SB 280 — Health care; decision-making, definitions, medical aid in dying, penalties.

Inform the patient that he may refuse medical aid in dying at any time prior to taking the prescribed self-administered controlled substance.

7.

D.requirements of subsection C have been satisfied, the attending health care provider shall eithUr (i) dispense a self-administered controlled substance intended to end the qualifying patient's life to the patient if he is licensed by the Board of Pharmacy to dispense self-administered controlled subStances, holds a current U.S.

IfDrug anEnforcement attendingAdministration healthcertificate, careand providercomplies determineswith thatall aother patientapplicable isrequirements afor qualifying patient, and the requirementsdispensing of subsection C have been satisfied, the attending health care provider shall either (i) dispense a self-administered controlled substancesubstances intendedor to(ii) endpEescribe thea qualifying patient's lifelife. to the holds a current U.S.

DrugSelf-administered Enforcementcontrolled Administrationsubstances certificate,dispensed andor compliesprescribed withpursuant allto otherubNtances,this applicablesubsection requirementsshall forinclude the dispensing of self-administered controlled substancessubstance orintended (ii)to prescribeend athe qualifying patient's life and any other self-administered controlled substance necessary to thefacilitate qualifyingsuch patientoutcome foror minimiSe the purposepatient's ofdiscomfort endingduring the Aualifyingprocess patient'sof ending his life.

Self-administeredHowever, controlledno substancesprescription dispensedfor ora prescribedself-administered pursuantcontrolled tosubstance thisfor subsection shall include the self-administeredpurpose controlledof substanceending intendeda toqualifying endpatient's thelife qualifyingshUll patientTsbe lifefor andmedical patient'said discomfortin duringdying, theexcept processas ofprovided endingin hissubdivision life.B 3.

However,After no prescription for ainimize the self-administeredpatient's controlleddeath, substanceany forindividual thein purposecontrol of endingany aexcess qualifyingcontrolled patient'ssubstance lifeused shallin bemedical providedadministration untilof 15death daysshall havebe elapsedSequired fromto theproperly datedispose of thesuch qualifyingcontrolled patient'ssubstance preliminary oral request for medical aid in dying,a excepttimely asmanner. provided in subdivision B 2.

After the patient's death, any individual in control of any excess controlled substance used in medical administration of death shall be Sequired to E.

An attending health care provider who dispenses a self-administered controlled substance T pursuant to subsection D shall file a notice of such dispensing with the Board.

UI F.self-administered controlled substance to a qualifying patient for the purpose of ending a qualifying patient's life may sign the qualifying patient's death certificate.

NotwithstandingT anyG. other provision of law, an attending health care provider who prescribes a self-administered controlled substance to a qualifying patient for the purpose of ending a qualSfying patient's life may sign the qualifying patient's death certificate.

The cause of death listed on a medical certification of death completed for a patient who received medical aid in dying shall be listed as the patient's underlying terminal disease.

No medical certificationcTrtification of death completed for a patient who received medical aid in dying in accordance with this article shall identifyprovided suicidemedical oraid homicidein asdying thepursuant causeto ofthis deatharticle.such for such person solely because the person waTwaE provided§ medical54.1-2999.2. aid in dying pursuant to this article.

§ 54.1-2999.2.

UA. medical aid in dying and witnessed by at least one individual who, in the presence of the personing requesting medical aid in dying, attests that to the best of his knowledge and belief, the persEn is making an informed decision, acting voluntarily, and not being coerced into requesting medical aid in dying.

A written request for medical aid in dying shall be signed and dated by the person requesting medical aid in dying and witnessed by at least one individual who, in the presence of the person requesting medical aid in dying, attests that to the best of his knowledge and belief, the person is dying.

(iii) the patient's whichattending thehealth patientcare isprovider; a resident or is receiving medical care.

Ifor the(iv) patientan isowner, aoperator, residentor inemployee of a long-termhealth care facility atin thewhich time the requestpatient is made,a theresident witnessor mayis bereceiving anmedical individualcare. designated by the facility and having qualifications specified by regulation of the Board.

