Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S1331 Compare Versions

Only one version of the bill is available at this time.

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2	2	SENATE DOCKET, NO. 265 FILED ON: 1/12/2023
3	3	SENATE . . . . . . . . . . . . . . No. 1331
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Joanne M. Comerford
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act relative to end of life options.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Joanne M. ComerfordHampshire, Franklin and WorcesterAnne M. GobiWorcester and Hampshire1/18/2023Mindy Domb3rd Hampshire1/18/2023Jack Patrick Lewis7th Middlesex1/20/2023Rebecca L. RauschNorfolk, Worcester and Middlesex1/24/2023Thomas M. Stanley9th Middlesex1/26/2023Jacob R. OliveiraHampden, Hampshire and Worcester1/27/2023Michael J. BarrettThird Middlesex1/27/2023Susan L. MoranPlymouth and Barnstable1/27/2023William N. BrownsbergerSuffolk and Middlesex1/27/2023Patricia D. JehlenSecond Middlesex1/30/2023Jason M. LewisFifth Middlesex1/30/2023John F. KeenanNorfolk and Plymouth2/2/2023Brian M. Ashe2nd Hampden2/6/2023Paul W. MarkBerkshire, Hampden, Franklin and
16	16	Hampshire
17	17	2/6/2023James B. EldridgeMiddlesex and Worcester2/9/2023Cynthia Stone CreemNorfolk and Middlesex2/14/2023 2 of 2
18	18	Adam Scanlon14th Bristol2/15/2023James J. O'Day14th Worcester2/15/2023Julian CyrCape and Islands2/22/2023Paul R. FeeneyBristol and Norfolk3/1/2023Edward R. Philips8th Norfolk3/3/2023Mark C. MontignySecond Bristol and Plymouth3/9/2023 1 of 18
19	19	SENATE DOCKET, NO. 265 FILED ON: 1/12/2023
20	20	SENATE . . . . . . . . . . . . . . No. 1331
21	21	By Ms. Comerford, a petition (accompanied by bill, Senate, No. 1331) of Joanne M. Comerford,
22	22	Anne M. Gobi, Mindy Domb, Jack Patrick Lewis and other members of the General Court for
23	23	legislation relative to end of life options. Public Health.
24	24	[SIMILAR MATTER FILED IN PREVIOUS SESSION
25	25	SEE SENATE, NO. 1384 OF 2021-2022.]
26	26	The Commonwealth of Massachusetts
27	27	_______________
28	28	In the One Hundred and Ninety-Third General Court
29	29	(2023-2024)
30	30	_______________
31	31	An Act relative to end of life options.
32	32	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
33	33	of the same, as follows:
34	34	1 The General Laws are hereby amended by inserting after Chapter 201F the following
35	35	2chapter:-
36	36	3 CHAPTER 201G
37	37	4 MASSACHUSETTS END OF LIFE OPTIONS ACT
38	38	5 Section 1. For the purposes of this chapter, the following terms shall have the following
39	39	6meanings unless the context clearly requires otherwise:
40	40	7 “Adult”, an individual who is 18 years of age or older. 2 of 18
41	41	8 “Attending physician”, a physician who has primary responsibility for the care of the
42	42	9patient and treatment of the patient’s terminal disease.
43	43	10 “Consulting physician”, a physician who is qualified by specialty or experience to make a
44	44	11professional diagnosis and prognosis regarding a terminally ill patient’s condition.
45	45	12 “Counseling”, one or more consultations as necessary between a licensed mental health
46	46	13care professional and a patient for the purpose of determining that the patient is capable and not
47	47	14suffering from a psychiatric or psychological disorder or depression causing impaired judgment.
48	48	15 “Guardian”, an individual who has qualified as a guardian of an incapacitated person
49	49	16pursuant to court appointment and includes a limited guardian, special guardian and temporary
50	50	17guardian, but excludes one who is merely a guardian ad litem as defined in section 5-101 of
51	51	18article V of chapter 190B. Guardianship shall not include a health care proxy as defined by
52	52	19chapter 201D.
53	53	20 “Health care provider”, an individual licensed, certified, or otherwise authorized or
54	54	21permitted by law to diagnose and treat medical conditions, and prescribe and dispense
55	55	22medication, including controlled substances.
