| 1 | 1 | | FIRSTREGULARSESSION |
|---|
| 2 | 2 | | HOUSEBILLNO.453 |
|---|
| 3 | 3 | | 103RDGENERALASSEMBLY |
|---|
| 4 | 4 | | INTRODUCEDBYREPRESENTATIVEMACKEY. |
|---|
| 5 | 5 | | 0343H.01I DANARADEMANMILLER,ChiefClerk |
|---|
| 6 | 6 | | ANACT |
|---|
| 7 | 7 | | Toamendchapters191and565,RSMo,byaddingtheretotwenty-sevennewsectionsrelating |
|---|
| 8 | 8 | | topatient-directedcareattheendoflife. |
|---|
| 9 | 9 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
|---|
| 10 | 10 | | SectionA.Chapters191and565,RSMo,areamendedbyaddingtheretotwenty- |
|---|
| 11 | 11 | | 2sevennewsections,tobeknownassections191.2400,191.2405,191.2410,191.2415, |
|---|
| 12 | 12 | | 3191.2420,191.2425,191.2430,191.2435,191.2440,191.2445,191.2450,191.2455, |
|---|
| 13 | 13 | | 4191.2460,191.2465,191.2470,191.2475,191.2480,191.2485,191.2490,191.2495, |
|---|
| 14 | 14 | | 5191.2496,191.2500,191.2505,191.2510,191.2515,191.2520,and565.017,toreadas |
|---|
| 15 | 15 | | 6follows: |
|---|
| 16 | 16 | | 191.2400.Sections191.2400to191.2520shallbeknownandmaybecitedasthe |
|---|
| 17 | 17 | | 2"MarilynTeitelbaumDeathwithDignityAct". |
|---|
| 18 | 18 | | 191.2405.Asusedinsections191.2400to191.2520,unlessthecontextotherwise |
|---|
| 19 | 19 | | 2indicates,thefollowingtermsmean: |
|---|
| 20 | 20 | | 3 (1)"Adult",apersonwhoiseighteenyearsofageorolder; |
|---|
| 21 | 21 | | 4 (2)"Attendingphysician",thephysicianwhohasprimaryresponsibilityforthe |
|---|
| 22 | 22 | | 5careofapatientandthetreatmentofthatpatient'sterminaldisease; |
|---|
| 23 | 23 | | 6 (3)"Competent",intheopinionofacourtorintheopinionofthepatient's |
|---|
| 24 | 24 | | 7attendingphysicianorconsultingphysician,psychiatrist,orpsychologist,apatienthas |
|---|
| 25 | 25 | | 8theabilitytomakeandcommunicateaninformeddecisiontohealthcareproviders, |
|---|
| 26 | 26 | | 9includingcommunicationthroughpersonsfamiliarwiththepatient'smannerof |
|---|
| 27 | 27 | | 10communicatingifthosepersonsareavailable; |
|---|
| 28 | 28 | | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
|---|
| 29 | 29 | | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 11 (4)"Consultingphysician",aphysicianwhoisqualifiedbyspecialtyor |
|---|
| 30 | 30 | | 12experiencetomakeaprofessionaldiagnosisandprognosisregardingapatient'sdisease; |
|---|
| 31 | 31 | | 13 (5)"Counseling",oneormoreconsultationsbetweenastate-licensed |
|---|
| 32 | 32 | | 14psychiatrist,state-licensedpsychologist,state-licensedclinicalsocialworker,orstate- |
|---|
| 33 | 33 | | 15licensedclinicalprofessionalcounselorandapatientforthepurposeofdeterminingthat |
|---|
| 34 | 34 | | 16thepatientiscompetentandnotsufferingfromapsychiatricorpsychologicaldisorder |
|---|
| 35 | 35 | | 17ordepressionthatsoimpairsjudgmentastopreventthepatient'sinformeddecision; |
|---|
| 36 | 36 | | 18 (6)"Healthcareprovider",thesamemeaninggiventotheterminsection |
|---|
| 37 | 37 | | 19376.1350andincludesanypersonlicensed,certified,orotherwisepermittedbylawto |
|---|
| 38 | 38 | | 20dispensemedicationintheordinarycourseofbusinessorpracticeofaprofession; |
|---|
| 39 | 39 | | 21 (7)"Informeddecision",adecisionbyaqualifiedpatienttorequestandobtaina |
|---|
| 40 | 40 | | 22prescriptionformedicationthatthequalifiedpatientmayself-administertoendthe |
|---|
| 41 | 41 | | 23qualifiedpatient'slifeinahumaneanddignifiedmannerthatisbasedonan |
|---|
| 42 | 42 | | 24appreciationoftherelevantfactsandthatismadeafterbeingfullyinformedbythe |
|---|
| 43 | 43 | | 25attendingphysicianof: |
|---|
| 44 | 44 | | 26 (a)Thequalifiedpatient'smedicaldiagnosis; |
|---|
| 45 | 45 | | 27 (b)Thequalifiedpatient'sprognosis; |
|---|
| 46 | 46 | | 28 (c)Thepotentialrisksassociatedwithtakingthemedicationtobeprescribed; |
|---|
| 47 | 47 | | 29 (d)Theprobableresultoftakingthemedicationtobeprescribed;and |
|---|
| 48 | 48 | | 30 (e)Thefeasiblealternativestotakingthemedicationtobeprescribed,including |
|---|
| 49 | 49 | | 31palliativecareandcomfortcare,hospicecare,paincontrol,anddisease-directed |
|---|
| 50 | 50 | | 32treatmentoptions; |
|---|
| 51 | 51 | | 33 (8)"Medicallyconfirmed",themedicalopinionofanattendingphysicianhas |
|---|
| 52 | 52 | | 34beenconfirmedbyaconsultingphysicianwhohasexaminedthepatientandthe |
|---|
| 53 | 53 | | 35patient'srelevantmedicalrecords; |
|---|
| 54 | 54 | | 36 (9)"Patient",anadultwhoisunderthecareofaphysician; |
|---|
| 55 | 55 | | 37 (10)"Physician",adoctorofmedicineorosteopathylicensedtopractice |
|---|
| 56 | 56 | | 38medicineinthisstate; |
|---|
| 57 | 57 | | 39 (11)"Qualifiedpatient",acompetentadultwhoisaresidentofthisstateand |
|---|
| 58 | 58 | | 40whohassatisfiedtherequirementsofsections191.2400to191.2520inordertoobtaina |
|---|
| 59 | 59 | | 41prescriptionformedicationthatthequalifiedpatientmayself-administertoendthe |
|---|
| 60 | 60 | | 42qualifiedpatient'slifeinahumaneanddignifiedmanner; |
|---|
| 61 | 61 | | 43 (12)"Self-administer",foraqualifiedpatient,tovoluntarilyandconsciously |
|---|
| 62 | 62 | | 44performthephysicalactofingestingorotherwiseadministeringtohimselforherselfthe |
|---|
| 63 | 63 | | 45medicationtoendthequalifiedpatient'sownlife; |
|---|
| 64 | 64 | | HB453 2 46 (13)"Terminaldisease",anincurableandirreversiblediseasethathasbeen |
|---|
