S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2445
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 20, 2023
                                ___________
 
 Introduced  by  Sens.  HOYLMAN-SIGAL, BRISPORT, BROUK, COMRIE, GIANARIS,
   HARCKHAM, JACKSON, KRUEGER, MYRIE, RAMOS, RIVERA,  SALAZAR,  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:
 
   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.
         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.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02188-01-3
              

 S. 2445                             2
 
   § 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.  "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,  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.
   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 HIS OR HER SCOPE OF PRACTICE AND
 WHO IS QUALIFIED, BY TRAINING AND EXPERIENCE,  CERTIFICATION,  OR  BOARD
 CERTIFICATION  OR  ELIGIBILITY,  TO  MAKE  A DETERMINATION 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
 S. 2445                             3
 
 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 CAPACITY, HAS MADE  AN  INFORMED  DECISION,  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.
   § 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 HIS
 OR HER 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 HIS OR HER 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 HIS OR HER KNOWLEDGE AND BELIEF THE
 PATIENT HAS CAPACITY, IS ACTING VOLUNTARILY, IS MAKING THE  REQUEST  FOR
 MEDICATION  OF  HIS OR HER OWN VOLITION AND IS NOT BEING COERCED TO SIGN
 THE REQUEST. THE WRITTEN REQUEST SHALL  BE  IN  SUBSTANTIALLY  THE  FORM
 DESCRIBED IN SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-K OF THIS ARTICLE.
   (B) ONE OF THE WITNESSES SHALL BE AN ADULT WHO IS 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; OR
   (III) AN OWNER, OPERATOR, EMPLOYEE  OR  INDEPENDENT  CONTRACTOR  OF  A
 HEALTH  CARE  FACILITY  WHERE THE PATIENT IS RECEIVING TREATMENT OR IS A
 RESIDENT.
   (C) THE ATTENDING PHYSICIAN, CONSULTING PHYSICIAN AND, IF  APPLICABLE,
 THE  MENTAL HEALTH PROFESSIONAL WHO PROVIDES A 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.
 S. 2445                             4
 
   § 2899-F. ATTENDING   PHYSICIAN  RESPONSIBILITIES.  1.  THE  ATTENDING
 PHYSICIAN SHALL EXAMINE THE PATIENT AND  HIS  OR  HER  RELEVANT  MEDICAL
 RECORDS AND:
   (A)  MAKE  A DETERMINATION OF WHETHER A PATIENT HAS A TERMINAL ILLNESS
 OR CONDITION, HAS CAPACITY, HAS MADE AN INFORMED DECISION AND  HAS  MADE
 THE  REQUEST VOLUNTARILY OF THE PATIENT'S OWN VOLITION AND WITHOUT COER-
 CION;
   (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 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,
 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) 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  HIS  OR  HER
 REQUEST FOR MEDICATION DENIED FOR THAT REASON;
   (H)  INFORM  THE  PATIENT  THAT  HE OR SHE MAY RESCIND THE REQUEST FOR
 MEDICATION AT ANY TIME AND IN ANY MANNER;
   (I) FULFILL THE MEDICAL RECORD DOCUMENTATION REQUIREMENTS  OF  SECTION
 TWENTY-EIGHT HUNDRED NINETY-NINE-J OF THIS ARTICLE; AND
   (J)  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 CAPACITY AND HAS MADE A VOLUNTARY 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
 S. 2445                             5
 
 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 OR ORDERING
 PHYSICIAN AND THE CONSENT OF THE PATIENT, THE PATIENT MAY  SELF-ADMINIS-
 TER  THE MEDICATION TO HIMSELF OR HERSELF. 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 HIS OR HER REQUEST FOR
 MEDICATION UNDER THIS ARTICLE WITHOUT REGARD TO THE PATIENT'S 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 HIS OR HER 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 CAPACITY, OR
 PROVIDE DOCUMENTATION THAT THE CONSULTING  PHYSICIAN  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  CAPACITY  TO MAKE AN INFORMED DECISION DUE TO A CONDITION, INCLUD-
 ING, 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  PROFES-
 SIONAL  FOR  A DETERMINATION OF WHETHER THE PATIENT HAS CAPACITY TO MAKE
 AN INFORMED DECISION. THE REFERRING PHYSICIAN 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, HIS OR HER INDEPENDENT CONCLUSIONS  ABOUT  WHETHER
 THE PATIENT HAS 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 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 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;
 S. 2445                             6
 
