Wisconsin 2023-2024 Regular Session

Wisconsin Senate Bill SB739 Compare Versions

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

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3	3	2023 - 2024 LEGISLATURE
4	4	2023 SENATE BILL 739
5	5	December 8, 2023 - Introduced by Senators HESSELBEIN, AGARD, CARPENTER,
6	6	TAYLOR, ROYS and SPREITZER, cosponsored by Representatives OHNSTAD, BARE,
7	7	JOERS, PALMERI, SNODGRASS, EMERSON, JACOBSON, CONLEY, STUBBS, SINICKI,
8	8	SUBECK and CLANCY. Referred to Committee on Health.
9	9	AN ACT to create chapter 156 and 979.01 (1j) of the statutes; relating to:
10	10	permitting certain qualified individuals to make a request for medication for
11	11	the purpose of ending their lives and providing a penalty.
12	12	Analysis by the Legislative Reference Bureau
13	13	This bill permits an individual who is at least 18 years of age, mentally capable,
14	14	and has a terminal disease with a prognosis of less than six months to live to
15	15	voluntarily request a prescription for medication for the purpose of ending his or her
16	16	life. Under the bill, “terminal disease” means an incurable and irreversible disease
17	17	that has been medically confirmed and will, within reasonable medical judgment,
18	18	produce death within six months. The bill authorizes the individual's attending
19	19	provider to issue a prescription for the medication if specified requirements are met.
20	20	Under the bill, an attending or consulting provider must be a licensed physician, an
21	21	advanced practice registered nurse, or a physician assistant. Death following
22	22	self-administering medication in accordance with the requirements of the bill does
23	23	not alone constitute grounds for post-mortem inquiry and such a death may not be
24	24	designated as suicide or homicide.
25	25	The bill requires that the Department of Health Services develop and distribute
26	26	certain standard forms to be used for reporting by attending providers in the context
27	27	of requests for medication under the provisions of the bill.
28	28	The bill establishes certain requirements that must be met before an attending
29	29	provider may issue a prescription in response to an individual's request for a
30	30	prescription for medication to end his or her life. With certain exceptions for an
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36	36	individual who is determined to be within 15 days of death, a qualified individual
37	37	must make an oral request and a written request and reiterate the oral request to
38	38	his or her attending provider no less than 15 days after making the initial oral
39	39	request. The oral and written requests for medical aid in dying may only be made
40	40	by the requesting individual and not by any surrogate decision-maker, health care
41	41	proxy, attorney-in-fact for health care, or through an advance health care directive.
42	42	The written request must be substantially in the form provided in the bill. It must
43	43	be signed and dated by the individual and witnessed by at least one individual who
44	44	meets certain qualifications and attests that the individual is capable, acting
45	45	voluntarily, and is not being coerced or unduly influenced to sign the request.
46	46	The bill requires an attending provider to comply with certain requirements
47	47	with respect to requests for medication under the bill, including 1) determining
48	48	whether an individual has a terminal disease with a prognosis of six months or less
49	49	to live and is mentally capable; 2) confirming that the individual's request does not
50	50	arise from coercion or undue influence; 3) informing the individual of certain
51	51	information specified in the bill, including the potential risks, benefits, and probable
52	52	result of self-administering the prescribed medication; 4) informing the individual
53	53	that there is no obligation to fill the prescription nor an obligation to self-administer
54	54	the medication, even if obtained; 6) providing a referral for comfort care, palliative
55	55	care, hospice care, pain control, or other end-of-life treatment options as requested
56	56	or as medically indicated; 7) referring the individual to a consulting provider for
57	57	medical confirmation that the individual requesting medication under the bill both
58	58	has a terminal disease with a prognosis of six months or less to live and is mentally
59	59	capable; and 8) before providing a prescription, confirming that the individual has
60	60	made an informed decision to obtain medication under the bill, offering the
61	61	individual an opportunity to rescind the request, and educating the individual on the
62	62	recommended procedure for self-administration of the medication, the safe-keeping
63	63	and proper disposal of unused medication, the importance of having another person
64	64	present when the person self-administers the medication, and not taking the
65	65	medication in a public place. Under the bill, a consulting provider must evaluate an
66	66	individual making a request for medication under the provisions of the bill and
67	67	confirm, in writing, to the attending provider that the individual has a terminal
68	68	disease with a prognosis of six months or less to live; that the individual is mentally
69	69	capable or that the consulting provider has referred the individual to a licensed
70	70	mental health provider for further evaluation; and that the individual is acting
71	71	voluntarily, free from coercion or undue influence. The bill requires that if either the
72	72	attending provider or the consulting provider is unable to confirm that the individual
73	73	is capable of making an informed decision, the attending provider or the consulting
74	74	provider must refer the individual to a licensed mental health provider for
75	75	determination regarding mental capability.