| 65 | 65 | | 47medicallyconfirmedandwill,withinreasonablemedicaljudgment,producedeath |
|---|
| 66 | 66 | | 48withinsixmonths. |
|---|
| 67 | 67 | | 191.2410.Apatienthasarighttoinformationregardingalltreatmentoptions |
|---|
| 68 | 68 | | 2reasonablyavailableforthecareofthepatient,including,butnotlimitedto, |
|---|
| 69 | 69 | | 3informationinresponsetospecificquestionsabouttheforeseeablerisksandbenefitsof |
|---|
| 70 | 70 | | 4medication,withoutaphysicianwithholdingrequestedinformationregardlessofthe |
|---|
| 71 | 71 | | 5purposeofthequestionsorthenatureoftheinformation. |
|---|
| 72 | 72 | | 191.2415.Anadultwhoiscompetent,isaresidentofthisstate,hasbeen |
|---|
| 73 | 73 | | 2determinedbyanattendingphysicianandaconsultingphysiciantobesufferingfroma |
|---|
| 74 | 74 | | 3terminaldisease,andhasvoluntarilyexpressedthewishtodiemaymakeawritten |
|---|
| 75 | 75 | | 4requestformedicationthattheadultmayself-administerinaccordancewithsections |
|---|
| 76 | 76 | | 5191.2400to191.2520.Anadultdoesnotqualifyundersections191.2400to191.2520 |
|---|
| 77 | 77 | | 6solelybecauseofageordisability. |
|---|
| 78 | 78 | | 191.2420.1.Avalidrequestformedicationundersections191.2400to191.2520 |
|---|
| 79 | 79 | | 2shallbesubstantiallyintheformdescribedinsection191.2515,signedanddatedbythe |
|---|
| 80 | 80 | | 3patient,andwitnessedbyatleasttwoindividualswho,inthepresenceofthepatient, |
|---|
| 81 | 81 | | 4attestthattothebestoftheirknowledgeandbeliefthepatientiscompetent,isacting |
|---|
| 82 | 82 | | 5voluntarily,andisnotbeingcoercedtosigntherequest. |
|---|
| 83 | 83 | | 6 2.(1)Thelanguageofawrittenrequestformedicationundersections191.2400 |
|---|
| 84 | 84 | | 7to191.2520shallbethelanguageinwhichanyconversationsorconsultationsor |
|---|
| 85 | 85 | | 8interpretedconversationsorconsultationsbetweenapatientandthepatient'sattending |
|---|
| 86 | 86 | | 9physicianorconsultingphysicianareheld. |
|---|
| 87 | 87 | | 10 (2)Notwithstandingsubdivision(1)ofthissubsection,thelanguageofawritten |
|---|
| 88 | 88 | | 11requestformedicationundersections191.2400to191.2520maybeEnglishwhenthe |
|---|
| 89 | 89 | | 12conversationsorconsultationsorinterpretedconversationsorconsultationsbetweena |
|---|
| 90 | 90 | | 13patientandthepatient'sattendingphysicianorconsultingphysicianwereconductedin |
|---|
| 91 | 91 | | 14alanguageotherthanEnglishiftheformdescribedinsection191.2515containsthe |
|---|
| 92 | 92 | | 15attachmentdescribedinsection191.2520. |
|---|
| 93 | 93 | | 16 3.Atleastoneofthetwoormorewitnessesrequiredunderthissectionandany |
|---|
| 94 | 94 | | 17interpreterrequiredunderthissectionshallbeapersonwhoisnot: |
|---|
| 95 | 95 | | 18 (1)Arelativeofthepatientbyblood,marriage,oradoption; |
|---|
| 96 | 96 | | 19 (2)Apersonwhoatthetimetherequestissignedwouldbeentitledtoany |
|---|
| 97 | 97 | | 20portionoftheestateofthequalifiedpatientupondeath,underanywill,trust,transfer |
|---|
| 98 | 98 | | 21ondeathelection,beneficiarydesignation,orotherwisebyoperationofanylaw;or |
|---|
| 99 | 99 | | 22 (3)Anowner,operator,oremployeeofahealthcarefacilitywherethequalified |
|---|
| 100 | 100 | | 23patientisreceivingmedicaltreatmentorisaresident. |
|---|
| 101 | 101 | | HB453 3 24 4.Thepatient'sattendingphysicianatthetimethewrittenrequestissigned |
|---|
| 102 | 102 | | 25shallnotbeawitness. |
|---|
| 103 | 103 | | 26 5.Ifthepatientisapatientinalong-termcarefacilityatthetimethepatient |
|---|
| 104 | 104 | | 27makesthewrittenrequest,oneofthewitnessesshallbeanindividualdesignatedbythe |
|---|
| 105 | 105 | | 28facilitywhohasthequalificationsspecifiedbythedepartmentofhealthandsenior |
|---|
| 106 | 106 | | 29servicesbyrule. |
|---|
| 107 | 107 | | 191.2425.Theattendingphysicianshall: |
|---|
| 108 | 108 | | 2 (1)Maketheinitialdeterminationofwhetherapatienthasaterminaldisease,is |
|---|
| 109 | 109 | | 3competent,andhasmadethewrittenrequestundersection191.2415voluntarily; |
|---|
| 110 | 110 | | 4 (2)Requestthatthepatientdemonstratestateresidencyasrequiredbysection |
|---|
| 111 | 111 | | 5191.2470; |
|---|
| 112 | 112 | | 6 (3)Toensurethatthepatientismakinganinformeddecision,informthepatient |
|---|
| 113 | 113 | | 7of: |
|---|
| 114 | 114 | | 8 (a)Thepatient'smedicaldiagnosis; |
|---|
| 115 | 115 | | 9 (b)Thepatient'sprognosis; |
|---|
| 116 | 116 | | 10 (c)Thepotentialrisksassociatedwithtakingthemedicationtobeprescribed; |
|---|
| 117 | 117 | | 11 (d)Theprobableresultoftakingthemedicationtobeprescribed;and |
|---|
| 118 | 118 | | 12 (e)Thefeasiblealternativestotakingthemedicationtobeprescribed,including |
|---|
| 119 | 119 | | 13palliativecareandcomfortcare,hospicecare,paincontrol,anddisease-directed |
|---|
| 120 | 120 | | 14treatmentoptions; |
|---|
| 121 | 121 | | 15 (4)Referthepatienttoaconsultingphysicianformedicalconfirmationofthe |
|---|
| 122 | 122 | | 16diagnosisandforadeterminationthatthepatientiscompetentandactingvoluntarily; |
|---|
| 123 | 123 | | 17 (5)Confirmthatthepatient'srequestdoesnotarisefromcoercionorundue |
|---|
| 124 | 124 | | 18influencebyanotherindividualbydiscussingwiththepatient,outsidethepresenceof |
|---|
| 125 | 125 | | 19anyotherindividual,exceptforaninterpreter,whetherthepatientisfeelingcoercedor |
|---|
| 126 | 126 | | 20undulyinfluenced; |
