S T A T E O F N E W Y O R K
________________________________________________________________________
995--B
2023-2024 Regular Sessions
I N A S S E M B L Y
January 12, 2023
___________
Introduced by M. of A. PAULIN, L. ROSENTHAL, DINOWITZ, HEVESI, STECK,
LAVINE, LUPARDO, RIVERA, THIELE, EPSTEIN, SEAWRIGHT, WOERNER, REYES,
DARLING, CRUZ, SAYEGH, AUBRY, DAVILA, DICKENS, STERN, BURDICK,
GALLAGHER, KELLES, GONZALEZ-ROJAS, MITAYNES, MAMDANI, CLARK, BURKE,
ANDERSON, JEAN-PIERRE, SILLITTI, JACKSON, PRETLOW, SEPTIMO, GLICK,
GIBBS, TAPIA, LUNSFORD, CUNNINGHAM, LEVENBERG, SIMONE, BORES, FORREST,
SHRESTHA, SHIMSKY, RAGA, RAJKUMAR, KIM, HUNTER, STIRPE, CHANDLER-WA-
TERMAN, ARDILA, LEE, TAYLOR, MEEKS, OTIS, ALVAREZ -- Multi-Sponsored
by -- M. of A. BRAUNSTEIN, BRONSON, BURGOS, HYNDMAN, RAMOS, ZINERMAN
-- read once and referred 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 Assembly Rule 3, sec. 2 -- committee discharged, bill
amended, ordered reprinted as amended and recommitted to said commit-
tee
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:
Section 1. This act shall be known and may be cited as the "medical
aid in dying act".
§ 2. The public health law is amended by adding a new article 28-F to
read as follows:
ARTICLE 28-F
MEDICAL AID IN DYING
SECTION 2899-D. DEFINITIONS.
2899-E. REQUEST PROCESS.
2899-F. ATTENDING PHYSICIAN RESPONSIBILITIES.
2899-G. RIGHT TO RESCIND REQUEST; REQUIREMENT TO OFFER OPPORTU-
NITY TO RESCIND.
2899-H. CONSULTING PHYSICIAN RESPONSIBILITIES.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02188-06-4
A. 995--B 2
2899-I. REFERRAL TO MENTAL HEALTH PROFESSIONAL.
2899-J. MEDICAL RECORD DOCUMENTATION REQUIREMENTS.
2899-K. FORM OF WRITTEN REQUEST AND WITNESS ATTESTATION.
2899-L. PROTECTION AND IMMUNITIES.
2899-M. PERMISSIBLE REFUSALS AND PROHIBITIONS.
2899-N. RELATION TO OTHER LAWS AND CONTRACTS.
2899-O. SAFE DISPOSAL OF UNUSED MEDICATIONS.
2899-P. DEATH CERTIFICATE.
2899-Q. REPORTING.
2899-R. PENALTIES.
2899-S. SEVERABILITY.
§ 2899-D. DEFINITIONS. AS USED IN THIS ARTICLE:
1. "ADULT" MEANS AN INDIVIDUAL WHO IS EIGHTEEN 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 ILLNESS OR CONDITION.
3. "DECISION-MAKING CAPACITY" MEANS THE ABILITY TO UNDERSTAND AND
APPRECIATE THE NATURE AND CONSEQUENCES OF HEALTH CARE DECISIONS, INCLUD-
ING THE BENEFITS AND RISKS OF AND ALTERNATIVES TO ANY PROPOSED HEALTH
CARE, INCLUDING MEDICAL AID IN DYING, AND TO REACH AN INFORMED DECISION.
4. "CONSULTING PHYSICIAN" MEANS A PHYSICIAN WHO IS QUALIFIED BY
SPECIALTY OR EXPERIENCE TO MAKE A PROFESSIONAL DIAGNOSIS AND PROGNOSIS
REGARDING A PERSON'S TERMINAL ILLNESS OR CONDITION.
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, OR A HOSPICE AS DEFINED IN SECTION FOUR
THOUSAND TWO OF THIS CHAPTER; PROVIDED THAT FOR THE PURPOSES OF SECTION
TWENTY EIGHT HUNDRED NINETY-NINE-M OF THIS ARTICLE, "HOSPICE" SHALL
REFER ONLY TO A FACILITY PROVIDING IN-PATIENT HOSPICE CARE OR A HOSPICE
RESIDENCE.
6. "HEALTH CARE PROVIDER" MEANS A PERSON LICENSED, CERTIFIED, OR
AUTHORIZED BY LAW TO ADMINISTER HEALTH CARE OR DISPENSE MEDICATION IN
THE ORDINARY COURSE OF BUSINESS OR PRACTICE OF A PROFESSION.
7. "INFORMED DECISION" MEANS A DECISION BY A PATIENT WHO IS SUFFERING
FROM A TERMINAL ILLNESS OR CONDITION TO REQUEST AND OBTAIN A
PRESCRIPTION FOR MEDICATION THAT THE PATIENT MAY SELF-ADMINISTER TO END
THE PATIENT'S LIFE THAT IS BASED ON AN UNDERSTANDING AND ACKNOWLEDGMENT
OF THE RELEVANT FACTS AND THAT IS MADE VOLUNTARILY, OF THE PATIENT'S OWN
VOLITION AND WITHOUT COERCION, AFTER BEING FULLY INFORMED OF:
(A) THE PATIENT'S MEDICAL DIAGNOSIS AND PROGNOSIS;
(B) THE POTENTIAL RISKS ASSOCIATED WITH TAKING THE MEDICATION TO BE
PRESCRIBED;
(C) THE PROBABLE RESULT OF TAKING THE MEDICATION TO BE PRESCRIBED;
(D) THE POSSIBILITY THAT THE PATIENT MAY CHOOSE NOT TO OBTAIN THE
MEDICATION, OR MAY OBTAIN THE MEDICATION BUT MAY DECIDE NOT TO SELF-AD-
MINISTER IT; AND
(E) THE FEASIBLE ALTERNATIVES AND APPROPRIATE TREATMENT OPTIONS,
INCLUDING BUT NOT LIMITED TO PALLIATIVE CARE AND HOSPICE CARE.
8. "MEDICAL AID IN DYING" MEANS THE MEDICAL PRACTICE OF A PHYSICIAN
PRESCRIBING MEDICATION TO A QUALIFIED INDIVIDUAL THAT THE INDIVIDUAL MAY
CHOOSE TO SELF-ADMINISTER TO BRING ABOUT DEATH.
9. "MEDICALLY CONFIRMED" MEANS THE MEDICAL OPINION OF THE ATTENDING
PHYSICIAN THAT A PATIENT HAS A TERMINAL ILLNESS OR CONDITION AND HAS
MADE AN INFORMED DECISION WHICH HAS BEEN CONFIRMED BY A CONSULTING
PHYSICIAN WHO HAS EXAMINED THE PATIENT AND THE PATIENT'S RELEVANT
MEDICAL RECORDS.
A. 995--B 3
10. "MEDICATION" MEANS MEDICATION PRESCRIBED BY A PHYSICIAN UNDER THIS
ARTICLE.