76	76	The bill specifies that a provider may choose whether or not to practice medical
77	77	aid in dying under the provisions of the bill, but if a provider is unable or unwilling
78	78	to fulfill an individual's request for medication under the bill, the provider must still
79	79	document the date of the individual's request in the patient's medical record and, if
80	80	requested, transfer the individual's medical records to a new provider. The bill also - 3 -2023 - 2024 Legislature
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84	84	specifies that a health care facility may prohibit providers from qualifying,
85	85	prescribing, or dispensing medication under the provisions of the bill while
86	86	performing duties for the facility, but if it does so, it must provide advance notice to
87	87	providers and staff in writing, and then on a yearly basis. If an individual wishes
88	88	to transfer to another facility, the facility must coordinate a timely transfer. Finally,
89	89	no health care facility may prohibit a provider from fulfilling the requirements of
90	90	informed consent and meeting the medical standard of care, including by allowing
91	91	a provider to prescribe medication under the provisions of the bill outside of the scope
92	92	of the provider's employment or contract with the prohibiting facility and off the
93	93	premises of the the prohibiting facility.
94	94	The bill includes immunity for actions taken in good faith, but also includes
95	95	penalties for intentionally or knowingly 1) altering or forging an individual's request
96	96	for medication under the bill; 2) concealing or destroying a rescission of a request for
97	97	medication under the bill; or 3) coercing or exerting undue influence on an individual
98	98	with a terminal disease to request or use medication under the bill. The bill expressly
99	99	does not not limit civil liability or damages arising from negligent conduct or
100	100	intentional misconduct.
101	101	Under the bill, insurance, including insurance rates, may not be conditioned on
102	102	or affected by an individual's act of making or rescinding a request for medication
103	103	under the provisions of the bill. Further, a qualified individual's act of
104	104	self-administering medication consistent with the provisions of the bill does not
105	105	invalidate any part of a life, health, or accident insurance policy, or an annuity policy.
106	106	Finally, no insurance plan may deny or alter benefits to an individual with a terminal
107	107	disease who is a covered beneficiary based on the availability of medical aid in dying,
108	108	the individual's request for medication under the provisions of the bill, or the absence
109	109	of such a request.
110	110	Because this bill creates a new crime or revises a penalty for an existing crime,
111	111	the Joint Review Committee on Criminal Penalties may be requested to prepare a
112	112	report.
113	113	For further information see the state fiscal estimate, which will be printed as
114	114	an appendix to this bill.
115	115	The people of the state of Wisconsin, represented in senate and assembly, do
116	116	enact as follows:
117	117	SECTION 1. Chapter 156 of the statutes is created to read:
118	118	CHAPTER 156
119	119	MEDICAL AID IN DYING
120	120	156.01 Short title. This chapter shall be known and may be cited as the “Our
121	121	Care, Our Options Act."
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129	129	156.03 Definitions. In this chapter:
130	130	(1) “Adult” means an individual who is 18 years of age or older.
131	131	(2) “Attending provider” means the provider who has primary responsibility
132	132	for the care of an individual and treatment of that individual's terminal disease.
133	133	(3) “Coercion or undue influence” means the willful attempt, whether by
134	134	deception, intimidation, or any other means, to do any of the following:
135	135	(a) Cause an individual to request, obtain, or self-administer medication under
136	136	this chapter with intent to cause the death of the individual.
137	137	(b) Prevent a qualified individual from obtaining or self-administering
138	138	medication under this chapter.
139	139	(4) “Consulting provider” means a provider who is qualified by specialty or
140	140	experience to make a professional diagnosis and prognosis regarding an individual's
141	141	disease.
142	142	(5) “Department” means the department of health services.
143	143	(6) “Health care facility” means a general hospital, medical clinic, nursing
144	144	home, or in-patient hospice facility or any other entity regulated under ch. 50. A
145	145	health care facility does not include individual providers.
146	146	(7) “Informed decision” means a decision by a qualified individual to request
147	147	and obtain a prescription for medication under this chapter that the qualified
148	148	individual may self-administer to bring about his or her peaceful death, after being
149	149	fully informed by the individual's attending provider of all of the following:
150	150	(a) The individual's diagnosis and prognosis.
