Rhode Island 2025 Regular Session

Rhode Island Senate Bill S0151 Compare Versions

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

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5	5	2025 -- S 0151
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7	7	LC000167
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9	9	S T A T E O F R H O D E I S L A N D
10	10	IN GENERAL ASSEMBLY
11	11	JANUARY SESSION, A.D. 2025
12	12	____________
13	13
14	14	A N A C T
15	15	RELATING TO HEALTH AND SAFETY -- LILA MANFIELD SAPINSLEY
16	16	COMPASSIONATE CARE A CT
17	17	Introduced By: Senators Kallman, Euer, Lauria, Valverde, Murray, Rogers, Bell, Acosta,
18	18	Zurier, and Gu
19	19	Date Introduced: January 31, 2025
20	20	Referred To: Senate Judiciary
21	21
22	22
23	23	It is enacted by the General Assembly as follows:
24	24	SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby 1
25	25	amended by adding thereto the following chapter: 2
26	26	CHAPTER 4.15 3
27	27	LILA MANFIELD SAPINSLEY COMPASSIONATE CARE ACT 4
28	28	23-4.15-1. Short title. 5
29	29	This chapter shall be known and may be cited as the "Lila Manfield Sapinsley 6
30	30	Compassionate Care Act". 7
31	31	23-4.15-2. Definitions. 8
32	32	As used in this chapter: 9
33	33	(1) "Bona fide physician-patient relationship" means a treating or consulting relationship 10
34	34	in the course of which a physician has completed a full assessment of the patient's medical history 11
35	35	and current medical condition, including a personal physical examination. 12
36	36	(2) "Capable" means that a patient has the ability to make and communicate health care 13
37	37	decisions to a physician, including communication through persons familiar with the patient's 14
38	38	manner of communicating if those persons are available. 15
39	39	(3) "Healthcare facility" shall have the same meaning as in § 23-17-2. 16
40	40	(4) "Healthcare provider" means a person, partnership, corporation, facility, or institution, 17
41	41	licensed or certified or authorized by law to administer health care or dispense medication in the 18
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43	43
44	44	LC000167 - Page 2 of 8
45	45	ordinary course of business or practice of a profession. 1
46	46	(5) "Impaired judgment" means that a person does not sufficiently understand or appreciate 2
47	47	the relevant facts necessary to make an informed decision. 3
48	48	(6) "Interested person" means: 4
49	49	(i) The patient's physician; 5
50	50	(ii) A person who knows that they are a relative of the patient by blood, civil marriage, 6
51	51	civil union, or adoption; 7
52	52	(iii) A person who knows that they would be entitled, upon the patient's death, to any 8
53	53	portion of the estate or assets of the patient under any will or trust, by operation of law, or by 9
54	54	contract; or 10
55	55	(iv) An owner, operator, or employee of a healthcare facility, nursing home, or residential 11
56	56	care facility where the patient is receiving medical treatment or is a resident. 12
57	57	(7) "Palliative care" shall have the same definition as in § 23-89-3. 13
58	58	(8) "Patient" means a person who is eighteen (18) years of age or older, a resident of Rhode 14
59	59	Island, and under the care of a physician. 15
60	60	(9) "Physician" means an individual licensed to engage in the practice of medicine as 16
61	61	defined in § 5-37-1. 17
62	62	(10) "Terminal condition" means an incurable and irreversible disease which would, within 18
63	63	reasonable medical judgment, result in death within six (6) months or less. 19
64	64	23-4.15-3. Requirements for prescription and documentation - Immunity. 20
65	65	(a) A physician shall not be subject to any civil or criminal liability or professional 21
66	66	disciplinary action if the physician prescribes to a patient with a terminal condition medication to 22
67	67	be self-administered for the purpose of hastening the patient's death and the physician affirms by 23
68	68	documenting in the patient's medical record that all of the following occurred: 24
69	69	(1) The patient made an oral request to the physician in the physician's physical presence 25
70	70	to be prescribed medication to be self-administered for the purpose of hastening the patient's death. 26
71	71	(2) No fewer than fifteen (15) days after the first oral request, the patient made a second 27
72	72	oral request to the physician in the physician's physical presence to be prescribed medication to be 28
73	73	self-administered for the purpose of hastening the patient's death. 29
74	74	(3) At the time of the second oral request, the physician offered the patient an opportunity 30
75	75	to rescind the request. 31
76	76	(4) The patient made a written request to be prescribed medication to be self-administered 32
77	77	for the purpose of hastening the patient's death that was signed by the patient in the presence of two 33
78	78	(2) or more subscribing witnesses at least one of whom is not an interested person as defined in § 34
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81	81	LC000167 - Page 3 of 8
82	82	23-4.15-2, who were at least eighteen (18) years of age, and who subscribed and attested that the 1
83	83	patient appeared to understand the nature of the document and to be free from duress or undue 2
84	84	influence at the time the request was signed. 3
85	85	(5) The physician determined that the patient: 4
86	86	(i) Is suffering a terminal condition, based on the physician's physical examination of the 5
87	87	patient and the physician's review of the patient's relevant medical records; 6
88	88	(ii) Is capable; 7
89	89	(iii) Is making an informed decision; 8
90	90	(iv) Has made a voluntary request for medication to hasten their death; and 9
91	91	(v) Is a Rhode Island resident. 10
