NY State Senate Bill 2017-S2045

Senate Bill S2045

2017-2018 Legislative Session

Relates to the patient self-determination act; authorizes the dispensation of lethal doses of medication to certain individuals

download bill text pdf

Archive: Last Bill Status - Stricken

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Feb 28, 2017	recommit, enacting clause stricken
Jan 11, 2017	referred to health

2017-S2045 (ACTIVE) - Details

Law Section:: Public Health Law
Laws Affected:: Add Art 28-F §§2899-d - 2899-p, Pub Health L
Versions Introduced in 2015-2016 Legislative Session:: S5814

2017-S2045 (ACTIVE) - Summary

Relates to patient self-determination at end of life; authorizes a physician with a bona fide physician-patient relationship with a patient with a terminal illness or condition to prescribe a lethal dose of the medication to be self-administered; defines terminal illness or condition to be an illness or condition which can reasonably be expected to cause death within six months, whether or not treatment is provided; provides immunity to health care providers.

2017-S2045 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S2045

 TITLE OF BILL :  An act to amend the public health law, in relation
to patient self-determination at end of life

 PURPOSE :

To provide that a physician who prescribes in compliance with the
provisions of this article medication to a terminally ill patient to
be self-administered for the purpose of hastening the patient's death
will not be subject to civil or criminal liability or professional
disciplinary action.

 SUMMARY OF PROVISIONS :

Section 1 provides that this act shall be "Patient Self-Determination
Act."known and may be cited as the

Section 2 amends the Public Health Law by Patient Self-Determination
Act, comprised adding a new article 28-F, the of the following
sections:

§ 2899-d sets forth definitions.

§ 2899-e sets forth the circumstances in which an adult may make a
written request for medication for the purpose of ending his or her

life in accordance with the provisions of this article.

§ 2899-f provides that a request for medication shall be signed and
dated by the patient and witnessed as provided in such section,
identifying persons who shall not serve as witnesses. The patient's
attending physician at the time the request shall not act as a
witness.

§ 2899-g sets forth the responsibilities of the attending physician.

§ 2899-h provides that if in the opinion of the attending physician a
patient may be suffering from a psychiatric or psychological disorder
or depression causing impaired judgment, such physician shall refer
the patient for counseling. No medication to end a patient's life
shall be prescribed, dispensed or ordered until the person performing
the counseling determines that the patient is not suffering from a
psychiatric or psychological disorder or depression causing impaired
judgment and has capacity.

§ 2899-i sets forth the items that must be documented or filed in the
patient's medical record.

§ 2899-j provides that only requests by New York state residents under
the provisions of this article may be granted and sets forth the
factors included that demonstrate New York state residency.

§ 2899-k provides that a physician, pharmacist, other health care
professional or other person shall not be subject to civil or criminal
liability or professional disciplinary action, and shall not be
subject to discipline, suspension, loss of license, loss of
privileges, or other penalty by any health care facility or health
care provider, for taking any reasonable good-faith action or refusing
to act under this article, including engaging in discussions with a
patient relating to the risks and benefits of palliative care and
end-of-life options in the circumstances described in this article and
being present when a patient self-administers medication.  The section
further provides (i) a physician, nurse, pharmacist, or other person
shall not be under any duty by law or contract to participate in the
provision of medication to a patient, (ii) a private health care
facility may prohibit the self-administering of medication under this
article while the patient is being treated or residing in such
facility if the requirements set forth in the section have been met,
(iii) a health care facility that prohibits the self-administering of
medication while the patient is being treated or residing in the
facility may prohibit a physician fr om prescribing, dispensing or
ordering medication for self-administering while the patient is being
treated or residing in the facility provided the facility notified the
physician in writing of its policy to prohibit such actions.

§ 2899-1 provides that (i) a patient who self-administers medication
under this article will not be considered a person who is suicidal and
self-administering medication under this article shall not be deemed
to be suicide for any purpose, (ii) action taken in accordance with
this article shall not be construed for any purpose to constitute
suicide, assisted suicide, attempted suicide, promoting a suicide
attempt, mercy killing, or homicide under the law, including as an
accomplice or accessory or otherwise, (iii)a request by a patient to
his or her attending physician to provide medication under this
article shall not, by itself, provide the basis for the appointment of
a guardian or conservator, (iv) no provision in a contract, will or
other agreement, whether written or oral, to the extent the provision
would affect whether a person may make or rescind a request for
medication or take any other action under this article, shall be
valid, (v) no obligation owing under any contract will be conditioned
or affected by the making or rescinding of a request by a person for
medication or taking any other action under this article, (vi) a
person and his or her beneficiaries shall not be denied benefits under
a life insurance policy for actions taken in accordance with this
article, an insurer shall not provide any information in
communications made to a person about the availability of medication
under this article absent a request by such person or by his or her
attending physician upon the request of such person and any
communication shall not include both the denial of treatment and
information as to the availability of medication under this article,
(vii) the sale, procurement or issue of any professional malpractice
insurance policy or the rate charged for the policy shall not be
conditioned on or affected by whether the insured does or does not
take or participate in any action under this article.

