103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB3499 Introduced 2/9/2024, by Sen. Linda Holmes SYNOPSIS AS INTRODUCED: New Act Creates the End-of-Life Options for Terminally Ill Patients Act. Authorizes a qualified patient with a terminal disease to request that a physician prescribe aid-in-dying medication that will allow the patient to end the patient's life in a peaceful manner. Contains provisions concerning: the procedures and forms to be used to request aid-in-dying medication; the responsibilities of attending and consulting physicians; the referral of patients for determinations of mental capacity; the residency of qualified patients; the safe disposal of unused medications; the obligations of health care entities; the immunities granted for actions taken in good faith reliance upon the Act; the reporting requirements of physicians; the effect of the Act on the construction of wills, contracts, and statutes; the effect of the Act on insurance policies and annuities; the procedures for the completion of death certificates; the liabilities and penalties provided by the Act; the construction of the Act; the definitions of terms used in the Act; and other matters. Effective 6 months after becoming law. LRB103 38464 RPS 68600 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB3499 Introduced 2/9/2024, by Sen. Linda Holmes SYNOPSIS AS INTRODUCED: New Act New Act Creates the End-of-Life Options for Terminally Ill Patients Act. Authorizes a qualified patient with a terminal disease to request that a physician prescribe aid-in-dying medication that will allow the patient to end the patient's life in a peaceful manner. Contains provisions concerning: the procedures and forms to be used to request aid-in-dying medication; the responsibilities of attending and consulting physicians; the referral of patients for determinations of mental capacity; the residency of qualified patients; the safe disposal of unused medications; the obligations of health care entities; the immunities granted for actions taken in good faith reliance upon the Act; the reporting requirements of physicians; the effect of the Act on the construction of wills, contracts, and statutes; the effect of the Act on insurance policies and annuities; the procedures for the completion of death certificates; the liabilities and penalties provided by the Act; the construction of the Act; the definitions of terms used in the Act; and other matters. Effective 6 months after becoming law. LRB103 38464 RPS 68600 b LRB103 38464 RPS 68600 b A BILL FOR
103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB3499 Introduced 2/9/2024, by Sen. Linda Holmes SYNOPSIS AS INTRODUCED:
New Act New Act
New Act
Creates the End-of-Life Options for Terminally Ill Patients Act. Authorizes a qualified patient with a terminal disease to request that a physician prescribe aid-in-dying medication that will allow the patient to end the patient's life in a peaceful manner. Contains provisions concerning: the procedures and forms to be used to request aid-in-dying medication; the responsibilities of attending and consulting physicians; the referral of patients for determinations of mental capacity; the residency of qualified patients; the safe disposal of unused medications; the obligations of health care entities; the immunities granted for actions taken in good faith reliance upon the Act; the reporting requirements of physicians; the effect of the Act on the construction of wills, contracts, and statutes; the effect of the Act on insurance policies and annuities; the procedures for the completion of death certificates; the liabilities and penalties provided by the Act; the construction of the Act; the definitions of terms used in the Act; and other matters. Effective 6 months after becoming law.
LRB103 38464 RPS 68600 b LRB103 38464 RPS 68600 b
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A BILL FOR
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1 AN ACT concerning health.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 1. Short title. This Act may be cited as the
5 End-of-Life Options for Terminally Ill Patients Act.
6 Section 5. Definitions. As used in this Act:
7 "Adult" means an individual 18 years of age or older.
8 "Advanced practice registered nurse" means an advanced
9 practice registered nurse licensed under the Nurse Practice
10 Act who is certified as a psychiatric mental health
11 practitioner.
12 "Aid in dying" means an end-of-life care option that
13 allows a qualified patient to obtain a prescription for
14 medication pursuant to this Act.
15 "Attending physician" means the physician who has primary
16 responsibility for the care of the patient and treatment of
17 the patient's terminal disease.
18 "Clinical psychologist" means a psychologist licensed
19 under the Clinical Psychologist Licensing Act.