151	151	(b) The potential risks associated with taking the medication to be prescribed.
152	152	(c) The probable result of taking the medication to be prescribed.
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181	181	(d) The feasible end-of-life care and treatment options for the individual's
182	182	terminal disease, including comfort care, palliative care, hospice care, and pain
183	183	control, and the risks and benefits of each.
184	184	(e) The individual's right to withdraw a request under this chapter or consent
185	185	for any other treatment at any time.
186	186	(8) Notwithstanding sub. (13), “licensed mental health care provider” means
187	187	a psychiatrist, psychologist, clinical social worker, psychiatric nurse practitioner,
188	188	clinical mental health counselor, or clinical professional counselor licensed, certified,
189	189	or otherwise credentialed in this state.
190	190	(9) “Medical aid in dying” means the practice of evaluating a request,
191	191	determining qualification, and providing a prescription to a qualified individual
192	192	under this chapter.
193	193	(10) “Medically confirmed” means that a consulting provider, after performing
194	194	a medical evaluation, has confirmed an attending provider's medical opinion that an
195	195	individual is eligible to receive medication under this chapter.
196	196	(11) “Mentally capable” means that in the opinion of an attending provider or
197	197	consulting provider, or a licensed mental health care provider if a determination is
198	198	requested under s. 156.17, an individual requesting medication under this chapter
199	199	has the ability to make and communicate an informed decision.
200	200	(12) “Prognosis of 6 months or less” means an individual's terminal disease
201	201	will, within reasonable medical judgment, result in the death of that individual
202	202	within 6 months.
203	203	(13) “Provider” means a person licensed, certified, or otherwise authorized or
204	204	permitted by this state to diagnose and treat medical conditions and prescribe and
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231	231	dispense medication, including controlled substances, but does not include a health
232	232	care facility. Provider includes any of the following:
233	233	(a) A physician licensed under ch. 448.
234	234	(b) An advanced practice registered nurse, as defined in s. 154.01 (1g).
235	235	(c) A physician assistant licensed under subch. IX of ch. 448.
236	236	(14) “Qualified individual” means a mentally capable adult who has satisfied
237	237	the requirements of this chapter in order to obtain a prescription for medication to
238	238	bring about a peaceful death. No person will be considered a “qualified individual”
239	239	under this chapter solely because of advanced age or disability.
240	240	(15) “Self-administer” means a qualified individual performs an affirmative,
241	241	conscious, and voluntary act to ingest medication prescribed under this chapter to
242	242	bring about the individual's peaceful death. Self-administration does not include
243	243	administration by intravenous or other parenteral injection or infusion.
244	244	(16) “Terminal disease” means an incurable and irreversible disease that has
245	245	been medically confirmed and will, within reasonable medical judgment, produce
246	246	death within 6 months.
247	247	156.05 Informed consent. (1) Nothing in this chapter may be construed to
248	248	limit the information a provider must provide to an individual in order to comply
249	249	with the medical standard of care and with informed consent requirements under
250	250	state law.
251	251	(2) If a provider is unable or unwilling to fulfill a request for medication under
252	252	this chapter, the provider shall proceed as required under s. 156.21 (2).
253	253	(3) Failure by a provider to provide information about medical aid in dying to
254	254	an individual who requests it, or failure to refer the individual to another provider
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283	283	who can provide the information upon request, shall constitute a failure to obtain
284	284	informed consent for subsequent medical treatments.
285	285	156.07 Standard of care. (1) Care that complies with the requirements of
286	286	this chapter meets the medical standard of care.
287	287	(2) Nothing in this chapter exempts a provider or other medical personnel from
288	288	meeting the medical standard of care for the treatment of individuals with a terminal
289	289	disease.
290	290	156.09 Qualification. (1) A mentally capable adult with a terminal disease
291	291	and a prognosis of 6 months or less may request a prescription for medication under
292	292	this chapter. A qualified individual shall have made an oral request and a written
293	293	request, and reiterated the oral request to the individual's attending provider no less
294	294	than 15 days after making the initial oral request.
295	295	(2) The attending provider and consulting provider of a qualified individual
296	296	shall have met each of their respective requirements as set forth in ss. 156.13 and
297	297	156.15.
298	298	(3) Notwithstanding sub. (1), if an individual's attending provider has
299	299	medically determined that the individual will, within reasonable medical judgment,
300	300	die within 15 days after making an initial oral request under sub. (1), the 15-day
301	301	waiting period set forth in sub. (1) is waived and the individual may reiterate the oral
302	302	request to the attending provider as required under sub. (1) at any time after making
303	303	the initial oral request.
