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

                                  5261

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            February 13, 2015
                               ___________

Introduced by M. of A. PAULIN, DINOWITZ, GALEF, ZEBROWSKI -- Multi-Spon-
  sored  by  --  M.  of  A.   CROUCH, DUPREY, SKARTADOS -- read once and
  referred 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. RIGHT TO INFORMATION.
        2899-F. IMMUNITY.
        2899-G. NO DUTY TO AID.
        2899-H. LIMITATIONS ON ACTIONS.
        2899-I. HEALTH CARE FACILITY EXCEPTIONS.
        2899-J. INSURANCE POLICIES; PROHIBITIONS.
        2899-K. NO EFFECT ON PALLIATIVE SEDATION.
        2899-L. PROTECTION OF PATIENT CHOICE AT END OF LIFE.
        2899-M. SAFE DISPOSAL OF UNUSED MEDICATIONS.
        2899-N. STATUTORY CONSTRUCTION.
  S 2899-D. DEFINITIONS. AS USED IN THIS ARTICLE:
  1.  "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.
  2. "CAPABLE" MEANS THAT A PATIENT HAS THE ABILITY TO MAKE AND COMMUNI-
CATE  HEALTH  CARE  DECISIONS  TO  A  PHYSICIAN, INCLUDING COMMUNICATION

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07446-01-5

              

A. 5261                             2

THROUGH PERSONS FAMILIAR WITH THE PATIENT'S MANNER OF  COMMUNICATING  IF
THOSE PERSONS ARE AVAILABLE.
  3.  "HEALTH  CARE FACILITY" SHALL INCLUDE HOSPITALS, NURSING HOMES AND
RESIDENTIAL HEALTH CARE FACILITIES AS DEFINED  IN  SECTION  TWENTY-EIGHT
HUNDRED ONE OF THIS CHAPTER.
  4.  "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.
  5. "IMPAIRED JUDGMENT" MEANS  THAT  A  PERSON  DOES  NOT  SUFFICIENTLY
UNDERSTAND  OR  APPRECIATE  THE  RELEVANT  FACTS  NECESSARY  TO  MAKE AN
INFORMED DECISION.
  6. "INTERESTED PERSON" MEANS:
  (A) THE PATIENT'S PHYSICIAN;
  (B) A PERSON WHO KNOWS THAT HE OR SHE IS A RELATIVE OF THE PATIENT  BY
BLOOD, CIVIL MARRIAGE, CIVIL UNION, OR ADOPTION;
  (C)  A  PERSON  WHO  KNOWS  THAT  HE OR SHE WOULD BE ENTITLED UPON THE
PATIENT'S DEATH TO ANY PORTION OF THE ESTATE OR ASSETS  OF  THE  PATIENT
UNDER ANY WILL OR TRUST, BY OPERATION OF LAW, OR BY CONTRACT; OR
  (D) AN OWNER, OPERATOR, OR EMPLOYEE OF A HEALTH CARE FACILITY, NURSING
HOME,  OR  RESIDENTIAL  CARE  FACILITY  WHERE  THE  PATIENT IS RECEIVING
MEDICAL TREATMENT OR IS A RESIDENT.
  7. "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.
  8.  "PATIENT"  MEANS A PERSON WHO IS EIGHTEEN YEARS OF AGE OR OLDER, A
RESIDENT OF NEW YORK STATE, AND UNDER THE CARE OF A PHYSICIAN.
  9. "PHYSICIAN" MEANS AN INDIVIDUAL LICENSED TO  PRACTICE  MEDICINE  IN
NEW YORK STATE.
  10.  "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. 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-F.  IMMUNITY. A PHYSICIAN SHALL NOT BE SUBJECT TO ANY CIVIL OR
CRIMINAL LIABILITY OR PROFESSIONAL DISCIPLINARY ACTION IF THE  PHYSICIAN
PRESCRIBES  TO A PATIENT WITH A TERMINAL ILLNESS OR CONDITION 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.
  S  2899-G. NO DUTY TO AID. A PATIENT WITH A TERMINAL ILLNESS OR CONDI-
TION 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  AND  NO PERSON SHALL BE SUBJECT TO CIVIL OR CRIMINAL LIABILITY
SOLELY FOR BEING PRESENT WHEN A  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.

A. 5261                             3

  S 2899-H. 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.
  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-I. 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-
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-F 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-J. 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-K. NO EFFECT ON PALLIATIVE SEDATION.  THIS  ARTICLE  SHALL  NOT
LIMIT  OR  OTHERWISE AFFECT THE PROVISION, ADMINISTRATION, OR RECEIPT OF
PALLIATIVE SEDATION CONSISTENT WITH ACCEPTED MEDICAL STANDARDS.
  S 2899-L. 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; AND
  4.  THE  PATIENT  MAKES  AN  INDEPENDENT DECISION TO SELF-ADMINISTER A
LETHAL DOSE OF THE MEDICATION.
  S 2899-M. 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-N. 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, MERCY KILLING, OR
HOMICIDE UNDER THE LAW.
  S 2. This act shall take effect immediately.

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

                                 5261--A

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            February 13, 2015
                               ___________

Introduced  by  M.  of A. PAULIN, DINOWITZ, GALEF, ZEBROWSKI, GOTTFRIED,
  BLAKE -- Multi-Sponsored by -- M. of A.  BRAUNSTEIN,  CROUCH,  DUPREY,
  SKARTADOS  --  read  once  and  referred to the Committee on Health --
  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.  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.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07446-04-5
              

A. 5261--A                          2

        2899-U. STATUTORY CONSTRUCTION.
        2899-V. SEVERABILITY.
  S 2899-D. DEFINITIONS. AS USED IN THIS ARTICLE:
  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 EIGHTEEN 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

A. 5261--A                          3

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.
  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

A. 5261--A                          4

  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  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.

A. 5261--A                          5

  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-
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

A. 5261--A                          6

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-
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.

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

                                 5261--C

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            February 13, 2015
                               ___________

Introduced  by  M.  of A. PAULIN, DINOWITZ, GALEF, ZEBROWSKI, GOTTFRIED,
  BLAKE -- Multi-Sponsored by -- M. of A.  BRAUNSTEIN,  CROUCH,  DUPREY,
  SKARTADOS  --  read  once  and  referred to the Committee on Health --
  committee discharged, bill amended, ordered reprinted as  amended  and
  recommitted  to  said  committee -- again reported from said committee
  with amendments, ordered reprinted as amended and recommitted to  said
  committee -- recommitted to the Committee on Health in accordance with
  Assembly Rule 3, sec. 2 -- 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.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07446-23-6
              

A. 5261--C                          2

        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.
  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

A. 5261--C                          3

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;
  (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

A. 5261--C                          4

  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  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

A. 5261--C                          5

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  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,

A. 5261--C                          6

HIS  OR  HER  FAMILY,  AND ANY HEALTH CARE PROVIDER ACTING IN CONNECTION
WITH SUCH PATIENT UNDER THIS ARTICLE.
  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.