56	56	23 “Incapacitated person”, an individual who for reasons other than advanced age or being a
57	57	24minor, has a clinically diagnosed condition that results in an inability to receive and evaluate
58	58	25information or make or communicate decisions to such an extent that the individual lacks the
59	59	26ability to meet essential requirements for physical health, safety, or self-care, even with
60	60	27appropriate technological assistance. An “incapacitated person” shall be defined consistent with
61	61	28the definition of an individual described in section 5-101 of article V of chapter 190B. 3 of 18
62	62	29 “Informed decision”, a decision by a mentally capable individual to request and obtain a
63	63	30prescription for medication pursuant to this chapter that the individual may self-administer to
64	64	31bring about a peaceful death, after being fully informed by the attending physician and
65	65	32consulting physician of:
66	66	33 (a) The individual’s diagnosis and prognosis;
67	67	34 (b) The potential risk associated with taking the medication to be prescribed;
68	68	35 (c) The probable result of taking the medication to be prescribed;
69	69	36 (d) The feasible end-of-life care and treatment options for the individual’s terminal
70	70	37disease, including but not limited to comfort care, palliative care, hospice care and pain control,
71	71	38and the risks and benefits of each as defined in section 227 of chapter 111; and
72	72	39 (e) The individual’s right to withdraw a request pursuant to this chapter, or consent for
73	73	40any other treatment, at any time.
74	74	41 ”Licensed mental health care professional”, a treatment provider who is a psychiatrist,
75	75	42psychologist, psychiatric social worker or psychiatric nurse and others who by virtue of
76	76	43education, credentials, and experience are permitted by law to evaluate and care for the mental
77	77	44health needs of patients.
78	78	45 “Medical aid in dying”, the practice of evaluating a request, determining qualification,
79	79	46performing the duties in sections 6, 7 and 8, and providing a prescription to a qualified individual
80	80	47pursuant to this chapter. 4 of 18
81	81	48 “Medically confirmed,” the medical opinion of the attending physician has been
82	82	49confirmed by a consulting physician who has examined the patient and the patient’s relevant
83	83	50medical records.
84	84	51 “Medication”, aid in dying medication.
85	85	52 “Mentally capable”, in the opinion of the attending physician or licensed mental health
86	86	53care professional, the individual requesting medication pursuant to this chapter has the ability to
87	87	54make and communicate an informed decision.
88	88	55 “Palliative care”, a health care treatment as defined in section 227 of chapter 111,
89	89	56including interdisciplinary end-of-life care and consultation with patients and family members, to
90	90	57prevent or relieve pain and suffering and to enhance the patient’s quality of life, including
91	91	58hospice.
92	92	59 “Patient”, an individual who has received health care services from a health care provider
93	93	60for treatment of a medical condition.
94	94	61 “Physician”, a doctor of medicine or osteopathy licensed to practice medicine in
95	95	62Massachusetts by the board of registration in medicine.
96	96	63 “Qualified patient”, a mentally capable adult who is a resident of Massachusetts, has been
97	97	64diagnosed as being terminally ill, and has satisfied the requirements of this chapter.
98	98	65 “Resident”, an individual who demonstrates residency in Massachusetts by presenting
99	99	66one form of identification which may include but is not limited to:
100	100	67 (a) possession of a Massachusetts driver’s license; 5 of 18
101	101	68 (b) proof of registration to vote in Massachusetts;
102	102	69 (c) proof that the individual owns or leases real property in Massachusetts;
103	103	70 (d) proof that the individual has resided in a Massachusetts health care facility for at least
104	104	713 months;
105	105	72 (e) computer-generated bill from a bank or mortgage company, utility company, doctor,
106	106	73or hospital;
107	107	74 (f) a W-2 form, property or excise tax bill, or Social Security Administration or other
108	108	75pension or retirement annual benefits summary statement dated within the current or prior year;
109	109	76 (g) a MassHealth or Medicare benefit statement; or
110	110	77 (h) filing of a Massachusetts tax return for the most recent tax year.
111	111	78 “Self-administer”, a qualified patient’s act of ingesting medication obtained under this
112	112	79chapter.
113	113	80 “Terminally ill”, having a terminal illness or condition which can reasonably be expected
114	114	81to cause death within 6 months, whether or not treatment is provided.