304	304	(4) At the time an individual makes the second oral request under sub. (1), the
305	305	individual's attending provider shall offer the individual an opportunity to rescind
306	306	the request.
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333	333	(5) Oral and written requests under sub. (1) for medical aid in dying may be
334	334	made only by the requesting individual and may not be made by the individual's
335	335	surrogate decision-maker, health care proxy, attorney-in-fact for health care, or
336	336	through an advance health care directive.
337	337	(6) If an individual decides to transfer care to another provider, the former
338	338	provider shall transfer all relevant medical records, including written
339	339	documentation of the date of the individual's request or requests concerning medical
340	340	aid in dying.
341	341	156.11 Form of written request. (1) A valid written request for medication
342	342	under this chapter shall be signed and dated by the requesting individual and
343	343	witnessed by at least one person who, in the presence of the requesting individual,
344	344	attests that, to the best of the witness's knowledge and belief, the individual is
345	345	capable, acting voluntarily, and is not being coerced nor unduly influenced to sign the
346	346	request.
347	347	(2) The witness required under this section must be a person who is not any
348	348	of the following:
349	349	(a) A relative of the requesting individual by blood, marriage, or adoption.
350	350	(b) A person who, at the time the request is signed, would be entitled to any
351	351	portion of the estate of the requesting individual upon death under any will or by
352	352	operation of law.
353	353	(c) An owner, operator, or employee of a health care facility where the
354	354	requesting individual is receiving medical treatment or is a resident.
355	355	(3) The requesting individual's attending provider at the time the request is
356	356	signed may not be a witness.
357	357	(4) The requesting individual's interpreter may not be a witness.
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387	387	(5) The written request for medication shall be in substantially the following
388	388	form:
389	389	REQUEST FOR MEDICATION
390	390	TO END MY LIFE IN A
391	391	PEACEFUL MANNER
392	392	I, .... (insert name), am an adult of sound mind. I have been diagnosed with ....
393	393	(insert description of terminal disease), and given a prognosis of 6 months or less to
394	394	live.
395	395	I have been fully informed of the feasible alternative, concurrent, or additional
396	396	treatment opportunities for my terminal disease, including comfort care, palliative
397	397	care, hospice care, or pain control, and the potential risks and benefits of each. I have
398	398	been offered or received resources or referrals to pursue these alternative,
399	399	concurrent, or additional treatment opportunities for my terminal disease.
400	400	I have been fully informed of the nature of the medication to be prescribed and
401	401	the risks and benefits, including that the likely outcome of self-administering the
402	402	medication is death. I understand that I can rescind this request at any time and that
403	403	I am under no obligation to fill the prescription once written nor to self-administer
404	404	the medication if I obtain it.
405	405	I request that my attending provider furnish a prescription for medication that
406	406	will end my life in a peaceful manner if I choose to self-administer it, and I authorize
407	407	my attending provider to contact a pharmacist to dispense the prescription at a time
408	408	of my choosing.
409	409	I make this request voluntarily, free from coercion or undue influence.
410	410	Signed: ....
411	411	Dated: ....
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438	438	SECTION 1 SENATE BILL 739
439	439	Witness Signature: ....
440	440	Dated: ....
441	441	156.13 Attending provider responsibilities. (1) The attending provider
442	442	for an individual shall do all of the following with regard to requests for medication
443	443	under this chapter:
444	444	(a) Determine whether the individual has a terminal disease with a prognosis
445	445	of 6 months or less and is mentally capable.
446	446	(b) Confirm that the individual's request for medication under this chapter does
447	447	not arise from coercion or undue influence by asking the individual about coercion
448	448	and influence outside the presence of other persons, except for an interpreter if
449	449	necessary.
450	450	(c) Inform the individual of all of the following:
451	451	1. The individual's diagnosis.
452	452	2. The individual's prognosis.
453	453	3. The potential risks, benefits, and probable result of self-administering the
454	454	prescribed medication to bring about a peaceful death.
455	455	4. The potential benefits and risks of feasible alternatives, including
456	456	concurrent or additional treatment options for the individual's terminal disease,
457	457	palliative care, comfort care, hospice care, and pain control.
458	458	5. The individual's right to rescind the request for medication under this
459	459	chapter at any time and in any manner.
460	460	(d) Inform the individual that there is no obligation to fill the prescription nor
461	461	an obligation to self-administer the medication if it is obtained.
