ARIZONA AID
IN DYING BILL
The following proposed law for
the state of Arizona
was copied from the State of Arizona Legislature Website
on April 25, 2007.
No changes have been made in
the text.
Only new line-divisions have been added,
to make the text easier to read on computer screens.
Because this bill is
substantially the same as the Oregon Death with Dignity Act,
no links to safeguards have been added.
See the Oregon
law for links to the safeguards embedded here.
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REFERENCE TITLE: aid in dying |
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State of Arizona House of Representatives Forty-eighth Legislature First Regular Session 2007
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HB 2572 |
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Introduced by Representatives Lopez, Bradley, Cajero Bedford, Sinema: Alvarez, Campbell CL, DeSimone, Garcia M, Miranda B
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AN ACT
amending
title 36, Arizona Revised Statutes,
by adding chapter 38; relating to aid in dying.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 36, Arizona Revised
Statutes,
is amended by adding chapter 38, to read:
CHAPTER 38
AID IN DYING
ARTICLE 1. GENERAL PROVISIONS
36-3801. Definitions
In this chapter, unless the context otherwise requires:
1. "Aid in dying" means
the issuance of a prescription for medication for self-administration
that will terminate the life of a qualified patient
in a painless, humane and dignified manner.
2. "Consulting physician" means
a physician who is qualified by specialty or experience
to make a professional diagnosis and prognosis regarding a patient's
disease.
3. "Counseling" means
a consultation between a psychiatrist or psychologist licensed by this
state
and a patient for the purpose of determining
whether the patient is suffering from a psychiatric or psychological
disorder
or depression causing impaired judgment.
4. "Department" means the department of health services.
5. "Informed decision" means
a decision by a qualified patient to request and obtain a prescription
to end the patient's life that is based on an appreciation of the
relevant facts
and after being fully informed by the attending physician of:
(a) The medical diagnosis.
(b) The Prognosis.
(c) The potential risks associated with taking the medication to be prescribed.
(d) The probable result of taking the medication to be prescribed.
(e) The feasible alternatives, including comfort care, hospice care and pain control.
6. "Medically confirmed" means
that the medical opinion of the attending physician
has been confirmed by a consulting physician
who has examined the patient and the patient's relevant medical records.
7. "Qualified patient" means
a capable adult who has resided in this state for at least ninety days
and who has satisfied the requirements of this article
in order to obtain a prescription to end the patient's life.
8. "Terminal
condition" means
a condition that results from an accident or an incurable and
irreversible disease,
that has been medically confirmed and that will cause,
with reasonable medical judgment, death within six months.
36-3802. Request for medication; requirements; signatures
A. A qualified patient may make a
written request
for medication to end the patient's life as prescribed by this article.
B. A request for medication under this
article
must be in substantially the form described in section 36-3818,
signed and dated by the patient and 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
competent,
is acting voluntarily and is not being coerced to sign the request.
C. At least one of the witnesses 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
is entitled to any portion of the estate of the patient on the
patient's death
under any will or by operation of law.
3. An owner, operator or employee of a
health care facility
where the patient is receiving medical treatment or is a resident.
D. The patient's attending physician
at the time the request is signed shall not be a witness.
E. Notwithstanding the requirements of
subsection B of this section,
if the patient resides in a long-term care facility at the time the
written request is made,
one of the witnesses must be a person who is designated by the facility
and who has the qualifications specified by the department as
prescribed by rule.
F. If the patient is competent but is
unable to write or to sign a statement,
the patient may substitute a video recording,
witnessed by two qualified individuals, for the written request.
36-3803. Safeguards; attending physician; responsibilities
The attending physician must:
1. Make the initial determination of
whether a patient has a terminal condition,
is competent and has made the request voluntarily.
2. Inform the patient of:
(a) The patient's medical diagnosis.
(b) The patient's prognosis.
(c) The potential risks associated with taking the medication to be prescribed.
(d) The probable result of taking the medication to be prescribed.
(e) The feasible alternatives, including comfort care, hospice care and pain control.
3. Refer the patient to a consulting
physician
for medical confirmation of the diagnosis
and for a determination that the patient is competent and is acting
voluntarily.
