House File 65 - Introduced
HOUSE FILE
BY MEYER, COHOON,
WINCKLER, STUTSMAN,
MASCHER, BROWN=POWERS,
WOLFE, ANDERSON, and
WESSEL=KROESCHELL
A BILL FOR
1 An Act creating the Iowa death with dignity Act and providing
2 penalties.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
TLSB 1385YH (8) 86
pf/nh
PAG LIN
1 1 Section 1. NEW SECTION. 142E.1 Short title.
1 2 This chapter shall be known and may be cited as the "Iowa
1 3 Death with Dignity Act".
1 4 Sec. 2. NEW SECTION. 142E.2 Definitions.
1 5 As used in this chapter, unless the context otherwise
1 6 requires:
1 7 1. "Adult" means an individual who is eighteen years of age
1 8 or older.
1 9 2. "Attending physician" means the physician who has primary
1 10 responsibility for the care of the patient and treatment of the
1 11 patient's terminal disease.
1 12 3. "Competent" means that in the opinion of a court or in
1 13 the opinion of the patient's attending physician or consulting
1 14 physician, psychiatrist, or psychologist, a patient has the
1 15 ability to make and communicate health care decisions to
1 16 health care providers, including communication through persons
1 17 familiar with the patient's manner of communicating if those
1 18 persons are available.
1 19 4. "Consulting physician" means a physician who is qualified
1 20 by specialty or experience to make a professional diagnosis and
1 21 prognosis regarding the patient's disease.
1 22 5. "Counseling" means one or more consultations as necessary
1 23 between a licensed psychiatrist or psychologist and a patient
1 24 for the purpose of determining that the patient is competent
1 25 and not suffering from a psychiatric or psychological disorder
1 26 or depression causing impaired judgment.
1 27 6. "Department" means the department of public health.
1 28 7. "Health care facility" means a health care facility as
1 29 defined in section 135C.1.
1 30 8. "Health care provider" means a person licensed,
1 31 certified, or otherwise authorized or permitted by the law of
1 32 this state to administer health care or dispense medication in
1 33 the ordinary course of business or practice of a profession,
1 34 and includes a health care facility.
1 35 9. "Informed decision" means a decision by a qualified
2 1 patient to request and obtain a prescription to end the
2 2 patient's life that is based on an appreciation of the relevant
2 3 facts and after being fully informed by the attending physician
2 4 of all of the following:
2 5 a. The patient's medical diagnosis.
2 6 b. The patient's prognosis.
2 7 c. The potential risks associated with taking the medication
2 8 to be prescribed.
2 9 d. The probable result of taking the medication to be
2 10 prescribed.
2 11 e. The feasible alternatives, including but not limited to
2 12 comfort care, hospice care, and pain control.
2 13 10. "Long=term care facility" means a long=term care unit
2 14 of a hospital, a health care facility, an elder group home as
2 15 defined in section 231B.1, or an assisted living program as
2 16 defined in section 231C.2.
2 17 11. "Medically confirmed" means the medical opinion of
2 18 the attending physician has been confirmed by a consulting
2 19 physician who has examined the patient and the patient's
2 20 relevant medical records.
2 21 12. "Patient" means a person who is under the care of a
2 22 physician.
2 23 13. "Physician" means a person licensed to practice medicine
2 24 and surgery or osteopathic medicine and surgery under chapter
2 25 148.
2 26 14. "Qualified patient" means a competent adult who is a
2 27 resident of Iowa and has satisfied the requirements of this
2 28 chapter to obtain a prescription for medication to end the
2 29 individual's life.
2 30 15. "Self=administer" means a qualified patient's act of
2 31 ingesting medication to end the patient's life.
2 32 16. "Terminal disease" means an incurable and irreversible
2 33 disease that has been medically confirmed and that will, within
2 34 reasonable medical judgment, produce death within six months.
2 35 Sec. 3. NEW SECTION. 142E.3 Request for medication.
