Allow Medical Aid in Dying

Section 1. This act shall be known and may be cited as the "New York end of life options act".

§ 2. The public health law is amended by adding a new article 29-CCCCC to read as follows:

ARTICLE 29-CCCCC

NEW YORK END OF LIFE OPTIONS ACT

Section 2994-aaa. Definitions.

2994-bbb. Right to request aid-in-dying medication.

2994-ccc. Request process.

2994-ddd. Right to rescind request; requirement to offer oppor-

tunity to rescind.

2994-eee. Attending physician responsibilities.

2994-fff. Death certificate.

2994-ggg. Consulting physician confirmation.

2994-hhh. Counseling referral.

2994-iii. Informed decision required.

2994-jjj. Form of request.

2994-kkk. Standard of care.

2994-lll. Effect on construction of wills, contracts and stat-

utes.

2994-mmm. Insurance or annuity policies.

EXPLANATION--Matter in italics (underscored) is new; matter in brackets

[ ] is old law to be omitted.

LBD05456-01-7

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2994-nnn. Immunities; prohibitions on certain healthcare provid-

ers; notification; permissible sanctions.

2994-ooo. Non-sanctionable activities.

2994-ppp. Penalties.

2994-qqq. Severability.

§ 2994-aaa. Definitions. As used in this article, the following words and phrases shall have the following meanings:

1. "Adult" means an individual who is eighteen years of age or older.

2. "Aid-in-dying medication" means medication prescribed by a physician to a qualified individual, which the patient may choose to self-administer to bring about a peaceful death if they find their suffering due to a terminal illness to be unbearable.

3. "Attending physician" means the physician who has primary responsibility for the care of an individual and treatment of the individual's terminal illness.

4. "Capacity" means that in the opinion of an individual's attending physician, consulting physician, psychiatrist, or psychologist the individual has the ability to make and communicate an informed decision to healthcare providers, including communication through a person familiar with the individual's manner of communicating if that person is available.

5. "Consulting physician" means a physician who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding an individual's illness.

6. "Counseling" means one or more consultations as necessary between an individual and a psychiatrist or psychologist licensed in this state for the purpose of determining that the individual is competent and is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.

7. "Healthcare provider" or "provider" means a person licensed, certified, or otherwise authorized or permitted by law to administer healthcare or dispense medication in the ordinary course of business or practice of a profession, nurse practitioners and physician assistants notwithstanding, and includes a healthcare facility.

8. "Informed decision" means a decision by a terminally ill individual to request and obtain a prescription for medication that the individual may self-administer to end the individual's life that is based on an understanding and acknowledgment of the relevant facts and that is made after being fully informed by the attending physician of:

(a) the individual'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 they may not choose to obtain the medication, or may obtain the medication but may decide not to take it; and

(e) the feasible alternatives or additional treatment opportunities, including but not limited to comfort care, hospice care and pain management.

9. "Medically confirmed" means the medical opinion of the attending physician has been confirmed by a consulting physician who has examined the individual and the individual's relevant medical records.

10. "Physician" means a doctor of medicine or osteopathy licensed to practice medicine in this state.

11. "Qualified individual" means a terminally ill adult possessing capacity who has satisfied the requirements of this article.

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12. "Self-administer" means a qualified individual's affirmative, conscious act of using the medication to bring about their own peaceful and humane death.

13. "Terminal illness" means an incurable and irreversible illness that has been medically confirmed and will, within reasonable medical judgment, result in death within six months.

§ 2994-bbb. Right to request aid-in-dying medication. 1. A qualified individual possessing capacity may make a documented request to receive a prescription for aid-in-dying medication if:

(a) the qualified individual's attending physician and a consulting physician have determined the qualified individual to be suffering from a terminal illness; and

(b) the qualified individual has voluntarily expressed the wish to receive a prescription for aid-in-dying medication.

2. A person may not qualify under the provisions of this article solely because of age or disability.

§ 2994-ccc. Request process. 1. A qualified individual wishing to receive a prescription for aid-in-dying medication pursuant to this article shall submit a written request and make an oral request to their attending physician.

2. A valid written request for aid-in-dying medication under this article must be:

(a) in substantially the form described in section twenty-nine hundred ninety-four-jjj of this article;

(b) signed and dated by the qualified individual seeking the medication; and

(c) witnessed by at least two other individuals who, in the presence of the qualified individual, attest that to the best of their knowledge and belief the qualified individual:

(i) possesses capacity;

(ii) is acting voluntarily; and

(iii) is not being coerced to sign the request.

3. One of the witnesses must be an individual who is not:

(a) related to the qualified individual by blood, marriage or adoption;

(b) at the time the request is signed, entitled to any portion of the qualified individual's estate upon death of the qualified individual under a will or any operation of law; or

(c) an owner, operator, or employee of a healthcare facility where the qualified individual is receiving medical treatment or where the qualified individual resides.