|---|
| 127 | 127 | | 21 (6)Referthepatientforcounseling,ifappropriate,asdescribedinsection |
|---|
| 128 | 128 | | 22191.2435; |
|---|
| 129 | 129 | | 23 (7)Recommendthatthepatientnotifythepatient'snextofkin; |
|---|
| 130 | 130 | | 24 (8)Counselthepatientabouttheimportanceofhavinganotherpersonpresent |
|---|
| 131 | 131 | | 25whenthepatienttakesthemedicationprescribedundersections191.2400to191.2520 |
|---|
| 132 | 132 | | 26andcounselthepatientaboutnottakingthemedicationprescribedundersections |
|---|
| 133 | 133 | | 27191.2400to191.2520inapublicplace; |
|---|
| 134 | 134 | | 28 (9)Informthepatientthatthepatienthasanopportunitytorescindtherequest |
|---|
| 135 | 135 | | 29atanytimeandinanymannerandofferthepatientanopportunitytorescindthe |
|---|
| 136 | 136 | | 30requestattheendofthefifteen-daywaitingperiodinaccordancewithsection191.2450; |
|---|
| 137 | 137 | | HB453 4 31 (10)Verify,immediatelybeforewritingtheprescriptionformedicationunder |
|---|
| 138 | 138 | | 32sections191.2400to191.2520,thatthepatientismakinganinformeddecision; |
|---|
| 139 | 139 | | 33 (11)Fulfillthemedicalrecorddocumentationrequirementsofsection191.2465; |
|---|
| 140 | 140 | | 34 (12)Ensurethatallappropriatestepsarecarriedoutinaccordancewithsections |
|---|
| 141 | 141 | | 35191.2400to191.2520beforewritingaprescriptionformedicationtoenableaqualified |
|---|
| 142 | 142 | | 36patienttoendthequalifiedpatient'slifeinahumaneanddignifiedmanner;and |
|---|
| 143 | 143 | | 37 (13)Dispensemedicationsdirectly,includingancillarymedicationsintendedto |
|---|
| 144 | 144 | | 38minimizethepatient'sdiscomfort,iftheattendingphysicianisauthorizedunderstate |
|---|
| 145 | 145 | | 39laworruletodispensemedicationsandhasacurrentDrugEnforcement |
|---|
| 146 | 146 | | 40Administrationcertificateor,withthepatient'swrittenconsent: |
|---|
| 147 | 147 | | 41 (a)Contactapharmacistandinformthepharmacistoftheprescription;and |
|---|
| 148 | 148 | | 42 (b)Deliverthewrittenprescriptionpersonally,bymail,orelectronicallytothe |
|---|
| 149 | 149 | | 43pharmacist,whomaydispensethemedicationsinpersontothepatient,theattending |
|---|
| 150 | 150 | | 44physician,oranexpresslyidentifiedagentofthepatient. |
|---|
| 151 | 151 | | 191.2430.Beforeapatientisdeterminedtobeaqualifiedpatientundersections |
|---|
| 152 | 152 | | 2191.2400to191.2520,aconsultingphysicianshallexaminethepatientandthepatient's |
|---|
| 153 | 153 | | 3relevantmedicalrecordsandconfirm,inwriting,theattendingphysician'sdiagnosis |
|---|
| 154 | 154 | | 4thatthepatientissufferingfromaterminaldiseaseandverifythatthepatientis |
|---|
| 155 | 155 | | 5competent,isactingvoluntarily,andhasmadeaninformeddecision. |
|---|
| 156 | 156 | | 191.2435.If,intheopinionoftheattendingphysicianortheconsulting |
|---|
| 157 | 157 | | 2physician,apatientmaybesufferingfromapsychiatricorpsychologicaldisorderor |
|---|
| 158 | 158 | | 3depressioncausingimpairedjudgment,thephysicianshallreferthepatientfor |
|---|
| 159 | 159 | | 4counseling.Medicationforthepatienttoself-administertoendthepatient'sownlifein |
|---|
| 160 | 160 | | 5ahumaneanddignifiedmannershallnotbeprescribeduntilthepersonperformingthe |
|---|
| 161 | 161 | | 6counselingdeterminesthatthepatientisnotsufferingfromapsychiatricor |
|---|
| 162 | 162 | | 7psychologicaldisorderordepressionthatsoimpairsjudgmentastopreventthe |
|---|
| 163 | 163 | | 8patient'sinformeddecision. |
|---|
| 164 | 164 | | 191.2440.Aqualifiedpatientshallnotreceiveaprescriptionformedication |
|---|
| 165 | 165 | | 2undersections191.2400to191.2520unlessthequalifiedpatienthasmadeaninformed |
|---|
| 166 | 166 | | 3decision.Immediatelybeforewritingaprescriptionformedicationundersections |
|---|
| 167 | 167 | | 4191.2400to191.2520,theattendingphysicianshallverifythatthequalifiedpatientis |
|---|
| 168 | 168 | | 5makinganinformeddecision. |
|---|
| 169 | 169 | | 191.2445.Apatientwhodeclinesorisunabletonotifythepatient'snextofkin |
|---|
| 170 | 170 | | 2shallnothavethepatient'srequestformedicationdeniedforthatreason. |
|---|
| 171 | 171 | | 191.2450.Toreceiveaprescriptionformedicationthatthequalifiedpatientmay |
|---|
| 172 | 172 | | 2self-administerundersections191.2400to191.2520,aqualifiedpatientshallmakean |
|---|
| 173 | 173 | | 3oralrequestandawrittenrequestandreiteratetheoralrequesttothequalified |
|---|
| 174 | 174 | | HB453 5 4patient'sattendingphysicianatleastfifteendaysaftermakingtheinitialoralrequest. |
|---|
| 175 | 175 | | 5Atthetimethequalifiedpatientmakesthequalifiedpatient'ssecondoralrequest,the |
|---|
| 176 | 176 | | 6attendingphysicianshallofferthequalifiedpatientanopportunitytorescindthe |
|---|
| 177 | 177 | | 7request. |
|---|
| 178 | 178 | | 191.2455.Apatientmayrescindthepatient'srequestatanytimeandinany |
|---|
| 179 | 179 | | 2mannerwithoutregardtothepatient'smentalstate.Aprescriptionformedicationshall |
|---|
| 180 | 180 | | 3notbewrittenundersections191.2400to191.2520withouttheattendingphysician |
|---|
| 181 | 181 | | 4offeringthequalifiedpatientanopportunitytorescindtherequest. |
|---|
| 182 | 182 | | 191.2460.Atleastfifteendaysarerequiredtoelapsebetweenthepatient'sinitial |
|---|
| 183 | 183 | | 2oralrequestandthedatethepatientsignsthewrittenrequestundersection191.2450. |