3 1 1. An adult patient who is competent, is a resident of
3 2 this state, has been determined by the patient's attending
3 3 physician and consulting physician to be suffering from a
3 4 terminal disease, and has voluntarily expressed a wish to die,
3 5 may make a written request for medication that the patient may
3 6 self=administer to end the patient's life in accordance with
3 7 this chapter.
3 8 2. A person shall not qualify to make a written request
3 9 under this section solely because of age or disability.
3 10 Sec. 4. NEW SECTION. 142E.4 Oral and written requests ==
3 11 right to rescind.
3 12 1. To receive a prescription for medication that a qualified
3 13 patient may self=administer to end the qualified patient's life
3 14 pursuant to this chapter, the qualified patient shall make an
3 15 initial oral request, followed by a subsequent oral request
3 16 at least fifteen days after the initial oral request, and a
3 17 written request to the qualified patient's attending physician.
3 18 2. At least fifteen days shall elapse between a qualified
3 19 patient's initial oral request and the writing of a
3 20 prescription under this chapter.
3 21 3. At least forty=eight hours shall elapse between the
3 22 submission of a qualified patient's written request and the
3 23 writing of a prescription under this chapter.
3 24 4. a. At the time the qualified patient makes the second
3 25 oral request, the attending physician shall offer the qualified
3 26 patient an opportunity to rescind the request.
3 27 b. A patient may rescind a request for a prescription for
3 28 medication under this chapter at any time and in any manner
3 29 without regard to the patient's mental state. A prescription
3 30 for medication under this chapter shall not be written prior
3 31 to the attending physician offering the qualified patient an
3 32 opportunity to rescind the request.
3 33 Sec. 5. NEW SECTION. 142E.5 Procedure for request ==
3 34 witnesses.
3 35 1. A qualified patient who is unable to orally communicate
4 1 may make a valid oral request under this chapter by reducing
4 2 the oral request to writing for submission to the qualified
4 3 patient's attending physician. Such writing is not subject
4 4 to the requirements otherwise applicable to a written request
4 5 under this chapter.
4 6 2. a. A valid written request for medication under this
4 7 chapter shall be in substantially the form described in section
4 8 142E.17, shall be signed and dated by the patient, and shall
4 9 be witnessed by at least two individuals who, in the presence
4 10 of the patient, attest that to the best of their knowledge and
4 11 belief the patient is competent, acting voluntarily, and is not
4 12 being coerced to sign the request.
4 13 b. One of the witnesses shall be a person who is not any of
4 14 the following:
4 15 (1) A relative of the patient by blood, marriage, or
4 16 adoption.
4 17 (2) A person who at the time the request is signed would be
4 18 entitled to any portion of the estate of the patient upon death
4 19 under any will or by operation of law.
4 20 (3) An owner, operator, or employee of a long=term care
4 21 facility where the patient is receiving medical treatment or
4 22 is a resident.
4 23 c. The patient's attending physician at the time the request
4 24 is signed shall not be a witness.
4 25 d. If the patient is a patient in a long=term care facility
4 26 at the time the written request is made, one of the witnesses
4 27 shall be an individual designated by the facility and having
4 28 the qualifications specified by the department by rule.
4 29 Sec. 6. NEW SECTION. 142E.6 Attending physician
4 30 responsibilities.
4 31 1. The attending physician shall do all of the following:
4 32 a. Make the initial determination of whether a patient has
4 33 a terminal disease, is competent, and has made the request for
4 34 medication under this chapter voluntarily.
4 35 b. Request that the patient demonstrate residency in the
5 1 state. Factors demonstrating residency in this state include
5 2 but are not limited to:
5 3 (1) Possession of an Iowa driver's license.
5 4 (2) Registration to vote in Iowa.
5 5 (3) Evidence that the person owns or leases property in
5 6 Iowa.
5 7 (4) Filing of an Iowa tax return for the most recent tax
5 8 year.
5 9 c. Verify immediately prior to writing the prescription for
5 10 medication, that the patient is making an informed decision.
5 11 d. Refer the patient to a consulting physician for medical
5 12 confirmation of the diagnosis, and for a determination that the
5 13 patient is competent and acting voluntarily.
