S05814 Summary:

BILL NOS05814A
 
SAME ASSAME AS A05261-C
 
SPONSORBONACIC
 
COSPNSR
 
MLTSPNSR
 
Add Art 28-F §§2899-d - 2899-p, Pub Health L
 
Relates to patient self-determination at end of life; authorizes a physician with a bona fide physician-patient relationship with a patient with a terminal illness or condition to prescribe a lethal dose of the medication to be self-administered; defines terminal illness or condition to be an illness or condition which can reasonably be expected to cause death within six months, whether or not treatment is provided; provides immunity to health care providers.
Go to top    

S05814 Actions:

BILL NOS05814A
 
06/04/2015REFERRED TO HEALTH
01/06/2016REFERRED TO HEALTH
01/25/2016AMEND AND RECOMMIT TO HEALTH
01/25/2016PRINT NUMBER 5814A
Go to top

S05814 Memo:

Memo not available
Go to top

S05814 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         5814--A
 
                               2015-2016 Regular Sessions
 
                    IN SENATE
 
                                      June 4, 2015
                                       ___________
 
        Introduced  by  Sen. BONACIC -- read twice and ordered printed, and when
          printed to be committed to the Committee on Health --  recommitted  to
          the  Committee  on  Health in accordance with Senate Rule 6, sec. 8 --
          committee discharged, bill amended, ordered reprinted as  amended  and
          recommitted to said committee

        AN  ACT to amend the public health law, in relation to patient self-det-
          ermination at end of life
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  This  act shall be known and may be cited as the "patient
     2  self-determination act".
     3    § 2. The public health law is amended by adding a new article 28-F  to
     4  read as follows:
     5                                ARTICLE 28-F
     6                                AID IN DYING
     7  Section 2899-d. Definitions.
     8          2899-e. Written request for medication.
     9          2899-f. Written request signed and witnessed.
    10          2899-g. Attending physician responsibilities.
    11          2899-h. Counseling referral.
    12          2899-i. Medical record documentation requirements.
    13          2899-j. Residency requirement.
    14          2899-k. Protection of health care providers and facilities.
    15          2899-l. Relation to other laws and contracts.
    16          2899-m. Safe disposal of unused medications.
    17          2899-n. Death certificate.
    18          2899-o. Reporting.
    19          2899-p. Severability.
    20    § 2899-d. Definitions. As used in this article:
    21    1.  "Adult"  means  an  individual  who  is twenty-one years of age or
    22  older.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD07446-24-6