4. Refer the patient for counseling if required pursuant to section 36-3805.
5. Request that the patient notify the patient's next of kin.
6. Inform the patient that the patient
can rescind the request
at any time and in any manner and offer the patient an opportunity to
rescind
at the end of the fifteen day waiting period prescribed in section
36-3810.
7. Verify, immediately before writing
the prescription for medication,
that the patient is making an informed decision.
8. Fulfill the medical record documentation requirement of section 36‑3811.
9. Ensure that all appropriate steps
are carried out
in accordance with this article before writing a prescription
for medication to enable the qualified patient
to end the patient's life in a humane and dignified manner.
36-3804. Consulting physician; confirmation of diagnosis
A. Before a patient is qualified under
this article,
a consulting physician must examine the patient
and the patient's relevant medical records,
must confirm, in writing, the attending physician's diagnosis
that the patient is suffering from a terminal condition
and must verify that the patient is competent,
is acting voluntarily and has made an informed decision.
B. The consulting physician may not be
a partner, shareholder or employee
in the same medical practice as the attending physician.
36-3805. Counseling referral
A. 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 must refer the patient for counseling.
B. A physician shall not prescribe
medication to end a patient's life
until the person performing the counseling determines
that the patient is not suffering from a psychiatric or psychological
disorder
or depression causing impaired judgment.
C. A counseling psychiatrist or
psychologist
shall not be a partner, shareholder or employee
in the same practice as the attending physician.
36-3806. Informed decision
A patient shall not receive a prescription for
medication to end the patient's life
unless the patient has made an informed decision as prescribed in
section 36-3803.
36-3807. Family notification
The attending physician must ask the patient to
notify the patient's next of kin
of the patient's request for medication pursuant to this article.
If a patient declines or is unable to notify the patient's next of kin,
the physician shall not deny a request for medication for this reason.
36-3808. Written and oral requests
A. In order to receive a prescription
for medication under this article,
a patient must make an oral and a written request
and must reiterate the oral request to the patient's attending
physician
at least fifteen days after making the initial oral request.
B. At the time the qualified patient
makes the second oral request,
the attending physician must offer the patient an opportunity to
rescind the request.
36-3809. Right to rescind request
A patient may rescind a request at any time and
in any manner
without regard to the patient's mental state.
No prescription for medication under this article may be written
without the attending physician offering the qualified patient
an opportunity to rescind the request.
If a directive or request is rescinded,
it must be as if the directive or request were never made.
36-3810. Waiting periods
A. At least fifteen days must elapse
between the patient's initial oral request
and the writing of a prescription under this article.
At least forty-eight hours must elapse
between the patient's written request
and the writing of a prescription under this article.
B. If all other requirements of this
article are met,
the waiting periods provided in this section may be shortened
if the primary physician certifies in writing that the patient is in
extreme pain
and the imposition of a waiting period
would serve only to extend the suffering of the patient.
36-3811. Medical records; documentation; requirements
The following information must be documented or filed in the patient's medical record:
1. All oral requests by a patient for medication to end the patient's life.
2. All written requests by a patient for medication to end the patient's life.
3. The attending physician's diagnosis
and prognosis
and verification that the patient is competent,
is acting voluntarily and has made an informed decision.
4. The consulting physician's
diagnosis and prognosis
and verification that the patient is competent,
is acting voluntarily and has made an informed decision.
5. A report of the outcome and
determinations
made during counseling, if performed.
6. The attending physician's offer to
the patient to rescind
the patient's request at the time of the patient's second oral request
pursuant to section 36-3808.
7. A note by the attending physician
indicating
that all requirements under this article have been met
and indicating the steps taken to carry out the request,
including a notation of the medication prescribed.
36-3812. Reporting requirements
A. The department shall annually
review a sample of records
maintained pursuant to this article.
B. The department
shall adopt rules
to facilitate the collection of information regarding compliance with
this article.
The information collected is not a public record
and is not available for inspection by the public.
C. The department shall generate
and make available to the public an annual statistical report
of information collected under this article.
36-3813. Effect on construction of wills and contracts
A. A provision in any contract, will
or other agreement,
whether written or oral,
that would affect whether a person may make or rescind
a request for medication to end the patient's life
in a humane and dignified manner is not valid.
B. An obligation owing under any
currently existing contract
shall not be conditioned on or affected by a person
making or rescinding a request for medication
to end the person's life in a humane and dignified manner.