4. Neither the qualified individual's attending physician nor any consulting physician may be a witness to the signing of a written request.

§ 2994-ddd. Right to rescind request; requirement to offer opportunity to rescind. 1. A qualified individual may at any time rescind their request for aid-in-dying medication without regard to the qualified individual's mental state.

2. A prescription for aid-in-dying medication under this article may not be written without the attending physician offering the qualified individual an opportunity to rescind the request.

§ 2994-eee. Attending physician responsibilities. The attending physician shall:

1. make the initial determination of whether an adult making a request under this article:

(a) has capacity;

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(b) has a terminal illness; and

(c) has voluntarily made the request for aid-in-dying medication pursuant to this article;

2. ensure to the greatest degree possible that the individual is making an informed decision by discussing with the individual:

(a) the individual's medical diagnosis and prognosis;

(b) the potential risks associated with taking the aid-in-dying medication to be prescribed;

(c) the probable result of taking the aid-in-dying medication to be prescribed;

(d) the possibility that they can choose to obtain the medication, but not take it; and

(e) the feasible alternatives or additional treatment opportunities, including but not limited to comfort care, hospice care, and pain management;

3. refer the individual to a consulting physician for medical confirmation of the diagnosis, and for a determination that the individual possesses capacity and is acting voluntarily;

4. refer the individual to counseling, if appropriate, pursuant to section twenty-nine hundred ninety-four-hhh of this article;

5. ensure to the greatest degree possible that the individual's request does not arise from coercion or undue influence by another person;

6. counsel the individual about the importance of:

(a) having another person present when they take the aid-in-dying medication prescribed pursuant to this article; and

(b) not taking the aid-in-dying medication in a public place;

7. inform the individual that they may rescind the request for aid-indying medication at any time and in any manner;

8. offer the individual an opportunity to rescind the request for medication before prescribing the aid-in-dying medication;

9. verify, immediately prior to writing the prescription for medication, that the individual is making an informed decision;

10. ensure that all appropriate steps are carried out in accordance with this article before writing a prescription for aid-in-dying medication; and

11. prescribe aid-in-dying medication by, with the qualified individual's written consent, contacting a pharmacist, informing the pharmacist of the prescription, and forwarding the written prescription to the pharmacist, who shall dispense the medications to either the qualified individual or a person expressly designated by the qualified individual.

§ 2994-fff. Death certificate. 1. Unless otherwise prohibited by law, the attending physician may sign the qualified individual's death certificate.

2. The cause of death listed on a qualified individual's death certificate who uses aid-in-dying medication will be the underlying terminal illness.

§ 2994-ggg. Consulting physician confirmation. Before a patient is qualified under the provisions of this article, a consulting physician shall examine the patient and his or her relevant medical records and confirm, in writing, the attending physician's diagnosis that the patient is suffering from a terminal disease, and verify that the patient is capable, is acting voluntarily and has made an informed decision.

§ 2994-hhh. Counseling referral. If in the opinion of the attending physician or the consulting physician an individual may be suffering

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from a psychiatric or psychological disorder or depression causing impaired judgment, either physician shall refer the patient for counseling. No aid-in-dying medication shall be prescribed until the person performing the counseling determines that the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.

§ 2994-iii. Informed decision required. An individual may not receive a prescription for aid-in-dying medication pursuant to this article unless they have made an informed decision as defined in this article.

§ 2994-jjj. Form of request. 1. A request for aid-in-dying medication as authorized by this article must be in substantially the following form:

REQUEST FOR MEDICATION TO END MY LIFE

IN A HUMANE AND DIGNIFIED MANNER

I, _________________________________, am an adult of sound mind. I am suffering from ______________________________________________, which my attending physician has determined is in its terminal phase and which has been medically confirmed.

I have been fully informed of my diagnosis and prognosis, the nature of the aid-in-dying medication to be prescribed and potential associated risks, the expected result, and the feasible alternatives or additional treatment opportunities including comfort care, hospice care and pain management.

I request that my attending physician prescribe medication that will end my life in a humane and dignified manner if I choose to take it, and I authorize my attending physician to contact any pharmacist about my request. INITIAL ONE:

I have informed my family of my decision and taken their opinions into consideration.

I have decided not to inform my family of my decision.

I have no family to inform of my decision.

I understand that I have the right to rescind this request at any time.

I understand the full import of this request, and I expect to die if I take the aid-in-dying 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 and without reservation, and I accept full moral responsibility for my actions. Signed: ___________________ Dated: ___________________

2. Pursuant to paragraph (a) of subdivision two of section twenty-nine hundred ninety-four-ccc of this article, each witness must complete documentation in substantially the following form: