in the circumstances described in this article, (b) provid-
    24  ing a patient, upon request, with a  referral  to  another  health  care
    25  provider, (c) being present when a qualified individual self-administers
    26  medication, (d) refraining from acting to prevent the qualified individ-
    27  ual  from  self-administering  such  medication,  or (e) refraining from
    28  acting to resuscitate the qualified individual after he or she  self-ad-
    29  ministers such medication.
    30    2. Nothing in this section shall limit civil or criminal liability for
    31  negligence, recklessness or intentional misconduct.
    32    § 2899-m. Permissible  refusals  and prohibitions. 1. (a) A physician,
    33  nurse, pharmacist, other health care provider or other person shall  not
    34  be  under  any duty, by law or contract, to participate in the provision
    35  of medication to a patient under this article.
    36    (b) If a health care provider is unable or unwilling to participate in
    37  the provision of medication to a patient  under  this  article  and  the
    38  patient  transfers  care to a new health care provider, the prior health
    39  care provider shall transfer or arrange for the transfer, upon  request,
    40  of  a  copy  of the patient's relevant medical records to the new health
    41  care provider.
    42    2. (a) A private health care facility may  prohibit  the  prescribing,
    43  dispensing,  ordering  or  self-administering  of  medication under this
    44  article while the patient is being treated in or while  the  patient  is
    45  residing in the health care facility if:
    46    (i)  the  prescribing,  dispensing,  ordering or self-administering is
    47  contrary to a formally adopted policy of the facility that is  expressly
    48  based  on  sincerely held religious beliefs or moral convictions central
    49  to the facility's operating principles; and
    50    (ii) the facility has informed the patient of  such  policy  prior  to
    51  admission or as soon as reasonably possible.
    52    (b) Where a facility has adopted a prohibition under this subdivision,
    53  if  a  patient who wishes to use medication under this article requests,

        S. 3947                            10
     1  the patient shall be transferred promptly to another health care facili-
     2  ty that is reasonably accessible under the circumstances and willing  to
     3  permit  the  prescribing, dispensing, ordering and self-administering of
     4  medication under this article with respect to the patient.
     5    3.  Where  a health care facility has adopted a prohibition under this
     6  subdivision,  any  health  care  provider  or  employee  or  independent
     7  contractor  of  the facility who violates the prohibition may be subject
     8  to sanctions otherwise available to the facility, provided the  facility
     9  has  previously notified the health care provider, employee or independ-
    10  ent contractor of the prohibition in writing.
    11    § 2899-n. Relation to other laws and contracts. 1. (a) A  patient  who
    12  requests  medication  under  this  article  shall  not,  because of that
    13  request, be considered to be a person who is suicidal, and self-adminis-
    14  tering medication under this article shall not be deemed to be  suicide,
    15  for any purpose.
    16    (b)  Action  taken  in  accordance  with  this  article  shall  not be
    17  construed for any  purpose  to  constitute  suicide,  assisted  suicide,
    18  attempted  suicide, promoting a suicide attempt, euthanasia, mercy kill-
    19  ing, or homicide under the law, including as an accomplice or  accessory
    20  or otherwise.
    21    2.  (a)  No  provision in a contract, will or other agreement, whether
    22  written or oral, to the extent the  provision  would  affect  whether  a
    23  person  may  make  or rescind a request for medication or take any other
    24  action under this article, shall be valid.
    25    (b) No obligation owing under any contract  shall  be  conditioned  or
    26  affected  by the making or rescinding of a request by a person for medi-
    27  cation or taking any other action under this article.
    28    3. (a) A person and his or her beneficiaries shall not be denied bene-
    29  fits under a life insurance policy for actions taken in accordance  with
    30  this article.
    31    (b)  Notwithstanding  the provisions of any law or contract, the sale,
    32  procurement or issuance of a life or health insurance or annuity policy,
    33  or the rate charged for a policy,  shall  not  be  conditioned  upon  or
    34  affected  by  a  patient  making  or rescinding a request for medication
    35  under this article.