115	115	82 Section 2. (a) A patient wishing to receive a prescription for medication under this
116	116	83chapter shall make an oral request to the patient's attending physician. No less than 15 days after
117	117	84making the request the patient shall submit a written request to the patient's attending physician
118	118	85in substantially the form set in section 4. 6 of 18
119	119	86 (b) A terminally ill patient may voluntarily make an oral request for medical aid in dying
120	120	87and a prescription for medication that the patient can choose to self-administer to bring about a
121	121	88peaceful death if the patient:
122	122	89 (1) is a mentally capable adult;
123	123	90 (2) is a resident of Massachusetts; and
124	124	91 (3) has been determined by the patient’s attending physician to be terminally ill.
125	125	92 (c) A patient may provide a written request for medical aid in dying and a prescription for
126	126	93medication that the patient can choose to self-administer to bring about a peaceful death if the
127	127	94patient:
128	128	95 (1) has met the requirements in subsection (b);
129	129	96 (2) has been determined by a consulting physician to be terminally ill; and
130	130	97 (3) has had no less than 15 days pass after making the oral request.
131	131	98 (d) A patient shall not qualify under this chapter if the patient has a guardian.
132	132	99 (e) A patient shall not qualify under this chapter solely because of age or disability.
133	133	100 Section 3. (a) A valid written request must be witnessed by at least two individuals who,
134	134	101in the presence of the patient, attest that to the best of their knowledge and belief that patient is:
135	135	102 (1) personally known to the witnesses or has provided proof of identity;
136	136	103 (2) acting voluntarily; and
137	137	104 (3) not being coerced to sign the request. 7 of 18
138	138	105 (b) At least one of the witnesses shall be an individual who is not:
139	139	106 (1) a relative of the patient by blood, marriage, or adoption;
140	140	107 (2) an individual who at the time the request is signed would be entitled to any portion of
141	141	108the estate of the qualified patient upon death under any will or by operation of law;
142	142	109 (3) financially responsible for the medical care of the patient; or
143	143	110 (4) an owner, operator, or employee of a health care facility where the qualified patient is
144	144	111receiving medical treatment or is a resident.
145	145	112 (c) The patient's attending physician at the time the request is signed shall not serve as a
146	146	113witness.
147	147	114 (d) If the patient is a patient in a long-term care facility at the time the written request is
148	148	115made, one of the witnesses shall be an individual designated by the facility.
149	149	116 Section 4.
150	150	117 REQUEST FOR MEDICAL AID IN DYING MEDICATION PURSUANT TO THE
151	151	118MASSACHUSETTS END OF LIFE OPTIONS ACT
152	152	119 I,. . . . . . . . . . . . . . . , am an adult of sound mind and a resident of the State of
153	153	120Massachusetts. I am suffering from . . . . . . . . . . . . . . , which my attending physician has
154	154	121determined is a terminal illness or condition which can reasonably be expected to cause death
155	155	122within 6 months. This diagnosis has been medically confirmed as required by law.
156	156	123 I have been fully informed of my diagnosis, prognosis, the nature of the medical aid in
157	157	124dying medication to be prescribed and potential associated risks, the expected result, and the 8 of 18
158	158	125feasible alternatives and additional treatment opportunities, including, but not limited to, comfort
159	159	126care, palliative care, hospice care, and pain control.
160	160	127 I request that my attending physician prescribe medical aid in dying medication that will
161	161	128end my life in a peaceful manner if I choose to take it, and I authorize my attending physician to
162	162	129contact any pharmacist to fill the prescription.
163	163	130 I understand that I have the right to rescind this request at any time. I understand the full
164	164	131import of this request and I expect to die if I take the medical aid in dying medication to be
165	165	132prescribed. I further understand that although most deaths occur within three hours, my death
166	166	133may take longer and my physician has counseled me about this possibility. I make this request
167	167	134voluntarily, without reservation, and without being coerced, and I accept full responsibility for
168	168	135my actions.
169	169	136 Signed:. . . . . . . . . . . . . . . Dated:. . . . . . . . . . . . . .
170	170	137 DECLARATION OF WITNESSES
171	171	138 By signing below, on the date the patient named above signs, we declare that the patient
172	172	139making and signing the above request is personally known to us or has provided proof of
173	173	140identity, and appears not to be under duress, fraud, or undue influence.
174	174	141 Printed Name of Witness 1: . . . . . . . . . . . . . . .
175	175	142 Signature of Witness l/Date:. . . . . . . . . . . . . . .