11. "MENTAL HEALTH PROFESSIONAL" MEANS A LICENSED PHYSICIAN, WHO IS A
DIPLOMATE OR ELIGIBLE TO BE CERTIFIED BY A NATIONAL BOARD OF PSYCHIATRY,
PSYCHIATRIC NURSE PRACTITIONER, OR PSYCHOLOGIST, LICENSED OR CERTIFIED
UNDER THE EDUCATION LAW ACTING WITHIN SUCH MENTAL HEALTH PROFESSIONAL'S
SCOPE OF PRACTICE AND WHO IS QUALIFIED, BY TRAINING AND EXPERIENCE,
CERTIFICATION, OR BOARD CERTIFICATION OR ELIGIBILITY, TO MAKE A DETERMI-
NATION UNDER SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-I OF THIS ARTICLE.
12. "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.
13. "PATIENT" MEANS A PERSON WHO IS EIGHTEEN YEARS OF AGE OR OLDER
UNDER THE CARE OF A PHYSICIAN.
14. "PHYSICIAN" MEANS AN INDIVIDUAL LICENSED TO PRACTICE MEDICINE IN
NEW YORK STATE.
15. "QUALIFIED INDIVIDUAL" MEANS A PATIENT WITH A TERMINAL ILLNESS OR
CONDITION, WHO HAS DECISION-MAKING CAPACITY, HAS MADE AN INFORMED DECI-
SION, AND HAS SATISFIED THE REQUIREMENTS OF THIS ARTICLE IN ORDER TO
OBTAIN A PRESCRIPTION FOR MEDICATION.
16. "SELF-ADMINISTER" MEANS A QUALIFIED INDIVIDUAL'S AFFIRMATIVE,
CONSCIOUS, AND VOLUNTARY ACT TO INGEST MEDICATION UNDER THIS ARTICLE.
SELF-ADMINISTRATION DOES NOT INCLUDE LETHAL INJECTION OR LETHAL
INFUSION.
17. "TERMINAL ILLNESS OR CONDITION" MEANS AN INCURABLE AND IRREVERS-
IBLE ILLNESS OR CONDITION THAT HAS BEEN MEDICALLY CONFIRMED AND WILL,
WITHIN REASONABLE MEDICAL JUDGMENT, PRODUCE DEATH WITHIN SIX MONTHS.
18. "THIRD-PARTY HEALTH CARE PAYER" HAS ITS ORDINARY MEANING AND
INCLUDES, BUT IS NOT LIMITED TO, AN INSURER, ORGANIZATION OR CORPORATION
LICENSED OR CERTIFIED UNDER ARTICLE THIRTY-TWO, FORTY-THREE OR FORTY-
SEVEN OF THE INSURANCE LAW, OR ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH
LAW; OR AN ENTITY SUCH AS A PHARMACY BENEFITS MANAGER, FISCAL ADMINIS-
TRATOR, OR ADMINISTRATIVE SERVICES PROVIDER THAT PARTICIPATES IN THE
ADMINISTRATION OF A THIRD-PARTY HEALTH CARE PAYER SYSTEM.
§ 2899-E. REQUEST PROCESS. 1. ORAL AND WRITTEN REQUEST. A PATIENT
WISHING TO REQUEST MEDICATION UNDER THIS ARTICLE SHALL MAKE AN ORAL
REQUEST AND SUBMIT A WRITTEN REQUEST TO THE PATIENT'S ATTENDING PHYSI-
CIAN.
2. MAKING A WRITTEN REQUEST. A PATIENT MAY MAKE A WRITTEN REQUEST FOR
AND CONSENT TO SELF-ADMINISTER MEDICATION FOR THE PURPOSE OF ENDING SUCH
PATIENT'S LIFE IN ACCORDANCE WITH THIS ARTICLE IF THE PATIENT:
(A) HAS BEEN DETERMINED BY THE ATTENDING PHYSICIAN TO HAVE A TERMINAL
ILLNESS OR CONDITION AND WHICH HAS BEEN MEDICALLY CONFIRMED BY A
CONSULTING PHYSICIAN; AND
(B) BASED ON AN INFORMED DECISION, EXPRESSES VOLUNTARILY, OF THE
PATIENT'S OWN VOLITION AND WITHOUT COERCION THE REQUEST FOR MEDICATION
TO END SUCH PATIENT'S LIFE.
3. WRITTEN REQUEST SIGNED AND WITNESSED. (A) A WRITTEN REQUEST FOR
MEDICATION UNDER THIS ARTICLE SHALL BE SIGNED AND DATED BY THE PATIENT
AND WITNESSED BY AT LEAST TWO ADULTS WHO, IN THE PRESENCE OF THE
PATIENT, ATTEST THAT TO THE BEST OF THE PERSONS KNOWLEDGE AND BELIEF THE
PATIENT HAS DECISION-MAKING CAPACITY, IS ACTING VOLUNTARILY, IS MAKING
THE REQUEST FOR MEDICATION OF THE PATIENT'S OWN VOLITION AND IS NOT
BEING COERCED TO SIGN THE REQUEST. THE WRITTEN REQUEST SHALL BE IN
A. 995--B 4
SUBSTANTIALLY THE FORM DESCRIBED IN SECTION TWENTY-EIGHT HUNDRED NINE-
TY-NINE-K OF THIS ARTICLE.
(B) BOTH WITNESSES SHALL BE ADULTS WHO ARE NOT:
(I) A RELATIVE OF THE PATIENT BY BLOOD, MARRIAGE OR ADOPTION;
(II) 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;
(III) AN OWNER, OPERATOR, EMPLOYEE OR INDEPENDENT CONTRACTOR OF A
HEALTH CARE FACILITY WHERE THE PATIENT IS RECEIVING TREATMENT OR IS A
RESIDENT;
(IV) A DOMESTIC PARTNER OF THE PATIENT, AS DEFINED IN SUBDIVISION
SEVEN OF SECTION TWENTY-NINE HUNDRED NINETY-FOUR-A OF THIS CHAPTER;
(V) AN AGENT UNDER THE PATIENT'S HEALTH CARE PROXY AS DEFINED IN
SUBDIVISION FIVE OF SECTION TWENTY-NINE HUNDRED EIGHTY OF THIS CHAPTER;
OR
(VI) AN AGENT ACTING UNDER A POWER OF ATTORNEY FOR THE PATIENT AS
DEFINED IN SECTION 5-1501 OF THE GENERAL OBLIGATIONS LAW.
(C) THE ATTENDING PHYSICIAN, CONSULTING PHYSICIAN AND, IF APPLICABLE,
THE MENTAL HEALTH PROFESSIONAL WHO PROVIDES A DECISION-MAKING CAPACITY
DETERMINATION OF THE PATIENT UNDER THIS ARTICLE SHALL NOT BE A WITNESS.
4. NO PERSON SHALL QUALIFY FOR MEDICAL AID IN DYING UNDER THIS ARTICLE
SOLELY BECAUSE OF AGE OR DISABILITY.
5. REQUESTS FOR A MEDICAL AID-IN-DYING PRESCRIPTION MUST BE MADE BY
THE QUALIFIED INDIVIDUAL AND MAY NOT BE MADE BY ANY OTHER INDIVIDUAL,
INCLUDING THE QUALIFIED INDIVIDUAL'S HEALTH CARE AGENT, OR OTHER AGENT
OR SURROGATE, OR VIA ADVANCE HEALTHCARE DIRECTIVE.