    36    4. An insurer shall not provide any information in communications made
    37  to a patient about the availability of  medication  under  this  article
    38  absent  a  request  by  the patient or by his or her attending physician
    39  upon the request of such patient. Any communication  shall  not  include
    40  both  the  denial  of  coverage  for treatment and information as to the
    41  availability of medication under this article.
    42    5. The sale, procurement, or issue  of  any  professional  malpractice
    43  insurance  policy or the rate charged for the policy shall not be condi-
    44  tioned upon or affected by whether the insured does or does not take  or
    45  participate in any action under this article.
    46    § 2899-o. Safe  disposal  of  unused  medications.    A person who has
    47  custody or control of any unused medication prescribed under this  arti-
    48  cle after the death of the qualified individual shall personally deliver
    49  the  unused  medication  for  disposal to the nearest qualified facility
    50  that properly disposes of controlled substances or shall dispose  of  it
    51  by lawful means in accordance with regulations made by the commissioner,
    52  regulations  made  by or guidelines of the commissioner of education, or
    53  guidelines of a federal drug enforcement administration  approved  take-
    54  back  program. A qualified facility that properly disposes of controlled
    55  substances shall accept and dispose of any medication delivered to it as
    56  provided hereunder regardless of whether such medication is a controlled

        S. 3947                            11
     1  substance. The commissioner may make regulations as may  be  appropriate
     2  for  the  safe  disposal  of unused medications prescribed, dispensed or
     3  ordered under this article as provided in this section.
     4    § 2899-p. Death  certificate.   1. If otherwise authorized by law, the
     5  attending physician may sign the qualified  individual's  death  certif-
     6  icate.
     7    2. The cause of death listed on a qualified individual's death certif-
     8  icate  who  dies  after self-administering medication under this article
     9  will be the underlying terminal illness or condition.
    10    § 2899-q. Reporting. 1.  The  commissioner  shall  annually  review  a
    11  sample  of  the  records  maintained under sections twenty-eight hundred
    12  ninety-nine-j and twenty-eight hundred ninety-nine-p  of  this  article.
    13  The commissioner shall adopt regulations establishing reporting require-
    14  ments  for  physicians  taking  action  under  this article to determine
    15  utilization and compliance with this article. The information  collected
    16  under  this  subdivision  shall not constitute a public record available
    17  for public inspection and shall be confidential and collected and  main-
    18  tained  in a manner that protects the privacy of the patient, his or her
    19  family, and any health care provider  acting  in  connection  with  such
    20  patient  under  this  article,  except  that  such  information  may  be
    21  disclosed to a governmental agency as  authorized  or  required  by  law
    22  relating  to professional discipline, protection of public health or law
    23  enforcement.
    24    2. The commissioner shall prepare a report annually  containing  rele-
    25  vant  data  regarding  utilization  and compliance with this article and
    26  shall send such report to the legislature, and post such report  on  the
    27  department's website.
    28    § 2899-r. Penalties.  1. Nothing in this article shall be construed to
    29  limit professional discipline or civil liability resulting from  conduct
    30  in  violation of this article, negligent conduct, or intentional miscon-
    31  duct by any person.
    32    2. Conduct in violation of this article shall be subject to applicable
    33  criminal liability under state law,  including,  where  appropriate  and
    34  without  limitation,  offenses constituting homicide, forgery, coercion,
    35  and related offenses, or federal law.
    36    § 2899-s. Severability. If any provision of this article or any appli-
    37  cation of any provision of this article, is held to be  invalid,  or  to
    38  violate  or  be  inconsistent  with  any federal law or regulation, that
    39  shall not affect the validity or effectiveness of any other provision of
    40  this article, or of any other application of any provision of this arti-
    41  cle, which can be given effect without that  provision  or  application;
    42  and  to  that  end,  the provisions and applications of this article are
    43  severable.
    44    § 3. This act shall take effect immediately.
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