§ 2899-m provides for the adoption of rules and regulations by the DOH
for the safe disposal of unused medications prescribed, dispensed or
ordered under this article.

§2899-n provides that in the event a patient dies as a result of
medication self-administered under this article, the death certificate
shall indicate that the cause of death was the underlying terminal
illness or condition of the patient.

§2899-o provides for the annual review by the commissioner of health
of a sample of the records maintained under section twenty-eight
hundred ninety-nine-i of this article. The section further provides
that the department may adopt regulations establishing reporting
requirements for physicians taking action under this article to
determine utilization and compliance with this article. The
information collected under this section shall be confidential and
shall be collected in a manner that protects the privacy of the
patient, his or her family, and any health care provider acting in
connection with such patient under this article. The department shall
prepare a report annually containing relevant data regarding
utilization and compliance with this article and shall post such
report on its website.

§2899-p provides the severability clause. Section 3 sets forth the
effective date.

 JUSTIFICATION :
The highly publicized, planned death of Brittany Maynard has
highlighted the need for terminally ill patients to be able to access
aid in dying. Ms. Maynard, who was a native of California, was forced
to move to Oregon to gain control of her dying process. Her death, and
the accompanying press attention, led the California legislature to
pass, and Governor Jerry Brown to sign, an aid in dying law on October
5, 2015.

The national debate that accompanies Ms. Maynard's plight focused the
nation on the desire of patients with a terminal illness to determine
for themselves - how and when they die. These patients, when mentally
competent and without impaired judgment, should be afforded this
right. Patients should not be forced to relocate to another state or
to leave the country to control how their lives end. Patients seek to
die with dignity, on their own terms, typically in their own homes,
surrounded by their family and other loved ones.

New Yorkers strongly support empowering terminally-ill, mentally
competent patients to control their own death. A 2015 poll found that
77% of all New Yorkers support aid in dying, including 75% of
Catholics, 72% of Republicans, 67% of self-identified Conservatives,
and 78% of New Yorkers Upstate.

Nationally, according to HealthDay/Harris poll findings released in
December 2014, 74% of American adults believe that terminally ill
patients in great pain should have the right to end their lives (14%
were opposed). Gallup, which has been polling this issue since 1947,
has found that a majority of Americans have supported aid in dying
since 1973. Their most recent poll found 68% of Americans support aid
in dying.

Physicians also support aid in dying. In a recent survey conducted by
Medscape, 54% of physicians in the U.S. believe that aid in dying
should be permitted, while only 31% opposed it.

The Patient Self-Determination Act will enable mentally competent,
terminally ill patients to choose to self-administer medication to
bring about a peaceful death. It also provides their physician, when
acting in good faith in accordance with the provisions of the Act,
protections from civil and criminal liability and professional
disciplinary action.

This legislation includes a provision that a request for medication
for the purpose of ending one's life should not be considered by
itself grounds for the appointment of a guardian or a conservator out
of an abundance of caution. A person who has been determined to have
capacity to request medication under the Act should not be forced to
undergo an additional proceeding resulting in delay, costs such as
legal fees, and additional strain.

Six states - Oregon, Vermont, Washington, California, Colorado and
Montana allow physician assisted aid in dying. In addition, New Mexico
had a court rule that patients have a constitutional right to aid in
dying; that decision is under appeal.

Aid in dying legislation recently passed the New Jersey Assembly, and
legislators in a total of 20 states, including all of New England,
Maryland, North Carolina, Tennessee, Oklahoma, Utah, Wyoming and
Missouri, have aid in dying bills pending.

Aid in dying legislation is supported by the American Public Health
Association, the American Medical Women's Association, the American
Medical Student Association, the American College of Legal Medicine,
and Lamda Legal.

 LEGISLATIVE HISTORY :
2015-16: S5814-A died in Senate Health

 FISCAL IMPLICATIONS :

None.

 EFFECTIVE DATE :
Effective immediately.