176	176	143 Printed Name of Witness 2:. . . . . . . . . . . . . . .
177	177	144 Signature of Witness 2/Date:. . . . . . . . . . . . . . . 9 of 18
178	178	145 Section 5. (a) A qualified patient may at any time rescind the request for medication
179	179	146under this chapter without regard to the qualified patient's mental state.
180	180	147 (b) A prescription for medication under this chapter may not be written without the
181	181	148attending physician offering the qualified patient an opportunity to rescind the request for
182	182	149medication.
183	183	150 Section 6. (a) The attending physician shall:
184	184	151 (1) make the initial determination of whether an adult patient:
185	185	152 (i) is a resident of this state;
186	186	153 (ii) is terminally ill;
187	187	154 (iii) is mentally capable; and
188	188	155 (iv) has voluntarily made the request for medical aid in dying.
189	189	156 (2) ensure that the patient is making an informed decision by discussing with the patient:
190	190	157 (i) the patient’s medical diagnosis;
191	191	158 (ii) the patient’s prognosis;
192	192	159 (iii) the potential risks associated with taking the medication to be prescribed;
193	193	160 (iv) the probable result of taking the medication to be prescribed; and
194	194	161 (v) the feasible alternatives and additional treatment opportunities, including, but not
195	195	162limited to, palliative care as defined in section 227 of chapter 111. 10 of 18
196	196	163 (3) refer the patient to a consulting physician to medically confirm the diagnosis and
197	197	164prognosis and for a determination that the patient is mentally capable and is acting voluntarily;
198	198	165 (4) refer the patient for counseling pursuant to section 8;
199	199	166 (5) ensure that sections 6 through 8, inclusive, are followed in chronological order;
200	200	167 (6) have a prior clinical relationship with the patient, unless the patient’s primary care
201	201	168physician is unwilling to participate;
202	202	169 (7) recommend that the patient notify the patient's family or any person who plays a
203	203	170significant role in an individual’s life;
204	204	171 (8) recommend that the patient complete a Medical Order for Life-Sustaining Treatment
205	205	172form;
206	206	173 (9) counsel the patient about the importance of:
207	207	174 (i) having another individual present when the patient takes the medication prescribed
208	208	175under this chapter; and
209	209	176 (ii) not taking the medication in a public place;
210	210	177 (10) inform the patient that the patient may rescind the request for medication at any time
211	211	178and in any manner;
212	212	179 (11) verify, immediately prior to writing the prescription for medication, that the patient
213	213	180is making an informed decision;
214	214	181 (12) educate the patient on how to self-administer the medication; 11 of 18
215	215	182 (13) fulfill the medical record documentation requirements of section 13;
216	216	183 (14) ensure that all appropriate steps are carried out in accordance with this chapter
217	217	184before writing a prescription for medication for a qualified patient; and
218	218	185 (15) (i) dispense medications directly, including ancillary medications intended to
219	219	186facilitate the desired effect to minimize the patient's discomfort, if the attending physician is
220	220	187authorized under law to dispense and has a current drug enforcement administration certificate;
221	221	188or
222	222	189 (ii) with the qualified patient’s written consent;
223	223	190 (A) contact a pharmacist, inform the pharmacist of the prescription, and
224	224	191 (B) deliver the written prescription personally, by mail, or by otherwise permissible
225	225	192electronic communication to the pharmacist, who will dispense the medications directly to either
226	226	193the patient, the attending physician, or an expressly identified agent of the patient. Medications
227	227	194dispensed pursuant to this paragraph shall not be dispensed by mail or other form of courier.
228	228	195 (b) The attending physician may sign the patient's death certificate which shall list the
229	229	196underlying terminal disease as the cause of death.
230	230	197 Section 7. (a) Before a patient may be considered a qualified patient under this chapter
231	231	198the consulting physician shall:
232	232	199 (1) examine the patient and the patient's relevant medical records;
233	233	200 (2) confirm in writing the attending physician's diagnosis that the patient is suffering
234	234	201from a terminal illness; and 12 of 18
235	235	202 (3) verify that the patient:
236	236	203 (i) is mentally capable;
237	237	204 (ii) is acting voluntarily; and
238	238	205 (iii) has made an informed decision.
