This bill permits an individual who is at least 18 years of age, mentally capable, and has a terminal disease with a prognosis of less than six months to live to voluntarily request a prescription for medication for the purpose of ending his or her life. Under the bill, “terminal disease” means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months. The bill authorizes the individual’s attending provider to issue a prescription for the medication if specified requirements are met. Under the bill, an attending or consulting provider must be a licensed physician, an advanced practice registered nurse, or a physician assistant. Death following self-administering medication in accordance with the requirements of the bill does not alone constitute grounds for post-mortem inquiry and such a death may not be designated as suicide or homicide.

The bill requires that the Department of Health Services develop and distribute certain standard forms to be used for reporting by attending providers in the context of requests for medication under the provisions of the bill.

The bill establishes certain requirements that must be met before an attending provider may issue a prescription in response to an individual’s request for a prescription for medication to end his or her life. With certain exceptions for an individual who is determined to be within 15 days of death, a qualified individual must make an oral request and a written request and reiterate the oral request to his or her attending provider no less than 15 days after making the initial oral request. The oral and written requests for medical aid in dying may only be made by the requesting individual and not by any surrogate decision-maker, health care proxy, attorney-in-fact for health care, or through an advance health care directive. The written request must be substantially in the form provided in the bill. It must be signed and dated by the individual and witnessed by at least one individual who meets certain qualifications and attests that the individual is capable, acting voluntarily, and is not being coerced or unduly influenced to sign the request.

The bill requires an attending provider to comply with certain requirements with respect to requests for medication under the bill, including 1) determining whether an individual has a terminal disease with a prognosis of six months or less to live and is mentally capable; 2) confirming that the individual’s request does not arise from coercion or undue influence; 3) informing the individual of certain information specified in the bill, including the potential risks, benefits, and probable result of self-administering the prescribed medication; 4) informing the individual that there is no obligation to fill the prescription nor an obligation to self-administer the medication, even if obtained; 6) providing a referral for comfort care, palliative care, hospice care, pain control, or other end-of-life treatment options as requested or as medically indicated; 7) referring the individual to a consulting provider for medical confirmation that the individual requesting medication under the bill both has a terminal disease with a prognosis of six months or less to live and is mentally capable; and 8) before providing a prescription, confirming that the individual has made an informed decision to obtain medication under the bill, offering the individual an opportunity to rescind the request, and educating the individual on the recommended procedure for self-administration of the medication, the safe-keeping and proper disposal of unused medication, the importance of having another person present when the person self-administers the medication, and not taking the medication in a public place. Under the bill, a consulting provider must evaluate an individual making a request for medication under the provisions of the bill and confirm, in writing, to the attending provider that the individual has a terminal disease with a prognosis of six months or less to live; that the individual is mentally capable or that the consulting provider has referred the individual to a licensed mental health provider for further evaluation; and that the individual is acting voluntarily, free from coercion or undue influence. The bill requires that if either the attending provider or the consulting provider is unable to confirm that the individual is capable of making an informed decision, the attending provider or the consulting provider must refer the individual to a licensed mental health provider for determination regarding mental capability.

The bill specifies that a provider may choose whether or not to practice medical aid in dying under the provisions of the bill, but if a provider is unable or unwilling to fulfill an individual’s request for medication under the bill, the provider must still document the date of the individual’s request in the patient’s medical record and, if requested, transfer the individual’s medical records to a new provider. The bill also specifies that a health care facility may prohibit providers from qualifying, prescribing, or dispensing medication under the provisions of the bill while performing duties for the facility, but if it does so, it must provide advance notice to providers and staff in writing, and then on a yearly basis. If an individual wishes to transfer to another facility, the facility must coordinate a timely transfer. Finally, no health care facility may prohibit a provider from fulfilling the requirements of informed consent and meeting the medical standard of care, including by allowing a provider to prescribe medication under the provisions of the bill outside of the scope of the provider’s employment or contract with the prohibiting facility and off the premises of the the prohibiting facility.

The bill includes immunity for actions taken in good faith, but also includes penalties for intentionally or knowingly 1) altering or forging an individual’s request for medication under the bill; 2) concealing or destroying a rescission of a request for medication under the bill; or 3) coercing or exerting undue influence on an individual with a terminal disease to request or use medication under the bill. The bill expressly does not not limit civil liability or damages arising from negligent conduct or intentional misconduct.

Under the bill, insurance, including insurance rates, may not be conditioned on or affected by an individual’s act of making or rescinding a request for medication under the provisions of the bill. Further, a qualified individual’s act of self-administering medication consistent with the provisions of the bill does not invalidate any part of a life, health, or accident insurance policy, or an annuity policy. Finally, no insurance plan may deny or alter benefits to an individual with a terminal disease who is a covered beneficiary based on the availability of medical aid in dying, the individual’s request for medication under the provisions of the bill, or the absence of such a request.