An Act To Enact the Maine Death with Dignity Act
Maine Legislature, Session 129, LD 1313
Committee: Health and Human Services
Sponsors: HYMANSON, WOODSOME, BAILEY, DENNO, MEYER, STEARNS, GRATWICK, MOORE

Legislative Document
No. 1313
H.P. 948
House of Representatives, March 19, 2019
An Act To Enact the Maine Death with Dignity Act
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative HYMANSON of York.
Cosponsored by Senator WOODSOME of York and
Representatives: BAILEY of Saco, DENNO of Cumberland, MEYER of Eliot, STEARNS of 
Guilford, Senators: GRATWICK of Penobscot, MOORE of Washington.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA c. 418 is enacted to read:
CHAPTER 418
PATIENT-DIRECTED CARE
§2140.  Patient-directed care at the end of life 
1.  Short title.  This chapter may be known and cited as "the Maine Death with 
Dignity Act."
2.  Definitions.  As used in this chapter, unless the context otherwise indicates, the 
following terms have the following meanings.
A.  "Adult" means a person who is 18 years of age or older.
B.  "Attending physician" means the physician who has primary responsibility for the 
care of a patient and the treatment of that patient's terminal disease.
C.  "Competent" means that, in the opinion of a court or in the opinion of the patient's 
attending physician or consulting physician, psychiatrist or psychologist, a patient has 
the ability to make and communicate an informed decision to health care providers, 
including communication through persons familiar with the patient's manner of 
communicating if those persons are available.
D.  "Consulting physician" means a physician who is qualified by specialty or 
experience to make a professional diagnosis and prognosis regarding a patient's 
disease.
E.  "Counseling" means one or more consultations between a state-licensed 
psychiatrist, state-licensed psychologist, state-licensed clinical social worker or state-
licensed clinical professional counselor and a patient for the purpose of determining 
that the patient is competent and not suffering from a psychiatric or psychological 
disorder or depression causing impaired judgment.
F.  "Health care provider" means:
(1)  A person licensed, certified or otherwise authorized or permitted by law to 
administer health care services or dispense medication in the ordinary course of 
business or practice of a profession; or
(2)  A health care facility.
G.  "Informed decision" means a decision by a qualified patient to request and obtain 
a prescription for medication that the qualified patient may self-administer to end the 
qualified patient's life in a humane and dignified manner that is based on an 
appreciation of the relevant facts and that is made after being fully informed by the 
attending physician of:
(1)  The qualified patient's medical diagnosis;
(2)  The qualified patient's prognosis;
(3)  The potential risks associated with taking the medication to be prescribed;
(4)  The probable result of taking the medication to be prescribed; and
(5)  The feasible alternatives to taking the medication to be prescribed, including 
palliative care and comfort care, hospice care, pain control and disease-directed 
treatment options.
H.  "Medically confirmed" means the medical opinion of an attending physician has 
been confirmed by a consulting physician who has examined the patient and the 
patient's relevant medical records.
I.  "Patient" means an adult who is under the care of a physician.
J.  "Physician" means a doctor of medicine or osteopathy licensed to practice 
medicine in this State. 
K.  "Qualified patient" means a competent adult who is a resident of this State and 
who has satisfied the requirements of this Act in order to obtain a prescription for 
medication that the qualified patient may self-administer to end the qualified patient's 
life in a humane and dignified manner.
L.  "Self-administer" means, for a qualified patient, to voluntarily ingest medication 
to end the qualified patient's life in a humane and dignified manner.
M.  "Terminal disease" means an incurable and irreversible disease that has been 
medically confirmed and will, within reasonable medical judgment, produce death 
within 6 months.
3.  Right to information.  A patient has a right to information regarding all treatment 
options reasonably available for the care of the patient, including, but not limited to, 
information in response to specific questions about the foreseeable risks and benefits of 
medication, without a physician's withholding requested information regardless of the 
purpose of the questions or the nature of the information.
4.  Written request for medication.  An adult who is competent, is a resident of this 
State, has been determined by an attending physician and a consulting physician to be 
suffering from a terminal disease and has voluntarily expressed the wish to die may make 
a written request for medication that the adult may self-administer in accordance with this 
Act. An adult does not qualify under this Act solely because of age or disability.
5.  Form of written request.  A valid request for medication under this Act must be 
substantially in the form described in subsection 24, signed and dated by the patient and 
witnessed by at least 2 individuals who, in the presence of the patient, attest that to the 
best of their knowledge and belief the patient is competent, is acting voluntarily and is not 
being coerced to sign the request.
A.  The language of a written request for medication under this Act must be the 
language in which any conversations or consultations or interpreted conversations or 
consultations between a patient and the patient's attending physician or consulting 
physician are held.
B.  Notwithstanding paragraph A, the language of a written request for medication 
under this Act may be English when the conversations or consultations or interpreted 
conversations or consultations between a patient and the patient's attending physician 
or consulting physician were conducted in a language other than English if the form 
described in subsection 24 contains the attachment described in subsection 25.
C.  At least one of the 2 or more witnesses required under this subsection and any 
interpreter required under this subsection must be a person who is not:
(1)  A relative of the patient by blood, marriage or adoption;
(2)  A person who at the time the request is signed would be entitled to any 
portion of the estate of the qualified patient upon death, under any will or by 
operation of any law; or
(3)  An owner, operator or employee of a health care facility where the qualified 
patient is receiving medical treatment or is a resident.
D.  The patient's attending physician at the time the written request is signed may not 
be a witness.
E.  If the patient is a patient in a long-term care facility at the time the patient makes 
the written request, one of the witnesses must be an individual designated by the 
facility who has the qualifications specified by the department by rule.
6.  Attending physician responsibilities.  The attending physician shall: 
A.  Make the initial determination of whether a patient has a terminal disease, is 
competent and has made the written request under subsection 4 voluntarily;
B.  Request that the patient demonstrate state residency as required by subsection 15;
C.  To ensure that the patient is making an informed decision, inform the patient of:
(1)  The patient's medical diagnosis;
(2)  The patient's prognosis;
(3)  The potential risks associated with taking the medication to be prescribed;
(4)  The probable result of taking the medication to be prescribed; and
(5)  The feasible alternatives to taking the medication to be prescribed, including 
palliative care and comfort care, hospice care, pain control and disease-directed 
treatment options;
D.  Refer the patient to a consulting physician for medical confirmation of the 
diagnosis and for a determination that the patient is competent and acting voluntarily;
E.  Confirm that the patient's request does not arise from coercion or undue influence 
by another individual by discussing with the patient, outside the presence of any other 
individual, except for an interpreter, whether the patient is feeling coerced or unduly 
influenced;
F.  Refer the patient for counseling, if appropriate, as described in subsection 8;
G.  Recommend that the patient notify the patient's next of kin;
H.  Counsel the patient about the importance of having another person present when 
the patient takes the medication prescribed under this Act, and counsel the patient 
about not taking the medication prescribed under this Act in a public place;
I.  Inform the patient that the patient has an opportunity to rescind the request at any 
time and in any manner and offer the patient an opportunity to rescind the request at 
the end of the 15-day waiting period pursuant to subsection 11;
J.  Verify, immediately before writing the prescription for medication under this Act, 
that the patient is making an informed decision;
K.  Fulfill the medical record documentation requirements of subsection 14;
L.  Ensure that all appropriate steps are carried out in accordance with this Act before 
writing a prescription for medication to enable a qualified patient to end the qualified 
patient's life in a humane and dignified manner; and
M.  Dispense medications directly, including ancillary medications intended to 
minimize the patient's discomfort, if the attending physician is authorized under state 
law or rule to dispense medications and has a current drug enforcement 
administration certificate or with the patient's written consent:
(1)  Contact a pharmacist and inform the pharmacist of the prescription; and
(2)  Deliver the written prescription personally, by mail or electronically to the 
pharmacist, who may dispense the medications in person to the patient, the 
attending physician or an expressly identified agent of the patient.
7.  Consulting physician confirmation.  Before a patient is determined to be a 
qualified patient under this Act, a consulting physician shall examine the patient and the 
patient's relevant medical records and confirm, in writing, the attending physician's 
diagnosis that the patient is suffering from a terminal disease and verify that the patient is 
competent, is acting voluntarily and has made an informed decision.
8.  Consulting referral.  If, in the opinion of the attending physician or the 
consulting physician, a patient may be suffering from a psychiatric or psychological 
disorder or depression causing impaired judgment, the physician shall refer the patient for 
counseling. Medication to end a patient's life in a humane and dignified manner may not 
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.
9.  Informed decision.  A qualified patient may not receive a prescription for 
medication under this Act unless the qualified patient has made an informed decision. 
Immediately before writing a prescription for medication under this Act, the attending 
physician shall verify that the qualified patient is making an informed decision.
10.  Notification of next of kin.  A patient who declines or is unable to notify the 
patient's next of kin may not have the patient's request for medication denied for that 
reason.
11.  Written and oral requests.  To receive a prescription for medication that the 
qualified patient may self-administer under this Act, a qualified patient must make an oral 
request and a written request and reiterate the oral request to the qualified patient's 
attending physician at least 15 days after making the initial oral request.  At the time the 
qualified patient makes the qualified patient's 2nd oral request, the attending physician 
shall offer the qualified patient an opportunity to rescind the request.
12.  Right to rescind request.  A patient may rescind the patient's request at any time 
and in any manner without regard to the patient's mental state. A prescription for 
medication may not be written under this Act without the attending physician's offering 
the qualified patient an opportunity to rescind the request. 
13.  Waiting periods.  At least 15 days must elapse between the patient's initial oral 
request and the date the patient signs the written request under subsection 11. At least 48 
hours must elapse between the date the patient signs the written request and the writing of 
a prescription under this Act. 
14.  Medical record documentation requirements.  The following must be 
documented or filed in a patient's medical record:
A.  All oral requests by the patient for medication to end that patient's life in a 
humane and dignified manner;
B.  All written requests by the patient for medication to end that patient's life in a 
humane and dignified manner;
C.  The attending physician's diagnosis and prognosis and the attending physician's 
determination that the patient is competent, is acting voluntarily and has made an 
informed decision;
D.  The consulting physician's diagnosis and prognosis and the consulting physician's 
verification that the patient is competent, is acting voluntarily and has made an 
informed decision;
E.  A report of the outcome and determinations made during counseling, if counseling 
is provided as described in subsection 8;
F.  The attending physician's offer to the patient to rescind the patient's request at the 
time of the patient's 2nd oral request under subsection 11; and
G.  A note by the attending physician indicating that all requirements under this Act 
have been met, including the requirements of subsection 6, and indicating the steps 
taken to carry out the patient's request, including a notation of the medication 
prescribed.
15.  Residency requirement.  For purposes of this Act, only requests made by 
residents of this State may be granted.  The residence of a person is that place where the 
person has established a fixed and principal home to which the person, whenever 
temporarily absent, intends to return.  The following factors may be offered in 
determining a person's residence under this Act and need not all be present in order to 
determine a person's residence: 
A.  Possession of a valid driver's license issued by the Department of the Secretary of 
State, Bureau of Motor Vehicles;
B.  Registration to vote in this State;
C.  Evidence that the person owns or leases property in this State;
D.  The location of any dwelling currently occupied by the person;
E.  The place where any motor vehicle owned by the person is registered;
F.  The residence address, not a post office box, shown on a current income tax 
return;
G.  The residence address, not a post office box, at which the person's mail is 
received;
H.  The residence address, not a post office box, shown on any current resident 
hunting or fishing licenses held by the person;
I.  The residence address, not a post office box, shown on any driver's license held by 
the person;
J.  The receipt of any public benefit conditioned upon residency, defined substantially 
as provided in this subsection; or
K.  Any other objective facts tending to indicate a person's place of residence.
16.  Disposal of unused medications.  A person who has custody of or control over 
any unused medications prescribed pursuant to this Act after the death of the qualified 
patient shall personally deliver the unused medications to the nearest facility qualified to 
dispose of controlled substances or, if such delivery is impracticable, personally dispose 
of the unused medications by any lawful means, in accordance with any guidelines 
adopted by the department.
17.  Reporting of information; adoption of rules; information collected not a 
public record; annual statistical report.  The department shall:
A.  Annually review all records maintained under this Act;
B.  Require any health care provider upon writing a prescription or dispensing 
medication under this Act to file a copy of the prescription or dispensing record, and 
other documentation required under subsection 14 associated with writing the 
prescription or dispensing the medication, with the department.
(1)  Documentation required to be filed under this paragraph must be mailed or 
otherwise transmitted as allowed by rules of the department no later than 30 
calendar days after the writing of the prescription or the dispensing of medication 
under this Act, except that all documents required to be filed with the department 
by the prescribing physician after the death of the qualified patient must be 
submitted no later than 30 calendar days after the date of the death of the 
qualified patient.
(2)  In the event that a person required under this Act to report information to the 
department provides an inadequate or incomplete report, the department shall 
contact the person to request an adequate or complete report;
C.  Within 6 months of the effective date of this Act, adopt rules, which are routine 
technical rules pursuant to Title 5, chapter 375, subchapter 2-A, to facilitate the 
collection of information regarding compliance with this Act. Except as otherwise 
provided by law, the information collected is confidential, is not a public record and 
may not be made available for inspection by the public; and
D.  Generate and make available to the public an annual statistical report of 
information collected under paragraph C and submit a copy of the report to the joint 
standing committee of the Legislature having jurisdiction over health matters 
annually by March 1st.
18.  Effect on construction of wills, contracts and other agreements.  Any 
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 the person's life in a humane and dignified manner, is not valid.  Any obligation 
owing under any currently existing contract may not be conditioned upon or affected by 
the making or rescinding of a request by a person for medication to end the person's life 
in a humane and dignified manner. 
19.  Insurance or annuity policies.  The sale, procurement or issuance of any life, 
health or accident insurance or annuity policy or the rate charged for any life, health or 
accident insurance or annuity policy may not be conditioned upon or affected by the 
making or rescinding of a request by a person for medication that the person may self-
administer to end the person's life in a humane and dignified manner. A qualified patient's 
act of ingesting medication to end the qualified patient's life in a humane and dignified 
manner does not have an effect upon a life, health or accident insurance or annuity policy.  
A qualified patient whose life is insured under a life insurance policy issued under the 
provisions of Title 24-A, chapter 29 and the beneficiaries of the policy may not be denied 
benefits on the basis of self-administration of medication by the qualified patient in 
accordance with this Act. The sale, procurement or issuance of any medical professional 
liability insurance policy issued under the provisions of Title 24-A and the rate charged 
by the insurer for the policy may not be conditioned upon or affected by the participation 
by the health care provider in the provision of medication to a qualified patient in 
accordance with this Act.
20.  Authority of Act; references to acts committed under Act; applicable 
standard of care.  This Act does not authorize a physician or any other person to end a 
patient's life by lethal injection, mercy killing or active euthanasia. Actions taken in 
accordance with this Act do not, for any purpose, constitute suicide, assisted suicide, 
mercy killing or homicide under the law. State reports may not refer to acts committed 
under this Act as "suicide" or "assisted suicide." Consistent with the provisions of this 
Act, state reports must refer to acts committed under this Act as obtaining and self- 
administering life-ending medication. A patient's death certificate, pursuant to section 
2842, must list the underlying terminal disease as the cause of death.  Nothing contained 
in this Act may be interpreted to lower the applicable standard of care for the attending 
physician, the consulting physician, a psychiatrist or a psychologist or other health care 
provider providing services under this Act.
21.  Basis for prohibiting persons or entities from participation; notification; 
penalties; permissible actions.  The following provisions govern the basis for 
prohibiting persons or entities from participating in activities under this Act, notification, 
penalties and permissible actions.
A.  Subject to compliance with paragraph B and notwithstanding any other law, a 
health care provider may prohibit its employees, independent contractors or other 
persons or entities, including other health care providers, from participating in 
activities under this Act while on premises owned or under the management or direct 
control of that prohibiting health care provider or while acting within the course and 
scope of any employment by, or contract with, the prohibiting health care provider.
B.  A health care provider that elects to prohibit its employees, independent 
contractors or other persons or entities, including other health care providers, from 
participating in activities under this Act, as described in paragraph A, shall first give 
notice of the policy prohibiting participation under this Act to those employees, 
independent contractors or other persons or entities, including other health care 
providers.  A health care provider that fails to provide notice to those employees, 
independent contractors or other persons or entities, including other health care 
providers, in compliance with this paragraph may not enforce such a policy against 
those employees, independent contractors or other persons or entities, including other 
health care providers.
C.  Subject to compliance with paragraph B, the prohibiting health care provider may 
take action, including, but not limited to, the following, as applicable, against an 
employee, independent contractor or other person or entity, including another health 
care provider, that violates this policy:
(1)  Loss of privileges, loss of membership or other action authorized by the 
bylaws or rules and regulations of the medical staff;
(2)  Suspension, loss of employment or other action authorized by the policies 
and practices of the prohibiting health care provider;
(3)  Termination of any lease or other contract between the prohibiting health 
care provider and the employee, independent contractor or other person or entity, 
including another health care provider, that violates the policy; or
(4)  Imposition of any other nonmonetary remedy provided for in any lease or 
contract between the prohibiting health care provider and the employee, 
independent contractor or other person or entity, including another health care 
provider, in violation of the policy.
D.  Nothing in this section may be construed to prevent, or to allow a prohibiting 
health care provider to prohibit, an employee, independent contractor or other person 
or entity, including another health care provider, from any of the following:
(1)  Participating, or entering into an agreement to participate, in activities under 
this Act while on premises that are not owned or under the management or direct 
control of the prohibiting health care provider or while acting outside the course 
and scope of the participant's duties as an employee of, or an independent 
contractor for, the prohibiting health care provider; or
(2)  Participating, or entering into an agreement to participate, in activities under 
this Act as an attending physician or consulting physician while on premises that 
are not owned or under the management or direct control of the prohibiting health 
care provider.
E.  In taking actions pursuant to paragraph C, a health care provider shall comply 
with all procedures required by law, its own policies or procedures and any contract 
with the employee, independent contractor or other person or entity, including 
another health care provider, in violation of the policy, as applicable.
F.  Any action taken by a prohibiting health care provider pursuant to this subsection 
is not reportable to the appropriate licensing board under Title 32, including, but not 
limited to, the Board of Licensure in Medicine and the Maine Board of Pharmacy. 
The fact that a health care provider participates in activities under this Act may not be 
the sole basis for a complaint or report by another health care provider to the 
appropriate licensing board under Title 32, including, but not limited to, the Board of 
Licensure in Medicine and the Maine Board of Pharmacy.
G.  As used in this subsection, unless the context otherwise indicates, the following 
terms have the following meanings.
(1)  "Notice" means a separate statement in writing advising of the prohibiting 
health care provider's policy with respect to participating in activities under this 
Act.
(2)  "Participating, or entering into an agreement to participate, in activities under 
this Act" means doing or entering into an agreement to do any one or more of the 
following:
(a)  Performing the duties of an attending physician as specified in this Act;
(b)  Performing the duties of a consulting physician as specified in this Act;
(c)  Performing the duties of a state-licensed psychiatrist, state-licensed 
psychologist, state-licensed clinical social worker or state-licensed clinical 
professional counselor, in the circumstance that a referral to one is made 
pursuant to subsection 8;
(d)  Delivering the prescription for, dispensing or delivering the dispensed 
medication pursuant to this Act; or
(e)  Being present when the qualified patient takes the medication prescribed 
pursuant to this Act.
"Participating, or entering into an agreement to participate, in activities under this 
Act" does not include doing, or entering into an agreement to do, any of the 
following: diagnosing whether a patient has a terminal disease, informing the 
patient of the medical prognosis or determining whether a patient has the capacity 
to make decisions; providing information to a patient about this Act; or providing 
a patient, upon the patient's request, with a referral to another health care provider 
for the purposes of participating in the activities authorized by this Act.
22.  Willful alteration or forgery; coercion or undue influence; penalties; civil 
damages; other penalties not precluded.  The following provisions govern criminal and 
other penalties for certain violations of this Act.
A.  A person who, without authorization of the patient, willfully alters or forges a 
request for medication or conceals or destroys a rescission of that request with the 
intent or effect of causing a patient's death commits a Class A crime.
B.  A person who coerces or exerts undue influence on a patient to request 
medication to end the patient's life or to destroy a rescission of a request commits a 
Class A crime.
C.  This Act does not limit liability for civil damages resulting from negligent 
conduct or intentional misconduct by a person.
D.  The penalties in this Act do not preclude criminal penalties applicable under other 
law for conduct that is inconsistent with this Act.
23.  Claims by governmental entity for costs incurred.  Any governmental entity 
that incurs costs resulting from a person ending the person's life under this Act in a public 
place has a claim against the estate of the person to recover the costs and reasonable 
attorney's fees related to enforcing the claim.
24.  Form of the request.  A request for medication as authorized by this Act must 
be in substantially the following form:
REQUEST FOR MEDICATION TO END MY LIFE IN A HUMANE AND 
DIGNIFIED MANNER
I, ......................., am an adult of sound mind. I am suffering from 
................................, which my attending physician has determined is a terminal 
disease and which has been medically confirmed by a consulting physician.
I have been fully informed of my diagnosis and prognosis, the nature of medication to 
be prescribed and potential associated risks, the expected result and feasible 
alternatives, including palliative care and comfort care, hospice care, pain control and 
disease-directed treatment options.
I request that my attending physician prescribe medication that I may self-administer 
to end my life in a humane and dignified manner and contact any pharmacist to fill 
the prescription.
INITIAL ONE:
.......... I have informed my family of my decision and taken their opinions into 
consideration.
.......... I have decided not to inform my family of my decision.
.......... I have no family to inform of my decision.
I understand that I have the right to rescind this request at any time.
I understand the full import of this request, and I expect to die when I take the 
medication to be prescribed. I further understand that, although most deaths occur 
within 3 hours, my death may take longer and my physician has counseled me about 
this possibility.
I make this request voluntarily and without reservation, and I accept full moral 
responsibility for my actions.
Signed: ....................................................
Dated: ......................................................
DECLARATION OF WITNESSES
By initialing and signing below on or after the date the person named above signs, we 
declare that the person making and signing the above request:
Initials of Witness 1:
.......... 1.  Is personally known to us or has provided proof of identity;
.......... 2.  Signed this request in our presence on the date of the person's signature;
......... 3.  Appears to be of sound mind and not under duress, fraud or undue 
influence; and
.......... 4.  Is not a patient for whom either of us is the attending physician.
Printed Name of Witness 1: ................................................
Signature of Witness 1/Date: ............................................
Initials of Witness 2:
.......... 1.  Is personally known to us or has provided proof of identity;
.......... 2.  Signed this request in our presence on the date of the person's signature;
......... 3.  Appears to be of sound mind and not under duress, fraud or undue 
influence; and
.......... 4.  Is not a patient for whom either of us is the attending physician.
Printed Name of Witness 2: ................................................
Signature of Witness 2/Date: .............................................
NOTE: One witness must be a person who is not a relative by blood, marriage or 
adoption of the person signing this request, is not entitled to any portion of the 
person's estate upon death and does not own or operate or is not employed at a health 
care facility where the person is a patient or resident. The person's attending 
physician at the time the request is signed may not be a witness.  If the person is an 
inpatient at a long-term care facility, one of the witnesses must be an individual 
designated by the facility.
25.  Form of interpreter attachment.  The form of an attachment for purposes of 
providing interpretive services as described in subsection 5, paragraph B must be in 
substantially the following form:
I, .........................., am fluent in English and (language of patient).
On (date) at approximately (time) I read the "REQUEST FOR MEDICATION TO 
END MY LIFE IN A HUMANE AND DIGNIFIED MANNER" to (name of patient) 
in (language of patient).
Mr./Ms. (name of patient) affirmed to me that he/she understands the content of this 
form, that he/she desires to sign this form under his/her own power and volition and 
that he/she requested to sign the form after consultations with an attending physician 
and a consulting physician.
Under penalty of perjury, I declare that I am fluent in English and (language of 
patient) and that the contents of this form, to the best of my knowledge, are true and 
correct.
Executed at (name of city, county and state) on (date).
Interpreter's signature: ..................................
Interpreter's printed name: ............................
Interpreter's address: .....................................
SUMMARY
This bill enacts the Maine Death with Dignity Act authorizing a person who is 18 
years of age or older, who meets certain qualifications and who has been determined by 
the person's attending physician to be suffering from a terminal disease, as defined in the 
Act, to make a request for medication prescribed for the purpose of ending the person's 
life.  The bill establishes the procedures for making these requests, including 2 waiting 
periods and one written and 2 oral requests and requires a 2nd opinion by a consulting 
physician.  The bill requires specified information to be documented in the person's 
medical record, including all oral and written requests for a medication to hasten death.
The bill requires the attending and consulting physicians to assess the patient for 
depression or other mental health condition that impairs judgment. If the attending or 
consulting physician, in the physician's professional opinion, believes such a condition 
exists, the patient must be evaluated and treated by a state-licensed psychiatrist, 
psychologist, clinical social worker or clinical professional counselor.  Medication to end 
a patient's life in a humane and dignified manner may not 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.
The bill prohibits a provision in a contract, will or other agreement from being 
conditioned upon, or affected by, a person's making or rescinding a request for 
medication under the Act.  The bill prohibits the sale, procurement or issuance of any life, 
health or accident insurance or annuity policy or the rate charged for any life, health or 
accident insurance or annuity policy from being conditioned upon or affected by the 
making or rescinding of such a request.
The bill authorizes a health care provider to prohibit its employees, independent 
contractors or other persons or entities, including other health care providers, from 
participating in activities under the Act while on premises owned by or under the 
management or direct control of that prohibiting health care provider or while acting 
within the course and scope of any employment by, or contract with, the prohibiting 
health care provider.
The bill makes it a Class A crime to knowingly alter or forge a request for medication 
to end a person's life without that person's authorization or to conceal or destroy a 
withdrawal or rescission of a request for medication, if it is done with the intent or effect 
of causing the person's death.  The bill makes it a Class A crime to knowingly coerce or 
exert undue influence on a person to request medication for the purpose of ending that 
person's life or to destroy a withdrawal or rescission of a request.  The bill provides that 
the Act does not authorize ending a patient's life by lethal injection, mercy killing or 
active euthanasia and provides that action taken in accordance with the Act does not 
constitute, among other things, suicide or homicide.
The bill requires health care providers to submit specified information to the 
Department of Health and Human Services upon their writing a prescription for or 
dispensing medication under the Act and after the death of the qualified patient.  The bill 
requires the department to generate and make available to the public an annual statistical 
report of information collected regarding compliance with the Act.  The bill requires a 
copy of the report to be submitted to the joint standing committee of the Legislature 
having jurisdiction over health matters annually by March 1st.