20 "Clinical social worker" means a person licensed under the
21 Clinical Social Work and Social Work Practice Act.
22 "Coercion or undue influence" means the willful attempt,
23 whether by deception, intimidation, or any other means to:
103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB3499 Introduced 2/9/2024, by Sen. Linda Holmes SYNOPSIS AS INTRODUCED:
New Act New Act
New Act
Creates the End-of-Life Options for Terminally Ill Patients Act. Authorizes a qualified patient with a terminal disease to request that a physician prescribe aid-in-dying medication that will allow the patient to end the patient's life in a peaceful manner. Contains provisions concerning: the procedures and forms to be used to request aid-in-dying medication; the responsibilities of attending and consulting physicians; the referral of patients for determinations of mental capacity; the residency of qualified patients; the safe disposal of unused medications; the obligations of health care entities; the immunities granted for actions taken in good faith reliance upon the Act; the reporting requirements of physicians; the effect of the Act on the construction of wills, contracts, and statutes; the effect of the Act on insurance policies and annuities; the procedures for the completion of death certificates; the liabilities and penalties provided by the Act; the construction of the Act; the definitions of terms used in the Act; and other matters. Effective 6 months after becoming law.
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A BILL FOR
New Act
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1 (1) cause a patient to request, obtain, or
2 self-administer medication pursuant to this Act with
3 intent to cause the death of the patient; or
4 (2) prevent a qualified patient, in a manner that
5 conflicts with the Health Care Right of Conscience Act,
6 from obtaining or self-administering medication pursuant
7 to this Act.
8 "Consulting physician" means a physician who is qualified
9 by specialty or experience to make a professional diagnosis
10 and prognosis regarding the patient's disease.
11 "Department" means the Department of Public Health.
12 "Health care entity" means a hospital or hospital
13 affiliate, nursing home, hospice or any other facility
14 licensed under any of the following Acts: the Ambulatory
15 Surgical Treatment Center Act; the Home Health, Home Services,
16 and Home Nursing Agency Licensing Act; the Hospice Program
17 Licensing Act; the Hospital Licensing Act; the Nursing Home
18 Care Act; or the University of Illinois Hospital Act. "Health
19 care entity" does not include a physician.
20 "Health care professional" means a physician, pharmacist,
21 or licensed mental health professional.
22 "Informed decision" means a decision by a patient with
23 mental capacity and a terminal disease to request and obtain a
24 prescription for medication pursuant to this Act, that the
25 qualified patient may self-administer to bring about a
26 peaceful death, after being fully informed by the attending
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1 physician and consulting physician of:
2 (1) the patient's diagnosis and prognosis;
3 (2) the potential risks and benefits associated with
4 taking the medication to be prescribed;
5 (3) the probable result of taking the medication to be
6 prescribed;
7 (4) the feasible end-of-life care and treatment
8 options for the patient's terminal disease, including, but
9 not limited to, comfort care, palliative care, hospice
10 care, and pain control, and the risks and benefits of
11 each;
12 (5) the patient's right to withdraw a request pursuant
13 this Act, or consent for any other treatment, at any time;
14 and
15 (6) the patient's right to choose not to obtain the
16 drug or to choose to obtain the drug but not to ingest it.
17 "Licensed mental health care professional" means a
18 psychiatrist, clinical psychologist, clinical social worker,
19 or advanced practice registered nurse.
20 "Mental capacity" means that, in the opinion of the
21 attending physician or the consulting physician or, if the
22 opinion of a licensed mental health care professional is
23 required under Section 40, the licensed mental health care
24 professional, the patient requesting medication pursuant to
25 this Act has the ability to make and communicate an informed
26 decision.
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1 "Oral request" means an affirmative statement that
2 demonstrates a contemporaneous affirmatively stated desire by
3 the patient seeking aid in dying.
4 "Pharmacist" means an individual licensed to engage in the
5 practice of pharmacy under the Pharmacy Practice Act.
6 "Physician" means a person licensed to practice medicine
7 in all of its branches under the Medical Practice Act of 1987.
8 "Psychiatrist" means a physician who has successfully
9 completed a residency program in psychiatry accredited by
10 either the Accreditation Council for Graduate Medical
11 Education or the American Osteopathic Association.
12 "Qualified patient" means an adult Illinois resident with
13 the mental capacity to make medical decisions who has
14 satisfied the requirements of this Act in order to obtain a
15 prescription for medication to bring about a peaceful death.
16 No person will be considered a "qualified patient" under this
17 Act solely because of advanced age, disability, or a mental
18 health condition, including depression.
19 "Self-administer" means an affirmative, conscious,
20 voluntary action, performed by a qualified patient, to ingest
21 medication prescribed pursuant to this Act to bring about the
22 patient's peaceful death. Self-administration does not include
23 administration by parenteral injection or infusion.