5 14 e. Refer the patient for counseling if appropriate under
5 15 section 142E.8.
5 16 f. Recommend that the patient notify next of kin. However,
5 17 a qualified patient's request for medication shall not
5 18 be denied based on the qualified patient's declination or
5 19 inability to notify next of kin.
5 20 g. Counsel the patient about the importance of having
5 21 another person present when the patient takes the medication
5 22 prescribed and of not taking the medication in a public place.
5 23 h. Inform the patient that the patient has an opportunity
5 24 to rescind the request at any time and in any manner, and offer
5 25 the patient an opportunity to rescind the request at the end of
5 26 the fifteen=day waiting period under section 142E.4.
5 27 i. Fulfill the medical record documentation requirements
5 28 under section 142E.9.
5 29 j. Ensure that all appropriate steps are carried out in
5 30 accordance with this chapter prior to writing a prescription
5 31 for medication to enable a qualified patient to end the
5 32 patient's life.
5 33 k. Do either of the following:
5 34 (1) Dispense medications directly, including ancillary
5 35 medications intended to facilitate the desired effect to
6 1 minimize the patient's discomfort, if the attending physician
6 2 is authorized under law and rule to dispense such medication
6 3 and has a current valid drug enforcement administration number,
6 4 if required under chapter 124.
6 5 (2) With the patient's written consent:
6 6 (a) Contact a pharmacist and inform the pharmacist of the
6 7 prescription.
6 8 (b) Deliver the written prescription personally, by
6 9 mail, or by facsimile to the pharmacist who will dispense the
6 10 medications to either the patient, the attending physician, or
6 11 an expressly identified agent of the patient.
6 12 2. Notwithstanding any other provision of law to the
6 13 contrary, the attending physician may sign the patient's death
6 14 certificate.
6 15 Sec. 7. NEW SECTION. 142E.7 Consulting physician
6 16 confirmation.
6 17 A consulting physician shall do all of the following in
6 18 confirming that a patient is a qualified patient under this
6 19 chapter:
6 20 1. Examine the patient and the patient's relevant medical
6 21 records and confirm, in writing, the attending physician's
6 22 diagnosis that the patient is suffering from a terminal
6 23 disease.
6 24 2. Verify that the patient is competent, acting
6 25 voluntarily, and has made an informed decision.
6 26 Sec. 8. NEW SECTION. 142E.8 Counseling referral.
6 27 1. If, in the opinion of the attending physician or the
6 28 consulting physician, a patient may be suffering from a
6 29 psychiatric or psychological disorder or depression causing
6 30 impaired judgment, either physician shall refer the patient for
6 31 counseling.
6 32 2. An attending physician shall not prescribe medication to
6 33 end a patient's life pursuant to this chapter until the person
6 34 performing the counseling determines and verifies that the
6 35 patient is not suffering from a psychiatric or psychological
7 1 disorder or depression causing impaired judgment.
7 2 Sec. 9. NEW SECTION. 142E.9 Medical record documentation
7 3 requirements.
7 4 All of the following shall be documented or filed in a
7 5 patient's medical record in regard to a request for medication
7 6 under this chapter:
7 7 1. All oral requests by a patient for medication to end the
7 8 patient's life pursuant to this chapter.
7 9 2. All written requests by a patient for medication to end
7 10 the patient's life pursuant to this chapter.
7 11 3. The attending physician's diagnosis and prognosis
7 12 and determinations that the patient is competent, is acting
7 13 voluntarily, and has made an informed decision.
7 14 4. The consulting physician's diagnosis and prognosis
7 15 and verification that the patient is competent, is acting
7 16 voluntarily, and has made an informed decision.
7 17 5. A report of the outcome and determinations made during
7 18 counseling, if performed.
7 19 6. The attending physician's offer to the patient to rescind
7 20 the patient's request at the time of the patient's second oral
7 21 request pursuant to section 142E.4.
7 22 7. A note by the attending physician indicating that all
7 23 requirements under this chapter have been met and indicating
7 24 the steps taken to carry out the request, including a notation
7 25 of the medication prescribed.
7 26 Sec. 10. NEW SECTION. 142E.10 Reporting requirements.
7 27 1. a. The department shall require any health care
7 28 provider, upon dispensing medication pursuant to this chapter,
7 29 to file a copy of the dispensing record with the department.
7 30 b. The department shall annually review a sample of records
7 31 maintained under this chapter.
7 32 2. The department shall adopt rules to facilitate the
7 33 collection of information regarding compliance with this
7 34 chapter. Except as otherwise required by law, the information
7 35 collected shall not be a public record and shall not be made
8 1 available for inspection by the public.
8 2 3. The department shall generate and make available to the
8 3 public an annual statistical report of information collected
8 4 under subsection 2.
8 5 Sec. 11. NEW SECTION. 142E.11 Effect on construction of
8 6 wills, contracts, and other agreements.
8 7 1. A provision in a contract, will, or other agreement,
8 8 whether written or oral, to the extent the provision would
8 9 affect whether a person may make or rescind a request for
8 10 medication to end the person's life pursuant to this chapter,
8 11 shall not be valid.
8 12 2. An obligation owing under any contract shall not be
8 13 conditioned or affected by the making or rescinding of a
8 14 request by a person for medication to end the person's life
8 15 pursuant to this chapter.
8 16 Sec. 12. NEW SECTION. 142E.12 Insurance or annuity
8 17 policies.
8 18 The sale, procurement, or issuance of any life, health,
8 19 or accident insurance or annuity policy or the rate charged
8 20 for any such policy shall not be conditioned upon or affected
8 21 by the making or rescinding of a request by a person for
8 22 medication that may be self=administered to end the person's
8 23 life pursuant to this chapter. A qualified patient's act of
8 24 self=administering medication to end the qualified patient's
8 25 life pursuant to this chapter shall not have an effect upon a
8 26 life, health, or accident insurance or annuity policy.
8 27 Sec. 13. NEW SECTION. 142E.13 Construction of chapter.
8 28 1. Nothing in this chapter shall be construed to authorize
8 29 a physician or any other person to end a patient's life by
8 30 lethal injection, mercy killing, or active euthanasia. An
8 31 action taken in accordance with this chapter shall not, for any
8 32 purpose, constitute suicide, assisted suicide, mercy killing,
8 33 or homicide under the law.
8 34 2. Nothing in this chapter shall be interpreted to lessen
8 35 the applicable standard of care for an attending physician,
9 1 consulting physician, psychiatrist, psychologist, or other
9 2 health care provider acting under this chapter.
9 3 Sec. 14. NEW SECTION. 142E.14 Immunities == basis
9 4 for prohibiting health care provider from participation ==
9 5 notification == permissible sanctions.
9 6 Except as otherwise provided in this chapter:
9 7 1. A person shall not be subject to civil or criminal
9 8 liability or professional disciplinary action for acting
9 9 in good=faith compliance with this chapter, including
9 10 being present when a qualified patient self=administers the
9 11 prescribed medication to end the qualified patient's life
9 12 pursuant to this chapter.
9 13 2. A professional organization or association, or
9 14 health care provider, shall not subject a person to censure,
9 15 discipline, suspension, loss of license, loss of privileges,
9 16 loss of membership, or other penalty for acting or refusing to
9 17 act in good=faith compliance with this chapter.
9 18 3. A request by a patient for or provision by an attending
9 19 physician of medication in good=faith compliance with this
9 20 chapter shall not constitute neglect under the law or provide
9 21 the sole basis for the appointment of a guardian or conservator
9 22 for the patient.
9 23 4. A health care provider shall not be under any duty,
9 24 whether by contract, statute, or any other legal requirement,
9 25 to participate in the provision to a qualified patient of
9 26 medication to end the patient's life pursuant to this chapter.
9 27 If a health care provider is unable or unwilling to carry out a
9 28 patient's request under this chapter and the patient transfers
9 29 the patient's care to a new health care provider, the prior
9 30 health care provider shall transfer, upon request, a copy of
9 31 the patient's relevant medical records to the new health care
9 32 provider.
9 33 5. a. Notwithstanding any other provision of law to the
9 34 contrary, a health care provider may prohibit another health
9 35 care provider from acting under this chapter on the premises
10 1 of the prohibiting provider if the prohibiting provider has
10 2 notified the health care provider of the prohibiting provider's
10 3 policy regarding actions under this chapter. Nothing in this
10 4 paragraph shall prevent a health care provider from providing
10 5 health care services to a patient that do not constitute action
10 6 under this chapter.
10 7 b. Notwithstanding the provisions of this section to the
10 8 contrary, a health care provider may subject another health
10 9 care provider to the following sanctions if the sanctioning
10 10 health care provider has notified the sanctioned provider prior
10 11 to action under this chapter that the health care provider
10 12 prohibits actions under this chapter:
10 13 (1) Loss of privileges, loss of membership, or other
10 14 sanction provided pursuant to the medical staff bylaws,
10 15 policies, or procedures of the sanctioning health care provider
10 16 if the sanctioned provider is a member of the sanctioning
10 17 provider's medical staff and acts under this chapter while on
10 18 the health care facility premises of the sanctioning health
10 19 care provider, but not including the private medical office of
10 20 a physician or other provider.
10 21 (2) Termination of a lease or other property contract or
10 22 other nonmonetary remedies provided by a lease or contract,
10 23 not including loss or restriction of medical staff privileges
10 24 or exclusion from a provider panel, if the sanctioned
10 25 provider acts under this chapter while on the premises of the
10 26 sanctioning health care provider or on property that is owned
10 27 by or under the direct control of the sanctioning health care
10 28 provider.
10 29 (3) Termination of a contract or other nonmonetary remedies
10 30 provided by a contract if the sanctioned provider acts under
10 31 this chapter while acting in the course and scope of the
10 32 sanctioned provider's capacity as an employee or independent
10 33 contractor of the sanctioning health care provider. Nothing
10 34 in this subparagraph shall be construed to prevent any of the
10 35 following:
11 1 (a) A health care provider from acting under this chapter
11 2 while acting outside the course and scope of the provider's
11 3 capacity as an employee or independent contractor.
11 4 (b) A patient from contracting with the patient's attending
11 5 physician and consulting physician to act outside the course
11 6 and scope of the provider's capacity as an employee or
11 7 independent contractor of the sanctioning health care provider.
11 8 c. A health care provider that imposes sanctions pursuant to
11 9 paragraph "b" shall follow all due process and other procedures
11 10 the sanctioning health care provider uses for the imposition of
11 11 sanctions on other health care providers under the authority of
11 12 the sanctioning health care provider.
11 13 d. For the purposes of this subsection:
11 14 (1) "Action under this chapter" means to perform the
11 15 duties of an attending physician, the consulting physician
11 16 function, or the counseling function as specified under this
11 17 chapter. "Action under this chapter" does not include any of
11 18 the following:
11 19 (a) Making an initial determination that a patient has
11 20 a terminal disease and informing the patient of the medical
11 21 prognosis.
11 22 (b) Providing information about this chapter to a patient
11 23 upon the request of the patient.
11 24 (c) Providing a patient, upon the request of the patient,
11 25 with a referral to another physician.
11 26 (d) A patient contracting with the patient's attending
11 27 physician and consulting physician to act outside of the
11 28 course and scope of the provider's capacity as an employee or
11 29 independent contractor of the sanctioning health care provider.
11 30 (2) "Notify" means a separate statement in writing to the
11 31 health care provider specifically informing the health care
11 32 provider prior to the provider's action under this chapter of
11 33 the sanctioning health care provider's policy about actions
11 34 under this chapter.
11 35 Sec. 15. NEW SECTION. 142E.15 Liabilities == penalties.
12 1 1. A person who without authorization of the patient
12 2 willfully alters or forges a request for medication under this
12 3 chapter or conceals or destroys a recision of a request for
12 4 medication under this chapter with the intent or effect of
12 5 causing the patient's death is guilty of a class "A" felony.