        S. 5814--A                          2
 
     1    2. "Attending physician" means the physician who has primary responsi-
     2  bility for the care of the patient and treatment of the patient's termi-
     3  nal disease.
     4    3.  "Capacity"  means  the  ability  to  understand and appreciate the
     5  nature and consequences of health care decisions, including the benefits
     6  and risks of and alternatives to any proposed health care, and to  reach
     7  an  informed  decision  and  to  communicate  health care decisions to a
     8  physician, including communication through  persons  familiar  with  the
     9  patient's manner of communicating if those persons are available.
    10    4. "Counseling" means one or more consultations as necessary between a
    11  state  licensed  psychiatrist  or  psychologist  and  a  patient for the
    12  purpose of determining that the patient has capacity and is not  suffer-
    13  ing  from  a psychiatric or psychological disorder or depression causing
    14  impaired judgment.
    15    5. "Health care facility" means a general hospital, nursing  home,  or
    16  residential  health  care  facility  as  defined in section twenty-eight
    17  hundred one of this chapter.
    18    6. "Health care provider" means a person or  entity  licensed,  certi-
    19  fied, or authorized by law to administer health care or dispense medica-
    20  tion in the ordinary course of business or practice of a profession.
    21    7. "Impaired judgment" means that a person lacks the ability to under-
    22  stand  and  appreciate  the nature and consequences of health care deci-
    23  sions, including the benefits and  risks  of  and  alternatives  to  any
    24  proposed health care, and to reach an informed decision.
    25    8. "Medication" means medication capable of ending and to be used with
    26  the intent of ending the patient's life, including any ancillary medica-
    27  tion intended to minimize the patient's discomfort.
    28    9.  "Palliative care" means health care treatment, including interdis-
    29  ciplinary end-of-life care, and consultation with  patients  and  family
    30  members,  to  prevent  or  relieve pain and suffering and to enhance the
    31  patient's quality of life, including hospice care under article forty of
    32  this chapter.
    33    10. "Patient" means a person who is twenty-one years of age or  older,
    34  a resident of New York state, and under the care of a physician.
    35    11.  "Physician"  means an individual licensed to practice medicine in
    36  New York state.
    37    12. "Terminal illness or condition"  means  an  illness  or  condition
    38  which  can  reasonably  be  expected  to  cause death within six months,
    39  whether or not treatment is provided.
    40    § 2899-e. Written request for medication. 1. An adult who has  capaci-
    41  ty,  is a resident of this state, and has been determined by the attend-
    42  ing physician and, if applicable, consulting physician to  be  suffering
    43  from a terminal illness or condition, may make a written request for and
    44  consent  to  self-administer medication for the purpose of ending his or
    45  her life in accordance with this article.
    46    2. No person shall qualify under this article solely because of age or
    47  disability.
    48    § 2899-f. Written request signed and witnessed. 1. A request for medi-
    49  cation under this article shall be signed and dated by the  patient  and
    50  witnessed  by  at  least  two  individuals  who,  in the presence of the
    51  patient, attest that to the best  of  their  knowledge  and  belief  the
    52  patient has capacity, is acting voluntarily, and is not being coerced to
    53  sign  the  request.  The  department  may develop a suggested form for a
    54  request under this article.
    55    2. One of the witnesses shall be a person who is not:
    56    (a) a relative of the patient by blood, marriage or adoption;

        S. 5814--A                          3
 
     1    (b) a person who at the time the request is signed would  be  entitled
     2  to any portion of the estate of the patient upon death under any will or
     3  by operation of law; or
     4    (c) an owner, operator or employee of a health care facility where the
     5  patient is receiving treatment or is a resident.
     6    3.  The  patient's  attending  physician or, if applicable, consulting
     7  physician at the time the request is signed shall not be a witness.
     8    § 2899-g.  Attending  physician  responsibilities.  1.  The  attending
     9  physician shall:
    10    (a) make the determination of whether a patient has a terminal illness
    11  or condition, has capacity, and has made the request voluntarily;
    12    (b) request that the patient demonstrate New York state residency;
    13    (c)  refer  the  patient for counseling, if appropriate, under section
    14  twenty-eight hundred ninety-nine-h of this article;
    15    (d) provide  information  and  counseling  under  section  twenty-nine
    16  hundred ninety-seven-c of this chapter; and
    17    (e)  fulfill  the medical record documentation requirements of section
    18  twenty-eight hundred ninety-nine-i of this article.
    19    2. Subject to section twenty-eight hundred ninety-nine-h of this arti-
    20  cle, the attending  physician  who  makes  the  determination  that  the
    21  patient has a terminal illness or condition, has capacity and has made a
    22  request for medication as provided in section twenty-eight hundred nine-
    23  ty-nine-e  of  this  article, may personally, or by direction to another
    24  physician,  prescribe,  dispense  or  order  appropriate  medication  in
    25  accordance  with  the  patient's  request under this article, and at the
    26  patient's request, facilitate the filling of the prescription and deliv-
    27  ery of the medication to the patient.
    28    3. In accordance with the direction of the prescribing, dispensing  or
    29  ordering  physician  and  the  consent  of  the patient, the patient may
    30  administer the medication to himself or herself. A health  care  profes-
    31  sional  shall  not  administer the medication to the patient but, acting
    32  within the scope of his or  her  lawful  practice,  may  facilitate  the
    33  patient in self-administering the medication.
    34    §  2899-h.  Counseling  referral.  If  in the opinion of the attending
    35  physician a patient may be suffering from a psychiatric or psychological
    36  disorder or depression causing impaired judgment, such  physician  shall
    37  refer  the patient for counseling. No medication to end a patient's life
    38  shall be prescribed, dispensed or ordered until  the  person  performing
    39  the  counseling  determines  that  the  patient  is not suffering from a
    40  psychiatric or psychological disorder  or  depression  causing  impaired
    41  judgment and has capacity.
    42    §  2899-i.  Medical  record  documentation requirements. The following
    43  shall be documented or filed in the patient's medical record:
    44    1. all oral requests by a patient for medication to  end  his  or  her
    45  life;
    46    2.  all written requests by a patient for medication to end his or her
    47  life;
    48    3. the attending physician's diagnosis  and  prognosis,  and  determi-
    49  nation whether the patient has capacity and is acting voluntarily;
    50    4.  a report of the outcome and determinations made during counseling,
    51  if performed; and
    52    5. a note by the attending physician indicating whether  all  require-
    53  ments under this article have been met and indicating the steps taken to
    54  carry   out   the  request,  including  a  notation  of  the  medication
    55  prescribed, dispensed or ordered.

        S. 5814--A                          4
 
     1    § 2899-j. Residency requirement. Only requests made by New York  state
     2  residents under the provisions of this article shall be granted. Factors
     3  demonstrating  New  York  state residency shall include but shall not be
     4  limited to:
     5    1. Possession of a New York state driver's license;
     6    2. Registration to vote in New York state;
     7    3. Evidence that the person owns or leases property in New York state;
     8  or
     9    4. Filing of a New York state tax return for the most recent tax year.
    10    §  2899-k.  Protection  of health care providers and facilities.  1. A
    11  physician, pharmacist, other health care professional  or  other  person
    12  shall  not  be  subject  to  civil or criminal liability or professional
    13  disciplinary action, and shall not be subject to discipline, suspension,
    14  loss of license, loss of privileges, or other penalty by any health care
    15  facility or health care provider, for taking any  reasonable  good-faith
    16  action or refusing to act under this article, including: (a) engaging in
    17  discussions with a patient relating to the risks and benefits of end-of-
    18  life  options  in the circumstances described in this article, (b) being
    19  present when a patient self-administers medication, (c) refraining  from
    20  acting  to  prevent the patient from self-administering such medication,
    21  or (d) refraining from acting to resuscitate or rescue the patient after
    22  he or she self-administers such medication. However, paragraphs (c)  and
    23  (d)  of  this  subdivision  shall  not  apply where there are reasonable
    24  grounds to believe,  under  the  circumstances,  that  the  patient  has
    25  rescinded  his  or  her request or consent to self-administer medication
    26  under this article or communicates a desire that the  lethal  action  of
    27  the medication be reversed.
    28    2.  A physician, nurse, pharmacist, or other person shall not be under
    29  any duty, by law or contract, to participate in the provision of medica-
    30  tion to a patient under this article.
    31    3. A private health care facility may prohibit the  self-administering
    32  of  medication  under  the article while the patient is being treated or
    33  residing in the health care facility if:
    34    (a) such prescribing, dispensing, ordering  or  self-administering  is
    35  contrary to a formally adopted policy of such facility that is expressly
    36  based  on  sincerely  held  religious  beliefs  or  sincerely held moral
    37  convictions central to the facility's operating principles;
    38    (b) such facility has informed the patient of such policy prior to  or
    39  upon admission, if reasonably possible; and
    40    (c)  if  the  patient requests, the patient is transferred promptly to
    41  another health care facility that is  reasonably  accessible  under  the
    42  circumstances  and willing to permit the prescribing, dispensing, order-
    43  ing and self-administering of medication under this article with respect
    44  to the patient.
    45    4. A health care facility that  prohibits  the  self-administering  of
    46  medication  under  this  article  while  the patient is being treated or
    47  residing in the health care facility under this section may  prohibit  a
    48  physician  from prescribing, dispensing or ordering medication for self-
    49  administering while the patient is being  treated  or  residing  in  the
    50  health care facility, provided the health care facility has notified the
    51  physician  in  writing  of its policy to prohibit such actions. Notwith-
    52  standing subdivision one of this section,  any  person  who  violates  a
    53  policy  established  by a health care facility under this section may be
    54  subject to sanctions otherwise allowable under law, contract and facili-
    55  ty policy.