24 "Terminal disease" means an incurable and irreversible
25 disease that will, within reasonable medical judgment, result
26 in death within 6 months. The existence of a terminal disease,
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1 as determined after in-person examination by the patient's
2 physician and concurrence by another physician, shall be
3 documented in writing in the patient's medical record. A
4 diagnosis of a major depressive disorder, as defined in the
5 current edition of the Diagnostic and Statistical Manual of
6 Mental Disorders, alone does not qualify as a terminal
7 disease.
8 Section 10. Informed consent.
9 (a) Nothing in this Act may be construed to limit the
10 amount of information provided to a patient to ensure the
11 patient can make a fully informed health care decision.
12 (b) An attending physician must provide sufficient
13 information to a patient regarding all appropriate end-of-life
14 care options, including comfort care, hospice care, palliative
15 care, and pain control, as well as the foreseeable risks and
16 benefits of each, so that the patient can make a voluntary and
17 affirmative decision regarding the patient's end-of-life care.
18 (c) If a patient requests for the patient's medical
19 records to be transmitted to an alternative physician, the
20 patient's medical records shall be transmitted without undue
21 delay.
22 Section 15. Standard of care. Nothing contained in this
23 Act shall be interpreted to lower the applicable standard of
24 care for the health care professionals participating under
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1 this Act.
2 Section 20. Qualification.
3 (a) A qualified patient with a terminal disease may
4 request a prescription for medication under this Act in the
5 following manner:
6 (1) The qualified patient may orally request a
7 prescription for medication under this Act from the
8 patient's attending physician.
9 (2) The oral request from the qualified patient shall
10 be documented by the attending physician.
11 (3) The qualified patient shall provide a written
12 request in accordance with this Act to the patient's
13 attending physician after making the initial oral request.
14 (4) The qualified patient shall repeat the oral
15 request to the patient's attending physician no less than
16 5 days after making the initial oral request.
17 (b) The attending and consulting physicians of a qualified
18 patient shall have met all the requirements of Sections 30 and
19 35.
20 (c) Notwithstanding subsection (a), if the individual's
21 attending physician has medically determined that the
22 individual will, within reasonable medical judgment, die
23 within 5 days after making the initial oral request under this
24 Section, the individual may satisfy the requirements of this
25 Section by providing a written request and reiterating the
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1 oral request to the attending physician at any time after
2 making the initial oral request.
3 (d) At the time the patient makes the second oral request,
4 the attending physician shall offer the patient an opportunity
5 to rescind the request.
6 (e) Oral and written requests for aid in dying may be made
7 only by the patient and shall not be made by the patient's
8 surrogate decision-maker, health care proxy, health care
9 agent, attorney-in-fact for health care, nor via advance
10 health care directive.
11 (f) If a requesting patient decides to transfer care to an
12 alternative physician, the records custodian shall, upon
13 written request, transmit, without undue delay, the patient's
14 medical records, including written documentation of the dates
15 of the patient's requests concerning aid in dying.
16 (g) A transfer of care or medical records does not toll or
17 restart any waiting period.
18 Section 25. Form of written request.
19 (a) A written request for medication under this Act shall
20 be in substantially the form below, signed and dated by the
21 requesting patient, and witnessed in the presence of the
22 patient by at least 2 witnesses who attest that to the best of
23 their knowledge and belief the patient has mental capacity, is
24 acting voluntarily, and is not being coerced or unduly
25 influenced to sign the request.
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1 (b) One of the witnesses required under this Section must
2 be a person who is not:
3 (1) a relative of the patient by blood, marriage,
4 civil union, registered domestic partnership, or adoption;
5 (2) a person who, at the time the request is signed,
6 would be entitled to any portion of the estate of the
7 qualified patient upon death, under any will or by
8 operation of law; or
9 (3) an owner, operator, or employee of a health care
10 entity where the qualified patient is receiving medical
11 treatment or is a resident.
12 (c) The patient's attending physician at the time the
13 request is signed shall not be a witness.
14 (d) If a person uses an interpreter, the interpreter shall
15 not be a witness.
16 (e) The written request for medication under this Act
17 shall be substantially as follows:
18 "Request for Medication to End My Life in a Peaceful Manner
19 I, ............... (insert name of patient), am an adult
20 of sound mind, and a resident of Illinois. I have been
21 diagnosed with ..............., (insert name of condition) and
22 given a terminal disease prognosis of 6 months or less to live
23 by my attending physician.
24 I affirm that my terminal disease diagnosis was given or
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1 confirmed during at least one in-person visit to a health care
2 professional.