2017-S2045 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2045
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                             January 11, 2017
                                ___________
 
 Introduced  by  Sen. BONACIC -- 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 patient  self-det-
   ermination at end of life
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. This act shall be known and may be cited  as  the  "patient
 self-determination act".
   §  2. The public health law is amended by adding a new article 28-F to
 read as follows:
                               ARTICLE 28-F
                               AID IN DYING
 SECTION 2899-D. DEFINITIONS.
         2899-E. WRITTEN REQUEST FOR MEDICATION.
         2899-F. WRITTEN REQUEST SIGNED AND WITNESSED.
         2899-G. ATTENDING PHYSICIAN RESPONSIBILITIES.
         2899-H. COUNSELING REFERRAL.
         2899-I. MEDICAL RECORD DOCUMENTATION REQUIREMENTS.
         2899-J. RESIDENCY REQUIREMENT.
         2899-K. PROTECTION OF HEALTH CARE PROVIDERS AND FACILITIES.
         2899-L. RELATION TO OTHER LAWS AND CONTRACTS.
         2899-M. SAFE DISPOSAL OF UNUSED MEDICATIONS.
         2899-N. DEATH CERTIFICATE.
         2899-O. REPORTING.
         2899-P. SEVERABILITY.
   § 2899-D. DEFINITIONS. AS USED IN THIS ARTICLE:
   1. "ADULT" MEANS AN INDIVIDUAL WHO  IS  TWENTY-ONE  YEARS  OF  AGE  OR
 OLDER.
   2. "ATTENDING PHYSICIAN" MEANS THE PHYSICIAN WHO HAS PRIMARY RESPONSI-
 BILITY FOR THE CARE OF THE PATIENT AND TREATMENT OF THE PATIENT'S TERMI-
 NAL DISEASE.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD01103-02-7

 S. 2045                             2

   3.  "CAPACITY"  MEANS  THE  ABILITY  TO  UNDERSTAND AND APPRECIATE THE
 NATURE AND CONSEQUENCES OF HEALTH CARE DECISIONS, INCLUDING THE BENEFITS
 AND RISKS OF AND ALTERNATIVES TO ANY PROPOSED HEALTH CARE, AND TO  REACH
 AN  INFORMED  DECISION  AND  TO  COMMUNICATE  HEALTH CARE DECISIONS TO A
 PHYSICIAN,  INCLUDING  COMMUNICATION  THROUGH  PERSONS FAMILIAR WITH THE
 PATIENT'S MANNER OF COMMUNICATING IF THOSE PERSONS ARE AVAILABLE.
   4. "COUNSELING" MEANS ONE OR MORE CONSULTATIONS AS NECESSARY BETWEEN A
 STATE LICENSED PSYCHIATRIST  OR  PSYCHOLOGIST  AND  A  PATIENT  FOR  THE
 PURPOSE  OF DETERMINING THAT THE PATIENT HAS CAPACITY AND IS NOT SUFFER-
 ING FROM A PSYCHIATRIC OR PSYCHOLOGICAL DISORDER OR  DEPRESSION  CAUSING
 IMPAIRED JUDGMENT.
   5.  "HEALTH  CARE FACILITY" MEANS A GENERAL HOSPITAL, NURSING HOME, OR
 RESIDENTIAL HEALTH CARE FACILITY  AS  DEFINED  IN  SECTION  TWENTY-EIGHT
 HUNDRED ONE OF THIS CHAPTER.
   6.  "HEALTH  CARE  PROVIDER" MEANS A PERSON OR ENTITY LICENSED, CERTI-
 FIED, OR AUTHORIZED BY LAW TO ADMINISTER HEALTH CARE OR DISPENSE MEDICA-
 TION IN THE ORDINARY COURSE OF BUSINESS OR PRACTICE OF A PROFESSION.
   7. "IMPAIRED JUDGMENT" MEANS THAT A PERSON LACKS THE ABILITY TO UNDER-
 STAND AND APPRECIATE THE NATURE AND CONSEQUENCES OF  HEALTH  CARE  DECI-
 SIONS,  INCLUDING  THE  BENEFITS  AND  RISKS  OF AND ALTERNATIVES TO ANY
 PROPOSED HEALTH CARE, AND TO REACH AN INFORMED DECISION.
   8. "MEDICATION" MEANS MEDICATION CAPABLE OF ENDING AND TO BE USED WITH
 THE INTENT OF ENDING THE PATIENT'S LIFE, INCLUDING ANY ANCILLARY MEDICA-
 TION INTENDED TO MINIMIZE THE PATIENT'S DISCOMFORT.
   9. "PALLIATIVE CARE" MEANS HEALTH CARE TREATMENT, INCLUDING  INTERDIS-
 CIPLINARY  END-OF-LIFE  CARE,  AND CONSULTATION WITH PATIENTS AND FAMILY
 MEMBERS, TO PREVENT OR RELIEVE PAIN AND SUFFERING  AND  TO  ENHANCE  THE
 PATIENT'S QUALITY OF LIFE, INCLUDING HOSPICE CARE UNDER ARTICLE FORTY OF
 THIS CHAPTER.
   10.  "PATIENT" MEANS A PERSON WHO IS TWENTY-ONE YEARS OF AGE OR OLDER,
 A RESIDENT OF NEW YORK STATE, AND UNDER THE CARE OF A PHYSICIAN.
   11. "PHYSICIAN" MEANS AN INDIVIDUAL LICENSED TO PRACTICE  MEDICINE  IN
 NEW YORK STATE.
   12.  "TERMINAL  ILLNESS  OR  CONDITION"  MEANS AN ILLNESS OR CONDITION
 WHICH CAN REASONABLY BE EXPECTED  TO  CAUSE  DEATH  WITHIN  SIX  MONTHS,
 WHETHER OR NOT TREATMENT IS PROVIDED.
   §  2899-E. WRITTEN REQUEST FOR MEDICATION. 1. AN ADULT WHO HAS CAPACI-
 TY, IS A RESIDENT OF THIS STATE, AND HAS BEEN DETERMINED BY THE  ATTEND-
 ING  PHYSICIAN  AND, IF APPLICABLE, CONSULTING PHYSICIAN TO BE SUFFERING
 FROM A TERMINAL ILLNESS OR CONDITION, MAY MAKE A WRITTEN REQUEST FOR AND
 CONSENT TO SELF-ADMINISTER MEDICATION FOR THE PURPOSE OF ENDING  HIS  OR
 HER LIFE IN ACCORDANCE WITH THIS ARTICLE.
   2. NO PERSON SHALL QUALIFY UNDER THIS ARTICLE SOLELY BECAUSE OF AGE OR
 DISABILITY.
   § 2899-F. WRITTEN REQUEST SIGNED AND WITNESSED. 1. A REQUEST FOR MEDI-
 CATION  UNDER  THIS ARTICLE SHALL BE SIGNED AND DATED BY THE PATIENT AND
 WITNESSED BY AT LEAST TWO  INDIVIDUALS  WHO,  IN  THE  PRESENCE  OF  THE
 PATIENT,  ATTEST  THAT  TO  THE  BEST  OF THEIR KNOWLEDGE AND BELIEF THE
 PATIENT HAS CAPACITY, IS ACTING VOLUNTARILY, AND IS NOT BEING COERCED TO
 SIGN THE REQUEST. THE DEPARTMENT MAY DEVELOP  A  SUGGESTED  FORM  FOR  A
 REQUEST UNDER THIS ARTICLE.
   2. ONE OF THE WITNESSES SHALL BE A PERSON WHO IS NOT:
   (A) A RELATIVE OF THE PATIENT BY BLOOD, MARRIAGE OR ADOPTION;
   (B)  A  PERSON WHO AT THE TIME THE REQUEST IS SIGNED WOULD BE ENTITLED
 TO ANY PORTION OF THE ESTATE OF THE PATIENT UPON DEATH UNDER ANY WILL OR
 BY OPERATION OF LAW; OR

 S. 2045                             3
 
   (C) AN OWNER, OPERATOR OR EMPLOYEE OF A HEALTH CARE FACILITY WHERE THE
 PATIENT IS RECEIVING TREATMENT OR IS A RESIDENT.
   3.  THE  PATIENT'S  ATTENDING  PHYSICIAN OR, IF APPLICABLE, CONSULTING
 PHYSICIAN AT THE TIME THE REQUEST IS SIGNED SHALL NOT BE A WITNESS.
   § 2899-G.  ATTENDING  PHYSICIAN  RESPONSIBILITIES.  1.  THE  ATTENDING
 PHYSICIAN SHALL:
   (A) MAKE THE DETERMINATION OF WHETHER A PATIENT HAS A TERMINAL ILLNESS
 OR CONDITION, HAS CAPACITY, AND HAS MADE THE REQUEST VOLUNTARILY;
   (B) REQUEST THAT THE PATIENT DEMONSTRATE NEW YORK STATE RESIDENCY;
   (C)  REFER  THE  PATIENT FOR COUNSELING, IF APPROPRIATE, UNDER SECTION
 TWENTY-EIGHT HUNDRED NINETY-NINE-H OF THIS ARTICLE;
   (D) PROVIDE  INFORMATION  AND  COUNSELING  UNDER  SECTION  TWENTY-NINE
 HUNDRED NINETY-SEVEN-C OF THIS CHAPTER; AND
   (E)  FULFILL  THE MEDICAL RECORD DOCUMENTATION REQUIREMENTS OF SECTION
 TWENTY-EIGHT HUNDRED NINETY-NINE-I OF THIS ARTICLE.
   2. SUBJECT TO SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-H OF THIS ARTI-
 CLE, THE ATTENDING  PHYSICIAN  WHO  MAKES  THE  DETERMINATION  THAT  THE
 PATIENT HAS A TERMINAL ILLNESS OR CONDITION, HAS CAPACITY AND HAS MADE A
 REQUEST FOR MEDICATION AS PROVIDED IN SECTION TWENTY-EIGHT HUNDRED NINE-
 TY-NINE-E  OF  THIS  ARTICLE, MAY PERSONALLY, OR BY DIRECTION TO ANOTHER
 PHYSICIAN,  PRESCRIBE,  DISPENSE  OR  ORDER  APPROPRIATE  MEDICATION  IN
 ACCORDANCE  WITH  THE  PATIENT'S  REQUEST UNDER THIS ARTICLE, AND AT THE
 PATIENT'S REQUEST, FACILITATE THE FILLING OF THE PRESCRIPTION AND DELIV-
 ERY OF THE MEDICATION TO THE PATIENT.
   3. IN ACCORDANCE WITH THE DIRECTION OF THE PRESCRIBING, DISPENSING  OR
 ORDERING  PHYSICIAN  AND  THE  CONSENT  OF  THE PATIENT, THE PATIENT MAY
 ADMINISTER THE MEDICATION TO HIMSELF OR HERSELF. A HEALTH  CARE  PROFES-
 SIONAL  SHALL  NOT  ADMINISTER THE MEDICATION TO THE PATIENT BUT, ACTING
 WITHIN THE SCOPE OF HIS OR  HER  LAWFUL  PRACTICE,  MAY  FACILITATE  THE
 PATIENT IN SELF-ADMINISTERING THE MEDICATION.
   §  2899-H.  COUNSELING  REFERRAL.  IF  IN THE OPINION OF THE ATTENDING
 PHYSICIAN A PATIENT MAY BE SUFFERING FROM A PSYCHIATRIC OR PSYCHOLOGICAL
 DISORDER OR DEPRESSION CAUSING IMPAIRED JUDGMENT, SUCH  PHYSICIAN  SHALL
 REFER  THE PATIENT FOR COUNSELING. NO MEDICATION TO END A PATIENT'S LIFE
 SHALL BE PRESCRIBED, DISPENSED OR ORDERED UNTIL  THE  PERSON  PERFORMING
 THE  COUNSELING  DETERMINES  THAT  THE  PATIENT  IS NOT SUFFERING FROM A
 PSYCHIATRIC OR PSYCHOLOGICAL DISORDER  OR  DEPRESSION  CAUSING  IMPAIRED
 JUDGMENT AND HAS CAPACITY.
   §  2899-I.  MEDICAL  RECORD  DOCUMENTATION REQUIREMENTS. THE FOLLOWING
 SHALL BE DOCUMENTED OR FILED IN THE PATIENT'S MEDICAL RECORD:
   1. ALL ORAL REQUESTS BY A PATIENT FOR MEDICATION TO  END  HIS  OR  HER
 LIFE;
   2.  ALL WRITTEN REQUESTS BY A PATIENT FOR MEDICATION TO END HIS OR HER
 LIFE;
   3. THE ATTENDING PHYSICIAN'S DIAGNOSIS  AND  PROGNOSIS,  AND  DETERMI-
 NATION WHETHER THE PATIENT HAS CAPACITY AND IS ACTING VOLUNTARILY;
   4.  A REPORT OF THE OUTCOME AND DETERMINATIONS MADE DURING COUNSELING,
 IF PERFORMED; AND
   5. A NOTE BY THE ATTENDING PHYSICIAN INDICATING WHETHER  ALL  REQUIRE-
 MENTS UNDER THIS ARTICLE HAVE BEEN MET AND INDICATING THE STEPS TAKEN TO
 CARRY   OUT   THE  REQUEST,  INCLUDING  A  NOTATION  OF  THE  MEDICATION
 PRESCRIBED, DISPENSED OR ORDERED.
   § 2899-J. RESIDENCY REQUIREMENT. ONLY REQUESTS MADE BY NEW YORK  STATE
 RESIDENTS UNDER THE PROVISIONS OF THIS ARTICLE SHALL BE GRANTED. FACTORS
 DEMONSTRATING  NEW  YORK  STATE RESIDENCY SHALL INCLUDE BUT SHALL NOT BE
 LIMITED TO:

 S. 2045                             4

   1. POSSESSION OF A NEW YORK STATE DRIVER'S LICENSE;
   2. REGISTRATION TO VOTE IN NEW YORK STATE;
   3. EVIDENCE THAT THE PERSON OWNS OR LEASES PROPERTY IN NEW YORK STATE;
 OR
   4. FILING OF A NEW YORK STATE TAX RETURN FOR THE MOST RECENT TAX YEAR.
   §  2899-K.  PROTECTION  OF HEALTH CARE PROVIDERS AND FACILITIES.  1. A
 PHYSICIAN, PHARMACIST, OTHER HEALTH CARE PROFESSIONAL  OR  OTHER  PERSON
 SHALL  NOT  BE  SUBJECT  TO  CIVIL OR CRIMINAL LIABILITY OR PROFESSIONAL
 DISCIPLINARY ACTION, AND SHALL NOT BE SUBJECT TO DISCIPLINE, SUSPENSION,
 LOSS OF LICENSE, LOSS OF PRIVILEGES, OR OTHER PENALTY BY ANY HEALTH CARE
 FACILITY OR HEALTH CARE PROVIDER, FOR TAKING ANY  REASONABLE  GOOD-FAITH
 ACTION OR REFUSING TO ACT UNDER THIS ARTICLE, INCLUDING: (A) ENGAGING IN
 DISCUSSIONS WITH A PATIENT RELATING TO THE RISKS AND BENEFITS OF END-OF-
 LIFE  OPTIONS  IN THE CIRCUMSTANCES DESCRIBED IN THIS ARTICLE, (B) BEING
 PRESENT WHEN A PATIENT SELF-ADMINISTERS MEDICATION, (C) REFRAINING  FROM
 ACTING  TO  PREVENT THE PATIENT FROM SELF-ADMINISTERING SUCH MEDICATION,
 OR (D) REFRAINING FROM ACTING TO RESUSCITATE OR RESCUE THE PATIENT AFTER
 HE OR SHE SELF-ADMINISTERS SUCH MEDICATION. HOWEVER, PARAGRAPHS (C)  AND
 (D)  OF  THIS  SUBDIVISION  SHALL  NOT  APPLY WHERE THERE ARE REASONABLE
 GROUNDS TO BELIEVE,  UNDER  THE  CIRCUMSTANCES,  THAT  THE  PATIENT  HAS
 RESCINDED  HIS  OR  HER REQUEST OR CONSENT TO SELF-ADMINISTER MEDICATION
 UNDER THIS ARTICLE OR COMMUNICATES A DESIRE THAT THE  LETHAL  ACTION  OF
 THE MEDICATION BE REVERSED.
   2.  A PHYSICIAN, NURSE, PHARMACIST, OR OTHER PERSON SHALL NOT BE UNDER
 ANY DUTY, BY LAW OR CONTRACT, TO PARTICIPATE IN THE PROVISION OF MEDICA-
 TION TO A PATIENT UNDER THIS ARTICLE.
   3. A PRIVATE HEALTH CARE FACILITY MAY PROHIBIT THE  SELF-ADMINISTERING
 OF  MEDICATION  UNDER  THE ARTICLE WHILE THE PATIENT IS BEING TREATED OR
 RESIDING IN THE HEALTH CARE FACILITY IF:
   (A) SUCH PRESCRIBING, DISPENSING, ORDERING  OR  SELF-ADMINISTERING  IS
 CONTRARY TO A FORMALLY ADOPTED POLICY OF SUCH FACILITY THAT IS EXPRESSLY
 BASED  ON  SINCERELY  HELD  RELIGIOUS  BELIEFS  OR  SINCERELY HELD MORAL
 CONVICTIONS CENTRAL TO THE FACILITY'S OPERATING PRINCIPLES;
   (B) SUCH FACILITY HAS INFORMED THE PATIENT OF SUCH POLICY PRIOR TO  OR
 UPON ADMISSION, IF REASONABLY POSSIBLE; AND
   (C)  IF  THE  PATIENT REQUESTS, THE PATIENT IS TRANSFERRED PROMPTLY TO
 ANOTHER HEALTH CARE FACILITY THAT IS  REASONABLY  ACCESSIBLE  UNDER  THE
 CIRCUMSTANCES  AND WILLING TO PERMIT THE PRESCRIBING, DISPENSING, ORDER-
 ING AND SELF-ADMINISTERING OF MEDICATION UNDER THIS ARTICLE WITH RESPECT
 TO THE PATIENT.
   4. A HEALTH CARE FACILITY THAT  PROHIBITS  THE  SELF-ADMINISTERING  OF
 MEDICATION  UNDER  THIS  ARTICLE  WHILE  THE PATIENT IS BEING TREATED OR
 RESIDING IN THE HEALTH CARE FACILITY UNDER THIS SECTION MAY  PROHIBIT  A
 PHYSICIAN  FROM PRESCRIBING, DISPENSING OR ORDERING MEDICATION FOR SELF-
 ADMINISTERING WHILE THE PATIENT IS BEING  TREATED  OR  RESIDING  IN  THE
 HEALTH CARE FACILITY, PROVIDED THE HEALTH CARE FACILITY HAS NOTIFIED THE
 PHYSICIAN  IN  WRITING  OF ITS POLICY TO PROHIBIT SUCH ACTIONS. NOTWITH-
 STANDING SUBDIVISION ONE OF THIS SECTION,  ANY  PERSON  WHO  VIOLATES  A
 POLICY  ESTABLISHED  BY A HEALTH CARE FACILITY UNDER THIS SECTION MAY BE
 SUBJECT TO SANCTIONS OTHERWISE ALLOWABLE UNDER LAW, CONTRACT AND FACILI-
 TY POLICY.
   § 2899-L. RELATION TO OTHER LAWS AND CONTRACTS.  1. (A) A PATIENT  WHO
 SELF-ADMINISTERS  MEDICATION  UNDER THIS ARTICLE SHALL NOT BE CONSIDERED
 TO BE A PERSON WHO IS SUICIDAL, AND SELF-ADMINISTERING MEDICATION  UNDER
 THIS ARTICLE SHALL NOT BE DEEMED TO BE SUICIDE, FOR ANY PURPOSE.

