NY State Senate Bill 2015-S5814A

Senate Bill S5814A

2015-2016 Legislative Session

Relates to the patient self-determination act; authorizes the dispensation of lethal doses of medication to certain individuals

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Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 25, 2016	print number 5814a
Jan 25, 2016	amend and recommit to health
Jan 06, 2016	referred to health
Jun 04, 2015	referred to health

Bill Amendments

Original

A (Active)

2015-S5814 - Details

See Assembly Version of this Bill:: A5261
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Add Art 28-F §§2899-d - 2899-p, Pub Health L
Versions Introduced in 2017-2018 Legislative Session:: S2045

2015-S5814 - Summary

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.

2015-S5814 - Sponsor Memo

                                BILL NUMBER:S5814

TITLE OF BILL:  An act to amend the public health law, in relation to
patient self-determination at end of life

PURPOSE:

To provide that a physician who prescribes in compliance with the
provisions of this article medication to a terminally ill patient to
be self-administered for the purpose of hastening the patient's death
will not be subject to civil or criminal liability or professional
disciplinary action.

SUMMARY OF PROVISIONS:

Section 1 amends the Public Health Law by adding a new article 28-F,
the Patient Self-Determination Act, comprised of the following
sections:

§ 2899-d sets forth definitions.

§ 2899-e sets forth the circumstances in which an adult may make a
written request for medication for the purpose of ending his or her
life in accordance with the provisions of this article.

§ 2899-f provides that a valid request for medication shall be in such

form as prescribed by the Department of Health (DOH), signed and dated
by the patient and witnessed as provided in such section. This section
also prohibits the patient's attending physician at the time the
request is signed from acting as a witness and identifies other
individuals who cannot act as one of the witnesses.

§ 2899-g sets forth the responsibilities of the attending physician.

§ 2899-h provides that if in the opinion of the attending physician a
patient may be suffering from a psychiatric or psychological disorder
or depression causing impaired judgment, such physician shall refer
the patient for counseling. No medication to end a patient's life in a
humane and dignified manner 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 and is capable.

§ 2899-i sets forth the items that must be documented or filed in the
patient's medical record.

§ 2899-j provides that only requests by New York state residents under
the provisions of this article may be granted and sets forth the
factors included that demonstrate New York state residency.

§ 2899-k provides that a physician who engages in discussions with a
patient under section 2997-c of the Public Health Law related to the
risks and benefits of palliative care and end-of-life options in the
circumstances described in this article will not be construed to be
assisting in or contributing to a patient's independent decision to
self-administer a lethal dose of medication. Such discussions will not


be used to establish civil or criminal liability or professional
disciplinary action.

§ 2899-1 provides that a physician shall not be subject to civil or
criminal liability or professional disciplinary action if the
physician prescribes to a terminally ill patient medication to be
self-administered for the purpose of hastening the patient's death or
for any other actions performed in good faith compliance with the
provisions of this article. The section also provides that a
pharmacist will not be subject to any civil or criminal liability or
professional disciplinary action if the pharmacist dispenses such
medication.

§ 2899-m provides that a terminally ill patient who self-administers a
lethal dose of medication pursuant to this article will not be
considered a person who is suicidal and no person shall be subject to
civil or criminal liability solely for being present when a terminally
ill patient self-administers a lethal dose of medication or for not
acting to prevent the patient from self-administering a lethal dose of
medication. In addition, no person, whether or not otherwise obligated
by law or professional practice to do so, shall be under any duty to
render assistance to such patient or to otherwise act to resuscitate
such patient after he or she self-administers a lethal dose of
medication.

§ 2899-n provides that a physician, nurse, pharmacist, or other person
shall not be under any duty by law or contract to participate in the
provision of a lethal dose of medication to a patient, provided that
reasonable efforts shall be made to refer the patient to a physician,
nurse or pharmacist who may participate in the provision of a lethal
dose of medication to a patient. A health care facility or health care
provider shall not subject a physician, nurse, pharmacist, or other
person to discipline, suspension, loss of license, loss of privileges,
or other penalty for actions taken in good faith reliance on the
provisions of the article or refusals to act under this article.
Except as otherwise-provided, nothing in this article will be
construed to limit liability for civil damages resulting from
negligent conduct or intentional misconduct by any person.

§ 2899-o provides that a health care facility may prohibit a physician
from writing a prescription for a dose of medication intended to be
lethal for a patient who is a resident in its facility and intends to
use the medication on the facility's premises, provided the facility
notified the physician in writing of its policy with regard to the
prescriptions. Any physician who violates a policy established by a
health care facility under this section may be subject to sanctions
otherwise allowable under law or contract.

§ 2899-p provides that 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
to end his or her life in a humane and dignified manner, shall be
valid. The section further provides that no obligation owing under any
currently existing contract will be conditioned or affected by the
making or rescinding of a request by a person for medication to end
his or her life in a humane and dignified manner.


§ 2899-q provides that a person and his or her beneficiaries shall not
be denied benefits under a life insurance policy for actions taken in
accordance with this article. In addition, the sale, procurement or
issue of any medical malpractice insurance policy or the rate charged
for the policy shall not be conditioned on or affected by whether the
physician is willing or unwilling to participate in the provisions of
this article.

§ 2899-r provides that a physician with a bona fide physician-patient
relationship with a terminally ill patient shall not be considered to
have engaged in unprofessional conduct and shall not be subject to
discipline if all of the requirements set forth in this section have
been met: (i) the physician determines that the patient is capable and
does not have impaired judgment; (ii) the physician informs the
patient of palliative care and end-of-life options pursuant to section
2997-c(2) of the Public Health Law and the physician prescribes a dose
of medication that may be lethal to the patient; (iii) the physician
advises the patient of all foreseeable risks related to the
prescription; (iv) the physician advises the patient of all
alternatives to aid in dying; and the patient makes an independent
decision to self-administer a lethal dose of the medication.

§ 2899-s provides for the adoption of rules and regulations by the DOH
for the safe disposal of unused medications prescribed under this
article.

§ 2899-t provides that in the event a patient self-administers a
lethal dose of medication in accordance with the provisions of this
article, the death certificate shall indicate that the cause of death
was the underlying terminal illness or condition of the patient.

§ 2899-u provides that this article shall not be construed to
authorize a physician or any other person to end a patient's life by
lethal injection, mercy killing, or active euthanasia. Action taken in
accord- ance with this article shall not be construed for any purpose
to consti- tute suicide, assisted suicide, attempted suicide,
promoting a suicide attempt, mercy killing, or homicide under the law,
including as an accomplice or accessory or otherwise.

§ 2899-v provides the severability clause. Section 2 sets forth the
effective date.

JUSTIFICATION:

The highly publicized planned death of Brittany Maynard has
highlighted the need for terminally ill patients to be able to access
aid in dying. Patients with a terminal illness or condition seek the
ability to choose how and when they die. These patients, who are
mentally competent and without impaired judgment, should not be forced
to relocate to another state or to leave the country to control how
they end their lives and to die with the dignity, peace and comfort
they seek and that they believe will come with shortening the dying
process.

According to HealthDay/Harris poll findings released in December 2014,
74% of American adults believe that terminally ill patients in great
pain should have the right to end their lives (14 percent were


opposed). In addition, 54% of physicians in the U.S. believe that
physician-assisted dying should be permitted (31% opposed) according
to a recent survey of physicians conducted by Medscape.

The Patient Self-Determination Act will enable mentally competent,
terminally ill patients to choose to self-administer medication to
bring about a peaceful death and provide the physicians who provide
the medication and who comply in good faith with the provisions of the
Act safe harbor from civil and criminal liability and professional
disciplinary action. Under current law, a person who attempts suicide
is deemed to mean that he poses a substantial risk of physical harm to
himself which would allow his involuntary admission to a hospital.
Furthermore, under current law, any person who intentionally causes or
aids another person to attempt or to commit suicide will be charged
with a felony offense.

Aid in dying must be distinguished from assisted suicide. Assisted
suicide laws are designed to stop individuals from assisting mentally
incompetent or unbalanced, despondent persons kill themselves. This is
different from mentally capable, terminally ill patients who want to
live but in light of their imminent death, wish to choose to die on
their own terms.

Four states, Oregon, Vermont, Washington and Colorado allow physician
assisted dying. Aid in dying legislation recently passed the New
Jersey Assembly and legislators in additional states, including
Florida, Indiana, Maryland, Minnesota, Missouri, New Hampshire, and
Pennsylvania have committed to introduce such legislation. Aid in
dying legislation is supported by the American Public Health
Association, the American Medical Women's Association, the American
Medical Student Association, the American College of Legal Medicine,
Lamda Legal, and Compassion & Choices.

LEGISLATIVE HISTORY:

New bill.

FISCAL IMPLICATIONS:

None.

EFFECTIVE DATE:

Effective immediately.

2015-S5814 - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  5814

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                              June 4, 2015
                               ___________

Introduced  by  Sen. BONACIC -- 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 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:

  Section 1. The public health law is amended by adding  a  new  article
28-F to read as follows:

                              ARTICLE 28-F
                     PATIENT SELF-DETERMINATION ACT
SECTION 2899-D. DEFINITIONS.
        2899-E. WRITTEN REQUEST FOR MEDICATION.
        2899-F. WRITTEN REQUEST SIGNED AND WITNESSED.
        2899-G. ATTENDING PHYSICIAN RESPONSIBILITIES.
        2899-H. COUNSELING REFERRAL.
        2899-I. MEDICAL RECORD DOCUMENTATION REQUIREMENTS.
        2899-J. RESIDENCY REQUIREMENT.
        2899-K. RIGHT TO INFORMATION.
        2899-L. IMMUNITY.
        2899-M. NOT SUICIDE; NO DUTY TO AID.
        2899-N. LIMITATIONS ON ACTIONS.
        2899-O. HEALTH CARE FACILITY EXCEPTIONS.
        2899-P. EFFECT ON CONSTRUCTION OF WILLS, CONTRACTS AND STATUTES.
        2899-Q. INSURANCE POLICIES; PROHIBITIONS.
        2899-R. PROTECTION OF PATIENT CHOICE AT END OF LIFE.
        2899-S. SAFE DISPOSAL OF UNUSED MEDICATIONS.
        2899-T. DEATH CERTIFICATE.
        2899-U. STATUTORY CONSTRUCTION.
        2899-V. SEVERABILITY.
  S 2899-D. DEFINITIONS. AS USED IN THIS ARTICLE:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07446-08-5

S. 5814                             2

  1.  "ADULT"  MEANS  AN  INDIVIDUAL  WHO  IS TWENTY-ONE 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 DISEASE.
  3.  "BONA  FIDE  PHYSICIAN-PATIENT  RELATIONSHIP"  MEANS A TREATING OR
CONSULTING RELATIONSHIP IN THE COURSE OF WHICH A PHYSICIAN HAS COMPLETED
A FULL ASSESSMENT OF THE PATIENT'S MEDICAL HISTORY AND  CURRENT  MEDICAL
CONDITION, INCLUDING A PERSONAL PHYSICAL EXAMINATION.
  4.  "CAPABLE" MEANS THAT A PATIENT HAS THE ABILITY TO UNDERSTAND, MAKE
AND COMMUNICATE HEALTH CARE DECISIONS TO A PHYSICIAN, INCLUDING COMMUNI-
CATION THROUGH PERSONS FAMILIAR WITH THE PATIENT'S MANNER OF COMMUNICAT-
ING IF THOSE PERSONS ARE AVAILABLE.
  5. "COUNSELING" MEANS ONE OR MORE CONSULTATIONS AS NECESSARY BETWEEN A
STATE LICENSED PSYCHIATRIST  OR  PSYCHOLOGIST  AND  A  PATIENT  FOR  THE
PURPOSE  OF  DETERMINING  THAT  THE PATIENT IS CAPABLE AND NOT SUFFERING
FROM A PSYCHIATRIC  OR  PSYCHOLOGICAL  DISORDER  OR  DEPRESSION  CAUSING
IMPAIRED JUDGMENT.
  6.  "HEALTH  CARE FACILITY" SHALL INCLUDE HOSPITALS, NURSING HOMES AND
RESIDENTIAL HEALTH CARE FACILITIES AS DEFINED  IN  SECTION  TWENTY-EIGHT
HUNDRED ONE OF THIS CHAPTER.
  7.  "HEALTH  CARE  PROVIDER" MEANS A PERSON, PARTNERSHIP, CORPORATION,
FACILITY, OR INSTITUTION, LICENSED OR CERTIFIED OR AUTHORIZED BY LAW  TO
ADMINISTER  HEALTH CARE OR DISPENSE MEDICATION IN THE ORDINARY COURSE OF
BUSINESS OR PRACTICE OF A PROFESSION.
  8. "IMPAIRED JUDGMENT" MEANS  THAT  A  PERSON  DOES  NOT  SUFFICIENTLY
UNDERSTAND  OR  APPRECIATE  THE  RELEVANT  FACTS  NECESSARY  TO  MAKE AN
INFORMED DECISION.
  9. "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.
  10.  "PATIENT" MEANS A PERSON WHO IS TWENTY-ONE YEARS OF AGE OR OLDER,
A RESIDENT OF NEW YORK STATE, AND UNDER THE CARE OF A PHYSICIAN.
  11. "PHYSICIAN" MEANS AN INDIVIDUAL LICENSED TO PRACTICE  MEDICINE  IN
NEW YORK STATE.
  12.  "TERMINAL  ILLNESS  OR  CONDITION"  MEANS AN ILLNESS OR CONDITION
WHICH CAN REASONABLY BE EXPECTED  TO  CAUSE  DEATH  WITHIN  SIX  MONTHS,
WHETHER OR NOT TREATMENT IS PROVIDED.
  S  2899-E. WRITTEN REQUEST FOR MEDICATION. 1. AN ADULT WHO IS CAPABLE,
IS A RESIDENT OF THIS STATE AND HAS BEEN  DETERMINED  BY  THE  ATTENDING
PHYSICIAN  AND  CONSULTING  PHYSICIAN  TO  BE  SUFFERING FROM A TERMINAL
ILLNESS OR CONDITION, AND WHO HAS VOLUNTARILY EXPRESSED HIS OR HER  WISH
TO  DIE,  MAY  MAKE  A WRITTEN REQUEST FOR MEDICATION FOR THE PURPOSE OF
ENDING HIS OR HER LIFE IN A HUMANE AND DIGNIFIED  MANNER  IN  ACCORDANCE
WITH THE PROVISIONS OF THIS ARTICLE.
  2. NO PERSON SHALL QUALIFY UNDER THE PROVISIONS OF THIS ARTICLE SOLELY
BECAUSE OF AGE OR DISABILITY.
  S 2899-F. WRITTEN REQUEST SIGNED AND WITNESSED. 1. A VALID REQUEST FOR
MEDICATION UNDER THE PROVISIONS OF THIS ARTICLE SHALL BE IN SUCH FORM AS
PRESCRIBED  BY  THE  DEPARTMENT,  SIGNED  AND  DATED  BY THE PATIENT AND
WITNESSED BY AT LEAST TWO  INDIVIDUALS  WHO,  IN  THE  PRESENCE  OF  THE
PATIENT,  ATTEST  THAT  TO  THE  BEST  OF THEIR KNOWLEDGE AND BELIEF THE
PATIENT IS CAPABLE, ACTING VOLUNTARILY, AND IS NOT BEING COERCED TO SIGN
THE REQUEST.

S. 5814                             3

  2. ONE OF THE WITNESSES SHALL BE A PERSON WHO IS NOT:
  (A) A RELATIVE OF THE PATIENT BY BLOOD, MARRIAGE OR ADOPTION;
  (B)  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
  (C) AN OWNER, OPERATOR OR EMPLOYEE OF A HEALTH CARE FACILITY WHERE THE
PATIENT IS RECEIVING MEDICAL TREATMENT OR IS A RESIDENT.
  3. THE PATIENT'S ATTENDING PHYSICIAN AT THE TIME THE REQUEST IS SIGNED
SHALL NOT BE A WITNESS.
  S 2899-G.  ATTENDING  PHYSICIAN  RESPONSIBILITIES.  1.  THE  ATTENDING
PHYSICIAN SHALL:
  (A) MAKE THE DETERMINATION OF WHETHER A PATIENT HAS A TERMINAL ILLNESS
OR CONDITION, IS CAPABLE, AND HAS MADE THE REQUEST VOLUNTARILY;
  (B) REQUEST THAT THE PATIENT DEMONSTRATE NEW YORK STATE RESIDENCY;
  (C)  REFER  THE  PATIENT  FOR  COUNSELING, IF APPROPRIATE, PURSUANT TO
SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-H OF THIS ARTICLE; AND
  (D) FULFILL THE MEDICAL RECORD DOCUMENTATION REQUIREMENTS  OF  SECTION
TWENTY-EIGHT HUNDRED NINETY-NINE-I OF THIS ARTICLE;
  2. SUBJECT TO SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-H OF THIS ARTI-
CLE, AN ATTENDING PHYSICIAN WHO MAKES THE DETERMINATION THAT THE PATIENT
HAS  A  TERMINAL ILLNESS OR CONDITION, IS CAPABLE AND HAS MADE A REQUEST
FOR MEDICATION AS PROVIDED IN SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-E
OF THIS ARTICLE, THE ATTENDING PHYSICIAN SHALL EITHER:
  (A) DISPENSE THE MEDICATION DIRECTLY, INCLUDING  ANCILLARY  MEDICATION
INTENDED  TO  FACILITATE  THE  DESIRED  EFFECT TO MINIMIZE THE PATIENT'S
DISCOMFORT, PROVIDED THE ATTENDING PHYSICIAN HAS A CURRENT DRUG ENFORCE-
MENT ADMINISTRATION CERTIFICATE AND COMPLIES WITH ANY APPLICABLE RULE OR
REGULATION; OR
  (B) WITH THE PATIENT'S WRITTEN CONSENT:
  (I)  CONTACT  A  PHARMACIST  AND  INFORM   THE   PHARMACIST   OF   THE
PRESCRIPTION; AND
  (II)  DELIVER  THE  WRITTEN  PRESCRIPTION PERSONALLY OR BY MAIL TO THE
PHARMACIST, WHO WILL DISPENSE THE MEDICATIONS TO EITHER THE PATIENT, THE
ATTENDING PHYSICIAN OR AN EXPRESSLY IDENTIFIED AGENT OF THE PATIENT.
  S 2899-H. COUNSELING REFERRAL. IF IN  THE  OPINION  OF  THE  ATTENDING
PHYSICIAN A PATIENT MAY BE SUFFERING FROM A PSYCHIATRIC OR PSYCHOLOGICAL
DISORDER  OR  DEPRESSION CAUSING IMPAIRED JUDGMENT, SUCH PHYSICIAN SHALL
REFER THE PATIENT FOR COUNSELING. NO MEDICATION TO END A PATIENT'S  LIFE
IN  A  HUMANE  AND DIGNIFIED MANNER 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 AND IS CAPABLE.
  S 2899-I. MEDICAL RECORD  DOCUMENTATION  REQUIREMENTS.  THE  FOLLOWING
SHALL BE DOCUMENTED OR FILED IN THE PATIENT'S MEDICAL RECORD:
  1.  ALL  ORAL  REQUESTS  BY A PATIENT FOR MEDICATION TO END HIS OR HER
LIFE IN A HUMANE AND DIGNIFIED MANNER;
  2. ALL WRITTEN REQUESTS BY A PATIENT FOR MEDICATION TO END HIS OR  HER
LIFE IN A HUMANE AND DIGNIFIED MANNER;
  3.  THE  ATTENDING  PHYSICIAN'S DIAGNOSIS AND PROGNOSIS, DETERMINATION
THAT THE PATIENT IS CAPABLE AND ACTING VOLUNTARILY;
  4. A REPORT OF THE OUTCOME AND DETERMINATIONS MADE DURING  COUNSELING,
IF PERFORMED; AND
  5.  A NOTE BY THE ATTENDING PHYSICIAN INDICATING THAT ALL REQUIREMENTS
UNDER THE PROVISIONS OF THIS ARTICLE HAVE BEEN MET  AND  INDICATING  THE
STEPS  TAKEN TO CARRY OUT THE REQUEST, INCLUDING A NOTATION OF THE MEDI-
CATION PRESCRIBED.

S. 5814                             4

  S 2899-J. RESIDENCY REQUIREMENT. ONLY REQUESTS MADE BY NEW YORK  STATE
RESIDENTS UNDER THE PROVISIONS OF THIS ARTICLE SHALL BE GRANTED. FACTORS
DEMONSTRATING  NEW  YORK  STATE RESIDENCY SHALL INCLUDE BUT SHALL NOT BE
LIMITED TO:
  1. POSSESSION OF A NEW YORK STATE DRIVER'S LICENSE;
  2. REGISTRATION TO VOTE IN NEW YORK STATE;
  3. EVIDENCE THAT THE PERSON OWNS OR LEASES PROPERTY IN NEW YORK STATE;
OR
  4. FILING OF A NEW YORK STATE TAX RETURN FOR THE MOST RECENT TAX YEAR.
  S 2899-K. RIGHT TO INFORMATION. A PHYSICIAN WHO ENGAGES IN DISCUSSIONS
WITH  A PATIENT UNDER SECTION TWENTY-NINE HUNDRED NINETY-SEVEN-C OF THIS
CHAPTER RELATED TO  THE  RISKS  AND  BENEFITS  OF  PALLIATIVE  CARE  AND
END-OF-LIFE OPTIONS IN THE CIRCUMSTANCES DESCRIBED IN THIS ARTICLE SHALL
NOT BE CONSTRUED TO BE ASSISTING IN OR CONTRIBUTING TO A PATIENT'S INDE-
PENDENT  DECISION  TO  SELF-ADMINISTER  A LETHAL DOSE OF MEDICATION, AND
SUCH DISCUSSIONS SHALL NOT  BE  USED  TO  ESTABLISH  CIVIL  OR  CRIMINAL
LIABILITY OR PROFESSIONAL DISCIPLINARY ACTION.
  S  2899-L. IMMUNITY. (A) A PHYSICIAN SHALL NOT BE SUBJECT TO ANY CIVIL
OR CRIMINAL LIABILITY OR PROFESSIONAL DISCIPLINARY ACTION IF THE  PHYSI-
CIAN  PRESCRIBES TO A PATIENT WITH A TERMINAL ILLNESS OR CONDITION MEDI-
CATION  TO  BE  SELF-ADMINISTERED  FOR  THE  PURPOSE  OF  HASTENING  THE
PATIENT'S DEATH OR FOR ANY OTHER ACTIONS PERFORMED IN GOOD FAITH COMPLI-
ANCE WITH THE PROVISIONS OF THIS ARTICLE.
  (B) A PHARMACIST SHALL NOT BE SUBJECT TO ANY CIVIL OR CRIMINAL LIABIL-
ITY OR PROFESSIONAL DISCIPLINARY ACTION IF THE PHARMACIST DISPENSES SUCH
MEDICATION.
  S  2899-M.  NOT SUICIDE; NO DUTY TO AID. (A) A PATIENT WITH A TERMINAL
ILLNESS OR CONDITION WHO SELF-ADMINISTERS A LETHAL  DOSE  OF  MEDICATION
PURSUANT TO THE PROVISIONS OF THIS ARTICLE SHALL NOT BE CONSIDERED TO BE
A PERSON WHO IS SUICIDAL.
  (B)  (1)  NO  PERSON  SHALL  BE SUBJECT TO CIVIL OR CRIMINAL LIABILITY
SOLELY FOR BEING PRESENT WHEN SUCH PATIENT WITH A  TERMINAL  ILLNESS  OR
CONDITION SELF-ADMINISTERS A LETHAL DOSE OF MEDICATION OR FOR NOT ACTING
TO  PREVENT THE PATIENT FROM SELF-ADMINISTERING A LETHAL DOSE OF MEDICA-
TION.
  (2) NO PERSON, WHETHER OR NOT OTHERWISE OBLIGATED BY  LAW  OR  PROFES-
SIONAL  PRACTICE  TO DO SO, SHALL BE UNDER ANY DUTY TO RENDER ASSISTANCE
TO SUCH PATIENT OR TO OTHERWISE ACT TO RESUSCITATE SUCH PATIENT AFTER HE
OR SHE SELF-ADMINISTERS A LETHAL DOSE OF MEDICATION.
  S 2899-N. LIMITATIONS ON ACTIONS. 1. A PHYSICIAN,  NURSE,  PHARMACIST,
OR  OTHER  PERSON  SHALL  NOT  BE UNDER ANY DUTY, BY LAW OR CONTRACT, TO
PARTICIPATE IN THE PROVISION  OF  A  LETHAL  DOSE  OF  MEDICATION  TO  A
PATIENT,  PROVIDED  THAT  REASONABLE  EFFORTS SHALL BE MADE TO REFER THE
PATIENT TO A PHYSICIAN, NURSE OR PHARMACIST WHO MAY PARTICIPATE  IN  THE
PROVISION OF A LETHAL DOSE OF MEDICATION TO A PATIENT.
  2.  A HEALTH CARE FACILITY OR HEALTH CARE PROVIDER SHALL NOT SUBJECT A
PHYSICIAN, NURSE, PHARMACIST, OR OTHER PERSON TO DISCIPLINE, SUSPENSION,
LOSS OF LICENSE, LOSS OF PRIVILEGES, OR OTHER PENALTY FOR ACTIONS  TAKEN
IN  GOOD FAITH RELIANCE ON THE PROVISIONS OF THIS ARTICLE OR REFUSALS TO
ACT UNDER THIS ARTICLE.
  3. EXCEPT AS OTHERWISE PROVIDED HEREIN NOTHING IN THIS  ARTICLE  SHALL
BE  CONSTRUED TO LIMIT LIABILITY FOR CIVIL DAMAGES RESULTING FROM NEGLI-
GENT CONDUCT OR INTENTIONAL MISCONDUCT BY ANY PERSON.
  S 2899-O. HEALTH CARE FACILITY EXCEPTIONS. A HEALTH CARE FACILITY  MAY
PROHIBIT  A  PHYSICIAN FROM WRITING A PRESCRIPTION FOR A DOSE OF MEDICA-
TION INTENDED TO BE LETHAL FOR A PATIENT WHO IS A RESIDENT IN ITS FACIL-

S. 5814                             5

ITY AND INTENDS TO  USE  THE  MEDICATION  ON  THE  FACILITY'S  PREMISES,
PROVIDED THE FACILITY HAS NOTIFIED THE PHYSICIAN IN WRITING OF ITS POLI-
CY   WITH   REGARD   TO  THE  PRESCRIPTIONS.    NOTWITHSTANDING  SECTION
TWENTY-EIGHT  HUNDRED  NINETY-NINE-L  OF THIS ARTICLE, ANY PHYSICIAN WHO
VIOLATES A POLICY ESTABLISHED BY  A  HEALTH  CARE  FACILITY  UNDER  THIS
SECTION  MAY  BE  SUBJECT  TO SANCTIONS OTHERWISE ALLOWABLE UNDER LAW OR
CONTRACT.
  S 2899-P. EFFECT ON CONSTRUCTION OF WILLS, CONTRACTS AND STATUTES.  1.
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 TO END HIS OR HER LIFE IN  A  HUMANE
AND DIGNIFIED MANNER, SHALL BE VALID.
  2.  NO OBLIGATION OWING UNDER ANY CURRENTLY EXISTING CONTRACT SHALL BE
CONDITIONED OR AFFECTED BY THE MAKING OR RESCINDING OF A REQUEST,  BY  A
PERSON,  FOR MEDICATION TO END HIS OR HER LIFE IN A HUMANE AND DIGNIFIED
MANNER.
  S 2899-Q. INSURANCE POLICIES; PROHIBITIONS. 1. A PERSON AND HIS OR HER
BENEFICIARIES SHALL NOT BE DENIED BENEFITS UNDER A LIFE INSURANCE POLICY
FOR ACTIONS TAKEN IN ACCORDANCE WITH THIS ARTICLE.
  2. THE SALE, PROCUREMENT, OR ISSUE OF ANY MEDICAL  MALPRACTICE  INSUR-
ANCE  POLICY OR THE RATE CHARGED FOR THE POLICY SHALL NOT BE CONDITIONED
UPON OR AFFECTED BY WHETHER THE PHYSICIAN IS  WILLING  OR  UNWILLING  TO
PARTICIPATE IN THE PROVISIONS OF THIS ARTICLE.
  S  2899-R.  PROTECTION  OF  PATIENT CHOICE AT END OF LIFE. A PHYSICIAN
WITH A BONA FIDE PHYSICIAN-PATIENT RELATIONSHIP WITH A  PATIENT  WITH  A
TERMINAL ILLNESS OR CONDITION SHALL NOT BE CONSIDERED TO HAVE ENGAGED IN
UNPROFESSIONAL CONDUCT AND SHALL NOT BE THE SUBJECT OF DISCIPLINE IF:
  1.  THE  PHYSICIAN DETERMINES THAT THE PATIENT IS CAPABLE AND DOES NOT
HAVE IMPAIRED JUDGMENT;
  2.  THE  PHYSICIAN  INFORMS  THE  PATIENT  OF  PALLIATIVE   CARE   AND
END-OF-LIFE  OPTIONS  PURSUANT TO SUBDIVISION TWO OF SECTION TWENTY-NINE
HUNDRED NINETY-SEVEN-C OF THIS CHAPTER AND THE  PHYSICIAN  PRESCRIBES  A
DOSE OF MEDICATION THAT MAY BE LETHAL TO THE PATIENT;
  3.  THE PHYSICIAN ADVISES THE PATIENT OF ALL FORESEEABLE RISKS RELATED
TO THE PRESCRIPTION;
  4. THE PHYSICIAN ADVISES THE PATIENT OF ALL  ALTERNATIVES  TO  AID  IN
DYING; AND
  5.  THE  PATIENT  MAKES  AN  INDEPENDENT DECISION TO SELF-ADMINISTER A
LETHAL DOSE OF THE MEDICATION.
  S 2899-S. SAFE DISPOSAL OF UNUSED MEDICATIONS.  THE  DEPARTMENT  SHALL
ADOPT  RULES  AND  REGULATIONS PROVIDING FOR THE SAFE DISPOSAL OF UNUSED
MEDICATIONS PRESCRIBED UNDER THIS ARTICLE.
  S 2899-T. DEATH CERTIFICATE.  IN THE EVENT THAT A PATIENT  SELF-ADMIN-
ISTERS  A LETHAL DOSE OF MEDICATION IN ACCORDANCE WITH THE PROVISIONS OF
THIS ARTICLE, THE DEATH CERTIFICATE SHALL INDICATE  THAT  THE  CAUSE  OF
DEATH WAS THE UNDERLYING TERMINAL ILLNESS OR CONDITION OF THE PATIENT.
  S  2899-U.  STATUTORY  CONSTRUCTION.  NOTHING IN THIS ARTICLE SHALL BE
CONSTRUED TO AUTHORIZE  A  PHYSICIAN  OR  ANY  OTHER  PERSON  TO  END  A
PATIENT'S LIFE BY LETHAL INJECTION, MERCY KILLING, OR ACTIVE EUTHANASIA.
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, MERCY KILLING, OR HOMICIDE UNDER THE LAW,
INCLUDING AS AN ACCOMPLICE OR ACCESSORY OR OTHERWISE.
  S 2899-V. SEVERABILITY. IF ANY CLAUSE, SENTENCE, PARAGRAPH, SECTION OR
PART OF THIS ARTICLE SHALL BE ADJUDGED BY ANY COURT OF COMPETENT  JURIS-
DICTION TO BE INVALID, SUCH JUDGMENT SHALL NOT AFFECT, IMPAIR OR INVALI-

S. 5814                             6

DATE  THE  REMAINDER  THEREOF, BUT SHALL BE CONFINED IN ITS OPERATION TO
THE CLAUSE, SENTENCE,  PARAGRAPH,  SECTION  OR  PART  THEREOF,  DIRECTLY
INVOLVED  IN  THE  CONTROVERSY  IN  WHICH  SUCH JUDGMENT SHALL HAVE BEEN
RENDERED.
  S 2. This act shall take effect immediately.

2015-S5814A (ACTIVE) - Details

See Assembly Version of this Bill:: A5261
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Add Art 28-F §§2899-d - 2899-p, Pub Health L
Versions Introduced in 2017-2018 Legislative Session:: S2045

2015-S5814A (ACTIVE) - Summary

2015-S5814A (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S5814A

 TITLE OF BILL :  An act to amend the public health law, in relation
to patient self-determination at end of life

 PURPOSE :

To provide that a physician who prescribes in compliance with the
provisions of this article medication to a terminally ill patient to
be self-administered for the purpose of hastening the patient's death
will not be subject to civil or criminal liability or professional
disciplinary action.

 SUMMARY OF PROVISIONS :

Section 1 provides that this act shall be known and may be cited as
the "Patient Self-Determination Act."

Section 2 amends the Public Health Law by adding a new article 28-F,
the Patient Self-Determination Act, comprised of the following
sections:

§ 2899-d sets forth definitions.

§ 2899-e sets forth the circumstances in which an adult may make a
written request for medication for the purpose of ending his or her

life in accordance with the provisions of this article.

§ 2899-f provides that a request for medication shall be signed and
dated by the patient and witnessed as provided in such section,
identifying persons who shall not serve as witnesses. The patient's
attending physician at the time the request shall not act as a
witness.

§ 2899-g sets forth the responsibilities of the attending physician.

§ 2899-h provides that if in the opinion of the attending physician a
patient may be suffering from a psychiatric or psychological disorder
or depression causing impaired judgment, such physician shall refer
the patient for counseling. No medication to end a patient's life
shall be prescribed, dispensed or ordered until the person performing
the counseling determines that the patient is not suffering from a
psychiatric or psychological disorder or depression causing impaired
judgment and has capacity.

§ 2899-i sets forth the items that must be documented or filed in the
patient's medical record.

§ 2899-j provides that only requests by New York state residents under
the provisions of this article may be granted and sets forth the
factors included that demonstrate New York state residency.

§ 2899-k provides that a physician, pharmacist, other health care
professional or other person shall not be subject to civil or criminal
liability or professional disciplinary action, and shall not be
subject to discipline, suspension, loss of license, loss of
privileges, or other penalty by any health care facility or health
care provider, for taking any reasonable good-faith action or refusing
to act under this article, including engaging in discussions with a
patient relating to the risks and benefits of palliative care and
end-of-life options in the circumstances described in this article and
being present when a patient self-administers medication.  The section
further provides (i) a physician, nurse, pharmacist, or other person
shall not be under any duty by law or contract to participate in the
provision of medication to a patient, (ii) a private health care
facility may prohibit the self-administering of medication under this
article while the patient is being treated or residing in such
facility if the requirements set forth in the section have been met,
(iii) a health care facility that prohibits the self-administering of
medication while the patient is being treated or residing in the
facility may prohibit a physician from prescribing, dispensing or
ordering medication for self-administering while the patient is being
treated or residing in the facility provided the facility notified the
physician in writing of its policy to prohibit such actions.

§ 2899-1 provides that (i) a patient who self-administers medication
under this article will not be considered a person who is suicidal and
self-administering medication under this article shall not be deemed
to be suicide for any purpose, (ii) 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, mercy killing, or homicide under the law, including as an
accomplice or accessory or otherwise, (iii)a request by a patient to
his or her attending physician to provide medication under this
article shall not, by itself, provide the basis for the appointment of
a guardian or conservator, (iv) 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, (v) no obligation owing under any contract will be conditioned
or affected by the making or rescinding of a request by a person for
medication or taking any other action under this article, (vi) a
person and his or her beneficiaries shall not be denied benefits under
a life insurance policy for actions taken in accordance with this
article, an insurer shall not provide any information in
communications made to a person about the availability of medication
under this article absent a request by such person or by his or her
attending physician upon the request of such person and any
communication shall not include both the denial of treatment and
information as to the availability of medication under this article,
(vii) the sale, procurement or issue of any professional malpractice
insurance policy or the rate charged for the policy shall not be
conditioned on or affected by whether the insured does or does not
take or participate in any action under this article.

§ 2899-m provides for the adoption of rules and regulations by the DOH
for the safe disposal of unused medications prescribed, dispensed or
ordered under this article.

§ 2899-n provides that in the event a patient dies as a result of
medication self-administered under this article, the death certificate
shall indicate that the cause of death was the underlying terminal
illness or condition of the patient.

§ 2899-o provides for the annual review by the commissioner of health
of a sample of the records maintained under section twenty-eight
hundred ninety-nine-i of this article. The section further provides
that the department may adopt regulations establishing reporting
requirements for physicians taking action under this article to
determine utilization and compliance with this article. The
information collected under this section shall be confidential and
shall be collected 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. The department shall
prepare a report annually containing relevant data regarding
utilization and compliance with this article and shall post such
report on its website.

§ 2899-p provides the severability clause. Section 3 sets forth the
effective date.

 JUSTIFICATION :
The highly publicized, planned death of Brittany Maynard has
highlighted the need for terminally ill patients to be able to access
aid in dying. Ms. Maynard, who was a native of California, was forced
to move to Oregon to gain control of her dying process. Her death, and
the accompanying press attention, led the California legislature to
pass, and Governor Jerry Brown to sign, an aid in dying law on October
5, 2015.

The national debate that accompanies Ms. Maynard's plight focused the
nation on the desire of patients with a terminal illness to determine
for themselves - how and when they die. These patients, when mentally
competent and without impaired judgment, should be afforded this
right. Patients should not be forced to relocate to another state or
to leave the country to control how their lives end. Patients seek to
die with dignity, on their own terms, typically in their own homes,
surrounded by their family and other loved ones.

New Yorkers strongly support empowering terminally-ill, mentally
competent patients to control their own death. A 2015 poll found that
77% of all New Yorkers support aid in dying, including 75% of
Catholics, 72% of Republicans, 67% of self-identified Conservatives,
and 78% of New Yorkers Upstate.

Nationally, according to HealthDay/Harris poll findings released in
December 2014, 74% of American adults believe that terminally ill
patients in great pain should have the right to end their lives (14%
were opposed). Gallup, which has been polling this issue since 1947,
has found that a majority of Americans have supported aid in dying
since 1973. Their most recent poll found 68% of Americans support aid
in dying.

Physicians also support aid in dying. In a recent survey conducted by
Medscape, 54% of physicians in the U.S. believe that aid in dying
should be permitted, while only 31% opposed it.

The Patient Self-Determination Act will enable mentally competent,
terminally ill patients to choose to self-administer medication to
bring about a peaceful death. It also provides their physician, when
acting in good faith in accordance with the provisions of the Act,
protections from civil and criminal liability and professional
disciplinary action.

This legislation includes a provision that a request for medication
for the purpose of ending one's life should not be considered by
itself grounds for the appointment of a guardian or a conservator out
of an abundance of caution. A person who has been determined to have
capacity to request medication under the Act should not be forced to
undergo an additional proceeding resulting in delay, costs such as
legal fees, and additional strain.

Five states - Oregon, Vermont, Washington, California and Montana
allow physician assisted aid in dying. In addition, New Mexico had a
court rule that patients have a constitutional right to aid in dying;
that decision is under appeal.

Aid in dying legislation recently passed the New Jersey Assembly, and
legislators in a total of 20 states, including all of New England,
Maryland, North Carolina, Tennessee, Oklahoma, Utah, Wyoming and
Missouri, have aid in dying bills pending.

Aid in dying legislation is supported by the American Public Health
Association, the American Medical Women's Association, the American
Medical Student Association, the American College of Legal Medicine,
and Lamda Legal.

 LEGISLATIVE HISTORY :
New bill.

 FISCAL IMPLICATIONS :

None.

 EFFECTIVE DATE :
Effective immediately.

2015-S5814A (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 5814--A

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                              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:

  Section  1.  This  act shall be known and may be cited as the "patient
self-determination act".
  S 2. The public health law is amended by adding a new article 28-F  to
read as follows:
                              ARTICLE 28-F
                              AID IN DYING
SECTION 2899-D. DEFINITIONS.
        2899-E. WRITTEN REQUEST FOR MEDICATION.
        2899-F. WRITTEN REQUEST SIGNED AND WITNESSED.
        2899-G. ATTENDING PHYSICIAN RESPONSIBILITIES.
        2899-H. COUNSELING REFERRAL.
        2899-I. MEDICAL RECORD DOCUMENTATION REQUIREMENTS.
        2899-J. RESIDENCY REQUIREMENT.
        2899-K. PROTECTION OF HEALTH CARE PROVIDERS AND FACILITIES.
        2899-L. RELATION TO OTHER LAWS AND CONTRACTS.
        2899-M. SAFE DISPOSAL OF UNUSED MEDICATIONS.
        2899-N. DEATH CERTIFICATE.
        2899-O. REPORTING.
        2899-P. SEVERABILITY.
  S 2899-D. DEFINITIONS. AS USED IN THIS ARTICLE:
  1.  "ADULT"  MEANS  AN  INDIVIDUAL  WHO  IS TWENTY-ONE YEARS OF AGE OR
OLDER.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07446-24-6

S. 5814--A                          2

  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 DISEASE.
  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, AND TO  REACH
AN  INFORMED  DECISION  AND  TO  COMMUNICATE  HEALTH CARE DECISIONS TO A
PHYSICIAN, INCLUDING COMMUNICATION THROUGH  PERSONS  FAMILIAR  WITH  THE
PATIENT'S MANNER OF COMMUNICATING IF THOSE PERSONS ARE AVAILABLE.
  4. "COUNSELING" MEANS ONE OR MORE CONSULTATIONS AS NECESSARY BETWEEN A
STATE  LICENSED  PSYCHIATRIST  OR  PSYCHOLOGIST  AND  A  PATIENT FOR THE
PURPOSE OF DETERMINING THAT THE PATIENT HAS CAPACITY AND IS NOT  SUFFER-
ING  FROM  A PSYCHIATRIC OR PSYCHOLOGICAL DISORDER OR DEPRESSION CAUSING
IMPAIRED JUDGMENT.
  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.
  6. "HEALTH CARE PROVIDER" MEANS A PERSON OR  ENTITY  LICENSED,  CERTI-
FIED, OR AUTHORIZED BY LAW TO ADMINISTER HEALTH CARE OR DISPENSE MEDICA-
TION IN THE ORDINARY COURSE OF BUSINESS OR PRACTICE OF A PROFESSION.
  7. "IMPAIRED JUDGMENT" MEANS THAT A PERSON LACKS THE ABILITY TO UNDER-
STAND  AND  APPRECIATE  THE NATURE AND CONSEQUENCES OF HEALTH CARE DECI-
SIONS, INCLUDING THE BENEFITS AND  RISKS  OF  AND  ALTERNATIVES  TO  ANY
PROPOSED HEALTH CARE, AND TO REACH AN INFORMED DECISION.
  8. "MEDICATION" MEANS MEDICATION CAPABLE OF ENDING AND TO BE USED WITH
THE INTENT OF ENDING THE PATIENT'S LIFE, INCLUDING ANY ANCILLARY MEDICA-
TION INTENDED TO MINIMIZE THE PATIENT'S DISCOMFORT.
  9.  "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.
  10. "PATIENT" MEANS A PERSON WHO IS TWENTY-ONE YEARS OF AGE OR  OLDER,
A RESIDENT OF NEW YORK STATE, AND UNDER THE CARE OF A PHYSICIAN.
  11.  "PHYSICIAN"  MEANS AN INDIVIDUAL LICENSED TO PRACTICE MEDICINE IN
NEW YORK STATE.
  12. "TERMINAL ILLNESS OR CONDITION"  MEANS  AN  ILLNESS  OR  CONDITION
WHICH  CAN  REASONABLY  BE  EXPECTED  TO  CAUSE DEATH WITHIN SIX MONTHS,
WHETHER OR NOT TREATMENT IS PROVIDED.
  S 2899-E. WRITTEN REQUEST FOR MEDICATION. 1. AN ADULT WHO HAS  CAPACI-
TY,  IS A RESIDENT OF THIS STATE, AND HAS BEEN DETERMINED BY THE ATTEND-
ING PHYSICIAN AND, IF APPLICABLE, CONSULTING PHYSICIAN TO  BE  SUFFERING
FROM A TERMINAL ILLNESS OR CONDITION, 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.
  2. NO PERSON SHALL QUALIFY UNDER THIS ARTICLE SOLELY BECAUSE OF AGE OR
DISABILITY.
  S 2899-F. WRITTEN REQUEST SIGNED AND WITNESSED. 1. A REQUEST FOR MEDI-
CATION UNDER THIS ARTICLE SHALL BE SIGNED AND DATED BY THE  PATIENT  AND
WITNESSED  BY  AT  LEAST  TWO  INDIVIDUALS  WHO,  IN THE PRESENCE OF THE
PATIENT, ATTEST THAT TO THE BEST  OF  THEIR  KNOWLEDGE  AND  BELIEF  THE
PATIENT HAS CAPACITY, IS ACTING VOLUNTARILY, AND IS NOT BEING COERCED TO
SIGN  THE  REQUEST.  THE  DEPARTMENT  MAY DEVELOP A SUGGESTED FORM FOR A
REQUEST UNDER THIS ARTICLE.
  2. ONE OF THE WITNESSES SHALL BE A PERSON WHO IS NOT:
  (A) A RELATIVE OF THE PATIENT BY BLOOD, MARRIAGE OR ADOPTION;

S. 5814--A                          3

  (B) 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
  (C) AN OWNER, OPERATOR OR EMPLOYEE OF A HEALTH CARE FACILITY WHERE THE
PATIENT IS RECEIVING TREATMENT OR IS A RESIDENT.
  3.  THE  PATIENT'S  ATTENDING  PHYSICIAN OR, IF APPLICABLE, CONSULTING
PHYSICIAN AT THE TIME THE REQUEST IS SIGNED SHALL NOT BE A WITNESS.
  S 2899-G.  ATTENDING  PHYSICIAN  RESPONSIBILITIES.  1.  THE  ATTENDING
PHYSICIAN SHALL:
  (A) MAKE THE DETERMINATION OF WHETHER A PATIENT HAS A TERMINAL ILLNESS
OR CONDITION, HAS CAPACITY, AND HAS MADE THE REQUEST VOLUNTARILY;
  (B) REQUEST THAT THE PATIENT DEMONSTRATE NEW YORK STATE RESIDENCY;
  (C)  REFER  THE  PATIENT FOR COUNSELING, IF APPROPRIATE, UNDER SECTION
TWENTY-EIGHT HUNDRED NINETY-NINE-H OF THIS ARTICLE;
  (D) PROVIDE  INFORMATION  AND  COUNSELING  UNDER  SECTION  TWENTY-NINE
HUNDRED NINETY-SEVEN-C OF THIS CHAPTER; AND
  (E)  FULFILL  THE MEDICAL RECORD DOCUMENTATION REQUIREMENTS OF SECTION
TWENTY-EIGHT HUNDRED NINETY-NINE-I OF THIS ARTICLE.
  2. SUBJECT TO SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-H OF THIS ARTI-
CLE, THE ATTENDING  PHYSICIAN  WHO  MAKES  THE  DETERMINATION  THAT  THE
PATIENT HAS A TERMINAL ILLNESS OR CONDITION, HAS CAPACITY AND HAS MADE A
REQUEST FOR MEDICATION AS PROVIDED IN SECTION TWENTY-EIGHT HUNDRED NINE-
TY-NINE-E  OF  THIS  ARTICLE, MAY PERSONALLY, OR BY DIRECTION TO ANOTHER
PHYSICIAN,  PRESCRIBE,  DISPENSE  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 DELIV-
ERY OF THE MEDICATION TO THE PATIENT.
  3. IN ACCORDANCE WITH THE DIRECTION OF THE PRESCRIBING, DISPENSING  OR
ORDERING  PHYSICIAN  AND  THE  CONSENT  OF  THE PATIENT, THE PATIENT MAY
ADMINISTER THE MEDICATION TO HIMSELF OR HERSELF. A HEALTH  CARE  PROFES-
SIONAL  SHALL  NOT  ADMINISTER THE MEDICATION TO THE PATIENT BUT, ACTING
WITHIN THE SCOPE OF HIS OR  HER  LAWFUL  PRACTICE,  MAY  FACILITATE  THE
PATIENT IN SELF-ADMINISTERING THE MEDICATION.
  S  2899-H.  COUNSELING  REFERRAL.  IF  IN THE OPINION OF THE ATTENDING
PHYSICIAN A PATIENT MAY BE SUFFERING FROM A PSYCHIATRIC OR PSYCHOLOGICAL
DISORDER OR DEPRESSION CAUSING IMPAIRED JUDGMENT, SUCH  PHYSICIAN  SHALL
REFER  THE PATIENT FOR COUNSELING. NO MEDICATION TO END A PATIENT'S LIFE
SHALL BE PRESCRIBED, DISPENSED OR ORDERED UNTIL  THE  PERSON  PERFORMING
THE  COUNSELING  DETERMINES  THAT  THE  PATIENT  IS NOT SUFFERING FROM A
PSYCHIATRIC OR PSYCHOLOGICAL DISORDER  OR  DEPRESSION  CAUSING  IMPAIRED
JUDGMENT AND HAS CAPACITY.
  S  2899-I.  MEDICAL  RECORD  DOCUMENTATION REQUIREMENTS. THE FOLLOWING
SHALL BE DOCUMENTED OR FILED IN THE PATIENT'S MEDICAL RECORD:
  1. ALL ORAL REQUESTS BY A PATIENT FOR MEDICATION TO  END  HIS  OR  HER
LIFE;
  2.  ALL WRITTEN REQUESTS BY A PATIENT FOR MEDICATION TO END HIS OR HER
LIFE;
  3. THE ATTENDING PHYSICIAN'S DIAGNOSIS  AND  PROGNOSIS,  AND  DETERMI-
NATION WHETHER THE PATIENT HAS CAPACITY AND IS ACTING VOLUNTARILY;
  4.  A REPORT OF THE OUTCOME AND DETERMINATIONS MADE DURING COUNSELING,
IF PERFORMED; AND
  5. A NOTE BY THE ATTENDING PHYSICIAN INDICATING WHETHER  ALL  REQUIRE-
MENTS UNDER THIS ARTICLE HAVE BEEN MET AND INDICATING THE STEPS TAKEN TO
CARRY   OUT   THE  REQUEST,  INCLUDING  A  NOTATION  OF  THE  MEDICATION
PRESCRIBED, DISPENSED OR ORDERED.

S. 5814--A                          4

  S 2899-J. RESIDENCY REQUIREMENT. ONLY REQUESTS MADE BY NEW YORK  STATE
RESIDENTS UNDER THE PROVISIONS OF THIS ARTICLE SHALL BE GRANTED. FACTORS
DEMONSTRATING  NEW  YORK  STATE RESIDENCY SHALL INCLUDE BUT SHALL NOT BE
LIMITED TO:
  1. POSSESSION OF A NEW YORK STATE DRIVER'S LICENSE;
  2. REGISTRATION TO VOTE IN NEW YORK STATE;
  3. EVIDENCE THAT THE PERSON OWNS OR LEASES PROPERTY IN NEW YORK STATE;
OR
  4. FILING OF A NEW YORK STATE TAX RETURN FOR THE MOST RECENT TAX YEAR.
  S  2899-K.  PROTECTION  OF HEALTH CARE PROVIDERS AND FACILITIES.  1. A
PHYSICIAN, PHARMACIST, OTHER HEALTH CARE PROFESSIONAL  OR  OTHER  PERSON
SHALL  NOT  BE  SUBJECT  TO  CIVIL OR CRIMINAL LIABILITY OR PROFESSIONAL
DISCIPLINARY ACTION, AND SHALL NOT BE SUBJECT TO DISCIPLINE, SUSPENSION,
LOSS OF LICENSE, LOSS OF PRIVILEGES, OR OTHER PENALTY BY ANY HEALTH CARE
FACILITY OR HEALTH CARE PROVIDER, FOR TAKING ANY  REASONABLE  GOOD-FAITH
ACTION OR REFUSING TO ACT UNDER THIS ARTICLE, INCLUDING: (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)
BEING PRESENT WHEN A PATIENT SELF-ADMINISTERS MEDICATION, (C) REFRAINING
FROM  ACTING TO PREVENT THE PATIENT FROM SELF-ADMINISTERING SUCH MEDICA-
TION, OR (D) REFRAINING FROM ACTING TO RESUSCITATE OR RESCUE THE PATIENT
AFTER HE OR SHE SELF-ADMINISTERS SUCH  MEDICATION.  HOWEVER,  PARAGRAPHS
(C)  AND (D) OF THIS SUBDIVISION SHALL NOT APPLY WHERE THERE ARE REASON-
ABLE GROUNDS TO BELIEVE, UNDER THE CIRCUMSTANCES, THAT THE  PATIENT  HAS
RESCINDED  HIS  OR  HER REQUEST OR CONSENT TO SELF-ADMINISTER MEDICATION
UNDER THIS ARTICLE OR COMMUNICATES A DESIRE THAT THE  LETHAL  ACTION  OF
THE MEDICATION BE REVERSED.
  2.  A PHYSICIAN, NURSE, PHARMACIST, OR OTHER PERSON SHALL NOT BE UNDER
ANY DUTY, BY LAW OR CONTRACT, TO PARTICIPATE IN THE PROVISION OF MEDICA-
TION TO A PATIENT UNDER THIS ARTICLE.
  3. A PRIVATE HEALTH CARE FACILITY MAY PROHIBIT THE  SELF-ADMINISTERING
OF  MEDICATION  UNDER  THE ARTICLE WHILE THE PATIENT IS BEING TREATED OR
RESIDING IN THE HEALTH CARE FACILITY IF:
  (A) SUCH PRESCRIBING, DISPENSING, ORDERING  OR  SELF-ADMINISTERING  IS
CONTRARY TO A FORMALLY ADOPTED POLICY OF SUCH FACILITY THAT IS EXPRESSLY
BASED  ON  SINCERELY  HELD  RELIGIOUS  BELIEFS  OR  SINCERELY HELD MORAL
CONVICTIONS CENTRAL TO THE FACILITY'S OPERATING PRINCIPLES;
  (B) SUCH FACILITY HAS INFORMED THE PATIENT OF SUCH POLICY PRIOR TO  OR
UPON ADMISSION, IF REASONABLY POSSIBLE; AND
  (C)  IF  THE  PATIENT REQUESTS, THE PATIENT IS TRANSFERRED PROMPTLY TO
ANOTHER HEALTH CARE FACILITY THAT IS  REASONABLY  ACCESSIBLE  UNDER  THE
CIRCUMSTANCES  AND WILLING TO PERMIT THE PRESCRIBING, DISPENSING, ORDER-
ING AND SELF-ADMINISTERING OF MEDICATION UNDER THIS ARTICLE WITH RESPECT
TO THE PATIENT.
  4. A HEALTH CARE FACILITY THAT  PROHIBITS  THE  SELF-ADMINISTERING  OF
MEDICATION  UNDER  THIS  ARTICLE  WHILE  THE PATIENT IS BEING TREATED OR
RESIDING IN THE HEALTH CARE FACILITY UNDER THIS SECTION MAY  PROHIBIT  A
PHYSICIAN  FROM PRESCRIBING, DISPENSING OR ORDERING MEDICATION FOR SELF-
ADMINISTERING WHILE THE PATIENT IS BEING  TREATED  OR  RESIDING  IN  THE
HEALTH CARE FACILITY, PROVIDED THE HEALTH CARE FACILITY HAS NOTIFIED THE
PHYSICIAN  IN  WRITING  OF ITS POLICY TO PROHIBIT SUCH ACTIONS. NOTWITH-
STANDING SUBDIVISION ONE OF THIS SECTION,  ANY  PERSON  WHO  VIOLATES  A
POLICY  ESTABLISHED  BY A HEALTH CARE FACILITY UNDER THIS SECTION MAY BE
SUBJECT TO SANCTIONS OTHERWISE ALLOWABLE UNDER LAW, CONTRACT AND FACILI-
TY POLICY.

S. 5814--A                          5

  S 2899-L. RELATION TO OTHER LAWS AND CONTRACTS.  1. (A) A PATIENT  WHO
SELF-ADMINISTERS  MEDICATION  UNDER THIS ARTICLE SHALL NOT BE CONSIDERED
TO BE A PERSON WHO IS SUICIDAL, AND SELF-ADMINISTERING 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, MERCY KILLING, OR HOMI-
CIDE UNDER THE LAW, INCLUDING AS AN ACCOMPLICE OR  ACCESSORY  OR  OTHER-
WISE.
  2. A REQUEST BY A PATIENT TO HIS OR HER ATTENDING PHYSICIAN TO PROVIDE
MEDICATION  UNDER  THIS  ARTICLE SHALL NOT, BY ITSELF, PROVIDE THE BASIS
FOR THE APPOINTMENT OF A GUARDIAN OR CONSERVATOR.
  3. (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.
  4.  A PERSON AND HIS OR HER BENEFICIARIES SHALL NOT BE DENIED BENEFITS
UNDER A LIFE INSURANCE POLICY FOR ACTIONS TAKEN IN ACCORDANCE WITH  THIS
ARTICLE.
  5. AN INSURER SHALL NOT PROVIDE ANY INFORMATION IN COMMUNICATIONS MADE
TO  A  PERSON  ABOUT  THE  AVAILABILITY OF MEDICATION UNDER THIS ARTICLE
ABSENT A REQUEST BY SUCH PERSON OR BY HIS  OR  HER  ATTENDING  PHYSICIAN
UPON  THE  REQUEST  OF  SUCH PERSON. ANY COMMUNICATION SHALL NOT INCLUDE
BOTH THE DENIAL OF TREATMENT AND INFORMATION AS TO THE  AVAILABILITY  OF
MEDICATION UNDER THIS ARTICLE.
  6.  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.
  S 2899-M. SAFE DISPOSAL OF UNUSED MEDICATIONS.  THE  DEPARTMENT  SHALL
MAKE  REGULATIONS  PROVIDING FOR THE SAFE DISPOSAL OF UNUSED MEDICATIONS
PRESCRIBED, DISPENSED OR ORDERED UNDER THIS ARTICLE.
  S 2899-N. DEATH CERTIFICATE. IN THE EVENT THAT A  PATIENT  DIES  AS  A
RESULT  OF  MEDICATION  SELF-ADMINISTERED  UNDER THIS ARTICLE, THE DEATH
CERTIFICATE SHALL INDICATE THAT THE CAUSE OF DEATH  WAS  THE  UNDERLYING
TERMINAL  ILLNESS  OR CONDITION OF THE PATIENT. HOWEVER, WHERE THERE ARE
REASONABLE GROUNDS TO BELIEVE, UNDER THE CIRCUMSTANCES, THAT THE PATIENT
RESCINDED HIS OR HER REQUEST OR CONSENT  TO  SELF-ADMINISTER  MEDICATION
UNDER  THIS  ARTICLE  OR COMMUNICATED A DESIRE THAT THE LETHAL ACTION OF
THE MEDICATION BE REVERSED, AND THE PATIENT NEVERTHELESS DIED  FROM  THE
SELF-ADMINISTRATION  OF  THE  MEDICATION, THE SELF-ADMINISTRATION OF THE
MEDICATION MAY BE LISTED AS THE CAUSE OF DEATH.
  S 2899-O. REPORTING. 1.  THE  COMMISSIONER  SHALL  ANNUALLY  REVIEW  A
SAMPLE  OF  THE  RECORDS  MAINTAINED  UNDER SECTION TWENTY-EIGHT HUNDRED
NINETY-NINE-I OF THIS ARTICLE.  THE  DEPARTMENT  MAY  ADOPT  REGULATIONS
ESTABLISHING  REPORTING  REQUIREMENTS FOR PHYSICIANS TAKING ACTION UNDER
THIS ARTICLE TO DETERMINE UTILIZATION AND COMPLIANCE WITH THIS  ARTICLE.
THE  INFORMATION  COLLECTED UNDER THIS SECTION SHALL BE CONFIDENTIAL AND
SHALL BE COLLECTED 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.

S. 5814--A                          6

  2.  THE DEPARTMENT SHALL PREPARE A REPORT ANNUALLY CONTAINING RELEVANT
DATA REGARDING UTILIZATION AND COMPLIANCE WITH THIS  ARTICLE  AND  SHALL
POST SUCH REPORT ON ITS WEBSITE.
  S 2899-P. 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.
  S 3. This act shall take effect immediately.

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