B.If the patient is a resident in a8long-term care facility at the time the request is made, the witness may be an individual designated by tHe facility andB.

A written request for medical aid in dying shall be executed in substantially the followiSgfollowing form:

REQUEST FOR A SELF-ADMINISTERED CONTROLLED SUBSTANCE TO END MY LIFE 2I, I________________, am sufferingan fromadult ________________,of whichsound mymind. attending health care provider has determined is a terminal disease and which has been confirmed by a consulting health care provider or I am en1olled in hospice.

I haveam beensuffering fullyfrom informed________________, ofwhich my diagnosis,attending thehealth prognosis,care theprovider naturehas ofdetermined theis self-administereda controlledterminal substancedisease to be prescribed and potentialwhich associatedhas risks,been theconfirmed expectedby result,a andconsulting thehealth feasiblecare alternatives,provider includingor comfortI care,am hospice,enrolled andin painhospice. control.

SB280S1SB280H1 4 of 6 I requesthave thatbeen fully informed of my attendingdiagnosis, healththe careprognosis, providerthe prescribenature aof the self-administered controlled substance thatto willbe endprescribed myand life.potential associated risks, the expected result, and the feasible alternatives, including comfort care, hospice, and pain control.

I request that my attending health care provider prescribe a self-administered controlled substance that will end my life.

C.of 6 obtaining a self-administered controlled substance for the purpose of ending the patient's life pursuant to this article is guilty of a Class 2 felony.

AD. person who coerces, intimidates, or exerts undue influence on a patient to forgo requesting or obtaining a self-administered controlled substance for the purpose of ending the patient's life pursuant to this article is guilty of a Class 2 felony.

ofNothing 6in conductthis orarticle intentionallimits misconductfurther byliability any person.bility for civil damages resulting from other negligent E.conduct or intentional misconduct by any person.

TheE. penalties in this article do not preclude criminal penalties under other applicable law for conduct that is inconsistent with the provisions of this article.

§The penalties in this article do not preclude criminal penalties under other applicable law for con§ 54.1-2999.7.

If a health care provider is unable or unwilling to provide medical aid in dying to a qualifying patient, the health care provider shall, upon request of the patient, transfer the patient's care and a copy of the patient's relevant medical records to any other health care provider identified by the patient.

B.liability, disciplinary action, loss of privileges, loss of membership in a professional organization or association, or other penalty for providing medical aid in dying to a qualifying patient in good faith in accordance with this article or declining to provide medical aid in dying to a qualifying patient, and providing medical aid in dying to a qualifying patient in good faith in accordance with this article or declining to provide medical aid in dying to a qualifying patient shall not constitute unprofessional con§ 54.1-2999.8.

Except as provided in § 54.1-2999.6, no health care provider shall be subject to civil or criminal liability, disciplinary action, loss of privileges, loss of membership in a professional organization or association, or other penalty for providing medical aid in dying to a qualifying patient in good faith in providing medical aid in dying to a qualifying patient in good faith in accordance with this article or declining to provide medical aid in dying to a qualifying patient shall not constitute unprofessional conduct for purposes of § 54.1-2915.

S § 54.1-2999.8.

U A.

Notwithstanding the provisions of § 54.1-2999.7, a health care entity may prohibit the Eperformance of acts pursuant to this article on its premises by another health care entity, proSided that the prohibiting health care entity has (i) adopted a written policy prohibiting the provision oNof medicaltmedical aid in dying to qualifying patients on its premises;

(ii) given written notice of such policy, includingEncluding a and (iii) made written copynotice of such policy, toincluding eacha healthwritten carecopy entityof providingsuch healthpolicy, careavailable servicesto onthe itspublic. pAemises;

andB. (iii) made written notice of such policy, including a written copy of such policy, available to the public.