12 6 2. A person who coerces or exerts undue influence on a
12 7 patient to request medication for the purpose of ending the
12 8 patient's life pursuant to this chapter, or to destroy a
12 9 recision of such a request, is guilty of a class "A" felony.
12 10 3. Nothing in this chapter shall be construed to limit
12 11 a person's liability for civil damages resulting from the
12 12 person's negligent conduct or intentional misconduct applicable
12 13 under other law for conduct which is inconsistent with the
12 14 provisions of this chapter.
12 15 4. The penalties specified in this section shall not
12 16 preclude criminal penalties applicable under other law for
12 17 conduct which is inconsistent with the provisions of this
12 18 chapter.
12 19 Sec. 16. NEW SECTION. 142E.16 Claims by governmental entity
12 20 for costs incurred.
12 21 A governmental entity that incurs costs resulting from a
12 22 person terminating the person's life pursuant to this chapter
12 23 in a public place shall have a claim against the estate of
12 24 the person to recover such costs and reasonable attorney fees
12 25 related to enforcing the claim.
12 26 Sec. 17. NEW SECTION. 142E.17 Form of written request.
12 27 A written request for medication as authorized by this
12 28 chapter shall be in substantially the following form:
12 29 REQUEST FOR MEDICATION
12 30 TO END MY LIFE IN A HUMANE
12 31 AND DIGNIFIED MANNER
12 32 I, ______________________, am an adult of sound mind.
12 33 I am suffering from _________, which my attending physician has
12 34 determined is a terminal disease and which has been medically
12 35 confirmed by a consulting physician.
13 1 I have been fully informed of my diagnosis, prognosis, the
13 2 nature of medication to be prescribed and potential associated
13 3 risks, the expected result, and the feasible alternatives,
13 4 including comfort care, hospice care, and pain control.
13 5 I request that my attending physician prescribe medication that
13 6 will end my life in a humane and dignified manner.
13 7 INITIAL ONE OF THE FOLLOWING:
13 8 ______ I have informed my family of my decision and taken their
13 9 opinions into consideration.
13 10 ______ I have decided not to inform my family of my decision.
13 11 ______ I have no family to inform of my decision.
13 12 I understand that I have the right to rescind this request at
13 13 any time.
13 14 I understand the full import of this request and I expect to
13 15 die when I take the medication to be prescribed. I further
13 16 understand that although most deaths occur within three hours,
13 17 my death may take longer and my physician has counseled me
13 18 about this possibility.
13 19 I make this request voluntarily and without reservation, and I
13 20 accept full moral responsibility for my actions.
13 21 Signed: _______________
13 22 Dated: _______________
13 23 DECLARATION OF WITNESSES
13 24 By initialing and signing below on or after the date the person
13 25 named above signs, we declare that the person making and
13 26 signing the above request:
13 27 (a) Is personally known to us or has provided proof of
13 28 identity.
13 29 (b) Signed this request in our presence on the date of the
13 30 person's signature.
13 31 (c) Appears to be of sound mind and not under duress, fraud, or
13 32 undue influence.
13 33 (d) Is not a patient for whom either of us is the attending
13 34 physician.
13 35 Printed name of Witness 1 ____________________
14 1 Signed name of Witness 1/Date ________________________
14 2 Printed name of Witness 2 ____________________
14 3 Signed name of Witness 2/Date ________________________
14 4 NOTE: One witness shall not be a relative by blood, marriage,
14 5 or adoption of the person signing this request, shall not be
14 6 entitled to any portion of the person's estate upon death,
14 7 and shall not own, operate, or be employed at a health care
14 8 facility where the person is a patient or resident. If the
14 9 patient is an inpatient at a health care facility, one of the
14 10 witnesses shall be an individual designated by the facility.
14 11 EXPLANATION
14 12 The inclusion of this explanation does not constitute agreement with
14 13 the explanation's substance by the members of the general assembly.
