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S.F. No. 1880 - Compassionate Care Act of 2015
 
Author: Senator Chris A. Eaton
 
Prepared By: Katie Cavanor, Senate Counsel (651/296-3801)
 
Date: March 15, 2016



 

SF 1880 establishes compassionate care for terminally ill patients by permitting qualified patients to receive aid in dying from their attending physician in the form of a prescribed medication in which the qualified patient can self-administer.

Section 1 (145.871) establishes the Compassionate Care Act.

Subd. 1 [Citation] permits this section to be cited as the “Minnesota Compassionate Care Act of 2015.”

Subd. 2 [Definitions] defines the following terms:  adult; aid in dying; attending physician; competent; consulting physician; counseling; health care provider; health care facility; informed decision; medically confirmed; palliative care; patient; pharmacist; physician; psychiatrist; psychologist; qualified patient; self-administer; and terminal illness.

Subd. 3 [Request for aid in dying] Paragraph (a) specifies that a person who is an adult; competent; a Minnesota resident; been determined to have a terminal illness by the person’s attending physician; and has voluntarily expressed a wish to receive aid in dying may request aid in dying by making two written requests.

Paragraph (b) states that no person may be a qualified patient solely based on age, disability, or any specific illness.

Paragraph (c) states that no person may act on behalf of a patient for the purposes of this section.

Subd. 4 [Signed, written requests required] Paragraph (a) requires a patient who wishes to receive aid in dying to submit two written requests to the patient’s attending physician that is signed and dated by the patient and is witnessed by at least two persons who, in the presence of the patient, attest that to the best of their knowledge and belief the patient is of sound mind and acting voluntarily and not being coerced in signing the request.  The second request must be submitted no earlier than 15 days after the first request was submitted.

Paragraph (b) specifies that at least one of the witnesses must not be a person who is: (1) related to the patient; (2) at the time of signing, not entitled to any portion of the patient’s estate upon the death of the patient; or (3) an owner, operator, or employee of a health care facility where the patient is receiving medical treatment or is a resident.

Paragraph (c) specifies that the patient’s attending physician may not be a witness.

Paragraph (d) states that if the patient is a resident of a residential home, nursing home, or skilled nursing facility at the time the written request is made, one of the witnesses must be a person designated by the home or facility.

Subd. 5 [Request form] specifies the form that must be used to request aid in dying.

Subd. 6 [Opportunity to rescind request] Paragraph (a) states that the qualified patient may rescind their request for aid in dying at any time and in any manner without regard to their mental state.

Paragraph (b) requires the attending physician to give a qualified patient the opportunity to rescind the request for aid in dying at the time the patient submits the second written request to the attending physician.

Paragraph (c) requires the attending physician to give a qualified patient a second opportunity to rescind the request before writing the prescription for medication.

Subd. 7 [Physician’s responsibilities] specifies the attending physician’s responsibilities when the physician is presented with a patient’s first written request for aid in dying.  The attending physician must: (1) make a determination that the patient is an adult, has a terminal illness, is competent, and has voluntarily requested aid in dying; (2) require the patient to demonstrate residency; (3) ensure that the patient is making an informed decision; and (4) refer the patient to a consulting physician for medical confirmation of the attending physician’s diagnosis, prognosis, and for the determination that the patient is competent and is acting voluntarily.

Subd. 8 [Qualified patient] requires a consulting physician to: (1) examine the patient and the patient’s relevant medical records; (2) confirm in writing the attending physician’s diagnosis and that the patient has a terminal illness; (3) verify that the patient is competent, acting voluntarily, and has made an informed decision; and (4) refer the patient to counseling if required under subdivision 9.

Subd. 9 [Medical determination on competency] Paragraph (a) requires the attending physician or the consulting physician to refer the patient for counseling to determine whether the patient is competent to request aid in dying if either of the physicians believes that the patient may be suffering from a psychiatric or psychological condition or depression that is causing impaired judgment.

Paragraph (b) prohibits an attending physician to provide the patient aid in dying until the person providing counseling determines that the patient is not suffering from a psychiatric or psychological condition or depression that is causing impaired judgment.