§ 2899-F. ATTENDING PHYSICIAN RESPONSIBILITIES. 1. THE ATTENDING
PHYSICIAN SHALL EXAMINE THE PATIENT AND THE PATIENT'S RELEVANT MEDICAL
RECORDS AND:
(A) MAKE A DETERMINATION OF WHETHER A PATIENT HAS A TERMINAL ILLNESS
OR CONDITION, HAS DECISION-MAKING CAPACITY, HAS MADE AN INFORMED DECI-
SION AND HAS MADE THE REQUEST VOLUNTARILY OF THE PATIENT'S OWN VOLITION
AND WITHOUT COERCION;
(B) INFORM THE PATIENT OF THE REQUIREMENT UNDER THIS ARTICLE FOR
CONFIRMATION BY A CONSULTING PHYSICIAN, AND REFER THE PATIENT TO A
CONSULTING PHYSICIAN UPON THE PATIENT'S REQUEST;
(C) REFER THE PATIENT TO A MENTAL HEALTH PROFESSIONAL PURSUANT TO
SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-I OF THIS ARTICLE IF THE
ATTENDING PHYSICIAN BELIEVES THAT THE PATIENT MAY LACK DECISION-MAKING
CAPACITY TO MAKE AN INFORMED DECISION;
(D) PROVIDE INFORMATION AND COUNSELING UNDER SECTION TWENTY-NINE
HUNDRED NINETY-SEVEN-C OF THIS CHAPTER;
(E) ENSURE THAT THE PATIENT IS MAKING AN INFORMED DECISION BY DISCUSS-
ING WITH THE PATIENT: (I) THE PATIENT'S MEDICAL DIAGNOSIS AND PROGNOSIS;
(II) THE POTENTIAL RISKS ASSOCIATED WITH TAKING THE MEDICATION TO BE
PRESCRIBED; (III) THE PROBABLE RESULT OF TAKING THE MEDICATION TO BE
PRESCRIBED; (IV) THE POSSIBILITY THAT THE PATIENT MAY CHOOSE TO OBTAIN
THE MEDICATION BUT NOT TAKE IT; (V) THE FEASIBLE ALTERNATIVES AND APPRO-
PRIATE TREATMENT OPTIONS, INCLUDING BUT NOT LIMITED TO (1) INFORMATION
AND COUNSELING REGARDING PALLIATIVE AND HOSPICE CARE AND END-OF-LIFE
OPTIONS APPROPRIATE TO THE PATIENT, INCLUDING BUT NOT LIMITED TO: THE
RANGE OF OPTIONS APPROPRIATE TO THE PATIENT; THE PROGNOSIS, RISKS AND
BENEFITS OF THE VARIOUS OPTIONS; AND THE PATIENT'S LEGAL RIGHTS TO
COMPREHENSIVE PAIN AND SYMPTOM MANAGEMENT AT THE END OF LIFE; AND (2)
INFORMATION REGARDING TREATMENT OPTIONS APPROPRIATE TO THE PATIENT,
A. 995--B 5
INCLUDING THE PROGNOSIS, RISKS AND BENEFITS OF THE VARIOUS TREATMENT
OPTIONS;
(F) OFFER TO REFER THE PATIENT FOR OTHER APPROPRIATE TREATMENT
OPTIONS, INCLUDING BUT NOT LIMITED TO PALLIATIVE CARE AND HOSPICE CARE;
(G) PROVIDE HEALTH LITERATE AND CULTURALLY APPROPRIATE EDUCATIONAL
MATERIAL REGARDING HOSPICE AND PALLIATIVE CARE THAT HAS BEEN PREPARED BY
THE DEPARTMENT IN CONSULTATION WITH REPRESENTATIVES OF HOSPICE AND
PALLIATIVE CARE PROVIDERS FROM ALL REGIONS OF NEW YORK STATE, AND THAT
IS AVAILABLE ON THE DEPARTMENT'S WEBSITE FOR ACCESS AND DOWNLOAD,
PROVIDED, HOWEVER, AN OTHERWISE ELIGIBLE PATIENT CANNOT BE DENIED CARE
UNDER THIS ARTICLE IF THESE MATERIALS ARE NOT DEVELOPED BY THE EFFECTIVE
DATE OF THIS ARTICLE;
(H) DISCUSS WITH THE PATIENT THE IMPORTANCE OF:
(I) HAVING ANOTHER PERSON PRESENT WHEN THE PATIENT TAKES THE MEDICA-
TION AND THE RESTRICTION THAT NO PERSON OTHER THAN THE PATIENT MAY
ADMINISTER THE MEDICATION;
(II) NOT TAKING THE MEDICATION IN A PUBLIC PLACE; AND
(III) INFORMING THE PATIENT'S FAMILY OF THE PATIENT'S DECISION TO
REQUEST AND TAKE MEDICATION THAT WILL END THE PATIENT'S LIFE; A PATIENT
WHO DECLINES OR IS UNABLE TO NOTIFY FAMILY SHALL NOT HAVE SUCH PATIENT'S
REQUEST FOR MEDICATION DENIED FOR THAT REASON;
(I) INFORM THE PATIENT THAT SUCH PATIENT MAY RESCIND THE REQUEST FOR
MEDICATION AT ANY TIME AND IN ANY MANNER;
(J) FULFILL THE MEDICAL RECORD DOCUMENTATION REQUIREMENTS OF SECTION
TWENTY-EIGHT HUNDRED NINETY-NINE-J OF THIS ARTICLE; AND
(K) ENSURE THAT ALL APPROPRIATE STEPS ARE CARRIED OUT IN ACCORDANCE
WITH THIS ARTICLE BEFORE WRITING A PRESCRIPTION FOR MEDICATION.
2. UPON RECEIVING CONFIRMATION FROM A CONSULTING PHYSICIAN UNDER
SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-H OF THIS ARTICLE AND SUBJECT
TO SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-I OF THIS ARTICLE, THE
ATTENDING PHYSICIAN WHO DETERMINES THAT THE PATIENT HAS A TERMINAL
ILLNESS OR CONDITION, HAS DECISION-MAKING CAPACITY AND HAS MADE A VOLUN-
TARY REQUEST FOR MEDICATION AS PROVIDED IN THIS ARTICLE, MAY PERSONALLY,
OR BY REFERRAL TO ANOTHER PHYSICIAN, PRESCRIBE 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 DELIVERY OF THE MEDICATION TO THE PATIENT.
3. IN ACCORDANCE WITH THE DIRECTION OF THE PRESCRIBING OR ORDERING
PHYSICIAN AND THE CONSENT OF THE PATIENT, THE PATIENT MAY SELF-ADMINIS-
TER THE MEDICATION TO THEMSELVES. A HEALTH CARE PROFESSIONAL OR OTHER
PERSON SHALL NOT ADMINISTER THE MEDICATION TO THE PATIENT.
§ 2899-G. RIGHT TO RESCIND REQUEST; REQUIREMENT TO OFFER OPPORTUNITY
TO RESCIND. 1. A PATIENT MAY AT ANY TIME RESCIND THE REQUEST FOR MEDI-
CATION UNDER THIS ARTICLE WITHOUT REGARD TO THE PATIENT'S DECISION-MAK-
ING CAPACITY.