 S. 2045                             5
 
   (B)  ACTION  TAKEN  IN  ACCORDANCE  WITH  THIS  ARTICLE  SHALL  NOT BE
 CONSTRUED FOR ANY  PURPOSE  TO  CONSTITUTE  SUICIDE,  ASSISTED  SUICIDE,
 ATTEMPTED  SUICIDE, PROMOTING A SUICIDE ATTEMPT, MERCY KILLING, OR HOMI-
 CIDE UNDER THE LAW, INCLUDING AS AN ACCOMPLICE OR  ACCESSORY  OR  OTHER-
 WISE.
   2. A REQUEST BY A PATIENT TO HIS OR HER ATTENDING PHYSICIAN TO PROVIDE
 MEDICATION  UNDER  THIS  ARTICLE SHALL NOT, BY ITSELF, PROVIDE THE BASIS
 FOR THE APPOINTMENT OF A GUARDIAN OR CONSERVATOR.
   3. (A) NO PROVISION IN A CONTRACT, WILL OR  OTHER  AGREEMENT,  WHETHER
 WRITTEN  OR  ORAL,  TO  THE  EXTENT THE PROVISION WOULD AFFECT WHETHER A
 PERSON MAY MAKE OR RESCIND A REQUEST FOR MEDICATION OR  TAKE  ANY  OTHER
 ACTION UNDER THIS ARTICLE, SHALL BE VALID.
   (B)  NO  OBLIGATION  OWING  UNDER ANY CONTRACT SHALL BE CONDITIONED OR
 AFFECTED BY THE MAKING OR RESCINDING OF A REQUEST BY A PERSON FOR  MEDI-
 CATION OR TAKING ANY OTHER ACTION UNDER THIS ARTICLE.
   4.  A PERSON AND HIS OR HER BENEFICIARIES SHALL NOT BE DENIED BENEFITS
 UNDER A LIFE INSURANCE POLICY FOR ACTIONS TAKEN IN ACCORDANCE WITH  THIS
 ARTICLE.
   5. AN INSURER SHALL NOT PROVIDE ANY INFORMATION IN COMMUNICATIONS MADE
 TO  A  PERSON  ABOUT  THE  AVAILABILITY OF MEDICATION UNDER THIS ARTICLE
 ABSENT A REQUEST BY SUCH PERSON OR BY HIS  OR  HER  ATTENDING  PHYSICIAN
 UPON  THE  REQUEST  OF  SUCH PERSON. ANY COMMUNICATION SHALL NOT INCLUDE
 BOTH THE DENIAL OF TREATMENT AND INFORMATION AS TO THE  AVAILABILITY  OF
 MEDICATION UNDER THIS ARTICLE.
   6.  THE  SALE,  PROCUREMENT,  OR ISSUE OF ANY PROFESSIONAL MALPRACTICE
 INSURANCE POLICY OR THE RATE CHARGED FOR THE POLICY SHALL NOT BE  CONDI-
 TIONED  UPON OR AFFECTED BY WHETHER THE INSURED DOES OR DOES NOT TAKE OR
 PARTICIPATE IN ANY ACTION UNDER THIS ARTICLE.
   § 2899-M. SAFE DISPOSAL OF UNUSED MEDICATIONS.  THE  DEPARTMENT  SHALL
 MAKE  REGULATIONS  PROVIDING FOR THE SAFE DISPOSAL OF UNUSED MEDICATIONS
 PRESCRIBED, DISPENSED OR ORDERED UNDER THIS ARTICLE.
   § 2899-N. DEATH CERTIFICATE. IN THE EVENT THAT A  PATIENT  DIES  AS  A