|---|
| 184 | 184 | | 3Atleastforty-eighthoursarerequiredtoelapsebetweenthedatethepatientsignsthe |
|---|
| 185 | 185 | | 4writtenrequestandthewritingofaprescriptionundersections191.2400to191.2520. |
|---|
| 186 | 186 | | 191.2465.Thefollowingshallbedocumentedorfiledinapatient'smedical |
|---|
| 187 | 187 | | 2record: |
|---|
| 188 | 188 | | 3 (1)Alloralrequestsbythepatientformedicationtoendthatpatient'slifeina |
|---|
| 189 | 189 | | 4humaneanddignifiedmanner; |
|---|
| 190 | 190 | | 5 (2)Allwrittenrequestsbythepatientformedicationtoendthatpatient'slifein |
|---|
| 191 | 191 | | 6ahumaneanddignifiedmanner; |
|---|
| 192 | 192 | | 7 (3)Theattendingphysician'sdiagnosisandprognosisandtheattending |
|---|
| 193 | 193 | | 8physician'sdeterminationthatthepatientiscompetent,isactingvoluntarily,andhas |
|---|
| 194 | 194 | | 9madeaninformeddecision; |
|---|
| 195 | 195 | | 10 (4)Theconsultingphysician'sdiagnosisandprognosisandtheconsulting |
|---|
| 196 | 196 | | 11physician'sverificationthatthepatientiscompetent,isactingvoluntarily,andhasmade |
|---|
| 197 | 197 | | 12aninformeddecision; |
|---|
| 198 | 198 | | 13 (5)Areportoftheoutcomeanddeterminationsmadeduringcounseling,if |
|---|
| 199 | 199 | | 14counselingisprovidedasdescribedinsection191.2435; |
|---|
| 200 | 200 | | 15 (6)Theattendingphysician'soffertothepatienttorescindthepatient'srequest |
|---|
| 201 | 201 | | 16atthetimeofthepatient'ssecondoralrequestundersection191.2450;and |
|---|
| 202 | 202 | | 17 (7)Anotebytheattendingphysicianindicatingthatallrequirementsunder |
|---|
| 203 | 203 | | 18sections191.2400to191.2520havebeenmet,includingtherequirementsofsection |
|---|
| 204 | 204 | | 19191.2425,andindicatingthestepstakentocarryoutthepatient'srequest,includinga |
|---|
| 205 | 205 | | 20notationofthemedicationprescribed. |
|---|
| 206 | 206 | | 191.2470.Forpurposesofsections191.2400to191.2520,onlyrequestsmadeby |
|---|
| 207 | 207 | | 2residentsofthisstateshallbegranted.Theresidenceofapersonisthatplacewherethe |
|---|
| 208 | 208 | | 3personhasestablishedafixedandprincipalhometowhichtheperson,whenever |
|---|
| 209 | 209 | | 4temporarilyabsent,intendstoreturn.Thefollowingfactorsmaybeofferedin |
|---|
| 210 | 210 | | HB453 6 5determiningaperson'sresidenceundersections191.2400to191.2520andneednotall |
|---|
| 211 | 211 | | 6bepresentinordertodetermineaperson'sresidence: |
|---|
| 212 | 212 | | 7 (1)Possessionofavaliddriver'slicenseissuedbythedepartmentofrevenue; |
|---|
| 213 | 213 | | 8 (2)Registrationtovoteinthisstate; |
|---|
| 214 | 214 | | 9 (3)Evidencethatthepersonownsorleasespropertyinthisstate; |
|---|
| 215 | 215 | | 10 (4)Thelocationofanydwellingcurrentlyoccupiedbytheperson; |
|---|
| 216 | 216 | | 11 (5)Theplacewhereanymotorvehicleownedbythepersonisregistered; |
|---|
| 217 | 217 | | 12 (6)Theresidenceaddress,notapostofficebox,shownonacurrentincometax |
|---|
| 218 | 218 | | 13return; |
|---|
| 219 | 219 | | 14 (7)Theresidenceaddress,notapostofficebox,atwhichtheperson'smailis |
|---|
| 220 | 220 | | 15received; |
|---|
| 221 | 221 | | 16 (8)Theresidenceaddress,notapostofficebox,shownonanycurrentresident |
|---|
| 222 | 222 | | 17huntingorfishinglicensesheldbytheperson; |
|---|
| 223 | 223 | | 18 (9)Theresidenceaddress,notapostofficebox,shownonanydriver'slicense |
|---|
| 224 | 224 | | 19heldbytheperson; |
|---|
| 225 | 225 | | 20 (10)Thereceiptofanypublicbenefitconditioneduponresidency,defined |
|---|
| 226 | 226 | | 21substantiallyasprovidedinthissection;or |
|---|
| 227 | 227 | | 22 (11)Anyotherobjectivefactstendingtoindicateaperson'splaceofresidence. |
|---|
| 228 | 228 | | 191.2475.Apersonwhohascustodyoforcontroloveranyunusedmedications |
|---|
| 229 | 229 | | 2prescribedinaccordancewithsections191.2400to191.2520afterthedeathofthe |
|---|
| 230 | 230 | | 3qualifiedpatientshallpersonallydelivertheunusedmedicationstothenearestfacility |
|---|
| 231 | 231 | | 4qualifiedtodisposeofcontrolledsubstancesor,ifsuchdeliveryisimpracticable, |
|---|
| 232 | 232 | | 5personallydisposeoftheunusedmedicationsbyanylawfulmeans,inaccordancewith |
|---|
| 233 | 233 | | 6anyguidelinesadoptedbythedepartmentofhealthandseniorservices. |
|---|
| 234 | 234 | | 191.2480.1.Thedepartmentofhealthandseniorservicesshallannuallyreview |
|---|
| 235 | 235 | | 2allrecordsmaintainedundersections191.2400to191.2520. |
|---|
| 236 | 236 | | 3 2.(1)Thedepartmentofhealthandseniorservicesshallrequireanyhealthcare |
|---|
| 237 | 237 | | 4provideruponwritingaprescriptionordispensingmedicationundersections191.2400 |
|---|
| 238 | 238 | | 5to191.2520tofileacopyoftheprescriptionordispensingrecord,andother |
|---|
| 239 | 239 | | 6documentationrequiredundersection191.2465associatedwithwritingtheprescription |
|---|
| 240 | 240 | | 7ordispensingthemedication,withthedepartment. |
|---|
| 241 | 241 | | 8 (2)Documentationrequiredtobefiledunderthissubsectionshallbemailedor |
|---|
| 242 | 242 | | 9otherwisetransmittedasallowedbyrulesofthedepartmentnolaterthanthirty |
|---|
| 243 | 243 | | 10calendardaysafterthewritingoftheprescriptionorthedispensingofmedicationunder |
|---|
| 244 | 244 | | 11sections191.2400to191.2520,exceptthatalldocumentsrequiredtobefiledwiththe |
|---|
