HB 598 - SB 640
FISCAL NOTE
Fiscal Review Committee
Tennessee General Assembly
March 1, 2025
Fiscal Analyst: Chris Higgins | Email: chris.higgins@capitol.tn.gov | Phone: 615-741-2564
HB 598 - SB 640
SUMMARY OF BILL: Establishes a procedure by which a person suffering from a terminal
disease may voluntarily receive medication to end his or her life in a humane and dignified manner.
Requires a patient to make a written request for such medication to his or her attending physician,
which must be witnessed by two people. Establishes that one witness must not be a relative of the
patient, entitled to any portion of the patient's estate, or an owner, operator, or employee of a
healthcare facility where the patient is receiving medical treatment or is a resident.
Requires the attending physician to make an initial determination of whether a patient has a terminal
disease, is capable to make a request to end his or her life, and has made the request voluntarily.
Requires a consulting physician to examine the patient and the patient's medical records, and
confirm in writing the attending physician's findings.
Establishes that in order to receive a prescription for medication, a qualified patient must: (1) make
an initial oral request to the patient's attending physician; (2) make a written request to the patient's
attending physician; and (3) make a second oral request to the patient's attending physician no less
than 15 days after making the initial oral request. Authorizes a patient to rescind a request at any
time and in any manner without regard to the patient's mental state.
Establishes that certain documentation regarding a request to receive medication to end a patient's
life must be filed in the patient's medical record. Requires the Department of Health (DOH) to
annually review a sample of such records, and to promulgate rules to facilitate the collection of
information regarding compliance with the legislation. Requires DOH to generate and make
available to the public an annual statistical report of such records.
Creates a Class A felony for: (1) willfully altering or forging a request for medication with the intent
of causing the patient’s death; (2) concealing or destroying a rescission of a request with the intent of
causing the patient’s death; (3) coercing or exerting undue influence on a patient to request
medication for the purpose of ending the patient's life; or (3) coercing or exerting undue influence
on a patient to destroy a rescission of a request.
Creates a Class A felony for willfully altering, forging, concealing, or destroying an instrument; the
reinstatement or revocation of an instrument; or any other evidence or document reflecting the
principal’s desires and interests with the intent and effect of causing a withholding or withdrawal of
life-sustaining procedures. Creates a Class A misdemeanor for willfully altering, forging, concealing,
or destroying an instrument; the reinstatement or revocation of an instrument; or any other evidence
or document reflecting the principal’s desires and interests with the intent or effect of affecting a
healthcare decision.
HB 598 - SB 640 2
FISCAL IMPACT:
NOT SIGNIFICANT
Assumptions:
• The Board of Medical Examiners, Board of Osteopathic Examination, and other health-
related boards can promulgate the necessary rules and comply with the proposed legislation
utilizing existing resources.
• According to information provided by DOH, the department can review patient records
and generate the required reports utilizing existing personnel and resources, without a
significant increase in expenditures.
• The proposed legislation provides civil and criminal liability to a person for actions taken in
good faith compliance with the proposed legislation. The proposed legislation also prohibits
any professional discipline to be taken against a person for actions taken in compliance with
the proposed legislation.
• There is not estimated to be a significant increase in Class A felonies or Class A
misdemeanors resulting from the proposed legislation; therefore, there is no expected
increase in state or local incarceration expenditures or fine revenue.
• Any increase in workload to the court system can be accommodated within existing resources.
CERTIFICATION:
The information contained herein is true and correct to the best of my knowledge.
Bojan Savic, Executive Director