239	239	206 Section 8. (a) An attending physician shall refer a patient who has requested medical aid
240	240	207in dying medication under this chapter to counseling to determine that the patient is not suffering
241	241	208from a psychiatric or psychological disorder or depression causing impaired judgment. The
242	242	209licensed mental health professional shall review the medical history of the patient relevant to the
243	243	210patient’s current mental health and then shall submit a final written report to the prescribing
244	244	211physician.
245	245	212 (b) The medical aid in dying medication may not be prescribed until the individual
246	246	213performing the counseling determines that:
247	247	214 (1) the patient is not suffering from a psychiatric or psychological disorder or depression
248	248	215causing impaired judgment; and
249	249	216 (2) there is no reason to suspect coercion in the patient’s decision-making process.
250	250	217 Section 9. A qualified patient may not receive a prescription for medical aid in dying
251	251	218medication pursuant to this chapter unless the patient has made an informed decision.
252	252	219Immediately before issuing a prescription for medical aid in dying medication under this chapter
253	253	220the attending physician shall verify that the qualified patient is making an informed decision. 13 of 18
254	254	221 Section 10. The attending physician shall recommend that a patient notify the patient's
255	255	222family or any person who plays a significant role in an individual’s life of the patient's request
256	256	223for medical aid in dying medication pursuant to this chapter. A request for medical aid in dying
257	257	224medication shall not be denied because a patient declines or is unable to notify the family or any
258	258	225person who plays a significant role in an individual’s life.
259	259	226 Section 11. The following items shall be documented or filed in the patient's medical
260	260	227record:
261	261	228 (1) the determination and the basis for determining that a patient requesting medical aid
262	262	229in dying medication pursuant to this chapter is a qualified patient;
263	263	230 (2) all oral requests by a patient for medical aid in dying medication;
264	264	231 (3) all written requests by a patient for medical aid in dying medication made pursuant to
265	265	232sections 3 through 5, inclusive;
266	266	233 (4) the attending physician's diagnosis, prognosis, and determination that the patient is
267	267	234mentally capable, is acting voluntarily, and has made an informed decision;
268	268	235 (5) the consulting physician's diagnosis, prognosis, and verification that the patient is
269	269	236mentally capable, is acting voluntarily, and has made an informed decision;
270	270	237 (6) a report of the outcome and determinations made during counseling;
271	271	238 (7) the attending physician's offer before prescribing the medical aid in dying medication
272	272	239to allow the qualified patient to rescind the patient's request for the medication; 14 of 18
273	273	240 (8) other care options that were offered to the patient, including, but not limited to,
274	274	241hospice and palliative care; and
275	275	242 (9) a note by the attending physician indicating:
276	276	243 (a) that all requirements under this chapter have been met; and
277	277	244 (b) the steps taken to carry out the request, including a notation of the medication
278	278	245prescribed.
279	279	246 Section 12. Any medical aid in dying medication dispensed under this chapter that was
280	280	247not self-administered shall be disposed of by lawful means. The medication dispenser shall be
281	281	248responsible for informing the individual collecting the medication what disposal by lawful means
282	282	249entails.
283	283	250 Section 13. Physicians shall keep a record of the number of requests for medical aid in
284	284	251dying medication; number of prescriptions written; number of requests rescinded; the number of
285	285	252qualified patients that took the medication under this chapter; the general demographic and
286	286	253socioeconomic characteristics of the patient, and any physical disability of the patient. This data
287	287	254shall be reported to the department of public health annually, and shall subsequently be made
288	288	255available to the public.
289	289	256 Section 14. (a) Any provision in a contract, will, or other agreement, whether written or
290	290	257oral, to the extent the provision would affect whether a patient may make or rescind a request for
291	291	258medical aid in dying medication pursuant to this chapter, is not valid.
292	292	259 (b) A qualified patient's act of making or rescinding a request for medical aid in dying
293	293	260shall not provide the sole basis for the appointment of a guardian or conservator. 15 of 18
294	294	261 (c) A qualified patient’s act of self-administering medical aid in dying medication
295	295	262obtained pursuant to this act shall not constitute suicide or have an effect upon any life, health, or
296	296	263accident insurance or annuity policy.
297	297	264 (d) Actions taken by health care providers and patient advocates supporting a qualified
298	298	265patient exercising his or her rights pursuant to this chapter, including being present when the
299	299	266patient self-administers medical aid in dying medication, shall not for any purpose, constitute
300	300	267elder abuse, neglect, assisted suicide, mercy killing, or homicide under any civil or criminal law.