2. A PRESCRIPTION FOR MEDICATION MAY NOT BE WRITTEN WITHOUT THE
ATTENDING PHYSICIAN OFFERING THE QUALIFIED INDIVIDUAL AN OPPORTUNITY TO
RESCIND THE REQUEST.
§ 2899-H. CONSULTING PHYSICIAN RESPONSIBILITIES. BEFORE A PATIENT WHO
IS REQUESTING MEDICATION MAY RECEIVE A PRESCRIPTION FOR MEDICATION UNDER
THIS ARTICLE, A CONSULTING PHYSICIAN MUST:
1. EXAMINE THE PATIENT AND SUCH PATIENT'S RELEVANT MEDICAL RECORDS;
2. CONFIRM, IN WRITING, TO THE ATTENDING PHYSICIAN AND THE PATIENT,
WHETHER: (A) THE PATIENT HAS A TERMINAL ILLNESS OR CONDITION; (B) THE
PATIENT IS MAKING AN INFORMED DECISION; (C) THE PATIENT HAS DECISION-
MAKING CAPACITY, OR PROVIDE DOCUMENTATION THAT THE CONSULTING PHYSICIAN
A. 995--B 6
HAS REFERRED THE PATIENT FOR A DETERMINATION UNDER SECTION TWENTY-EIGHT
HUNDRED NINETY-NINE-I OF THIS ARTICLE; AND (D) THE PATIENT IS ACTING
VOLUNTARILY, OF THE PATIENT'S OWN VOLITION AND WITHOUT COERCION.
§ 2899-I. REFERRAL TO MENTAL HEALTH PROFESSIONAL. 1. IF THE ATTENDING
PHYSICIAN OR THE CONSULTING PHYSICIAN DETERMINES THAT THE PATIENT MAY
LACK DECISION-MAKING CAPACITY TO MAKE AN INFORMED DECISION DUE TO A
CONDITION, INCLUDING, BUT NOT LIMITED TO, A PSYCHIATRIC OR PSYCHOLOGICAL
DISORDER, OR OTHER CONDITION CAUSING IMPAIRED JUDGEMENT, THE ATTENDING
PHYSICIAN OR CONSULTING PHYSICIAN SHALL REFER THE PATIENT TO A MENTAL
HEALTH PROFESSIONAL FOR A DETERMINATION OF WHETHER THE PATIENT HAS DECI-
SION-MAKING CAPACITY TO MAKE AN INFORMED DECISION. THE REFERRING PHYSI-
CIAN SHALL ADVISE THE PATIENT THAT THE REPORT OF THE MENTAL HEALTH
PROFESSIONAL WILL BE PROVIDED TO THE ATTENDING PHYSICIAN AND THE
CONSULTING PHYSICIAN.
2. A MENTAL HEALTH PROFESSIONAL WHO EVALUATES A PATIENT UNDER THIS
SECTION SHALL REPORT, IN WRITING, TO THE ATTENDING PHYSICIAN AND THE
CONSULTING PHYSICIAN, THE MENTAL HEALTH PROFESSIONAL'S INDEPENDENT
CONCLUSIONS ABOUT WHETHER THE PATIENT HAS DECISION-MAKING CAPACITY TO
MAKE AN INFORMED DECISION, PROVIDED THAT IF, AT THE TIME OF THE REPORT,
THE PATIENT HAS NOT YET BEEN REFERRED TO A CONSULTING PHYSICIAN, THEN
UPON REFERRAL THE ATTENDING PHYSICIAN SHALL PROVIDE THE CONSULTING
PHYSICIAN WITH A COPY OF THE MENTAL HEALTH PROFESSIONAL'S REPORT. IF THE
MENTAL HEALTH PROFESSIONAL DETERMINES THAT THE PATIENT LACKS DECISION-
MAKING CAPACITY TO MAKE AN INFORMED DECISION, THE PATIENT SHALL NOT BE
DEEMED A QUALIFIED INDIVIDUAL, AND THE ATTENDING PHYSICIAN SHALL NOT
PRESCRIBE MEDICATION TO THE PATIENT.
3. A DETERMINATION MADE PURSUANT TO THIS SECTION THAT AN ADULT PATIENT
LACKS DECISION-MAKING CAPACITY SHALL NOT BE CONSTRUED AS A FINDING THAT
THE PATIENT LACKS DECISION-MAKING CAPACITY FOR ANY OTHER PURPOSE.
§ 2899-J. MEDICAL RECORD DOCUMENTATION REQUIREMENTS. AN ATTENDING
PHYSICIAN SHALL DOCUMENT OR FILE THE FOLLOWING IN THE PATIENT'S MEDICAL
RECORD:
1. THE DATES OF ALL ORAL REQUESTS BY THE PATIENT FOR MEDICATION UNDER
THIS ARTICLE;
2. THE WRITTEN REQUEST BY THE PATIENT FOR MEDICATION UNDER THIS ARTI-
CLE, INCLUDING THE DECLARATION OF WITNESSES AND INTERPRETER'S DECLARA-
TION, IF APPLICABLE;
3. THE ATTENDING PHYSICIAN'S DIAGNOSIS AND PROGNOSIS, DETERMINATION OF
DECISION-MAKING CAPACITY, AND DETERMINATION THAT THE PATIENT IS ACTING
VOLUNTARILY, OF THE PATIENT'S OWN VOLITION AND WITHOUT COERCION, AND HAS
MADE AN INFORMED DECISION;
4. IF APPLICABLE, WRITTEN CONFIRMATION OF DECISION-MAKING CAPACITY
UNDER SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-I OF THIS ARTICLE; AND
5. A NOTE BY THE ATTENDING PHYSICIAN INDICATING THAT ALL REQUIREMENTS
UNDER THIS ARTICLE HAVE BEEN MET AND INDICATING THE STEPS TAKEN TO CARRY
OUT THE REQUEST, INCLUDING A NOTATION OF THE MEDICATION PRESCRIBED OR
ORDERED.
§ 2899-K. FORM OF WRITTEN REQUEST AND WITNESS ATTESTATION. 1. A
REQUEST FOR MEDICATION UNDER THIS ARTICLE SHALL BE IN SUBSTANTIALLY THE
FOLLOWING FORM:
REQUEST FOR MEDICATION TO END MY LIFE
I, _________________________________, AM AN ADULT WHO HAS DECISION-
MAKING CAPACITY, WHICH MEANS I 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
A. 995--B 7
INFORMED DECISION AND TO COMMUNICATE HEALTH CARE DECISIONS TO A PHYSI-
CIAN.
I HAVE BEEN DIAGNOSED WITH (INSERT DIAGNOSIS), WHICH MY ATTENDING
PHYSICIAN HAS DETERMINED IS A TERMINAL ILLNESS OR CONDITION, WHICH HAS
BEEN MEDICALLY CONFIRMED BY A CONSULTING PHYSICIAN.
I HAVE BEEN FULLY INFORMED OF MY DIAGNOSIS AND PROGNOSIS, THE NATURE
OF THE MEDICATION TO BE PRESCRIBED AND POTENTIAL ASSOCIATED RISKS, THE
EXPECTED RESULT, AND THE FEASIBLE ALTERNATIVES AND TREATMENT OPTIONS
INCLUDING BUT NOT LIMITED TO PALLIATIVE CARE AND HOSPICE CARE.