14 14 This bill provides for a competent adult patient, who is
14 15 a resident of the state of Iowa, who is terminally ill with
14 16 less than six months to live as verified by two physicians, to
14 17 voluntarily request medication that will end the person's life.
14 18 The bill provides that the patient must make an oral request, a
14 19 subsequent oral request no less than 15 days after the initial
14 20 request, and a written request for the medication. There is
14 21 also a 48=hour waiting period between the submission of the
14 22 written request and the writing of the prescription. The bill
14 23 specifies the responsibilities of the attending physician and
14 24 the consulting physician. The bill includes a provision for
14 25 counseling if the attending physician deems it appropriate, the
14 26 notification of next of kin, the right to rescind a request at
14 27 any time, and documentation requirements. The bill provides
14 28 for the effect of a request for medication to end the person's
14 29 life on the construction of wills, contracts, and statutes as
14 30 well as on insurance and annuity policies.
14 31 The bill provides that the provisions of the bill are not
14 32 to be construed to authorize a physician or any other person
14 33 to end a patient's life by lethal injection, mercy killing,
14 34 or active euthanasia, and that actions taken in accordance
14 35 with the bill shall not, for any purpose, constitute suicide,
15 1 assisted suicide, mercy killing, or homicide under the
15 2 law. Additionally, the provisions of the bill are not to be
15 3 interpreted to lessen the applicable standard of care for the
15 4 attending physician, consulting physician, psychiatrist, or
15 5 psychologist, or other health care provider acting under the
15 6 bill.
15 7 The bill provides immunities for a person who acts in
15 8 good=faith compliance with the bill, including being present
15 9 when a patient takes the prescribed medication to end the
15 10 patient's life.
15 11 The bill provides that a professional organization or
15 12 association, or health care provider, shall not subject a
15 13 person to censure, discipline, suspension, loss of license,
15 14 loss of privileges, loss of membership, or other penalty for
15 15 acting or refusing to act in good=faith compliance with the
15 16 bill, but does provide for prohibitions by a health care
15 17 provider on the premises of the health care provider relative
15 18 to the bill. The bill provides that a request by a patient
15 19 for or provision by an attending physician of medication in
15 20 good=faith compliance with the bill does not constitute neglect
15 21 under the law or provide the sole basis for the appointment
15 22 of a guardian or conservator for the patient. Under the
15 23 bill, a health care provider is not to be under any duty,
15 24 whether by contract, statute, or any other legal requirement
15 25 to participate in the provision to a patient of medication to
15 26 end the patient's life. If a health care provider is unable
15 27 or unwilling to carry out a patient's request under the bill,
15 28 however, and the patient transfers the patient's care to a
15 29 new health care provider, the prior health care provider is
15 30 required to transfer, upon request, a copy of the patient's
15 31 relevant medical records to the new health care provider.
15 32 The bill provides that a person who without authorization of
15 33 the patient willfully alters or forges a request for medication
15 34 under the bill or conceals or destroys a recision of such a
15 35 request with the intent or effect of causing the patient's
16 1 death is guilty of a class "A" felony. Additionally, a person
16 2 who coerces or exerts undue influence on a patient to request
16 3 medication for the purpose of ending the patient's life under
16 4 the bill, or to destroy a recision of such a request, is guilty
16 5 of a class "A" felony. A class "A" felony is punishable by
16 6 confinement for life without possibility of parole.
16 7 The bill provides that the provisions of the bill are
16 8 not to be construed to limit a person's liability for civil
16 9 damages resulting from other negligent conduct or intentional
16 10 misconduct by the person and that the penalties specified in
16 11 the bill shall not preclude criminal penalties applicable under
16 12 other law for conduct which is inconsistent with the provisions
16 13 of the bill.
16 14 The bill provides that if a governmental entity incurs costs
16 15 resulting from a person terminating the person's life under the
16 16 bill in a public place, the governmental entity has a claim
16 17 against the estate of the person to recover such costs and
16 18 reasonable attorney fees related to enforcing the claim.
16 19 The bill also provides the form for the request for
16 20 medication to end a person's life.
LSB 1385YH (8) 86
pf/nh