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489	489	(e) Provide the individual with a referral for comfort care, palliative care,
490	490	hospice care, pain control, or any other end-of-life treatment option as requested or
491	491	as clinically indicated.
492	492	(f) Refer the individual to a consulting provider for medical confirmation that
493	493	the individual requesting medication under this chapter both has a terminal disease
494	494	with a prognosis of 6 months or less and is mentally capable.
495	495	(g) Include the consulting provider's written determination, as provided under
496	496	s. 156.15, in the individual's medical record.
497	497	(h) Refer the individual to a licensed mental health care provider if the
498	498	attending provider observes signs that the individual may not be capable of making
499	499	an informed decision.
500	500	(i) Include the licensed mental health care provider's written determination,
501	501	as provided under s. 156.17, in the individual's medical record if such determination
502	502	was requested.
503	503	(j) Inform the individual of the benefits of notifying next of kin of the
504	504	individual's decision to request medication under this chapter.
505	505	(k) Fulfill all medical record documentation requirements.
506	506	(L) Ensure that all procedures required in order to fulfill a request for
507	507	medication under this chapter are followed before providing a prescription to a
508	508	qualified individual for medication under this chapter, including all of the following:
509	509	1. Confirm that the individual has made an informed decision to obtain a
510	510	prescription for medication under this chapter.
511	511	2. Offer the individual an opportunity to rescind the request for medication
512	512	under this chapter.
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539	539	3. Educate the individual on the recommended procedure for
540	540	self-administering the medication to be prescribed; the safekeeping and proper
541	541	disposal of unused medication in accordance with state and federal law; the
542	542	importance of having another person present when the individual self-administers
543	543	the medication to be prescribed; and not taking the medication in a public place.
544	544	(m) Deliver the prescription personally, by mail, or through an authorized
545	545	electronic transmission to a licensed pharmacist who will dispense the medication,
546	546	including any ancillary medications, to the attending provider, to the qualified
547	547	individual, or to an individual expressly designated by the qualified individual in
548	548	person or with a signature required on delivery, by mail service or by messenger
549	549	service, or, if authorized by the federal drug enforcement agency, dispense the
550	550	prescribed medication, including any ancillary medications, to the qualified
551	551	individual or an individual expressly designated by the qualified individual in
552	552	person.
553	553	(n) Document in the qualified individual's medical record the individual's
554	554	diagnosis and prognosis, determination of mental capability, the date of the oral
555	555	request or requests, a copy of the written request, a notation that the requirements
556	556	under this chapter have been completed, and identification of the medication and
557	557	ancillary medications prescribed to the qualified individual under this chapter.
558	558	(2) Notwithstanding any other provision of law, the attending provider may
559	559	sign the individual's death certificate.
560	560	156.15 Consulting provider responsibilities. A consulting provider for an
561	561	individual shall do all of the following with regard to requests for medication under
562	562	this chapter:
563	563	(1) Evaluate the individual and the individual's relevant medical records.
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591	591	SECTION 1
592	592	SENATE BILL 739
593	593	(2) Confirm, in writing, to the individual's attending provider that all of the
594	594	following are true:
595	595	(a) The individual has a terminal disease with prognosis of 6 months or less.
596	596	(b) The individual is mentally capable. If the consulting provider is unable to
597	597	confirm that the individual is mentally capable, the consulting provider shall provide
598	598	documentation that the consulting provider has referred the individual for further
599	599	evaluation in accordance with s. 156.17.
600	600	(c) The individual is acting voluntarily, free from coercion or undue influence.
601	601	156.17 Referral for confirmation that the requesting individual is
602	602	mentally capable. (1) If either an attending provider or a consulting provider is
603	603	unable to confirm that an individual making a request for medication under this
604	604	chapter is capable of making an informed decision, the attending provider or the
605	605	consulting provider shall refer the individual to a licensed mental health care
606	606	provider for determination regarding mental capability.
607	607	(2) The licensed mental health care provider who evaluates the individual
608	608	under this section shall submit to the requesting attending provider or consulting
609	609	provider a written determination of whether the individual is mentally capable.
610	610	(3) If the licensed mental health care provider determines that the individual
611	611	is not mentally capable, the individual may not be deemed a qualified individual and
612	612	the attending provider may not prescribe medication to the individual under this
613	613	chapter.
614	614	156.19 Safe disposal of unused medications. A person who has custody or
615	615	control of medication prescribed under this chapter after a qualified individual's
616	616	death shall dispose of the medication by lawful means in accordance with state and
617	617	federal guidelines.