 RESULT  OF  MEDICATION  SELF-ADMINISTERED  UNDER THIS ARTICLE, THE DEATH
 CERTIFICATE SHALL INDICATE THAT THE CAUSE OF DEATH  WAS  THE  UNDERLYING
 TERMINAL  ILLNESS  OR CONDITION OF THE PATIENT. HOWEVER, WHERE THERE ARE
 REASONABLE GROUNDS TO BELIEVE, UNDER THE CIRCUMSTANCES, THAT THE PATIENT
 RESCINDED HIS OR HER REQUEST OR CONSENT  TO  SELF-ADMINISTER  MEDICATION
 UNDER  THIS  ARTICLE  OR COMMUNICATED A DESIRE THAT THE LETHAL ACTION OF
 THE MEDICATION BE REVERSED, AND THE PATIENT NEVERTHELESS DIED  FROM  THE
 SELF-ADMINISTRATION  OF  THE  MEDICATION, THE SELF-ADMINISTRATION OF THE
 MEDICATION MAY BE LISTED AS THE CAUSE OF DEATH.
   § 2899-O. REPORTING. 1.  THE  COMMISSIONER  SHALL  ANNUALLY  REVIEW  A
 SAMPLE  OF  THE  RECORDS  MAINTAINED  UNDER SECTION TWENTY-EIGHT HUNDRED
 NINETY-NINE-I OF THIS ARTICLE.  THE  DEPARTMENT  MAY  ADOPT  REGULATIONS
 ESTABLISHING  REPORTING  REQUIREMENTS FOR PHYSICIANS TAKING ACTION UNDER
 THIS ARTICLE TO DETERMINE UTILIZATION AND COMPLIANCE WITH THIS  ARTICLE.
 THE  INFORMATION  COLLECTED UNDER THIS SECTION SHALL BE CONFIDENTIAL AND
 SHALL BE COLLECTED IN A MANNER THAT PROTECTS THE PRIVACY OF THE PATIENT,
 HIS OR HER FAMILY, AND ANY HEALTH CARE  PROVIDER  ACTING  IN  CONNECTION
 WITH SUCH PATIENT UNDER THIS ARTICLE.
   2.  THE DEPARTMENT SHALL PREPARE A REPORT ANNUALLY CONTAINING RELEVANT
 DATA REGARDING UTILIZATION AND COMPLIANCE WITH THIS  ARTICLE  AND  SHALL
 POST SUCH REPORT ON ITS WEBSITE.
   § 2899-P. SEVERABILITY. IF ANY PROVISION OF THIS ARTICLE OR ANY APPLI-
 CATION  OF  ANY  PROVISION OF THIS ARTICLE, IS HELD TO BE INVALID, OR TO
 VIOLATE OR BE INCONSISTENT WITH ANY  FEDERAL  LAW  OR  REGULATION,  THAT

 S. 2045                             6
 
 SHALL NOT AFFECT THE VALIDITY OR EFFECTIVENESS OF ANY OTHER PROVISION OF
 THIS ARTICLE, OR OF ANY OTHER APPLICATION OF ANY PROVISION OF THIS ARTI-
 CLE,  WHICH  CAN  BE GIVEN EFFECT WITHOUT THAT PROVISION OR APPLICATION;
 AND  TO  THAT  END,  THE PROVISIONS AND APPLICATIONS OF THIS ARTICLE ARE
 SEVERABLE.
   § 3. This act shall take effect immediately.

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