I REQUEST THAT MY ATTENDING PHYSICIAN PRESCRIBE MEDICATION THAT WILL
END MY LIFE IF I CHOOSE TO TAKE IT, AND I AUTHORIZE MY ATTENDING PHYSI-
CIAN TO CONTACT ANOTHER PHYSICIAN OR ANY PHARMACIST ABOUT MY REQUEST.
INITIAL ONE:
( ) I HAVE INFORMED OR INTEND TO INFORM ONE OR MORE MEMBERS OF MY
FAMILY OF MY DECISION.
( ) I HAVE DECIDED NOT TO INFORM ANY MEMBER OF MY FAMILY OF MY DECI-
SION.
( ) I HAVE NO FAMILY TO INFORM OF MY DECISION.
I UNDERSTAND THAT I HAVE THE RIGHT TO RESCIND THIS REQUEST OR DECLINE
TO USE THE MEDICATION AT ANY TIME.
I UNDERSTAND THE IMPORTANCE OF THIS REQUEST, AND I EXPECT TO DIE IF I
TAKE THE MEDICATION TO BE PRESCRIBED. I FURTHER UNDERSTAND THAT ALTHOUGH
MOST DEATHS OCCUR WITHIN THREE HOURS, MY DEATH MAY TAKE LONGER, AND MY
ATTENDING PHYSICIAN HAS COUNSELED ME ABOUT THIS POSSIBILITY.
I MAKE THIS REQUEST VOLUNTARILY, OF MY OWN VOLITION AND WITHOUT BEING
COERCED, AND I ACCEPT FULL RESPONSIBILITY FOR MY ACTIONS.
SIGNED: __________________________
DATED: ___________________________
DECLARATION OF WITNESSES
I DECLARE THAT THE PERSON SIGNING THIS "REQUEST FOR MEDICATION TO END
MY LIFE":
(A) IS PERSONALLY KNOWN TO ME OR HAS PROVIDED PROOF OF IDENTITY;
(B) VOLUNTARILY SIGNED THE "REQUEST FOR MEDICATION TO END MY LIFE" IN
MY PRESENCE OR ACKNOWLEDGED TO ME THAT THE PERSON SIGNED IT; AND
(C) TO THE BEST OF MY KNOWLEDGE AND BELIEF, HAS DECISION-MAKING CAPAC-
ITY AND IS MAKING THE "REQUEST FOR MEDICATION TO END MY LIFE" VOLUNTAR-
ILY, OF THE PERSON'S OWN VOLITION AND IS NOT BEING COERCED TO SIGN THE
"REQUEST FOR MEDICATION TO END MY LIFE".
I AM NOT THE ATTENDING PHYSICIAN OR CONSULTING PHYSICIAN OF THE PERSON
SIGNING THE "REQUEST FOR MEDICATION TO END MY LIFE" OR, IF APPLICABLE,
THE MENTAL HEALTH PROFESSIONAL WHO PROVIDES A DECISION-MAKING CAPACITY
DETERMINATION OF THE PERSON SIGNING THE "REQUEST FOR MEDICATION TO END
MY LIFE" AT THE TIME THE "REQUEST FOR MEDICATION TO END MY LIFE" WAS
SIGNED.
I FURTHER DECLARE UNDER PENALTY OF PERJURY THAT THE STATEMENTS MADE
HEREIN ARE TRUE AND CORRECT AND FALSE STATEMENTS MADE HEREIN ARE PUNISH-
ABLE.
WITNESS 1, DATE:
(PRINTED NAME)
A. 995--B 8
(ADDRESS)
(TELEPHONE NUMBER)
I FURTHER DECLARE THAT I AM NOT (I) RELATED TO THE ABOVE-NAMED PATIENT
BY BLOOD, MARRIAGE OR ADOPTION, (II) ENTITLED AT THE TIME THE PATIENT
SIGNED THE "REQUEST FOR MEDICATION TO END MY LIFE" TO ANY PORTION OF THE
ESTATE OF THE PATIENT UPON SUCH PATIENT'S DEATH UNDER ANY WILL OR BY
OPERATION OF LAW, OR (III) AN OWNER, OPERATOR, EMPLOYEE OR INDEPENDENT
CONTRACTOR OF A HEALTH CARE FACILITY WHERE THE PATIENT IS RECEIVING
TREATMENT OR IS A RESIDENT.
WITNESS 2, DATE:
(PRINTED NAME)
(ADDRESS)
(TELEPHONE NUMBER)
I FURTHER DECLARE THAT I AM NOT (I) RELATED TO THE ABOVE-NAMED PATIENT
BY BLOOD, MARRIAGE OR ADOPTION, (II) ENTITLED AT THE TIME THE PATIENT
SIGNED THE "REQUEST FOR MEDICATION TO END MY LIFE" TO ANY PORTION OF THE
ESTATE OF THE PATIENT UPON SUCH PATIENT'S DEATH UNDER ANY WILL OR BY
OPERATION OF LAW, OR (III) AN OWNER, OPERATOR, EMPLOYEE OR INDEPENDENT
CONTRACTOR OF A HEALTH CARE FACILITY WHERE THE PATIENT IS RECEIVING
TREATMENT OR IS A RESIDENT.
2. (A) THE "REQUEST FOR MEDICATION TO END MY LIFE" SHALL BE WRITTEN IN
THE SAME LANGUAGE AS ANY CONVERSATIONS, CONSULTATIONS, OR INTERPRETED
CONVERSATIONS OR CONSULTATIONS BETWEEN A PATIENT AND AT LEAST ONE OF THE
PATIENT'S ATTENDING OR CONSULTING PHYSICIANS.
(B) NOTWITHSTANDING PARAGRAPH (A) OF THIS SUBDIVISION, THE WRITTEN
"REQUEST FOR MEDICATION TO END MY LIFE" MAY BE PREPARED IN ENGLISH EVEN
WHEN THE CONVERSATIONS OR CONSULTATIONS OR INTERPRETED CONVERSATIONS OR
CONSULTATIONS WERE CONDUCTED IN A LANGUAGE OTHER THAN ENGLISH OR WITH
AUXILIARY AIDS OR HEARING, SPEECH OR VISUAL AIDS, IF THE ENGLISH
LANGUAGE FORM INCLUDES AN ATTACHED DECLARATION BY THE INTERPRETER OF THE
CONVERSATION OR CONSULTATION, WHICH SHALL BE IN SUBSTANTIALLY THE
FOLLOWING FORM:
INTERPRETER'S DECLARATION
I, (INSERT NAME OF INTERPRETER), (MARK AS APPLICABLE):
( ) FOR A PATIENT WHOSE CONVERSATIONS OR CONSULTATIONS OR INTERPRETED
CONVERSATIONS OR CONSULTATIONS WERE CONDUCTED IN A LANGUAGE OTHER THAN
ENGLISH AND THE "REQUEST FOR MEDICATION TO END MY LIFE" IS IN ENGLISH: I
DECLARE THAT I AM FLUENT IN ENGLISH AND (INSERT TARGET LANGUAGE). I HAVE
THE REQUISITE LANGUAGE AND INTERPRETER SKILLS TO BE ABLE TO INTERPRET
EFFECTIVELY, ACCURATELY AND IMPARTIALLY INFORMATION SHARED AND COMMUNI-
CATIONS BETWEEN THE ATTENDING OR CONSULTING PHYSICIAN AND (NAME OF
PATIENT).