301	301	268 (e) State regulations, documents and reports shall not refer to the practice of medical aid
302	302	269in dying under this chapter as "suicide" or "assisted suicide."
303	303	270 Section 15. (a) A health care provider may choose not to practice medical aid in dying.
304	304	271 (b) A health care provider or professional organization or association may not subject an
305	305	272individual to censure, discipline, suspension, loss of license, loss of privileges, loss of
306	306	273membership, or other penalty for participating or refusing to participate in providing medical aid
307	307	274in dying medication to a qualified patient under this chapter.
308	308	275 (c) If a health care provider is unable or unwilling to carry out a patient's request under
309	309	276this chapter and the patient transfers care to a new health care provider, the prior health care
310	310	277provider shall transfer, upon request, a copy of the patient's relevant medical records to the new
311	311	278health care provider.
312	312	279 (d) (1) Health care providers shall maintain and disclose upon request their written
313	313	280policies outlining the extent to which they refuse to participate in providing to a qualified patient
314	314	281any medical aid in dying medication under this chapter. 16 of 18
315	315	282 (2) The required consumer disclosure shall at minimum:
316	316	283 (i) include information about this chapter;
317	317	284 (ii) identify the specific services in which the health care provider refuses to participate;
318	318	285 (iii) clarify any difference between institution-wide objections and those that may be
319	319	286raised by individual licensed providers who are employed or work on contract with the provider;
320	320	287 (iv) describe the mechanism the provider will use to provide patients a referral to another
321	321	288provider or provider in the provider’s service area who is willing to perform the specific health
322	322	289care service;
323	323	290 (v) describe the provider’s policies and procedures relating to transferring patients to
324	324	291other providers who will implement the health care decision; and
325	325	292 (vi) inform consumers that the cost of transferring records will be borne by the
326	326	293transferring provider.
327	327	294 (c) The consumer disclosure shall be provided to an individual upon request.
328	328	295 (d) A health care entity that prohibits health care providers from qualifying, prescribing,
329	329	296or dispensing medication pursuant to this chapter while they are performing duties for the entity
330	330	297shall provide notice of such policy to the public by posting the information on its website.
331	331	298 Section 16. (a) Purposely or knowingly altering or forging a request for medical aid in
332	332	299dying medication under this chapter without authorization of the patient or concealing or
333	333	300destroying a rescission of a request for medical aid in dying medication is punishable as a felony
334	334	301if the act is done with the intent or effect of causing the patient's death. 17 of 18
335	335	302 (b) An individual who coerces or exerts undue influence on a patient to request medical
336	336	303aid in dying medication, or to destroy a rescission of a request, shall be guilty of a felony
337	337	304punishable by imprisonment in the state prison for not more than 3 years or in the house of
338	338	305correction for not more than 2½ years or by a fine of not more than $1,000 or by both such fine
339	339	306and imprisonment.
340	340	307 (c) Nothing in this chapter limits further liability for civil damages resulting from other
341	341	308negligent conduct or intentional misconduct by any individual.
342	342	309 (d) The penalties in this chapter do not preclude criminal penalties applicable under other
343	343	310law for conduct inconsistent with the provisions of this chapter.
344	344	311 Section 17. A governmental entity that incurs costs resulting from a qualified patient self-
345	345	312administering medical aid in dying medication in a public place while acting pursuant to this
346	346	313chapter may submit a claim against the estate of the patient to recover costs and reasonable
347	347	314attorney fees related to enforcing the claim.
348	348	315 Section 18. If an emergency medical provider finds a patient who has self-administered
349	349	316medical aid in dying medication, they shall follow standard resuscitation protocol. If a Medical
350	350	317Order for Life-Sustaining Treatment or other legally recognized do-not-resuscitate order is
351	351	318found, then the medical provider shall follow the directives of the form.
352	352	319 Section 19. Nothing in this chapter may be construed to authorize a physician or any
353	353	320other individual to end a patient's life by lethal injection, mercy killing, assisted suicide, or active
354	354	321euthanasia. 18 of 18
355	355	322 Section 20. If any provision of this chapter or its application to any individual or
356	356	323circumstance is held invalid, the remainder of the act or the application of the provision to other
357	357	324individuals or circumstances is not affected.