| 245 | 245 | | 12departmentbytheprescribingphysicianafterthedeathofthequalifiedpatientshallbe |
|---|
| 246 | 246 | | HB453 7 13submittednolaterthanthirtycalendardaysafterthedateofthedeathofthequalified |
|---|
| 247 | 247 | | 14patient. |
|---|
| 248 | 248 | | 15 (3)Intheeventthatapersonrequiredundersections191.2400to191.2520to |
|---|
| 249 | 249 | | 16reportinformationtothedepartmentprovidesaninadequateorincompletereport,the |
|---|
| 250 | 250 | | 17departmentshallcontactthepersontorequestanadequateorcompletereport. |
|---|
| 251 | 251 | | 18 3.Thedepartmentofhealthandseniorservicesshallpromulgaterulesto |
|---|
| 252 | 252 | | 19facilitatethecollectionofinformationregardingcompliancewithsections191.2400to |
|---|
| 253 | 253 | | 20191.2520.Exceptasotherwiseprovidedbylaw,theinformationcollectedisconfidential, |
|---|
| 254 | 254 | | 21isnotapublicrecord,andshallnotbemadeavailableforinspectionbythepublic. |
|---|
| 255 | 255 | | 22 4.Thedepartmentofhealthandseniorservicesshallgenerateandmake |
|---|
| 256 | 256 | | 23availabletothepublicanannualstatisticalreportofinformationcollectedunderthis |
|---|
| 257 | 257 | | 24sectionandsubmitacopyofthereporttothestandingcommitteesofthehouseof |
|---|
| 258 | 258 | | 25representativesandthesenatehavingjurisdictionoverhealthmattersannuallyby |
|---|
| 259 | 259 | | 26Marchfirst. |
|---|
| 260 | 260 | | 27 5.Inadditiontotherulesrequiredtobepromulgatedunderthissection,the |
|---|
| 261 | 261 | | 28departmentofhealthandseniorservicesshallpromulgateallnecessaryrulesforthe |
|---|
| 262 | 262 | | 29administrationofsections191.2400to191.2520.Anyruleorportionofarule,asthat |
|---|
| 263 | 263 | | 30termisdefinedinsection536.010,thatiscreatedundertheauthoritydelegatedinthis |
|---|
| 264 | 264 | | 31sectionshallbecomeeffectiveonlyifitcomplieswithandissubjecttoallofthe |
|---|
| 265 | 265 | | 32provisionsofchapter536and,ifapplicable,section536.028.Thissectionandchapter |
|---|
| 266 | 266 | | 33536arenonseverableandifanyofthepowersvestedwiththegeneralassembly |
|---|
| 267 | 267 | | 34pursuanttochapter536toreview,todelaytheeffectivedate,ortodisapproveandannul |
|---|
| 268 | 268 | | 35arulearesubsequentlyheldunconstitutional,thenthegrantofrulemakingauthority |
|---|
| 269 | 269 | | 36andanyruleproposedoradoptedafterAugust28,2025,shallbeinvalidandvoid. |
|---|
| 270 | 270 | | 191.2485.Anyprovisioninacontract,will,orotheragreement,whetherwritten |
|---|
| 271 | 271 | | 2ororal,totheextenttheprovisionwouldaffectwhetherapersonmaymakeorrescinda |
|---|
| 272 | 272 | | 3requestformedicationtoendtheperson'slifeinahumaneanddignifiedmanner,isnot |
|---|
| 273 | 273 | | 4valid.Anyobligationowingunderanycurrentlyexistingcontractshallnotbe |
|---|
| 274 | 274 | | 5conditioneduponoraffectedbythemakingorrescindingofarequestbyapersonfor |
|---|
| 275 | 275 | | 6medicationtoendtheperson'slifeinahumaneanddignifiedmanner. |
|---|
| 276 | 276 | | 191.2490.Thesale,procurement,orissuanceofanylife,health,oraccident |
|---|
| 277 | 277 | | 2insuranceorannuitypolicyortheratechargedforanylife,health,oraccident |
|---|
| 278 | 278 | | 3insuranceorannuitypolicyshallnotbeconditioneduponoraffectedbythemakingor |
|---|
| 279 | 279 | | 4rescindingofarequestbyaqualifiedpatientformedicationthatthepatientmayself- |
|---|
| 280 | 280 | | 5administertoendthepatient'slifeinaccordancewithsections191.2400to191.2520.A |
|---|
| 281 | 281 | | 6qualifiedpatientwhoselifeisinsuredunderalifeinsurancepolicyissuedbyinsurers |
|---|
| 282 | 282 | | 7organizedunderchapter376andthebeneficiariesofthepolicyshallnotbedenied |
|---|
| 283 | 283 | | HB453 8 8benefitsonthebasisofself-administrationofmedicationbythequalifiedpatientin |
|---|
| 284 | 284 | | 9accordancewithsections191.2400to191.2520.Therating,sale,procurement,or |
|---|
| 285 | 285 | | 10issuanceofanymedicalprofessionalliabilityinsurancepolicydeliveredorissuedfor |
|---|
| 286 | 286 | | 11deliveryinthisstateshallbeinaccordancewiththeinsurancelawsofthisstate. |
|---|
| 287 | 287 | | 191.2495.Sections191.2400to191.2520donotauthorizeaphysicianorany |
|---|
| 288 | 288 | | 2otherpersontoendapatient'slifebylethalinjection,mercykilling,oractive |
|---|
| 289 | 289 | | 3euthanasia.Actionstakeninaccordancewithsections191.2400to191.2520donot,for |
|---|
| 290 | 290 | | 4anypurpose,constitutesuicide,assistedsuicide,mercykilling,orhomicideunderthe |
|---|
| 291 | 291 | | 5law.Statereportsshallnotrefertoactscommittedundersections191.2400to191.2520 |
|---|
| 292 | 292 | | 6as"suicide"or"assistedsuicide".Consistentwiththeprovisionsofsections191.2400to |
|---|
| 293 | 293 | | 7191.2520,statereportsshallrefertoactscommittedundersections191.2400to191.2520 |
|---|
| 294 | 294 | | 8asobtainingandself-administeringlife-endingmedication.Nothingcontainedin |
|---|
| 295 | 295 | | 9sections191.2400to191.2520shallbeinterpretedtolowertheapplicablestandardof |
|---|
| 296 | 296 | | 10carefortheattendingphysician,theconsultingphysician,apsychiatrist,apsychologist, |
|---|
| 297 | 297 | | 11orotherhealthcareproviderprovidingservicesundersections191.2400to191.2520. |
|---|
| 298 | 298 | | 191.2496.1.Asusedinthissection,theterm"coveredindividual"meansa |
|---|
| 299 | 299 | | 2healthcareprovider,physician,psychiatrist,psychologist,clinicalsocialworker, |
