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North Carolina House Bill H410

North Carolina 2025-2026 Regular Session

North Carolina House Bill H410 Compare Versions

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11 GENERAL ASSEMBLY OF NORTH CAROLINA
22 SESSION 2025
3-H 1
4-HOUSE BILL 410
3+H D
4+HOUSE BILL DRH10005-MGa-18
5+
56
67
78 Short Title: NCIOM Study/Medical Aid in Dying. (Public)
8-Sponsors: Representatives Harrison, Lambeth, Howard, and Prather (Primary Sponsors).
9-For a complete list of sponsors, refer to the North Carolina General Assembly web site.
10-Referred to: Rules, Calendar, and Operations of the House
11-March 18, 2025
12-*H410 -v-1*
9+Sponsors: Representative Harrison.
10+Referred to:
11+
12+*DRH10005 -MGa-18*
1313 A BILL TO BE ENTITLED 1
1414 AN ACT DIRECTING THE NORTH CAROLINA INSTITUTE OF MEDICINE TO STUDY 2
1515 THE LEGALIZATION OF MEDICAL AID IN DYING IN NORTH CAROLINA; AND 3
1616 APPROPRIATING FUNDS FOR THIS PURPOSE. 4
1717 Whereas, medical aid in dying (MAID) is a recognized end-of-life (EOL) option for 5
1818 terminally ill, mentally competent adults who have been diagnosed with a life expectancy of less 6
1919 than 6 months to hasten the dying process; and 7
2020 Whereas, since 1997, 10 states and the District of Columbia have legalized MAID to 8
2121 enable eligible adults who have been examined by at least two physicians to receive an aid in 9
2222 dying medication that these adults may choose to self-administer in the comfort of their own 10
2323 homes among family members and friends; and 11
2424 Whereas, many adults choose not to take the aid in dying medication even after 12
2525 completing the rigorous application process, but are nevertheless comforted by a renewed sense 13
2626 of autonomy and control in having the aid in dying medication on hand; and 14
2727 Whereas, data from the 11 United States jurisdictions that have legalized MAID 15
2828 indicates that over 90% of MAID applicants have medical insurance and are enrolled in hospice 16
2929 but nevertheless prefer to abbreviate the dying process through MAID; and 17
3030 Whereas, in the collective 50 years of data available from the 11 United States 18
3131 juridictions that have legalized MAID, there have been no recorded instances of misuse, abuse, 19
3232 or coercion and the MAID laws have been operating as envisioned since the time of enactment; 20
3333 and 21
3434 Whereas, the percentage of eligible adults who have availed themselves of this 22
3535 end-of-life option in each United States jurisdiction where MAID has been legalized has not 23
3636 exceeded 0.75%; Now, therefore, 24
3737 The General Assembly of North Carolina enacts: 25
3838 SECTION 1.(a) The North Carolina Institute of Medicine shall study the advantages 26
3939 and disadvantages of legalizing medical aid in dying (MAID) in North Carolina. The study shall 27
4040 include an evaluation of at least all of the following: 28
4141 (1) In the 11 United States jurisdictions that have legalized MAID (current MAID 29
4242 states), the process by which a person applies and receives approval for 30
4343 MAID, including applicant qualifications and safeguards. 31
4444 (2) The factors that contribute most to a person's decision to seek MAID. 32
4545 (3) The characteristics and demographic backgrounds of persons who seek 33
46-MAID. 34 General Assembly Of North Carolina Session 2025
47-Page 2 House Bill 410-First Edition
48-(4) The social and emotional impacts on a person's family members when MAID 1
49-is available to a person as an alternative to an extended dying process. 2
50-(5) Which medications have been or are currently being used for MAID, and 3
51-whether intravenous self-administration would be an improvement over 4
52-self-ingestion through the gastrointestinal tract. 5
53-(6) The best options for healthcare providers to opt out of participating in MAID. 6
54-(7) Available data from the current MAID states that are reporting on conclusions 7
55-arising from the legalization of MAID, particularly with respect to the 8
56-effectiveness of MAID laws in providing an end-of-life option. 9
57-(8) What end-of-life options are currently available in North Carolina and 10
58-recommendations about whether MAID is an advisable additional alternative. 11
59-(9) To what extent the absence of MAID in North Carolina and other states 12
60-increases the chance that a terminally ill person will choose to commit suicide 13
61-by violent or other means. 14
62-(10) Developments in MAID legislation since Oregon's 1997 Death with Dignity 15
63-Act and recommendations about what safeguards are essential to ensure that 16
64-only mentally competent, terminally ill persons are seeking MAID and that 17
65-they are seeking MAID without coercion or undue pressure; and, by contrast, 18
66-which current safeguards have become redundant and are no longer needed. 19
67-(11) Using data from current MAID states, the number of people who would likely 20
68-utilize MAID if it became legal in North Carolina. 21
69-(12) In current MAID states, whether there are indications that individuals have 22
70-been coerced into using MAID. 23
71-(13) In current MAID states, the implementation impact of MAID on healthcare 24
72-systems, institutions, and providers. 25
73-(14) In current MAID states, the impact of MAID on awareness or utilization of 26
74-hospice and palliative care as an alternative to MAID. 27
75-(15) The reasons why approximately one-third of the persons who apply for and 28
76-receive MAID drugs decide not to take them, including whether there are 29
77-psychological benefits to having MAID as a legal option even if people 30
78-ultimately decide against using or even applying for MAID. 31
79-(16) The percentage of eligible terminally ill, mentally competent persons in each 32
80-United States jurisdiction where MAID is legal who do, in fact, avail 33