I CERTIFY THAT ON (INSERT DATE), AT APPROXIMATELY (INSERT TIME), I
INTERPRETED THE COMMUNICATIONS AND INFORMATION CONVEYED BETWEEN THE
PHYSICIAN AND (NAME OF PATIENT) AS ACCURATELY AND COMPLETELY TO THE BEST
OF MY KNOWLEDGE AND ABILITY AND READ THE "REQUEST FOR MEDICATION TO END
MY LIFE" TO (NAME OF PATIENT) IN (INSERT TARGET LANGUAGE).
A. 995--B 9
(NAME OF PATIENT) AFFIRMED TO ME SUCH PATIENT'S DESIRE TO SIGN THE
"REQUEST FOR MEDICATION TO END MY LIFE" VOLUNTARILY, OF (NAME OF
PATIENT)'S OWN VOLITION AND WITHOUT COERCION.
( ) FOR A PATIENT WITH A SPEECH, HEARING OR VISION DISABILITY: I
DECLARE THAT I HAVE THE REQUISITE LANGUAGE, READING AND/OR INTERPRETER
SKILLS TO COMMUNICATE WITH THE PATIENT AND TO BE ABLE TO READ AND/OR
INTERPRET EFFECTIVELY, ACCURATELY AND IMPARTIALLY INFORMATION SHARED AND
COMMUNICATIONS THAT OCCURRED ON (INSERT DATE) BETWEEN THE ATTENDING OR
CONSULTING PHYSICIAN AND (NAME OF PATIENT).
I CERTIFY THAT ON (INSERT DATE), AT APPROXIMATELY (INSERT TIME), I
READ AND/OR INTERPRETED THE COMMUNICATIONS AND INFORMATION CONVEYED
BETWEEN THE PHYSICIAN AND (NAME OF PATIENT) IMPARTIALLY AND AS ACCURATE-
LY AND COMPLETELY TO THE BEST OF MY KNOWLEDGE AND ABILITY AND, WHERE
NEEDED FOR EFFECTIVE COMMUNICATION, READ OR INTERPRETED THE "REQUEST FOR
MEDICATION TO END MY LIFE" TO (NAME OF PATIENT).
(NAME OF PATIENT) AFFIRMED TO ME SUCH PATIENT'S DESIRE TO SIGN THE
"REQUEST FOR MEDICATION TO END MY LIFE" VOLUNTARILY, OF (NAME OF
PATIENT)'S OWN VOLITION AND WITHOUT COERCION.
I FURTHER DECLARE UNDER PENALTY OF PERJURY THAT (I) THE FOREGOING IS
TRUE AND CORRECT; (II) I AM NOT (A) RELATED TO (NAME OF PATIENT) BY
BLOOD, MARRIAGE OR ADOPTION, (B) ENTITLED AT THE TIME (NAME OF PATIENT)
SIGNED THE "REQUEST FOR MEDICATION TO END MY LIFE" TO ANY PORTION OF THE
ESTATE OF (NAME OF PATIENT) UPON SUCH PATIENT'S DEATH UNDER ANY WILL OR
BY OPERATION OF LAW, OR (C) AN OWNER, OPERATOR, EMPLOYEE OR INDEPENDENT
CONTRACTOR OF A HEALTH CARE FACILITY WHERE (NAME OF PATIENT) IS RECEIV-
ING TREATMENT OR IS A RESIDENT, EXCEPT THAT IF I AM AN EMPLOYEE OR INDE-
PENDENT CONTRACTOR AT SUCH HEALTH CARE FACILITY, PROVIDING INTERPRETER
SERVICES IS PART OF MY JOB DESCRIPTION AT SUCH HEALTH CARE FACILITY OR I
HAVE BEEN TRAINED TO PROVIDE INTERPRETER SERVICES AND (NAME OF PATIENT)
REQUESTED THAT I PROVIDE INTERPRETER SERVICES TO SUCH PATIENT FOR THE
PURPOSES STATED IN THIS DECLARATION; AND (III) FALSE STATEMENTS MADE
HEREIN ARE PUNISHABLE.
EXECUTED AT (INSERT CITY, COUNTY AND STATE) ON THIS (INSERT DAY OF
MONTH) OF (INSERT MONTH), (INSERT YEAR).
(SIGNATURE OF INTERPRETER)
(PRINTED NAME OF INTERPRETER)
(ID # OR AGENCY NAME)
(ADDRESS OF INTERPRETER)
(LANGUAGE SPOKEN BY INTERPRETER)
(C) AN INTERPRETER WHOSE SERVICES ARE PROVIDED UNDER PARAGRAPH (B) OF
THIS SUBDIVISION SHALL NOT (I) BE RELATED TO THE PATIENT WHO SIGNS THE
"REQUEST FOR MEDICATION TO END MY LIFE" BY BLOOD, MARRIAGE OR ADOPTION,
(II) BE ENTITLED AT THE TIME THE "REQUEST FOR MEDICATION TO END MY LIFE"
IS SIGNED BY THE PATIENT TO ANY PORTION OF THE ESTATE OF THE PATIENT
UPON DEATH UNDER ANY WILL OR BY OPERATION OF LAW, OR (III) BE AN OWNER,
OPERATOR, EMPLOYEE OR INDEPENDENT CONTRACTOR OF A HEALTH CARE FACILITY
WHERE THE PATIENT IS RECEIVING TREATMENT OR IS A RESIDENT; PROVIDED THAT
AN EMPLOYEE OR INDEPENDENT CONTRACTOR WHOSE JOB DESCRIPTION AT THE
HEALTH CARE FACILITY INCLUDES INTERPRETER SERVICES OR WHO IS TRAINED TO
A. 995--B 10
PROVIDE INTERPRETER SERVICES AND WHO HAS BEEN REQUESTED BY THE PATIENT
TO SERVE AS AN INTERPRETER UNDER THIS ARTICLE SHALL NOT BE PROHIBITED
FROM SERVING AS AN INTERPRETER UNDER THIS ARTICLE.
§ 2899-L. PROTECTION AND IMMUNITIES. 1. A PHYSICIAN, PHARMACIST, OTHER
HEALTH CARE PROVIDER OR OTHER PERSON SHALL NOT BE SUBJECT TO CIVIL,
ADMINISTRATIVE, OR CRIMINAL LIABILITY OR PENALTY OR PROFESSIONAL DISCI-
PLINARY ACTION BY ANY GOVERNMENT ENTITY FOR TAKING ANY REASONABLE GOOD-
FAITH ACTION OR REFUSING TO ACT UNDER THIS ARTICLE, INCLUDING, BUT NOT
LIMITED TO: (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) PROVIDING A PATIENT, UPON REQUEST, WITH A REFERRAL
TO ANOTHER HEALTH CARE PROVIDER, (C) BEING PRESENT WHEN A QUALIFIED
INDIVIDUAL SELF-ADMINISTERS MEDICATION, (D) REFRAINING FROM ACTING TO
PREVENT THE QUALIFIED INDIVIDUAL FROM SELF-ADMINISTERING SUCH MEDICA-
TION, OR (E) REFRAINING FROM ACTING TO RESUSCITATE THE QUALIFIED INDI-
VIDUAL AFTER THE QUALIFIED INDIVIDUAL SELF-ADMINISTERS SUCH MEDICATION.