|---|
| 300 | 300 | | 3professionalcounselor,pharmacist,pharmacist'sassistant,patient,witness,orfamily |
|---|
| 301 | 301 | | 4memberorfriendofapatient. |
|---|
| 302 | 302 | | 5 2.Anycoveredindividualwhoispresentduring,hasknowledgeof,performs,or |
|---|
| 303 | 303 | | 6engagesinanyoftheactivitiesdescribedinsections191.2400to191.2520shallnot,on |
|---|
| 304 | 304 | | 7accountofsuchactivities,besubjecttoanycivilorcriminalliability,professional |
|---|
| 305 | 305 | | 8discipline,orotherpenaltyofanynaturesolongassuchcoveredindividualisactingin |
|---|
| 306 | 306 | | 9goodfaithandisnotguiltyofwillfulmisconductorgrossnegligence. |
|---|
| 307 | 307 | | 191.2500.Nothinginsections191.2400to191.2520requiresahealthcare |
|---|
| 308 | 308 | | 2providertoprovidemedicationtoaqualifiedpatienttoendthequalifiedpatient'slife. |
|---|
| 309 | 309 | | 3Ifahealthcareproviderisunableorunwillingtocarryoutthequalifiedpatient's |
|---|
| 310 | 310 | | 4requestundersections191.2400to191.2520,thehealthcareprovidershalltransferany |
|---|
| 311 | 311 | | 5relevantmedicalrecordsforthepatienttoanewhealthcareprovideruponrequestby |
|---|
| 312 | 312 | | 6thepatient. |
|---|
| 313 | 313 | | 191.2505.1.Asusedinthissection,unlessthecontextotherwiseindicates,the |
|---|
| 314 | 314 | | 2followingtermsmean: |
|---|
| 315 | 315 | | 3 (1)"Notice",aseparatestatementinwritingadvisingoftheprohibitinghealth |
|---|
| 316 | 316 | | 4careprovider'spolicywithrespecttoparticipatinginactivitiesundersections191.2400 |
|---|
| 317 | 317 | | 5to191.2520; |
|---|
| 318 | 318 | | HB453 9 6 (2)"Participating,orenteringintoanagreementtoparticipate,inactivities |
|---|
| 319 | 319 | | 7undersections191.2400to191.2520",doingorenteringintoanagreementtodoanyone |
|---|
| 320 | 320 | | 8ormoreofthefollowing: |
|---|
| 321 | 321 | | 9 (a)Performingthedutiesofanattendingphysicianasspecifiedinsections |
|---|
| 322 | 322 | | 10191.2400to191.2520; |
|---|
| 323 | 323 | | 11 (b)Performingthedutiesofaconsultingphysicianasspecifiedinsections |
|---|
| 324 | 324 | | 12191.2400to191.2520; |
|---|
| 325 | 325 | | 13 (c)Performingthedutiesofastate-licensedpsychiatrist,state-licensed |
|---|
| 326 | 326 | | 14psychologist,state-licensedclinicalsocialworker,orstate-licensedclinicalprofessional |
|---|
| 327 | 327 | | 15counselor,inthecircumstancethatareferraltooneismadeundersection191.2435; |
|---|
| 328 | 328 | | 16 (d)Deliveringtheprescriptionfor,dispensing,ordeliveringthedispensed |
|---|
| 329 | 329 | | 17medicationinaccordancewithsections191.2400to191.2520;or |
|---|
| 330 | 330 | | 18 (e)Beingpresentwhenthequalifiedpatienttakesthemedicationprescribedin |
|---|
| 331 | 331 | | 19accordancewithsections191.2400to191.2520. |
|---|
| 332 | 332 | | 20 |
|---|
| 333 | 333 | | 21"Participating,orenteringintoanagreementtoparticipate,inactivitiesundersections |
|---|
| 334 | 334 | | 22191.2400to191.2520"doesnotincludedoing,orenteringintoanagreementtodo,any |
|---|
| 335 | 335 | | 23ofthefollowing:diagnosingwhetherapatienthasaterminaldisease;informingthe |
|---|
| 336 | 336 | | 24patientofthemedicalprognosisordeterminingwhetherapatienthasthecapacityto |
|---|
| 337 | 337 | | 25makedecisions;providinginformationtoapatientaboutsections191.2400to191.2520; |
|---|
| 338 | 338 | | 26orprovidingapatient,uponthepatient'srequest,withareferraltoanotherhealthcare |
|---|
| 339 | 339 | | 27providerforthepurposesofparticipatingintheactivitiesauthorizedbysections |
|---|
| 340 | 340 | | 28191.2400to191.2520. |
|---|
| 341 | 341 | | 29 2.Theprovisionsofthissectiongovernthebasisforprohibitingpersonsor |
|---|
| 342 | 342 | | 30entitiesfromparticipatinginactivitiesundersections191.2400to191.2520,notification, |
|---|
| 343 | 343 | | 31penalties,andpermissibleactions. |
|---|
| 344 | 344 | | 32 3.Subjecttocompliancewithsubsection4ofthissectionandnotwithstanding |
|---|
| 345 | 345 | | 33anyotherlaw,ahealthcareprovidermayprohibititsemployees,independent |
|---|
| 346 | 346 | | 34contractors,orotherpersonsorentities,includingotherhealthcareproviders,from |
|---|
| 347 | 347 | | 35participatinginactivitiesundersections191.2400to191.2520whileonpremisesowned |
|---|
| 348 | 348 | | 36orunderthemanagementordirectcontrolofthatprohibitinghealthcareprovideror |
|---|
| 349 | 349 | | 37whileactingwithinthecourseandscopeofanyemploymentby,orcontractwith,the |
|---|
| 350 | 350 | | 38prohibitinghealthcareprovider. |
|---|
| 351 | 351 | | 39 4.Ahealthcareproviderthatelectstoprohibititsemployees,independent |
|---|
| 352 | 352 | | 40contractors,orotherpersonsorentities,includingotherhealthcareproviders,from |
|---|
| 353 | 353 | | 41participatinginactivitiesundersections191.2400to191.2520,asdescribedinsubsection |
|---|
| 354 | 354 | | 423ofthissection,shallfirstgivenoticeofthepolicyprohibitingparticipationunder |
|---|
| 355 | 355 | | HB453 10 43sections191.2400to191.2520tothoseemployees,independentcontractors,orother |
|---|
| 356 | 356 | | 44personsorentities,includingotherhealthcareproviders.Ahealthcareproviderthat |
|---|
| 357 | 357 | | 45failstoprovidenoticetothoseemployees,independentcontractors,orotherpersonsor |
|---|
| 358 | 358 | | 46entities,includingotherhealthcareproviders,incompliancewiththissubsectionshall |