92	92	(6) The physician informed the patient in person, both verbally and in writing, of all the 11
93	93	following: 12
94	94	(i) The patient's medical diagnosis; 13
95	95	(ii) The patient's prognosis, including an acknowledgement that the physician's prediction 14
96	96	of the patient's life expectancy is an estimate based on the physician's best medical judgment and 15
97	97	is not a guarantee of the actual time remaining in the patient's life, and that the patient could live 16
98	98	longer than the time predicted; 17
99	99	(iii) The range of treatment options appropriate for the patient and the patient's diagnosis; 18
100	100	(iv) If the patient is not enrolled or participating in hospice care, all feasible end-of-life 19
101	101	services, including palliative care, comfort care, hospice care, and pain control; 20
102	102	(v) The range of possible results, including potential risks associated with taking the 21
103	103	medication to be prescribed; and 22
104	104	(vi) The probable result of taking the medication to be prescribed. 23
105	105	(7) The physician has referred the patient to a second physician for medical confirmation 24
106	106	of the diagnosis, prognosis, and a determination that the patient was capable, was acting voluntarily, 25
107	107	and had made an informed decision. 26
108	108	(8) The physician has either verified that the patient did not have impaired judgment or 27
109	109	referred the patient for an evaluation by a psychiatrist, psychologist, or clinical social worker, 28
110	110	licensed in Rhode Island, for confirmation that the patient was capable and did not have impaired 29
111	111	judgment. 30
112	112	(9) If applicable, the physician has consulted with the patient's primary care physician with 31
113	113	the patient's consent. 32
114	114	(10) The physician has informed the patient that the patient may rescind the request at any 33
115	115	time and in any manner and offered the patient an opportunity to rescind after the patient's second 34
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118	118	LC000167 - Page 4 of 8
119	119	oral request. 1
120	120	(11) The physician has ensured that all required steps were carried out in accordance with 2
121	121	this section and confirmed, immediately prior to writing the prescription for medication, that the 3
122	122	patient was making an informed decision. 4
123	123	(12) The physician wrote the prescription no fewer than forty-eight (48) hours after the last 5
124	124	to occur of the following events: 6
125	125	(i) The patient's written request for medication to hasten their death; 7
126	126	(ii) The patient's second oral request; or 8
127	127	(iii) The physician's offering the patient an opportunity to rescind the request. 9
128	128	(13) The physician either: 10
129	129	(i) Dispensed the medication directly; provided, that at the time the physician dispensed 11
130	130	the medication, the physician was licensed to dispense medication in Rhode Island, had a current 12
131	131	Drug Enforcement Administration certificate, and complied with any applicable administrative 13
132	132	rules; or 14
133	133	(ii) With the patient's written consent: 15
134	134	(A) Contacted a pharmacist and informed the pharmacist of the prescription; and 16
135	135	(B) Delivered the written prescription personally or by mail or electronically to the 17
136	136	pharmacist, who dispensed the medication to the patient, the physician, or an expressly identified 18
137	137	agent of the patient. 19
138	138	(14) The physician recorded and filed the following in the patient's medical record: 20
139	139	(i) The date, time and detailed description of all oral requests of the patient for medication 21
140	140	to hasten their death; 22
141	141	(ii) All written requests by the patient for medication to hasten their death; 23
142	142	(iii) The physician's diagnosis, prognosis, and basis for the determination that the patient 24
143	143	was capable, was acting voluntarily, and had made an informed decision; 25
144	144	(iv) The second physician's diagnosis, prognosis, and verification that the patient was 26
145	145	capable, was acting voluntarily, and had made an informed decision; 27
146	146	(v) The physician's attestation that the patient was enrolled in hospice care at the time of 28
147	147	the patient's oral and written requests for medication to hasten the patient's death or that the 29
148	148	physician informed the patient of all feasible end-of-life services; 30
149	149	(vi) The physician's verification that the patient either did not have impaired judgment or 31
150	150	that the physician referred the patient for an evaluation and the person conducting the evaluation 32
151	151	has determined that the patient did not have impaired judgment; 33
152	152	(vii) A report of the outcome and determinations made during any evaluation which the 34
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155	155	LC000167 - Page 5 of 8
156	156	patient may have received; 1
157	157	(viii) The date, time, and detailed description of the physician's offer to the patient to 2
158	158	rescind the request for medication at the time of the patient's second oral request; and 3
159	159	(ix) A note by the physician indicating that all requirements under this section were 4
160	160	satisfied and describing all of the steps taken to carry out the request, including a notation of the 5
161	161	medication prescribed. 6
162	162	(15) After writing the prescription, the physician promptly filed a report with the 7
163	163	department of health documenting completion of all of the requirements under this section. 8
164	164	(b) This section shall not be construed to limit civil or criminal liability for gross 9
165	165	negligence, recklessness, or intentional misconduct. 10
166	166	23-4.15-4. No duty to aid. 11