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644	644	SECTION 1 SENATE BILL 739
645	645	156.21 No duty to provide medical aid in dying. (1) A provider shall
646	646	provide sufficient information to an individual with a terminal disease regarding
647	647	available options, the alternatives, and the foreseeable risks and benefits of each
648	648	option so that the individual is able to make informed decisions regarding his or her
649	649	end-of-life health care, but a provider may choose whether or not to practice medical
650	650	aid in dying under this chapter.
651	651	(2) If a provider is unable or unwilling to fulfill an individual's request for
652	652	medication under this chapter, the provider shall do all of the following:
653	653	(a) Document the date of the individual's request in the individual's medical
654	654	record.
655	655	(b) Upon the individual's request, transfer the individual's medical records to
656	656	the new provider, consistent with federal and state law.
657	657	(3) A provider may not engage in false, misleading, or deceptive practices
658	658	relating to the provider's willingness to qualify an individual or provide a
659	659	prescription to a qualified individual under this chapter. Intentionally misleading
660	660	an individual constitutes coercion or undue influence.
661	661	156.23 Health care facility permissible prohibitions and duties. (1) A
662	662	health care facility may prohibit providers from qualifying, prescribing, or
663	663	dispensing medication under this chapter while performing duties for the facility.
664	664	A prohibiting facility must provide express advance notice in writing at the time of
665	665	hiring, contracting with, or privileging providers and staff, and on a yearly basis
666	666	thereafter. A health care facility that fails to provide advance notice in writing
667	667	waives the right to enforce any prohibition.
668	668	(2) If an individual who is a patient at a prohibiting health care facility, as
669	669	described under sub. (1), and who has made a request concerning medical aid in
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697	697	SECTION 1
698	698	SENATE BILL 739
699	699	dying wishes to transfer care to another health care facility, the prohibiting facility
700	700	shall coordinate a timely transfer, including transfer of the individual's medical
701	701	records that include notation of the date the individual first made a request
702	702	concerning medical aid in dying.
703	703	(3) No health care facility may prohibit a provider from doing any of the
704	704	following in fulfilling the requirements of informed consent and meeting the medical
705	705	of standard of care:
706	706	(a) Providing information to an individual regarding the individual's health
707	707	status, including diagnosis, prognosis, recommended treatment, treatment
708	708	alternatives, and any potential risks to the individual's health.
709	709	(b) Providing information about available services, including health care
710	710	services available under this chapter, information about relevant community
711	711	resources, and information about how to access those resources to obtain the care of
712	712	the individual's choice.
713	713	(c) Prescribing medication under this chapter for a qualified individual outside
714	714	the scope of the provider's employment or contract with the prohibiting facility and
715	715	off the premises of the prohibiting facility.
716	716	(d) Being present when a qualified individual self-administers medication
717	717	prescribed under this chapter or at the time of death, if requested by the qualified
718	718	individual or his or her representative and if outside the scope of the provider's
719	719	employment or contractual duties with the prohibiting facility.
720	720	(4) A health care facility may not engage in false, misleading, or deceptive
721	721	practices relating to its policy regarding end-of-life care services, including whether
722	722	it has a policy that prohibits affiliated providers from determining an individual's
723	723	qualification for medical aid in dying or writing a prescription for a qualified
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750	750	SECTION 1 SENATE BILL 739
751	751	individual under this chapter. A health care facility may not intentionally deny an
752	752	individual access to medication under this chapter by failing to transfer an
753	753	individual and the individual's medical records to another provider in a timely
754	754	manner. Intentionally misleading an individual or deploying misinformation to
755	755	obstruct access to services under this chapter constitutes coercion or undue
756	756	influence.
757	757	(5) If any part of this chapter is found to be in conflict with federal requirements
758	758	that are a prescribed condition for the receipt of federal funds, the conflicting part
759	759	of this chapter is inoperative solely to the extent of the conflict with respect to the
760	760	facility directly affected, and such finding or determination does not affect the
761	761	operation of the remainder of the chapter.
762	762	156.25 Immunities for actions in good faith; prohibition against
763	763	reprisals. (1) No person or health care facility shall be subject to civil or criminal
764	764	liability or professional disciplinary action, including censure, suspension, loss of
765	765	license, loss of privileges, loss of membership, or any other penalty, for engaging in
766	766	good faith compliance with this chapter.