2. A HEALTH CARE PROVIDER OR OTHER PERSON SHALL NOT BE SUBJECT TO
EMPLOYMENT, CREDENTIALING, OR CONTRACTUAL LIABILITY OR PENALTY FOR ANY
REASONABLE GOOD-FAITH ACTION OR REFUSING TO ACT UNDER THIS ARTICLE,
INCLUDING, BUT NOT LIMITED TO:
(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) PROVIDING A PATIENT, UPON REQUEST, WITH A REFERRAL TO ANOTHER
HEALTH CARE PROVIDER;
(C) BEING PRESENT WHEN A QUALIFIED INDIVIDUAL SELF-ADMINISTERS MEDICA-
TION;
(D) REFRAINING FROM ACTING TO PREVENT THE QUALIFIED INDIVIDUAL FROM
SELF-ADMINISTERING SUCH MEDICATION; OR
(E) REFRAINING FROM ACTING TO RESUSCITATE THE QUALIFIED INDIVIDUAL
AFTER THE QUALIFIED INDIVIDUAL SELF-ADMINISTERS SUCH MEDICATION. HOWEV-
ER, THIS SUBDIVISION DOES NOT BAR A HEALTH CARE FACILITY FROM ACTING
UNDER PARAGRAPH (C) OF SUBDIVISION TWO OF SECTION TWENTY-EIGHT HUNDRED
NINETY-NINE-M OF THIS ARTICLE.
3. NOTHING IN THIS SECTION SHALL LIMIT CIVIL, ADMINISTRATIVE, OR CRIM-
INAL LIABILITY OR PENALTY OR ANY PROFESSIONAL DISCIPLINARY ACTION, OR
EMPLOYMENT, CREDENTIALING, OR CONTRACTUAL LIABILITY OR PENALTY FOR
NEGLIGENCE, RECKLESSNESS OR INTENTIONAL MISCONDUCT.
§ 2899-M. PERMISSIBLE REFUSALS AND PROHIBITIONS. 1. (A) A PHYSICIAN,
NURSE, PHARMACIST, OTHER HEALTH CARE PROVIDER OR OTHER PERSON SHALL NOT
BE UNDER ANY DUTY, BY LAW OR CONTRACT, TO PARTICIPATE IN THE PROVISION
OF MEDICATION TO A PATIENT UNDER THIS ARTICLE.
(B) IF A HEALTH CARE PROVIDER IS UNABLE OR UNWILLING TO PARTICIPATE IN
THE PROVISION OF MEDICATION TO A PATIENT UNDER THIS ARTICLE AND THE
PATIENT TRANSFERS CARE TO A NEW HEALTH CARE PROVIDER, THE PRIOR HEALTH
CARE PROVIDER SHALL TRANSFER OR ARRANGE FOR THE TRANSFER, UPON REQUEST,
OF A COPY OF THE PATIENT'S RELEVANT MEDICAL RECORDS TO THE NEW HEALTH
CARE PROVIDER.
2. (A) A PRIVATE HEALTH CARE FACILITY MAY PROHIBIT THE PRESCRIBING,
DISPENSING, ORDERING OR SELF-ADMINISTERING OF MEDICATION UNDER THIS
ARTICLE WHILE THE PATIENT IS BEING TREATED IN OR WHILE THE PATIENT IS
RESIDING IN THE HEALTH CARE FACILITY IF:
(I) THE PRESCRIBING, DISPENSING, ORDERING OR SELF-ADMINISTERING IS
CONTRARY TO A FORMALLY ADOPTED POLICY OF THE FACILITY THAT IS EXPRESSLY
BASED ON SINCERELY HELD RELIGIOUS BELIEFS OR MORAL CONVICTIONS CENTRAL
TO THE FACILITY'S OPERATING PRINCIPLES; AND
A. 995--B 11
(II) THE FACILITY HAS INFORMED THE PATIENT OF SUCH POLICY PRIOR TO
ADMISSION OR AS SOON AS REASONABLY POSSIBLE.
(B) WHERE A FACILITY HAS ADOPTED A PROHIBITION UNDER THIS SUBDIVISION,
IF A PATIENT WHO WISHES TO USE MEDICATION UNDER THIS ARTICLE REQUESTS,
THE PATIENT SHALL BE TRANSFERRED PROMPTLY TO ANOTHER HEALTH CARE FACILI-
TY THAT IS REASONABLY ACCESSIBLE UNDER THE CIRCUMSTANCES AND WILLING TO
PERMIT THE PRESCRIBING, DISPENSING, ORDERING AND SELF-ADMINISTERING OF
MEDICATION UNDER THIS ARTICLE WITH RESPECT TO THE PATIENT.
(C) WHERE A HEALTH CARE FACILITY HAS ADOPTED A PROHIBITION UNDER THIS
SUBDIVISION, ANY HEALTH CARE PROVIDER OR EMPLOYEE OR INDEPENDENT
CONTRACTOR OF THE FACILITY WHO VIOLATES THE PROHIBITION MAY BE SUBJECT
TO SANCTIONS OTHERWISE AVAILABLE TO THE FACILITY, PROVIDED THE FACILITY
HAS PREVIOUSLY NOTIFIED THE HEALTH CARE PROVIDER, EMPLOYEE OR INDEPEND-
ENT CONTRACTOR OF THE PROHIBITION IN WRITING.
§ 2899-N. RELATION TO OTHER LAWS AND CONTRACTS. 1. (A) A PATIENT WHO
REQUESTS MEDICATION UNDER THIS ARTICLE SHALL NOT, BECAUSE OF THAT
REQUEST, BE CONSIDERED TO BE A PERSON WHO IS SUICIDAL, AND SELF-ADMINIS-
TERING MEDICATION UNDER THIS ARTICLE SHALL NOT BE DEEMED TO BE SUICIDE,
FOR ANY PURPOSE.
(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, EUTHANASIA, MERCY KILL-
ING, OR HOMICIDE UNDER THE LAW, INCLUDING AS AN ACCOMPLICE OR ACCESSORY
OR OTHERWISE.
2. (A) NO PROVISION IN A CONTRACT, OTHER AGREEMENT OR TESTAMENTARY
INSTRUMENT, 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, OTHER AGREEMENT OR TESTA-
MENTARY INSTRUMENT SHALL 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.
3. (A) A PERSON AND SUCH PERSON'S BENEFICIARIES SHALL NOT BE DENIED
BENEFITS UNDER A LIFE INSURANCE POLICY FOR ACTIONS TAKEN IN ACCORDANCE
WITH THIS ARTICLE.