167	167	A patient with a terminal condition who self-administers a lethal dose of medication shall 12
168	168	not be considered to be a person exposed to grave physical harm under § 11-56-1, and no person 13
169	169	shall be subject to civil or criminal liability solely for being present when a patient with a terminal 14
170	170	condition self-administers a lethal dose of medication pursuant to this chapter, or for not acting to 15
171	171	prevent the patient from self-administering a lethal dose of medication pursuant to this chapter, or 16
172	172	for not rendering aid to a patient who has self-administered medication pursuant to this chapter. 17
173	173	23-4.15-5. Limitations on actions. 18
174	174	(a) A physician, nurse, pharmacist, or other person shall not be under any duty, by law or 19
175	175	contract, to participate in the provision of a lethal dose of medication to a patient. 20
176	176	(b) A healthcare facility or healthcare provider shall not subject a physician, nurse, 21
177	177	pharmacist, or other person to discipline, suspension, loss of license, loss of privileges, or other 22
178	178	penalty for actions taken in good faith reliance on the provisions of this chapter or refusals to act 23
179	179	under this chapter. 24
180	180	(c) Except as otherwise provided in this chapter herein, nothing in this chapter shall be 25
181	181	construed to limit liability for civil damages resulting from negligent conduct or intentional 26
182	182	misconduct by any person. 27
183	183	23-4.15-6. Healthcare facility exception. 28
184	184	A healthcare facility may prohibit a physician from writing a prescription for a dose of 29
185	185	medication intended to be lethal for a patient who is a resident in its facility and intends to use the 30
186	186	medication on the facility's premises, provided the facility has notified the physician in writing of 31
187	187	its policy with regard to the said prescriptions. Notwithstanding the provisions of § 23-4.15-5(b), 32
188	188	any physician who violates a policy established by a healthcare facility under this section may be 33
189	189	subject to sanctions otherwise allowable under law or contract. 34
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193	193	23-4.15-7. Insurance policies -- Prohibitions. 1
194	194	(a) A person and their beneficiaries shall not be denied benefits under any life insurance 2
195	195	policy, as defined in § 27-4-0.1, for actions taken in accordance with this chapter. 3
196	196	(b) The sale, procurement, or issue of any medical malpractice insurance policy or the rate 4
197	197	charged for the policy shall not be conditioned upon or affected by whether the physician is willing 5
198	198	or unwilling to participate in the provisions of this chapter. 6
199	199	23-4.15-8. No effect on palliative sedation. 7
200	200	This chapter shall not limit or otherwise affect the provision, administration, or receipt of 8
201	201	palliative sedation consistent with accepted medical standards. 9
202	202	23-4.15-9. Protection of patient choice at end-of-life. 10
203	203	A physician with a bona fide physician-patient relationship with a patient with a terminal 11
204	204	condition shall not be considered to have engaged in unprofessional conduct under § 5-37-5.1 if: 12
205	205	(1) The physician determines that the patient is capable and does not have impaired 13
206	206	judgment; 14
207	207	(2) The physician informs the patient of all feasible end-of-life services, including 15
208	208	palliative care, comfort care, hospice care, and pain control; 16
209	209	(3) The physician prescribes a dose of medication that may be lethal to the patient; 17
210	210	(4) The physician advises the patient of all foreseeable risks related to the prescription; and 18
211	211	(5) The patient makes an independent decision to self-administer a lethal dose of the 19
212	212	medication. 20
213	213	23-4.15-10. Immunity for physicians. 21
214	214	A physician shall be immune from any civil or criminal liability or professional disciplinary 22
215	215	action for actions performed in good faith compliance with the provisions of this chapter. 23
216	216	23-4.15-11. Safe disposal of unused medications. 24
217	217	The department of health shall adopt rules and regulations providing for the safe disposal 25
218	218	of unused medications prescribed under this chapter. 26
219	219	23-4.15-12. Statutory construction. 27
220	220	Nothing in this chapter shall be construed to authorize a physician or any other person to 28
221	221	end a patient's life by lethal injection, mercy killing, or active euthanasia. Action taken in 29
222	222	accordance with this chapter shall not be construed for any purpose to constitute suicide, assisted 30
223	223	suicide, mercy killing, or homicide under the law. This section shall not be construed to conflict 31
224	224	with section 1553 of the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, as 32
225	225	amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152. 33
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228	228	LC000167 - Page 7 of 8
229	229	SECTION 2. This act shall take effect upon passage. 1
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231	231	LC000167
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235	235	LC000167 - Page 8 of 8
236	236	EXPLANATION
237	237	BY THE LEGISLATIVE COUNCIL
238	238	OF
239	239	A N A C T
240	240	RELATING TO HEALTH AND SAFETY -- LILA MANFIELD SAPINSLEY
241	241	COMPASSIONATE CARE A CT
242	242	***
243	243	This act would establish the process to provide a legal mechanism whereby a terminally ill 1
244	244	patient may choose to end their life using medications prescribed by a physician. 2
245	245	This act would take effect upon passage. 3
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247	247	LC000167
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