|---|
| 359 | 359 | | 47notenforcesuchapolicyagainstthoseemployees,independentcontractors,orother |
|---|
| 360 | 360 | | 48personsorentities,includingotherhealthcareproviders. |
|---|
| 361 | 361 | | 49 5.Subjecttocompliancewithsubsection4ofthissection,theprohibitinghealth |
|---|
| 362 | 362 | | 50careprovidermaytakeaction,including,butnotlimitedto,thefollowing,asapplicable, |
|---|
| 363 | 363 | | 51againstanemployee,independentcontractor,orotherpersonorentity,including |
|---|
| 364 | 364 | | 52anotherhealthcareprovider,thatviolatesthehealthcareprovider'spolicyprohibiting |
|---|
| 365 | 365 | | 53participationinactivitiesundersections191.2400to191.2520: |
|---|
| 366 | 366 | | 54 (1)Lossofprivileges,lossofmembership,orotheractionauthorizedbythe |
|---|
| 367 | 367 | | 55bylawsorrulesandregulationsofthemedicalstaff; |
|---|
| 368 | 368 | | 56 (2)Suspension,lossofemployment,orotheractionauthorizedbythepolicies |
|---|
| 369 | 369 | | 57andpracticesoftheprohibitinghealthcareprovider; |
|---|
| 370 | 370 | | 58 (3)Terminationofanyleaseorothercontractbetweentheprohibitinghealth |
|---|
| 371 | 371 | | 59careproviderandtheemployee,independentcontractor,orotherpersonorentity, |
|---|
| 372 | 372 | | 60includinganotherhealthcareprovider,thatviolatesthepolicy;or |
|---|
| 373 | 373 | | 61 (4)Impositionofanyothernonmonetaryremedyprovidedforinanyleaseor |
|---|
| 374 | 374 | | 62contractbetweentheprohibitinghealthcareproviderandtheemployee,independent |
|---|
| 375 | 375 | | 63contractor,orotherpersonorentity,includinganotherhealthcareprovider,inviolation |
|---|
| 376 | 376 | | 64ofthepolicy. |
|---|
| 377 | 377 | | 65 6.Nothinginthissectionshallbeconstruedtoprevent,ortoallowaprohibiting |
|---|
| 378 | 378 | | 66healthcareprovidertoprohibit,anemployee,independentcontractor,orotherperson |
|---|
| 379 | 379 | | 67orentity,includinganotherhealthcareprovider,fromanyofthefollowing: |
|---|
| 380 | 380 | | 68 (1)Participating,orenteringintoanagreementtoparticipate,inactivitiesunder |
|---|
| 381 | 381 | | 69sections191.2400to191.2520whileonpremisesthatarenotownedorunderthe |
|---|
| 382 | 382 | | 70managementordirectcontroloftheprohibitinghealthcareproviderorwhileacting |
|---|
| 383 | 383 | | 71outsidethecourseandscopeoftheparticipant'sdutiesasanemployeeof,oran |
|---|
| 384 | 384 | | 72independentcontractorfor,theprohibitinghealthcareprovider;or |
|---|
| 385 | 385 | | 73 (2)Participating,orenteringintoanagreementtoparticipate,inactivitiesunder |
|---|
| 386 | 386 | | 74sections191.2400to191.2520asanattendingphysicianorconsultingphysicianwhileon |
|---|
| 387 | 387 | | 75premisesthatarenotownedorunderthemanagementordirectcontrolofthe |
|---|
| 388 | 388 | | 76prohibitinghealthcareprovider. |
|---|
| 389 | 389 | | 77 7.Intakingactionsundersubsection5ofthissection,ahealthcareprovider |
|---|
| 390 | 390 | | 78shallcomplywithallproceduresrequiredbylaw,itsownpoliciesorprocedures,and |
|---|
| 391 | 391 | | HB453 11 79anycontractwiththeemployee,independentcontractor,orotherpersonorentity, |
|---|
| 392 | 392 | | 80includinganotherhealthcareprovider,inviolationofthepolicy,asapplicable. |
|---|
| 393 | 393 | | 81 8.Anyactiontakenbyaprohibitinghealthcareproviderunderthissectionis |
|---|
| 394 | 394 | | 82notreportabletotheappropriatelicensingboardincluding,butnotlimitedto,thestate |
|---|
| 395 | 395 | | 83boardofregistrationforthehealingartsandthestateboardofpharmacy.Thefactthat |
|---|
| 396 | 396 | | 84ahealthcareproviderparticipatesinactivitiesundersections191.2400to191.2520shall |
|---|
| 397 | 397 | | 85notbethesolebasisforacomplaintorreportbyanotherhealthcareprovidertothe |
|---|
| 398 | 398 | | 86appropriatelicensingboardincluding,butnotlimitedto,thestateboardofregistration |
|---|
| 399 | 399 | | 87forthehealingartsandthestateboardofpharmacy. |
|---|
| 400 | 400 | | 191.2510.Anygovernmentalentitythatincurscostsresultingfromaperson |
|---|
| 401 | 401 | | 2endingtheperson'slifeundersections191.2400to191.2520inapublicplacehasaclaim |
|---|
| 402 | 402 | | 3againsttheestateofthepersontorecoverthecostsandreasonableattorney'sfees |
|---|
| 403 | 403 | | 4relatedtoenforcingtheclaim. |
|---|
| 404 | 404 | | 191.2515.Arequestformedicationasauthorizedbysections191.2400to |
|---|
| 405 | 405 | | 2191.2520shallbeinsubstantiallythefollowingform: |
|---|
| 406 | 406 | | 3 REQUESTFORMEDICATIONTOENDMYLIFEINA |
|---|
| 407 | 407 | | 4 HUMANEANDDIGNIFIEDMANNER |
|---|
| 408 | 408 | | 5 I,______,amanadultofsoundmind.Iamsufferingfrom_____ |
|---|
| 409 | 409 | | 6 _,whichmyattendingphysicianhasdeterminedisaterminal |
|---|
| 410 | 410 | | 7 diseaseandwhichhasbeenmedicallyconfirmedbyaconsulting |
|---|
| 411 | 411 | | 8 physician. |
|---|
| 412 | 412 | | 9 Ihavebeenfullyinformedofmydiagnosisandprognosis,the |
|---|
| 413 | 413 | | 10 natureofmedicationtobeprescribedandpotentialassociated |
|---|
| 414 | 414 | | 11 risks,theexpectedresult,andfeasiblealternatives,including |
|---|
| 415 | 415 | | 12 palliativecareandcomfortcare,hospicecare,paincontrol,and |
|---|
| 416 | 416 | | 13 disease-directedtreatmentoptions. |
|---|
| 417 | 417 | | 14 IrequestthatmyattendingphysicianprescribemedicationthatI |
|---|