   3. THE ATTENDING PHYSICIAN'S DIAGNOSIS AND PROGNOSIS, DETERMINATION OF
 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 CAPACITY UNDER SECTION TWEN-
 TY-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 CAPACITY,
 WHICH MEANS I UNDERSTAND AND APPRECIATE THE NATURE AND  CONSEQUENCES  OF
 HEALTH  CARE DECISIONS, INCLUDING THE BENEFITS AND RISKS OF AND ALTERNA-
 TIVES TO ANY PROPOSED HEALTH CARE, AND TO REACH AN INFORMED DECISION AND
 TO COMMUNICATE HEALTH CARE DECISIONS TO A PHYSICIAN.
   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;
 S. 2445                             7
 
   (B) VOLUNTARILY SIGNED THE "REQUEST FOR MEDICATION TO END MY LIFE"  IN
 MY PRESENCE OR ACKNOWLEDGED TO ME THAT HE OR SHE SIGNED IT; AND
   (C) TO THE BEST OF MY KNOWLEDGE AND BELIEF, HAS CAPACITY AND IS MAKING
 THE  "REQUEST  FOR MEDICATION TO END MY LIFE" VOLUNTARILY, OF HIS OR HER
 OWN VOLITION AND IS NOT BEING COERCED TO SIGN THE "REQUEST  FOR  MEDICA-
 TION 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 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)

 __________________________ (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 HIS/HER 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)
 
   NOTE: ONLY ONE OF THE TWO WITNESSES MAY (I) BE A RELATIVE  (BY  BLOOD,
 MARRIAGE  OR ADOPTION) OF THE PERSON SIGNING THE "REQUEST FOR MEDICATION
 TO END MY LIFE", (II) BE ENTITLED TO ANY PORTION OF THE PERSON'S  ESTATE
 UPON DEATH UNDER ANY WILL OR BY OPERATION OF LAW, OR (III) OWN, OPERATE,
 BE  EMPLOYED  OR  BE AN INDEPENDENT CONTRACTOR AT A HEALTH CARE FACILITY
 WHERE THE PERSON 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 HIS
 OR HER 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
 S. 2445                             8
 
 CONVERSATION OR  CONSULTATION,  WHICH  SHALL  BE  IN  SUBSTANTIALLY  THE
 FOLLOWING FORM:
 
                         INTERPRETER'S DECLARATION
 
   I,  ___________  (INSERT  NAME OF INTERPRETER)_____ ,(MARK AS APPLICA-
 BLE):
   (  ) 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).
   (NAME  OF  PATIENT) AFFIRMED TO ME HIS/HER 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 HIS/HER 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 HIS/HER 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  HIM/HER  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).
 S. 2445                             9
 
 __________________________ (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
 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 A WITNESS UNDER THIS ARTICLE.
   § 2899-L. PROTECTION AND IMMUNITIES. 1. A PHYSICIAN, PHARMACIST, OTHER
 HEALTH  CARE  PROFESSIONAL OR OTHER PERSON SHALL NOT BE SUBJECT TO CIVIL
 OR CRIMINAL LIABILITY OR PROFESSIONAL DISCIPLINARY ACTION BY ANY GOVERN-
 MENT 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) PROVID-
 ING 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 INDIVID-
 UAL  FROM  SELF-ADMINISTERING  SUCH  MEDICATION,  OR (E) REFRAINING FROM
 ACTING TO RESUSCITATE THE QUALIFIED INDIVIDUAL AFTER HE OR SHE  SELF-AD-
 MINISTERS SUCH MEDICATION.
   2. NOTHING IN THIS SECTION SHALL LIMIT CIVIL OR CRIMINAL LIABILITY 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
 S. 2445                            10
 