(B) THE SALE, PROCUREMENT OR ISSUANCE OF A LIFE INSURANCE OR ANNUITY
POLICY OR THIRD-PARTY HEALTH CARE PAYER POLICY OR COVERAGE, OR THE RATE
CHARGED FOR A POLICY OR COVERAGE, SHALL NOT BE CONDITIONED UPON OR
AFFECTED BY A PATIENT MAKING OR RESCINDING A REQUEST FOR MEDICATION
UNDER THIS ARTICLE.
(C) NO THIRD-PARTY HEALTH CARE PAYER MAY DENY COVERAGE FOR ANY SERVICE
OR ITEM THAT WOULD OTHERWISE BE COVERED BY THE POLICY BECAUSE THE
PATIENT HAS OR HAS NOT CHOSEN TO REQUEST OR USE MEDICATION UNDER THIS
ARTICLE.
4. AN INSURER OR THIRD-PARTY HEALTH CARE PAYER SHALL NOT PROVIDE ANY
INFORMATION IN COMMUNICATIONS MADE TO A PATIENT ABOUT THE AVAILABILITY
OF MEDICATION UNDER THIS ARTICLE ABSENT A REQUEST BY THE PATIENT OR BY
SUCH PATIENT'S ATTENDING PHYSICIAN UPON THE REQUEST OF SUCH PATIENT. ANY
COMMUNICATION SHALL NOT INCLUDE BOTH THE DENIAL OF COVERAGE FOR TREAT-
MENT AND INFORMATION AS TO THE AVAILABILITY OF MEDICATION UNDER THIS
ARTICLE. THIS SUBDIVISION DOES NOT BAR THE INCLUSION OF INFORMATION AS
TO THE COVERAGE OF MEDICATION AND PROFESSIONAL SERVICES UNDER THIS ARTI-
CLE IN INFORMATION GENERALLY STATING WHAT IS COVERED BY A THIRD-PARTY
HEALTH CARE PAYER OR PROVIDED IN RESPONSE TO A REQUEST BY THE PATIENT OR
BY SUCH PATIENT'S ATTENDING PHYSICIAN UPON THE REQUEST OF THE PATIENT.
A. 995--B 12
5. 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-O. SAFE DISPOSAL OF UNUSED MEDICATIONS. A PERSON WHO HAS
CUSTODY OR CONTROL OF ANY UNUSED MEDICATION PRESCRIBED UNDER THIS ARTI-
CLE AFTER THE DEATH OF THE QUALIFIED INDIVIDUAL SHALL PERSONALLY DELIVER
THE UNUSED MEDICATION FOR DISPOSAL TO THE NEAREST QUALIFIED FACILITY
THAT PROPERLY DISPOSES OF CONTROLLED SUBSTANCES OR SHALL DISPOSE OF IT
BY LAWFUL MEANS IN ACCORDANCE WITH REGULATIONS MADE BY THE COMMISSIONER,
REGULATIONS MADE BY OR GUIDELINES OF THE COMMISSIONER OF EDUCATION, OR
GUIDELINES OF A FEDERAL DRUG ENFORCEMENT ADMINISTRATION APPROVED TAKE-
BACK PROGRAM. A QUALIFIED FACILITY THAT PROPERLY DISPOSES OF CONTROLLED
SUBSTANCES SHALL ACCEPT AND DISPOSE OF ANY MEDICATION DELIVERED TO IT AS
PROVIDED HEREUNDER REGARDLESS OF WHETHER SUCH MEDICATION IS A CONTROLLED
SUBSTANCE. THE COMMISSIONER MAY MAKE REGULATIONS AS MAY BE APPROPRIATE
FOR THE SAFE DISPOSAL OF UNUSED MEDICATIONS PRESCRIBED, DISPENSED OR
ORDERED UNDER THIS ARTICLE AS PROVIDED IN THIS SECTION.
§ 2899-P. DEATH CERTIFICATE. 1. IF OTHERWISE AUTHORIZED BY LAW, THE
ATTENDING PHYSICIAN MAY SIGN THE QUALIFIED INDIVIDUAL'S DEATH CERTIF-
ICATE.
2. THE CAUSE OF DEATH LISTED ON A QUALIFIED INDIVIDUAL'S DEATH CERTIF-
ICATE WHO DIES AFTER SELF-ADMINISTERING MEDICATION UNDER THIS ARTICLE
WILL BE THE UNDERLYING TERMINAL ILLNESS OR CONDITION.
§ 2899-Q. REPORTING. 1. THE COMMISSIONER SHALL ANNUALLY REVIEW A
SAMPLE OF THE RECORDS MAINTAINED UNDER SECTIONS TWENTY-EIGHT HUNDRED
NINETY-NINE-J AND TWENTY-EIGHT HUNDRED NINETY-NINE-P OF THIS ARTICLE.
THE COMMISSIONER SHALL ADOPT REGULATIONS ESTABLISHING REPORTING REQUIRE-
MENTS FOR PHYSICIANS TAKING ACTION UNDER THIS ARTICLE TO DETERMINE
UTILIZATION AND COMPLIANCE WITH THIS ARTICLE. THE INFORMATION COLLECTED
UNDER THIS SUBDIVISION SHALL NOT CONSTITUTE A PUBLIC RECORD AVAILABLE
FOR PUBLIC INSPECTION AND SHALL BE CONFIDENTIAL AND COLLECTED AND MAIN-
TAINED IN A MANNER THAT PROTECTS THE PRIVACY OF THE PATIENT, THE
PATIENT'S FAMILY, AND ANY HEALTH CARE PROVIDER ACTING IN CONNECTION WITH
SUCH PATIENT UNDER THIS ARTICLE, EXCEPT THAT SUCH INFORMATION MAY BE
DISCLOSED TO A GOVERNMENTAL AGENCY AS AUTHORIZED OR REQUIRED BY LAW
RELATING TO PROFESSIONAL DISCIPLINE, PROTECTION OF PUBLIC HEALTH OR LAW
ENFORCEMENT.
2. THE COMMISSIONER SHALL PREPARE A REPORT ANNUALLY CONTAINING RELE-
VANT DATA REGARDING UTILIZATION AND COMPLIANCE WITH THIS ARTICLE AND
SHALL SEND SUCH REPORT TO THE LEGISLATURE, AND POST SUCH REPORT ON THE
DEPARTMENT'S WEBSITE.
§ 2899-R. PENALTIES. 1. NOTHING IN THIS ARTICLE SHALL BE CONSTRUED TO
LIMIT PROFESSIONAL DISCIPLINE OR CIVIL LIABILITY RESULTING FROM CONDUCT
IN VIOLATION OF THIS ARTICLE, NEGLIGENT CONDUCT, OR INTENTIONAL MISCON-
DUCT BY ANY PERSON.
2. CONDUCT IN VIOLATION OF THIS ARTICLE SHALL BE SUBJECT TO APPLICABLE
CRIMINAL LIABILITY UNDER STATE LAW, INCLUDING, WHERE APPROPRIATE AND
WITHOUT LIMITATION, OFFENSES CONSTITUTING HOMICIDE, FORGERY, COERCION,
AND RELATED OFFENSES, OR FEDERAL LAW.
§ 2899-S. 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
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;
A. 995--B 13
AND TO THAT END, THE PROVISIONS AND APPLICATIONS OF THIS ARTICLE ARE
SEVERABLE.
§ 3. This act shall take effect immediately.