| 418 | 418 | | 15 mayself-administertoendmylifeinahumaneanddignified |
|---|
| 419 | 419 | | 16 mannerandcontactanypharmacisttofilltheprescription. |
|---|
| 420 | 420 | | 17 INITIALONE: |
|---|
| 421 | 421 | | 18 ______Ihaveinformedmyfamilyofmydecisionandtakentheir |
|---|
| 422 | 422 | | 19 opinionsintoconsideration. |
|---|
| 423 | 423 | | 20 ______Ihavedecidednottoinformmyfamilyofmydecision. |
|---|
| 424 | 424 | | HB453 12 21 ______Ihavenofamilytoinformofmydecision. |
|---|
| 425 | 425 | | 22 IunderstandthatIhavetherighttorescindthisrequestatany |
|---|
| 426 | 426 | | 23 time. |
|---|
| 427 | 427 | | 24 Iunderstandthefullimportofthisrequest,andIexpecttodie |
|---|
| 428 | 428 | | 25 whenItakethemedicationtobeprescribed.Ifurther |
|---|
| 429 | 429 | | 26 understandthat,althoughmostdeathsoccurwithinthreehours, |
|---|
| 430 | 430 | | 27 mydeathmaytakelonger,andmyphysicianhascounseledme |
|---|
| 431 | 431 | | 28 aboutthispossibility. |
|---|
| 432 | 432 | | 29 Imakethisrequestvoluntarilyandwithoutreservation,andI |
|---|
| 433 | 433 | | 30 acceptfullmoralresponsibilityformyactions. |
|---|
| 434 | 434 | | 31 Signed:__________________ |
|---|
| 435 | 435 | | 32 Dated:__________________ |
|---|
| 436 | 436 | | 33 DECLARATIONOFWITNESSES |
|---|
| 437 | 437 | | 34 Byinitialingandsigningbelowonorafterthedatetheperson |
|---|
| 438 | 438 | | 35 namedabovesigns,wedeclarethatthepersonmakingand |
|---|
| 439 | 439 | | 36 signingtheaboverequest: |
|---|
| 440 | 440 | | 37 InitialsofWitness1: |
|---|
| 441 | 441 | | 38 ______1.Ispersonallyknowntousorhasprovidedproofof |
|---|
| 442 | 442 | | 39 identity; |
|---|
| 443 | 443 | | 40 ______2.Signedthisrequestinourpresenceonthedateofthe |
|---|
| 444 | 444 | | 41 person'ssignature; |
|---|
| 445 | 445 | | 42 ______3.Appearstobeofsoundmindandnotunderduress, |
|---|
| 446 | 446 | | 43 fraud,orundueinfluence;and |
|---|
| 447 | 447 | | 44 ______4.Isnotapatientforwhomeitherofusistheattending |
|---|
| 448 | 448 | | 45 physician. |
|---|
| 449 | 449 | | 46 PrintedNameofWitness1:__________________ |
|---|
| 450 | 450 | | 47 SignatureofWitness1/Date:__________________ |
|---|
| 451 | 451 | | HB453 13 48 InitialsofWitness2: |
|---|
| 452 | 452 | | 49 ______1.Ispersonallyknowntousorhasprovidedproofof |
|---|
| 453 | 453 | | 50 identity; |
|---|
| 454 | 454 | | 51 ______2.Signedthisrequestinourpresenceonthedateofthe |
|---|
| 455 | 455 | | 52 person'ssignature; |
|---|
| 456 | 456 | | 53 ______3.Appearstobeofsoundmindandnotunderduress, |
|---|
| 457 | 457 | | 54 fraud,orundueinfluence;and |
|---|
| 458 | 458 | | 55 ______4.Isnotapatientforwhomeitherofusistheattending |
|---|
| 459 | 459 | | 56 physician. |
|---|
| 460 | 460 | | 57 PrintedNameofWitness2:__________________ |
|---|
| 461 | 461 | | 58 SignatureofWitness2/Date:__________________ |
|---|
| 462 | 462 | | 59 NOTE:Onewitnessmustbeapersonwhoisnotarelativeby |
|---|
| 463 | 463 | | 60 blood,marriage,oradoptionofthepersonsigningthisrequest,is |
|---|
| 464 | 464 | | 61 notentitledtoanyportionoftheperson'sestateupondeath,and |
|---|
| 465 | 465 | | 62 doesnotownoroperateorisnotemployedatahealthcare |
|---|
| 466 | 466 | | 63 facilitywherethepersonisapatientorresident.Theperson's |
|---|
| 467 | 467 | | 64 attendingphysicianatthetimetherequestissignedmaynotbea |
|---|
| 468 | 468 | | 65 witness.Ifthepersonisaninpatientatalong-termcarefacility, |
|---|
| 469 | 469 | | 66 oneofthewitnessesmustbeanindividualdesignatedbythe |
|---|
| 470 | 470 | | 67 facility. |
|---|
| 471 | 471 | | 191.2520.Theformofanattachmentforpurposesofprovidinginterpretive |
|---|
| 472 | 472 | | 2servicesasdescribedinsubsection2ofsection191.2420shallbeinsubstantiallythe |
|---|
| 473 | 473 | | 3followingform: |
|---|
| 474 | 474 | | 4 I,______,amfluentinEnglishand(languageofpatient). |
|---|
| 475 | 475 | | 5 On(date)atapproximately(time)Ireadthe"REQUESTFOR |
|---|
| 476 | 476 | | 6 MEDICATIONTOENDMYLIFEINAHUMANEAND |
|---|
| 477 | 477 | | 7 DIGNIFIEDMANNER"to(nameofpatient)in(languageof |
|---|
| 478 | 478 | | 8 patient). |
|---|
| 479 | 479 | | 9 Mr./Ms.(nameofpatient)affirmedtomethathe/sheunderstands |
|---|
| 480 | 480 | | 10 thecontentofthisform,thathe/shedesirestosignthisform |
|---|
| 481 | 481 | | HB453 14 11 underhis/herownpowerandvolitionandthathe/sherequested |
|---|
| 482 | 482 | | 12 tosigntheformafterconsultationswithanattendingphysician |
|---|
| 483 | 483 | | 13 andaconsultingphysician. |
|---|
| 484 | 484 | | 14 Underpenaltyofperjury,IdeclarethatIamfluentinEnglish |
|---|
| 485 | 485 | | 15 and(languageofpatient)andthatthecontentsofthisform,tothe |
|---|
| 486 | 486 | | 16 bestofmyknowledge,aretrueandcorrect. |
|---|
| 487 | 487 | | 17 Executedat(nameofcity,county,andstate)on(date). |
|---|
| 488 | 488 | | 18 Interpreter'ssignature:__________________ |
|---|
| 489 | 489 | | 19 Interpreter'sprintedname:__________________ |
|---|
| 490 | 490 | | 20 Interpreter'saddress:__________________ |
|---|
| 491 | 491 | | 565.017.Itshallbeanaffirmativedefensetoprosecutionsundersections |
|---|
| 492 | 492 | | 2565.020,565.021,and565.023thattheperson'sconductwasexpresslyauthorizedby |
|---|
| 493 | 493 | | 3sections191.2400to191.2520. |
|---|
| 494 | 494 | | âś” |
|---|
| 495 | 495 | | HB453 15 |
|---|