767	767	(2) No provider, health care facility, professional organization, or association
768	768	shall subject a provider to discharge, demotion, censure, discipline, suspension, loss
769	769	of license, loss of privileges, loss of membership, discrimination, or any other penalty
770	770	for providing medical aid in dying in accordance with the medical standard of care
771	771	and in good faith under this chapter, except if a provider acts in violation of a health
772	772	care facility's valid prohibition or prohibitions under s. 156.23.
773	773	(3) No provider, health care facility, professional organization, or association
774	774	shall subject a provider to discharge, demotion, censure, discipline, suspension, loss
775	775	of license, loss of privileges, loss of membership, discrimination, or any other penalty
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803	803	SECTION 1
804	804	SENATE BILL 739
805	805	for providing medical aid in dying in accordance with the medical standard of care
806	806	and in good faith under this chapter while engaged in the outside practice of medicine
807	807	and off the facility premises or for providing scientific and accurate information
808	808	about medical aid in dying to an individual when discussing end-of-life care options.
809	809	(4) An individual is not subject to civil or criminal liability or professional
810	810	discipline if, at the request of a qualified individual, the individual is present outside
811	811	the scope of the individual's employment contract and off the facility premises when
812	812	the qualified individual self-administers medication under this chapter or at the
813	813	time of death. An individual who is present may, without civil or criminal liability,
814	814	assist the qualified individual by preparing the medication prescribed under this
815	815	chapter.
816	816	(5) A request by an individual for and the provision of medication under this
817	817	chapter alone does not constitute neglect or elder abuse for any purpose of law, nor
818	818	shall it be the sole basis for appointment of a guardian or conservator.
819	819	(6) This chapter does not limit civil liability for intentional or negligent
820	820	misconduct.
821	821	156.27 Reporting requirements. (1) The department shall create a
822	822	checklist form and a follow-up form for attending providers to facilitate collection of
823	823	the information described in this chapter and post these forms to the department's
824	824	Internet site.
825	825	(2) Within 30 calendar days of providing a prescription for medication under
826	826	this chapter, an attending provider shall submit to the department a completed
827	827	checklist form, as provided under sub. (1), with all of the following information:
828	828	(a) The qualified individual's name and date of birth.
829	829	(b) The qualified individual's terminal diagnosis and prognosis.
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856	856	SECTION 1 SENATE BILL 739
857	857	(c) Notice that the requirements under this chapter have been completed.
858	858	(d) Notice that medication has been prescribed under this chapter.
859	859	(3) Within 60 calendar days of notification of a qualified individual's death from
860	860	self-administration of medication prescribed under this chapter, the attending
861	861	provider shall submit to the department a follow up form, as provided under sub. (1),
862	862	with all of the following information:
863	863	(a) The qualified individual's name and date of birth.
864	864	(b) The date of the qualified individual's death.
865	865	(c) A notation of whether or not the qualified individual was enrolled in hospice
866	866	services at the time of the qualified individual's death.
867	867	(4) The department shall annually review a sample of records related to
868	868	requests under this chapter to ensure compliance and issue a public statistical
869	869	report. The report shall not include any identifying information and shall be limited
870	870	to the following statistical information:
871	871	(a) The number of prescriptions for medication written under this chapter.
872	872	(b) The number of providers who wrote prescriptions for medication under this
873	873	chapter.
874	874	(c) The number of qualified individuals who died following self-administration
875	875	of medication prescribed and dispensed under this chapter.
876	876	(5) Except as otherwise required by law, the information collected by the
877	877	department that is related to requests under this chapter is not a public record and
878	878	is not available for public inspection under s. 19.35.
879	879	(6) Willful failure or refusal to timely submit records required under this
880	880	chapter nullifies protections under s. 156.25.
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907	907	SECTION 1
908	908	SENATE BILL 739
909	909	156.29 Effect on construction of will, contracts, and statutes. (1) No
910	910	provision in a contract, will, or other agreement, whether written or oral, that would
911	911	determine whether an individual may make or rescind a request under this chapter
912	912	is valid.
913	913	(2) No obligation owing under any existing contract may be conditioned or
914	914	affected by an individual's act of making or rescinding a request under this chapter.
915	915	(3) It is unlawful for an insurer to deny or alter health care benefits otherwise
916	916	available to an individual with a terminal disease based on the availability of
917	917	medical aid in dying or to otherwise attempt to coerce an individual with a terminal
918	918	disease to make a request for medical aid-in-dying medication.