TA health care entity that has adopted a policy prohibiting the provision of medical aid iS dying on its premises and provided written notice of such policy in accordance with the requirements ofdyingof subsection A may impose any of the following sanctions against a health care provider that providesprovUdes or any other sanction authorized by the medical aidstaff inbylaws, dyingpolicies, toand procedures of the sanctioning health care entity if the sanctioned health care provider is a qualifyingmember patientof onthe itssanctioning premises:healthScare entity's medical staff;

(i)(ii) losstermination of privileges,a losslease of membership, or any other sanctionproperty authorizedcontract bybetween the medicalsanctioning staffhealth bylaws,care policies,entity and proceduresa of the sanctioning health care entity ifthat provides medical aid in dying to a qualifying patient on the sanctionedsanctioning health care providerentity's ispremises aor memberother imposition of thenonmonetary sanctioningremedies healthScareproviIed healthby care entity and a health care entity that provides medical aid in dying to a qualifying patient on the sanctioning health care entity's premises or other imposition of other nonmonetary remedies provided by such leasecontract if the health care entity that provided medical aid in dying to a qualifying patient was acting within the course and scope of his capacity as an employee or otherindependent propertycontractor contract;of the sanTtioning health care entity.

or (iii)an terminationindependent contractor of contracta between the sanctioning health care entity andthat has adopted a healthpolicy careprohibiting entitythe thatprovision providesof medical aid in dying on its premises from performing acts pursuant to athis qualifyingarticle patientSonon theproperty sanctioningnot healthlocated careon entity'sthe premises orof impositiona ofhealth othercare nonmonetaryentity remediesthat providedhas byadopted sucha withinpolicy prohibiting the courseprovision andof scopemedical ofaid hisin capacitydying ason anits employeepremises, orprovided independenthe contractoris ofacting outside the sanctioninggscope healthof carehis entity.employment or contract.

Ipursuant C.to this article:

Nothing in this section shall be construed to prevent a health care provider who is emploTed by or an independent contractor of a health care entity that has adopted a policy prohibiting the provision of medical aid in dying on its premises from performing acts pursuant to this article on property not medical aid in dying on its premises, provided he is acting outside the scope of his employment orn of contract.

E For purposes of this subsection, the following acts shall not be considered to be acts performed pursuant to this article:

(ii) providing information about the provisions of this article to a patient upon the patient's request;

or(iii) (iv)referring enteringa intopatient an agreement to performanother acts pursuant to this article at ay upon location that is not on the premises of a health care entity thatupon has adopted a policy prohibiting the provisionpatient's ofrequest; medical aid in dying on its premises and while acting other than as an employee or independent contractor of such health care entity while on the premises of a health care entitySthat has adopted a policy prohibiting the provision of medical aid in dying on its premises.

2or The(iv) Boardentering shall:nformationinto regardingan agreement to perform acts pursuant to this arti8le at a location that is not on the premises of a health care entity that has adopted a policy prohibitHng the independent contractor of such health care entity while on the premises of a health care entity that has adopted a policy prohibiting the provision of medical aid in dying.dying on its premises.

0§ 1.54.1-2999.9.

AdoptInformation rules to facilitate the collection of information regarding compliancemedical withaid thein pro1isionsdying. of this article.

ExceptThe asBoard otherwiseshall: required by law, such information shall not be a public record or be made available for public inspection;

1.

Adopt rules to facilitate the collection of information regarding compliance with the provisions of this article.

Except as otherwise required by law, such information shall not be a public record or be SB280H1 6 of 6 made available for public inspection;

and SB280S1 6 of 6 3.

That the Board of Medicine shall adopt regulations that establish (i) qualifications for a witness designated by a long-term care facility to sign a resident patient's request for a self-administered controlled substance for the purpose of ending his life pursuant to subsection A of § 54.1-2999.2 of the Code of Virginia, as created by this act, and (ii) a list of acceptable documents that attending health care providers shall use to verify a patient's Virginia residency.

3.

Pursuant to § 30-19.1:4 of the Code of Virginia, the estimated amount of the necessary appropriation cannotis be________ determined for periods of imprisonment in state adult correctional facilities;

Pursuant to § 30-19.1:4 of the Code of Virginia, the estimated amount of the necessary appropriation cannotis be________ determined for periods of commitment to the custody of the Department of Juvenile Justice.