81-themselves of this law. 34
82-(17) Any other areas the Department deems relevant or helpful to determining 35
83-whether to legalize MAID in North Carolina. 36
84-SECTION 1.(b) The North Carolina Institute of Medicine (NCIOM) shall, prior to 37
85-submitting the report required by subsection (c) of this section, conduct at least one public hearing 38
86-to ensure the general public has an opportunity to provide the NCIOM with comments regarding 39
87-the advantages and disadvantages of legalizing MAID in North Carolina. The NCIOM shall 40
88-provide at least 15 days' advance notice of a public hearing conducted pursuant to this subsection. 41
89-All interested persons shall be heard at the public hearing. 42
90-SECTION 1.(c) By April 1, 2027, the North Carolina Institute of Medicine shall 43
91-report its findings and any recommendations with respect to legalizing MAID in North Carolina, 44
92-including any recommendations regarding proposed legislation, to the Joint Legislative 45
93-Oversight Committee on Health and Human Services and the Department of Health and Human 46
94-Services. 47
95-SECTION 2. Effective July 1, 2025, there is appropriated from the General Fund to 48
96-the Department of Health and Human Services the sum of one hundred fifty thousand dollars 49
97-($150,000) in nonrecurring funds for the 2025-2026 fiscal year to be allocated to the North 50
98-Carolina Institute of Medicine to fund the study authorized by Section 1 of this act. 51 General Assembly Of North Carolina Session 2025
99-House Bill 410-First Edition Page 3
100-SECTION 3. Except as otherwise provided, this act is effective when it becomes 1
101-law. 2
46+MAID. 34
47+(4) The social and emotional impacts on a person's family members when MAID 35
48+is available to a person as an alternative to an extended dying process. 36
49+H.B. 410
50+Mar 17, 2025
51+HOUSE PRINCIPAL CLERK General Assembly Of North Carolina Session 2025
52+Page 2 DRH10005-MGa-18
53+(5) Which medications have been or are currently being used for MAID, and 1
54+whether intravenous self-administration would be an improvement over 2
55+self-ingestion through the gastrointestinal tract. 3
56+(6) The best options for healthcare providers to opt out of participating in MAID. 4
57+(7) Available data from the current MAID states that are reporting on conclusions 5
58+arising from the legalization of MAID, particularly with respect to the 6
59+effectiveness of MAID laws in providing an end-of-life option. 7
60+(8) What end-of-life options are currently available in North Carolina and 8
61+recommendations about whether MAID is an advisable additional alternative. 9
62+(9) To what extent the absence of MAID in North Carolina and other states 10
63+increases the chance that a terminally ill person will choose to commit suicide 11
64+by violent or other means. 12
65+(10) Developments in MAID legislation since Oregon's 1997 Death with Dignity 13
66+Act and recommendations about what safeguards are essential to ensure that 14
67+only mentally competent, terminally ill persons are seeking MAID and that 15
68+they are seeking MAID without coercion or undue pressure; and, by contrast, 16
69+which current safeguards have become redundant and are no longer needed. 17
70+(11) Using data from current MAID states, the number of people who would likely 18
71+utilize MAID if it became legal in North Carolina. 19
72+(12) In current MAID states, whether there are indications that individuals have 20
73+been coerced into using MAID. 21
74+(13) In current MAID states, the implementation impact of MAID on healthcare 22
75+systems, institutions, and providers. 23
76+(14) In current MAID states, the impact of MAID on awareness or utilization of 24
77+hospice and palliative care as an alternative to MAID. 25
78+(15) The reasons why approximately one-third of the persons who apply for and 26
79+receive MAID drugs decide not to take them, including whether there are 27
80+psychological benefits to having MAID as a legal option even if people 28
81+ultimately decide against using or even applying for MAID. 29
82+(16) The percentage of eligible terminally ill, mentally competent persons in each 30
83+United States jurisdiction where MAID is legal who do, in fact, avail 31
84+themselves of this law. 32
85+(17) Any other areas the Department deems relevant or helpful to determining 33
86+whether to legalize MAID in North Carolina. 34
87+SECTION 1.(b) The North Carolina Institute of Medicine (NCIOM) shall, prior to 35
88+submitting the report required by subsection (c) of this section, conduct at least one public hearing 36
89+to ensure the general public has an opportunity to provide the NCIOM with comments regarding 37
90+the advantages and disadvantages of legalizing MAID in North Carolina. The NCIOM shall 38
91+provide at least 15 days' advance notice of a public hearing conducted pursuant to this subsection. 39
92+All interested persons shall be heard at the public hearing. 40
93+SECTION 1.(c) By April 1, 2027, the North Carolina Institute of Medicine shall 41
94+report its findings and any recommendations with respect to legalizing MAID in North Carolina, 42
95+including any recommendations regarding proposed legislation, to the Joint Legislative 43
96+Oversight Committee on Health and Human Services and the Department of Health and Human 44
97+Services. 45
98+SECTION 2. Effective July 1, 2025, there is appropriated from the General Fund to 46
99+the Department of Health and Human Services the sum of one hundred fifty thousand dollars 47
100+($150,000) in nonrecurring funds for the 2025-2026 fiscal year to be allocated to the North 48
101+Carolina Institute of Medicine to fund the study authorized by Section 1 of this act. 49
102+SECTION 3. Except as otherwise provided, this act is effective when it becomes 50
103+law. 51