        S. 5814--A                          5
 
     1    § 2899-l. Relation to other laws and contracts.  1. (a) A patient  who
     2  self-administers  medication  under this article shall not be considered
     3  to be a person who is suicidal, and self-administering medication  under
     4  this article shall not be deemed to be suicide, for any purpose.
     5    (b)  Action  taken  in  accordance  with  this  article  shall  not be
     6  construed for any  purpose  to  constitute  suicide,  assisted  suicide,
     7  attempted  suicide, promoting a suicide attempt, mercy killing, or homi-
     8  cide under the law, including as an accomplice or  accessory  or  other-
     9  wise.
    10    2. A request by a patient to his or her attending physician to provide
    11  medication  under  this  article shall not, by itself, provide the basis
    12  for the appointment of a guardian or conservator.
    13    3. (a) No provision in a contract, will or  other  agreement,  whether
    14  written  or  oral,  to  the  extent the provision would affect whether a
    15  person may make or rescind a request for medication or  take  any  other
    16  action under this article, shall be valid.
    17    (b)  No  obligation  owing  under any contract shall be conditioned or
    18  affected by the making or rescinding of a request by a person for  medi-
    19  cation or taking any other action under this article.
    20    4.  A person and his or her beneficiaries shall not be denied benefits
    21  under a life insurance policy for actions taken in accordance with  this
    22  article.
    23    5. An insurer shall not provide any information in communications made
    24  to  a  person  about  the  availability of medication under this article
    25  absent a request by such person or by his  or  her  attending  physician
    26  upon  the  request  of  such person. Any communication shall not include
    27  both the denial of treatment and information as to the  availability  of
    28  medication under this article.
    29    6.  The  sale,  procurement,  or issue of any professional malpractice
    30  insurance policy or the rate charged for the policy shall not be  condi-
    31  tioned  upon or affected by whether the insured does or does not take or
    32  participate in any action under this article.
    33    § 2899-m. Safe disposal of unused medications.  The  department  shall
    34  make  regulations  providing for the safe disposal of unused medications
    35  prescribed, dispensed or ordered under this article.
    36    § 2899-n. Death certificate. In the event that a  patient  dies  as  a
    37  result  of  medication  self-administered  under this article, the death
    38  certificate shall indicate that the cause of death  was  the  underlying
    39  terminal  illness  or condition of the patient. However, where there are
    40  reasonable grounds to believe, under the circumstances, that the patient
    41  rescinded his or her request or consent  to  self-administer  medication
    42  under  this  article  or communicated a desire that the lethal action of
    43  the medication be reversed, and the patient nevertheless died  from  the
    44  self-administration  of  the  medication, the self-administration of the
    45  medication may be listed as the cause of death.
    46    § 2899-o. Reporting. 1.  The  commissioner  shall  annually  review  a
    47  sample  of  the  records  maintained  under section twenty-eight hundred
    48  ninety-nine-i of this article.  The  department  may  adopt  regulations
    49  establishing  reporting  requirements for physicians taking action under
    50  this article to determine utilization and compliance with this  article.
    51  The  information  collected under this section shall be confidential and
    52  shall be collected in a manner that protects the privacy of the patient,
    53  his or her family, and any health care  provider  acting  in  connection
    54  with such patient under this article.

        S. 5814--A                          6
 
     1    2.  The department shall prepare a report annually containing relevant
     2  data regarding utilization and compliance with this  article  and  shall
     3  post such report on its website.
     4    § 2899-p. Severability. If any provision of this article or any appli-
     5  cation  of  any  provision of this article, is held to be invalid, or to
     6  violate or be inconsistent with any  federal  law  or  regulation,  that
     7  shall not affect the validity or effectiveness of any other provision of
     8  this article, or of any other application of any provision of this arti-
     9  cle,  which  can  be given effect without that provision or application;
    10  and to that end, the provisions and applications  of  this  article  are
    11  severable.
    12    § 3. This act shall take effect immediately.
Go to top