3 I have been fully informed of the feasible alternatives
4 and concurrent or additional treatment opportunities for my
5 terminal disease, including, but not limited to, comfort care,
6 palliative care, hospice care, or pain control, as well as the
7 potential risks and benefits of each. I have been offered,
8 have received, or have been offered and received resources or
9 referrals to pursue these alternatives and concurrent or
10 additional treatment opportunities for my terminal disease.
11 I have been fully informed of the nature of the medication
12 to be prescribed, including the risks and benefits, and I
13 understand that the likely outcome of self-administering the
14 medication is death.
15 I understand that I can rescind this request at any time,
16 that I am under no obligation to fill the prescription once
17 written, and that I have no duty to self-administer the
18 medication if I obtain it.
19 I request that my attending physician furnish a
20 prescription for medication that will end my life if I choose
21 to self-administer it, and I authorize my attending physician
22 to transmit the prescription to a pharmacist to dispense the
23 medication at a time of my choosing.
24 I make this request voluntarily, free from coercion or
25 undue influence.
26 Dated: ................
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1 Signed..................................
2 (patient)
3 Dated: ................
4 Signed...............................
5 (witness #1)
6 Dated: ................
7 Signed..............................
8 (witness #2)"
9 (f) The interpreter attachment for a written request for
10 medication under this Act shall be substantially as follows:
11 "Request for Medication to End My Life in a Peaceful Manner
12 Interpreter Attachment
13 I, ...............(insert name of interpreter), am fluent
14 in English and ...............(insert language of patient,
15 including sign language).
16 On .......(insert date) at approximately .......(insert
17 time), I read the "Request for Medication to End My Life in a
18 Peaceful Manner" form to ...............(insert name of
19 patient) in ...............(insert language of patient).
20 ...............(insert name of patient) affirmed to me
21 that they understand the content of this form, that they
22 desire to sign this form under their own power and volition,
23 and that they requested to sign the form after consultations
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(patient)
(witness #1)
(witness #2)"
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1 with an attending physician and a consulting physician.
2 Under penalty of perjury, I declare that I am fluent in
3 English and ...............(language of patient, including
4 sign language) and that the contents of this form, to the best
5 of my knowledge, are true and correct. Executed at
6 ..................................(insert name of city,
7 county, and state) on .......(date).
8 Interpreter's signature: ....................................
9 Interpreter's printed name: .................................
10 Interpreter's address: ......................................".
11 Section 30. Attending physician responsibilities.
12 (a) Following the request of a patient for aid in dying,
13 the attending physician shall conduct an evaluation of the
14 patient and:
15 (1) determine whether the patient has a terminal
16 disease or has been diagnosed as having a terminal
17 disease;
18 (2) determine whether a patient has mental capacity;
19 (3) confirm that the patient's request does not arise
20 from coercion or undue influence;
21 (4) inform the patient of:
22 (A) the diagnosis;
23 (B) the prognosis;
24 (C) the potential risks, benefits, and probable
25 result of self-administering the prescribed medication
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1 to bring about a peaceful death;
2 (D) the potential benefits and risks of feasible
3 alternatives, including, but not limited to,
4 concurrent or additional treatment options for the
5 patient's terminal disease, comfort care, palliative
6 care, hospice care, and pain control; and
7 (E) the patient's right to rescind the request for
8 medication pursuant to this Act at any time;
9 (5) inform the patient that there is no obligation to
10 fill the prescription nor an obligation to self-administer
11 the medication, if it is obtained;
12 (6) provide the patient with a referral for comfort
13 care, palliative care, hospice care, pain control, or
14 other end-of-life treatment options as requested by the
15 patient and as clinically indicated;
16 (7) refer the patient to a consulting physician for
17 medical confirmation that the patient requesting
18 medication pursuant to this Act:
19 (A) has a terminal disease with a prognosis of 6
20 months or less to live; and
21 (B) has mental capacity.
22 (8) include the consulting physician's written
23 determination in the patient's medical record;
24 (9) refer the patient to a licensed mental health
25 professional in accordance with Section 40 if the
26 attending physician observes signs that the individual may
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1 not be capable of making an informed decision;
2 (10) include the licensed mental health professional's
3 written determination in the patient's medical record, if
4 such determination was requested;
5 (11) inform the patient of the benefits of notifying
6 the next of kin of the patient's decision to request
7 medication pursuant to this Act;
8 (12) fulfill the medical record documentation
9 requirements;
10 (13) ensure that all steps are carried out in
11 accordance with this Act before providing a prescription
12 to a qualified patient for medication pursuant to this Act
13 including:
14 (A) confirming that the patient has made an
15 informed decision to obtain a prescription for
16 medication;
17 (B) offering the patient an opportunity to rescind
18 the request for medication; and
19 (C) providing information to the patient on:
20 (I) the recommended procedure for
21 self-administering the medication to be
22 prescribed;
23 (II) the safekeeping and proper disposal of
24 unused medication in accordance with State and
25 federal law; and
26 (III) the importance of having another person
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1 present when the patient self-administers the
2 medication to be prescribed;
3 (D) not taking the aid-in-dying medication in a
4 public place;
5 (14) deliver, in accordance with State and federal
6 law, the prescription personally, by mail, or through an
7 authorized electronic transmission to a licensed
8 pharmacist who will dispense the medication, including any
9 ancillary medications, to the qualified patient, or to a
10 person expressly designated by the qualified patient in
11 person or with a signature required on delivery, by mail
12 service, or by messenger service;
13 (15) if authorized by the Drug Enforcement
14 Administration, dispense the prescribed medication,
15 including any ancillary medications, to the qualified
16 patient or a person designated by the qualified patient;
17 and
18 (16) include, in the qualified patient's medical
19 record, the patient's diagnosis and prognosis,
20 determination of mental capacity, the date of each oral
21 request, a copy of the written request, a notation that
22 the requirements under this Section have been completed,
23 and an identification of the medication and ancillary
24 medications prescribed to the qualified patient pursuant
25 to this Act.
26 (b) Notwithstanding any other provision of law, the
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1 attending physician may sign the patient's death certificate.
2 Section 35. Consulting physician responsibilities. A
3 consulting physician shall:
4 (1) conduct an evaluation of the patient and review
5 the patient's relevant medical records, including the
6 evaluation pursuant to Section 40, if such evaluation was
7 necessary;
8 (2) confirm in writing to the attending physician that
9 the patient:
10 (A) has requested a prescription for aid-in-dying
11 medication;
12 (B) has a documented terminal disease;
13 (C) has mental capacity or has provided
14 documentation that the consulting health care
15 professional has referred the individual for further
16 evaluation in accordance with Section 40; and
17 (D) is acting voluntarily, free from coercion or
18 undue influence.
19 Section 40. Referral for determination that the requesting
20 patient has mental capacity.
21 (a) If either the attending physician or the consulting
22 physician has doubts whether the individual has mental
23 capacity and if either one is unable to confirm that the
24 individual is capable of making an informed decision, the
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1 attending physician or consulting physician shall refer the
2 patient to a licensed mental health professional for
3 determination regarding mental capability.
4 (b) The licensed mental health professional shall
5 additionally determine whether the patient is suffering from a
6 psychiatric or psychological disorder causing impaired
7 judgment.
8 (c) The licensed mental health professional who evaluates
9 the patient under this Section shall submit to the requesting
10 attending or consulting physician a written determination of
11 whether the patient has mental capacity.
12 (d) If the licensed mental health professional determines
13 that the patient does not have mental capacity, or is
14 suffering from a psychiatric or psychological disorder causing
15 impaired judgment, the patient shall not be deemed a qualified
16 patient and the attending physician shall not prescribe
17 medication to the patient under this Act.
18 Section 45. Residency requirement.
19 (a) Only requests made by Illinois residents may be
20 granted under this Act.
21 (b) A patient is able to establish residency through any
22 one or more of the following means:
23 (1) possession of a driver's license or other
24 identification issued by the Secretary of State or State
25 of Illinois;
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1 (2) registration to vote in Illinois;
2 (3) evidence that the person owns, rents, or leases
3 property in Illinois;
4 (4) the location of any dwelling occupied by the
5 person;
6 (5) the place where any motor vehicle owned by the
7 person is registered;
8 (6) the residence address, not a post office box,
9 shown on an income tax return filed for the year preceding
10 the year in which the person initially makes an oral
11 request under this Act;
12 (7) the residence address, not a post office box, at
13 which the person's mail is received;
14 (8) the residence address, not a post office box,
15 shown on any unexpired resident hunting or fishing or
16 other licenses held by the person;
17 (9) the residence address, not a post office box,
18 shown on any driver's license held by the person;
19 (10) the receipt of any public benefit conditioned
20 upon residency; or
21 (11) any other objective facts tending to indicate a
22 person's place of residence is in Illinois.
23 Section 50. Safe disposal of unused medications. A person
24 who has custody or control of medication prescribed pursuant
25 to this Act after the qualified patient's death shall dispose
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1 of the medication by delivering it to the nearest qualified
2 facility that properly disposes of controlled substances or,
3 if none is available, by lawful means in accordance with
4 applicable State and federal guidelines.
5 Section 55. No duty to provide aid in dying.
6 (a) A health care professional shall not be under any
7 duty, by law or contract, to participate in the provision of
8 aid-in-dying care to a patient as set forth in this Act.
9 (b) A health care professional shall not be subject to
10 civil or criminal liability for participating or refusing to
11 participate in the provision of aid-in-dying care to a patient
12 in good faith compliance with this Act.
13 (c) A health care entity or licensing board shall not
14 subject a health care professional to censure, discipline,
15 suspension, loss of license, loss of privileges, loss of
16 membership, or other penalty for participating or refusing to
17 participate in accordance with this Act.
18 (d) A health care professional may choose not to engage in
19 aid-in-dying care.
20 (e) Only willing health care professionals shall provide
21 aid-in-dying care in accordance with this Act. If a health
22 care professional is unable or unwilling to carry out a
23 patient's request under this Act, and the patient transfers
24 the patient's care to a new health care professional, the
25 prior health care professional shall transmit, upon request, a
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1 copy of the patient's relevant medical records to the new
2 health care professional without undue delay.
3 (f) A health care professional shall not engage in false,
4 misleading, or deceptive practices relating to a willingness
5 to qualify a patient or provide aid-in-dying care.
6 Intentionally misleading a patient constitutes coercion.
7 (g) The provisions of the Health Care Right of Conscience
8 Act apply to this Act and are incorporated by reference.
9 Section 60. Health care entity permissible prohibitions
10 and duties.
11 (a) A health care entity may prohibit health care
12 professionals from practicing aid-in-dying care while
13 performing duties for the entity. A prohibiting entity must
14 provide advance notice in writing to health care professionals
15 and staff at the time of hiring, contracting with, or
16 privileging and on a yearly basis thereafter.
17 (b) If a patient wishes to transfer care to another health
18 care entity, the prohibiting entity shall coordinate a timely
19 transfer of care, including transmitting, without undue delay,
20 the patient's medical records that include notation of the
21 date the patient first made a request concerning aid-in-dying
22 care.
23 (c) No health care entity shall prohibit a health care
24 professional from:
25 (1) providing information to a patient regarding the
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1 patient's health status, including, but not limited to,
2 diagnosis, prognosis, recommended treatment and treatment
3 alternatives, and the risks and benefits of each;
4 (2) providing information regarding health care
5 services available pursuant to this Act, information about
6 relevant community resources, and how to access those
7 resources for obtaining care of the patient's choice;
8 (3) practicing aid-in-dying care outside the scope of
9 the health care professional's employment or contract with
10 the prohibiting entity and off the premises of the
11 prohibiting entity; or
12 (4) being present, if outside the scope of the health
13 care professional's employment or contractual duties, when
14 a qualified patient self-administers medication prescribed
15 pursuant to this Act or at the time of death, if requested
16 by the qualified patient or their representative.
17 (d) A health care entity shall not engage in false,
18 misleading, or deceptive practices relating to its policy
19 around end-of-life care services, including whether it has a
20 policy that prohibits affiliated health care professionals
21 from practicing aid-in-dying care; or intentionally denying a
22 patient access to medication pursuant to this Act by
23 intentionally failing to transfer a patient and the patient's
24 medical records to another health care professional in a
25 timely manner. Intentionally misleading a patient or deploying
26 misinformation to obstruct access to services pursuant to this
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1 Act constitutes coercion or undue influence.
2 (e) The provisions of the Health Care Right of Conscience
3 Act apply to this Act and are incorporated by reference.
4 (f) If any part of this Section is found to be in conflict
5 with federal requirements which are a prescribed condition to
6 receipt of federal funds, the conflicting part of this Section
7 is inoperative solely to the extent of the conflict with
8 respect to the entity directly affected, and such finding or
9 determination shall not affect the operation of the remainder
10 of the Section or this Act.
11 Section 65. Immunities for actions in good faith;
12 prohibition against reprisals.
13 (a) A health care professional or health care entity shall
14 not be subject to civil or criminal liability, licensing
15 sanctions, or other professional disciplinary action for
16 actions taken in good faith compliance with this Act.
17 (b) If a health care professional or health care entity is
18 unable or unwilling to carry out an individual's request for
19 aid in dying, the professional or entity shall, at a minimum:
20 (1) inform the individual of the professional's or
21 entity's inability or unwillingness;
22 (2) refer the individual either to a health care
23 professional who is able and willing to evaluate and
24 qualify the individual or to another individual or entity
25 to assist the requesting individual in seeking aid in
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1 dying, in accordance with the Health Care Right of
2 Conscience Act; and
3 (3) note, in the medical record, the individual's date
4 of request and health care professional's notice to the
5 individual of the health care professional's unwillingness
6 or inability to carry out the individual's request.
7 (c) A health care entity or licensing board shall not
8 subject a health care professional to censure, discipline,
9 suspension, loss of license, loss of privileges, loss of
10 membership, or other penalty for engaging in good faith
11 compliance with this Act.
12 (d) A health care professional, health care entity, or
13 licensing board shall not subject a health care professional
14 to discharge, demotion, censure, discipline, suspension, loss
15 of license, loss of privileges, loss of membership,
16 discrimination, or any other penalty for providing
17 aid-in-dying care in accordance with the standard of care and
18 in good faith under this Act when:
19 (1) engaged in the outside practice of medicine and
20 off of the objecting health care entity's premises; or
21 (2) providing scientific and accurate information
22 about aid-in-dying care to a patient when discussing
23 end-of-life care options.
24 (e) A physician is not subject to civil or criminal
25 liability or professional discipline if, at the request of the
26 qualified patient, the physician is present outside the scope
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1 of the physician's employment contract and off the entity's
2 premises, when the qualified patient self-administers
3 medication pursuant to this Act, or at the time of death.
4 (f) A physician who is present at self-administration may,
5 without civil or criminal liability, assist the qualified
6 patient by preparing the medication prescribed pursuant to
7 this Act.
8 (g) A request by a patient for aid in dying does not alone
9 constitute grounds for neglect or elder abuse for any purpose
10 of law, nor shall it be the sole basis for appointment of a
11 guardian.
12 (h) This Section does not limit civil liability for
13 intentional misconduct.
14 Section 70. Reporting requirements.
15 (a) Within 45 days after the effective date of this Act,
16 the Department shall create and post to its website an
17 Attending Physician Checklist Form and Attending Physician
18 Follow-Up Form to facilitate collection of the information
19 described in this Section. Failure to create or post the
20 Attending Physician Checklist Form, the Attending Physician
21 Follow-Up Form, or both shall not suspend the effective date
22 of this Act.
23 (b) Within 30 calendar days of providing a prescription
24 for medication pursuant to this Act, the attending physician
25 shall submit to the Department an Attending Physician
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1 Checklist Form with the following information:
2 (1) the qualifying patient's name and date of birth;
3 (2) the qualifying patient's terminal diagnosis and
4 prognosis;
5 (3) notice that the requirements under this Act were
6 completed; and
7 (4) notice that medication has been prescribed
8 pursuant to this Act.
9 (c) Within 60 calendar days of notification of a qualified
10 patient's death from self-administration of medication
11 prescribed pursuant to this Act, the attending physician shall
12 submit to the Department, an Attending Physician Follow-Up
13 Form with the following information:
14 (1) the qualified patient's name and date of birth;
15 (2) the date of the qualified patient's death; and
16 (3) a notation of whether the qualified patient was
17 enrolled in hospice services at the time of the qualified
18 patient's death.
19 (d) The Department shall collect and annually review the
20 forms filed pursuant to Section to ensure compliance. If a
21 physician required to report information to the Department
22 under this Act provides an inadequate or incomplete report,
23 the Department shall contact the physician to request an
24 adequate or complete report. The information collected shall
25 be confidential and shall be collected in a manner that
26 protects the privacy of the patient, the patient's family, and
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1 any health care professional involved with the patient under
2 the provisions of this Act. The information shall be
3 privileged and strictly confidential, and shall not be
4 disclosed, discoverable, or compelled to be produced in any
5 civil, criminal, administrative, or other proceeding.