   (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.
   3. 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, 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.
   3. (A) A PERSON AND HIS OR HER BENEFICIARIES SHALL NOT BE DENIED BENE-
 FITS  UNDER A LIFE INSURANCE POLICY FOR ACTIONS TAKEN IN ACCORDANCE WITH
 THIS ARTICLE.
   (B) NOTWITHSTANDING THE PROVISIONS OF ANY LAW OR CONTRACT,  THE  SALE,
 PROCUREMENT OR ISSUANCE OF A LIFE OR HEALTH INSURANCE OR ANNUITY POLICY,
 OR  THE  RATE  CHARGED  FOR  A  POLICY, SHALL NOT BE CONDITIONED UPON OR
 AFFECTED BY A PATIENT MAKING OR  RESCINDING  A  REQUEST  FOR  MEDICATION
 UNDER THIS ARTICLE.
   4. AN INSURER 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 HIS  OR  HER  ATTENDING  PHYSICIAN
 UPON  THE  REQUEST  OF SUCH PATIENT. ANY COMMUNICATION SHALL NOT INCLUDE
 BOTH THE DENIAL OF COVERAGE FOR TREATMENT  AND  INFORMATION  AS  TO  THE
 AVAILABILITY OF MEDICATION UNDER THIS ARTICLE.
   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
 S. 2445                            11
 
 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, HIS OR HER
 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;
 AND  TO  THAT  END,  THE PROVISIONS AND APPLICATIONS OF THIS ARTICLE ARE
 SEVERABLE.
   § 3. This act shall take effect immediately.

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2445--A
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 20, 2023
                                ___________
 
 Introduced  by  Sens. HOYLMAN-SIGAL, SCARCELLA-SPANTON, BRISPORT, BROUK,
   COMRIE, COONEY,  FERNANDEZ,  GIANARIS,  GONZALEZ,  HARCKHAM,  JACKSON,
   KENNEDY,  KRUEGER,  MYRIE,  RAMOS, RIVERA, SALAZAR, SEPULVEDA, WEBB --
   read twice and ordered printed, and when printed to  be  committed  to
   the Committee on Health -- committee discharged, bill amended, ordered
   reprinted as amended and recommitted to said committee
 
 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.
         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.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02188-04-3
              

 S. 2445--A                          2
 
         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.
   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 HIS OR HER SCOPE OF PRACTICE AND
 WHO IS QUALIFIED, BY TRAINING AND EXPERIENCE,  CERTIFICATION,  OR  BOARD
 CERTIFICATION  OR  ELIGIBILITY,  TO  MAKE  A DETERMINATION UNDER SECTION
 TWENTY-EIGHT HUNDRED NINETY-NINE-I OF THIS ARTICLE.
 S. 2445--A                          3
 
   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.
   § 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 HIS
 OR HER 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 HIS OR HER 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 HIS OR HER KNOWLEDGE AND BELIEF THE
 PATIENT HAS DECISION-MAKING CAPACITY, IS ACTING VOLUNTARILY,  IS  MAKING
 THE  REQUEST  FOR MEDICATION OF HIS OR HER OWN VOLITION AND IS NOT BEING
 COERCED TO SIGN THE REQUEST. THE WRITTEN REQUEST SHALL  BE  IN  SUBSTAN-
 TIALLY  THE FORM DESCRIBED IN SECTION TWENTY-EIGHT HUNDRED NINETY-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; OR
   (III)  AN  OWNER,  OPERATOR,  EMPLOYEE  OR INDEPENDENT CONTRACTOR OF A
 HEALTH CARE FACILITY WHERE THE PATIENT IS RECEIVING TREATMENT  OR  IS  A
 RESIDENT.
   (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.
 S. 2445--A                          4
 
   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  HIS  OR  HER  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,
 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 HIS OR HER
 REQUEST FOR MEDICATION DENIED FOR THAT REASON;
   (I) INFORM THE PATIENT THAT HE OR SHE  MAY  RESCIND  THE  REQUEST  FOR
 MEDICATION AT ANY TIME AND IN ANY MANNER;
 S. 2445--A                          5
 