36-3814. Insurance or annuity policies
A. The sale, procurement or issuance
of any life, health or accident insurance
or annuity policy or the rate charged for any policy
shall not be conditioned on or affected by a person
making or rescinding a request for medication
to end the person's life in a humane and dignified manner.
B. An insurer shall not require or
request an insured
to disclose whether the insured has considered or executed a request
for aid in dying.
C. A qualified patient's act of
ingesting medication
to end the patient's life in a humane and dignified manner
does not affect a life, health or accident insurance or annuity policy.
36-3815. Construction
This article does not authorize a physician or
any other person
to end a patient's life by lethal injection, mercy killing or active
euthanasia.
Notwithstanding any other law,
actions taken in accordance with this article do not constitute,
for any purpose, suicide, assisted suicide, mercy killing or homicide.
36-3816. Immunities
Except as provided in section 36-3817:
1. A person is not subject to civil or
criminal liability
or professional disciplinary action
for participating in good faith compliance with this article.
This includes being present when a qualified patient
takes the prescribed medication to end the patient's life in a humane
and dignified manner.
2. This article does not authorize any
person
to assist in the administration of medication
unless that person is designated by a qualified patient
to administer or dispense the medication
because of the qualified patient's physical disability.
3. A professional organization or
association or health care provider
shall not subject a person to censure, discipline, suspension,
loss of privileges, loss of membership or any other penalty
for participating or refusing to participate in good faith compliance
with this article.
4. A request by a patient for or
provision by an attending physician
of medication in good faith compliance with this article
does not constitute neglect for any purpose of law
or provide the sole basis for the appointment of a guardian or
conservator.
5. A health care provider is not under
any duty,
whether by contract, by statute or by any other legal requirement,
to participate in the provision to a qualified patient
of medication to end the patient's life in a humane and dignified
manner.
If a health care provider is unable or unwilling
to carry out a patient's request under this article,
the health care provider must promptly transfer
the responsibility to another provider
who is willing to act in accordance with the qualified patient's
wishes.
The health care provider must transfer, on request,
a copy of the patient's relevant medical records to the new health care
provider.
6. A health care facility that refuses
to allow aid in dying
to be prescribed or administered on its premises
shall not deny staff privileges or employment to a person
for the sole reason that the person previously participated in aid in
dying.
7. A licensed pharmacist who dispenses
lethal medicine
based on a valid prescription by a physician aiding a patient to die
under this article
is not subject to civil, criminal or administrative liability for doing
so.
36-3817. Violations; classification; liability
A. A person who without authorization
of the patient
wilfully alters or forges a request for medication
or conceals or destroys a rescission of that request
with the intent or effect of causing the patient's death is guilty of
manslaughter.
B. A person who coerces or exerts
undue influence on a patient
to request medication for the purpose of ending the patient's life
or to destroy a rescission of such a request is guilty of manslaughter.
C. This article does not limit further
liability for civil damages
resulting from other negligent conduct or intentional misconduct by any
person.
D. The penalties in this article do
not preclude criminal penalties
applicable under any other law for conduct that is inconsistent with
this article.
36-3818. Sample form
A request
for a medication as authorized by this article
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, my prognosis,
the nature of medication to be prescribed and potential associated
risks,
the expected result and the feasible alternatives,
including comfort care, hospice care and pain control.
I
request that my attending physician prescribe medication
that will end my life in a humane and dignified manner.
INITIAL ONE:
_____ I have informed my family
of my decision
and have 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 make
this request voluntarily and without reservation,
and I accept full moral responsibility for my actions.
Signed: ________________________
Dated: ________________________
DECLARATION OF WITNESSES
We declare that the person signing this request:
1. Is personally known to us or has provided proof of identity.
2. Signed this request in our presence.
3. Appears to be of sound mind and not under duress, fraud or undue influence.
4. Is not a patient for whom either of us is the attending physician.
Witness 1 ________________________________
Date _____________________________________
Witness 2 ________________________________
Date _____________________________________
NOTE: One
witness shall not be a relative (by blood, marriage or adoption)
of the person signing this request,
shall not be entitled to any portion of the person's estate on death
and shall not own, operate or be employed at a health care facility
where the person is a patient or resident.
If the patient is an inpatient at a health care facility,
one of the witnesses must be an individual
designated by the facility.