6 (e) One year after the effective date of this Act, and each
7 year thereafter, the Department shall create and post on its
8 website a public statistical report of nonidentifying
9 information. The report shall be limited to:
10 (1) the number of prescriptions for medication written
11 pursuant to this Act;
12 (2) the number of physicians who wrote prescriptions
13 for medication pursuant to this Act;
14 (3) the number of qualified patients who died
15 following self-administration of medication prescribed and
16 dispensed pursuant to this Act; and
17 (4) the number of people who died due to using an
18 aid-in-dying drug, with demographic percentages organized
19 by the following characteristics:
20 (A) age at death;
21 (B) education level;
22 (C) race;
23 (D) gender;
24 (E) type of insurance, including whether the
25 patient had insurance;
26 (F) underlying illness; and
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1 (G) enrollment in hospice.
2 (f) Except as otherwise required by law, the information
3 collected by the Department is not a public record and is not
4 available for public inspection.
5 (g) Willful failure or refusal to timely submit records
6 required under this Act may result in disciplinary action.
7 Section 75. Effect on construction of wills, contracts,
8 and statutes.
9 (a) No provision in a contract, will, or other agreement,
10 whether written or oral, that would determine whether a
11 patient may make or rescind a request pursuant to this Act is
12 valid.
13 (b) No obligation owing under any contract that is in
14 effect on the effective date of this Act shall be conditioned
15 or affected by a patient's act of making or rescinding a
16 request pursuant to this Act.
17 (c) It is unlawful for an insurer to deny or alter health
18 care benefits otherwise available to a patient with a terminal
19 disease based on the availability of aid-in-dying care or
20 otherwise attempt to coerce a patient with a terminal disease
21 to make a request for aid-in-dying medication.
22 Section 80. Insurance or annuity policies.
23 (a) The sale, procurement, or issuance of a life, health,
24 or accident insurance policy, annuity policy, or the rate
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1 charged for a policy shall not be conditioned upon or affected
2 by a patient's act of making or rescinding a request for
3 medication pursuant to this Act.
4 (b) A qualified patient's act of self-administering
5 medication pursuant to this Act does not invalidate any part
6 of a life, health, or accident insurance, or annuity policy.
7 (c) An insurance plan, including medical assistance under
8 Article V of the Illinois Public Aid Code, shall not deny or
9 alter benefits to a patient with a terminal disease who is a
10 covered beneficiary of a health insurance plan, based on the
11 availability of aid-in-dying care, their request for
12 medication pursuant to this Act, or the absence of a request
13 for medication pursuant to this Act. Failure to meet this
14 requirement shall constitute a violation of the Illinois
15 Insurance Code.
16 Section 85. Death certificate.
17 (a) Unless otherwise prohibited by law, the attending
18 physician may sign the death certificate of a qualified
19 patient who obtained and self-administered a prescription for
20 medication pursuant to this Act.
21 (b) When a death has occurred in accordance with this Act,
22 the death shall be attributed to the underlying terminal
23 disease.
24 (1) Death following self-administering medication
25 under this Act does not alone constitute grounds for
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1 postmortem inquiry.
2 (2) Death in accordance with this Act shall not be
3 designated a suicide or homicide.
4 (c) A qualified patient's act of self-administering
5 medication prescribed pursuant to this Act shall not be
6 indicated on the death certificate.
7 Section 90. Liabilities and penalties.
8 (a) Nothing in this Act limits civil or criminal liability
9 arising from:
10 (1) Intentionally or knowingly altering or forging a
11 patient's request for medication pursuant to this Act or
12 concealing or destroying a rescission of a request for
13 medication pursuant to this Act.
14 (2) Intentionally or knowingly coercing or exerting
15 undue influence on a patient with a terminal disease to
16 request medication pursuant to this Act or to request or
17 use or not use medication pursuant to this Act.
18 (3) Intentional misconduct by a health care
19 professional or health care entity.
20 (b) The penalties specified in this Act do not preclude
21 criminal penalties applicable under other laws for conduct
22 inconsistent with this Act.
23 (c) As used in this Section, "intentionally" and
24 "knowingly" have the meanings provided in Sections 4-4 and 4-5
25 of the Criminal Code of 2012.
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1 Section 95. Construction.
2 (a) Nothing in this Act authorizes a physician or any
3 other person, including the qualified patient, to end the
4 qualified patient's life by lethal injection, lethal infusion,
5 mercy killing, homicide, murder, manslaughter, euthanasia, or
6 any other criminal act.
7 (b) Actions taken in accordance with this Act do not, for
8 any purposes, constitute suicide, assisted suicide,
9 euthanasia, mercy killing, homicide, murder, manslaughter,
10 elder abuse or neglect, or any other civil or criminal
11 violation under the law.
12 Section 100. Severability. The provisions of this Act are
13 severable under Section 1.31 of the Statute on Statutes.
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