   (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 HIMSELF OR HERSELF. 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 HIS OR HER REQUEST FOR
 MEDICATION UNDER THIS ARTICLE WITHOUT REGARD TO THE PATIENT'S  DECISION-
 MAKING 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 HIS OR HER 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
 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, HIS OR HER 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 ATTEND-
 ING 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
 S. 2445--A                          6
 
 INFORMED  DECISION, THE PATIENT SHALL NOT BE DEEMED A QUALIFIED INDIVID-
 UAL, 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
 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
 S. 2445--A                          7
 
 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 HE OR SHE 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  HIS  OR  HER 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)
 
 __________________________ (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 HIS/HER 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
 S. 2445--A                          8
 
 SIGNED THE "REQUEST FOR MEDICATION TO END MY LIFE" TO ANY PORTION OF THE
 ESTATE  OF THE PATIENT UPON HIS/HER 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 HIS
 OR HER 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  APPLICA-
 BLE):
   (  ) 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).
   (NAME OF PATIENT) AFFIRMED TO ME HIS/HER 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 HIS/HER 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)
 S. 2445--A                          9
 
 SIGNED THE "REQUEST FOR MEDICATION TO END MY LIFE" TO ANY PORTION OF THE
 ESTATE OF (NAME OF PATIENT) UPON HIS/HER 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  HIM/HER  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
 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 A WITNESS UNDER THIS ARTICLE.
   § 2899-L. PROTECTION AND IMMUNITIES. 1. A PHYSICIAN, PHARMACIST, OTHER
 HEALTH  CARE  PROFESSIONAL OR OTHER PERSON SHALL NOT BE SUBJECT TO CIVIL
 OR CRIMINAL LIABILITY OR PROFESSIONAL DISCIPLINARY ACTION BY ANY GOVERN-
 MENT 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) PROVID-
 ING 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 INDIVID-
 UAL  FROM  SELF-ADMINISTERING  SUCH  MEDICATION,  OR (E) REFRAINING FROM
 ACTING TO RESUSCITATE THE QUALIFIED INDIVIDUAL AFTER HE OR SHE  SELF-AD-
 MINISTERS SUCH MEDICATION.
   2. NOTHING IN THIS SECTION SHALL LIMIT CIVIL OR CRIMINAL LIABILITY 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
 S. 2445--A                         10
 
 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
   (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.
   3.  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, 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.
   3. (A) A PERSON AND HIS OR HER BENEFICIARIES SHALL NOT BE DENIED BENE-
 FITS UNDER A LIFE INSURANCE POLICY FOR ACTIONS TAKEN IN ACCORDANCE  WITH
 THIS ARTICLE.
   (B)  NOTWITHSTANDING  THE PROVISIONS OF ANY LAW OR CONTRACT, THE SALE,
 PROCUREMENT OR ISSUANCE OF A LIFE OR HEALTH INSURANCE OR ANNUITY POLICY,
 OR THE RATE CHARGED FOR A POLICY,  SHALL  NOT  BE  CONDITIONED  UPON  OR
 AFFECTED  BY  A  PATIENT  MAKING  OR RESCINDING A REQUEST FOR MEDICATION
 UNDER THIS ARTICLE.
 S. 2445--A                         11
 
   4. AN INSURER 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 HIS OR HER ATTENDING PHYSICIAN
 UPON THE REQUEST OF SUCH PATIENT. ANY COMMUNICATION  SHALL  NOT  INCLUDE
 BOTH  THE  DENIAL  OF  COVERAGE  FOR TREATMENT AND INFORMATION AS TO THE
 AVAILABILITY OF MEDICATION UNDER THIS ARTICLE.
   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, HIS OR  HER
 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.
 S. 2445--A                         12

   § 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;
 AND TO THAT END, THE PROVISIONS AND APPLICATIONS  OF  THIS  ARTICLE  ARE
 SEVERABLE.
   § 3. This act shall take effect immediately.