919	919	156.31 Insurance or annuity policies. (1) Neither the sale, procurement,
920	920	or issuance of a life, health, or accident insurance policy or an annuity policy nor the
921	921	rate charged for such a policy may be conditioned upon or affected by an individual's
922	922	act of making or rescinding a request for medication under this chapter.
923	923	(2) A qualified individual's act of self-administering medication under this
924	924	chapter does not invalidate any part of a life, health, or accident insurance policy or
925	925	an annuity policy.
926	926	(3) An insurance plan, including the Medical Assistance program under subch.
927	927	IV of ch. 49, may not deny or alter benefits to an individual with a terminal disease
928	928	who is a covered beneficiary of an insurance plan based on the availability of medical
929	929	aid in dying, the individual's request for medication under this chapter, or the
930	930	absence of a request for medication under this chapter. Failure to meet this
931	931	requirement shall constitute a violation of the insurance code of this state.
932	932	156.33 Death certificate. (1) Unless otherwise prohibited by law, an
933	933	attending provider or a hospice medical director may sign the death certificate of a
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960	960	SECTION 1 SENATE BILL 739
961	961	qualified individual who obtained and self-administered a prescription for
962	962	medication under this chapter.
963	963	(2) When a death has occurred in accordance with this chapter, the death shall
964	964	be attributed to the underlying terminal disease.
965	965	(3) A death following self-administering medication under this chapter does
966	966	not alone constitute grounds for post-mortem inquiry.
967	967	(4) A death in accordance with this chapter may not be designated as suicide
968	968	or homicide.
969	969	(5) A qualified individual's act of self-administering medication prescribed
970	970	under this chapter may not be indicated on the individual's death certificate.
971	971	(6) A coroner may conduct a preliminary investigation to determine whether
972	972	an individual received a prescription for medication under this chapter.
973	973	156.35 Liabilities and penalties. (1) Intentionally or knowingly altering
974	974	or forging an individual's request for medication under this chapter or concealing or
975	975	destroying a rescission of a request for medication under this chapter is a Class F
976	976	felony.
977	977	(2) Intentionally or knowingly exercising coercion or undue influence on an
978	978	individual with a terminal disease to request or use medication under this chapter
979	979	is a Class F felony.
980	980	(3) Nothing in this chapter limits civil liability nor damages arising from
981	981	negligent conduct or intentional misconduct, including failure to obtain informed
982	982	consent by any person, provider, or health care facility.
983	983	(4) The penalties specified in this chapter do not preclude criminal penalties
984	984	applicable under other laws for conduct inconsistent with this chapter.
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1011	1011	SECTION 1
1012	1012	SENATE BILL 739
1013	1013	(5) For purposes of this chapter, “intentionally” has the meaning given under
1014	1014	s. 939.23.
1015	1015	156.37 Claims by governmental entity for costs incurred. Any
1016	1016	governmental entity that incurs costs resulting from self-administration of
1017	1017	medication prescribed under this chapter in a public place has a claim against the
1018	1018	estate of the qualified individual to recover those costs and, notwithstanding s.
1019	1019	814.04 (1), reasonable attorney fees and costs incurred in enforcing the claim.
1020	1020	156.39 Construction. (1) Nothing in this chapter authorizes a provider or
1021	1021	any other person, including a qualified individual, to end the qualified individual's
1022	1022	life by intravenous or other parenteral injection or infusion, mercy killing, homicide,
1023	1023	murder, manslaughter, euthanasia, or any other criminal act.
1024	1024	(2) Actions taken in accordance with this chapter do not, for any purposes,
1025	1025	constitute suicide, assisted suicide, euthanasia, mercy killing, homicide, murder,
1026	1026	manslaughter, elder abuse or neglect, or any other civil or criminal violation under
1027	1027	the law.
1028	1028	SECTION 2. 979.01 (1j) of the statutes is created to read:
1029	1029	979.01 (1j) Subsection (1) does not apply to a death that results from taking
1030	1030	medication under a fulfilled request for medication that meets the requirements of
1031	1031	ch. 156.
1032	1032	SECTION 3.0Nonstatutory provisions.
1033	1033	(1) No later than 45 days after the effective date of this subsection, the
1034	1034	department of health services shall create the checklist form and the follow-up form
1035	1035	required under s. 156.27 (1).
1036	1036	SECTION 4.0Effective date.
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1062	1062	SECTION 4 SENATE BILL 739
1063	1063	(1) This act takes effect on the first day of the 7th month beginning after
1064	1064	publication.
1065	1065	(END)
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