Section 10 [Process] Paragraph (a) upon determining that the patient is a qualified patient and after receiving the second request, the attending physician is required to: (1) recommend the qualified patient to notify their next of kin of the patient’s request in aid of dying; (2) counsel the qualified patient on the importance of having another person present when it is time to self-administer the medication and not to take the medication in a public place; (3) inform the qualified patient  that the patient may rescind the request at any time and in any manner; (4) verify immediately before writing the prescription that the qualified patient is making an informed decision; (5) fulfill the medical record documentation requirements; and (6) dispense medications if authorized to the qualified patient or upon the request and written consent of the qualified patient contact a pharmacist and inform the pharmacist of the prescription and deliver the prescription to the pharmacist to dispense.

Paragraph (b) authorizes the attending physician to sign the qualified patient’s death certificate listing the cause of death as the underlying terminal illness.

Subd. 11 [Medical record] specifies what items must be included in the qualified patient’s medical record by the attending physician.

Subd. 12 [Use of records] specifies that the records or information collected or maintained under this section are not subject to subpoena or discovery or introduction as evidence in any proceeding, except to resolve matters concerning compliance with this section or as otherwise specified by law.

Subd. 13 [Disposing of medication] requires any person in possession of medication prescribed for aid in dying that has not been self-administered to dispose of the medication.

Subd. 14 [Contract, will, or other instrument] Paragraph (a) specifies that any provision that is entered into after October 1, 2016, that would affect whether a person may make or rescind a request for aid in dying is not valid.

Paragraph (b) states that no obligation under any currently existing contract shall not be conditioned or affected by the making or rescinding of a request for aid in dying.

Paragraph (c) specifies that the sale, procurement, or issuance of a life, health, or accident insurance or annuity policy or the rate charged for the policy shall not be conditioned upon or affected by the making or rescinding of a request for aid in dying.

Paragraph (d) specifies that a qualified patient’s act of requesting aid in dying or self-administering medication prescribed for aid in dying shall not: (1) affect an insurance or annuity policy or benefits payable under the policy; (2) be grounds for eviction from a person’s place of residence or basis for discrimination in terms of a sale or rental of a dwelling or in the provision of services or facilities; (3) provide the sole basis for the appointment of a conservator or guardian; or (4) constitute suicide for any purpose.

Subd. 15 [Participate in provision of medication] Paragraph (a) specifies the meaning of “participate in the provision of medication.”

Paragraph (b) specifies that participation in any act under this section by a patient, health care provider, or any other person is voluntary.  Specifies that a health care facility shall not require a health care provider to participate in the provision of medication to a qualified patient for aid in dying and may prohibit such participation.

Paragraph (c) states that if a health care provider or facility is unwilling to participate, the provider or facility must transfer all relevant medical records to a provider or facility willing to participate as requested by a qualified patient.

Paragraph (d) authorizes a health care facility to adopt written policies prohibiting a provider associated with the facility from participating in the provision of medication to a patient for aid in dying provided the facility has provided written notice of the policy and any sanctions to the provider.  Notwithstanding any policies adopted, a health care provider may diagnose a patient with a terminal illness; inform the patient of the patient’s medical prognosis; provide the patient with information upon the patient’s request; refer the patient to another facility or provider; transfer the patient’s medical records to a provider or facility upon the patient’s request; or participate in the provision of medication for aid in dying when the provider is acting outside the scope of the provider’s employment or contract with the facility that prohibits participation.

Subd. 16 [Criminal act] states that any person who without authorization of a patient willfully alters or forges a request for aid in dying or conceals or destroys a rescission of a request in dying with the intent or effect of causing a patient’s death  or who coerces or exerts undue influence on a patient to complete a request for aid in dying or coerces or exerts undue influence on a patient to destroy a rescission of the request with the intent or effect of causing the patient’s death is guilty of attempted murder or murder.

Subd. 17 [Aid in dying] Paragraph (a) specifies that nothing in this section authorizes a physician or any other person to end a patient’s life by lethal injection, mercy killing, assisting a suicide, or any other active euthanasia.

Paragraph (b) specifies that any action taken according to this section does not constitute causing or assisting another person to commit suicide.

Paragraph (c) prohibits any public agency report from referring to the practice of obtaining and self-administering life-ending medication to end a qualified person’s life as a “suicide” or “assisted suicide” and states that it must be referred to as “aid in dying”.

 Subd. 18 [Civil damages] states that this section does not limit liability for civil damages resulting from negligent conduct or intentional misconduct.

Subd. 19 [Criminal prosecution] states that nothing in this section precludes criminal prosecution for conduct that is inconsistent with this section.

KC:dv

 

 

 

 
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