Introduction
This bill is the fourth introduced by the same representative
for the purpose of legalizing assisted suicide. The first (HB1561) was introduced in 2017. HB1157 was introduced in 2018 and HB1184 in 2019. All were referred to legislative committees, where they appear to have died.
The present bill is identical to HB1184 (2019).
Provisions relevant to protection of conscience are reproduced below. Some have remained unchanged since 2017. Differences between the present bill and earlier versions are set side-by-side.
Subheadings (*) have been provided by the Protection of Conscience Project.
The description of participation in assisted suicide in the bills has evolved from the provision of "assistance" in 2017 to the provision of "medical care" in 2019. This has serious implications for objecting physicians. See the Project commentary, Indiana assisted suicide bill fails to protect objecting practitioners.
SECTION 3.
IC 16-36-7 IS ADDED TO THE INDIANA CODE AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY 14 1, 2020]:
Chapter 7. Medical Aid in Dying
. . . [Obligations of attending physicians]*
Sec. 4. (a) For a patient who has made a [HB1561: first written] request under this chapter, the attending physician shall do the following:
(1) Make an initial determination of whether the patient:
(A) has a terminal illness;
(B) is competent; and
(C) has made the request voluntarily.
(2) Refer the patient to counseling if, after examining the patient, the attending physician considers it necessary.
(3) Refer the patient to a consulting physician for medical confirmation:
(A) of the terminal illness diagnosis;
(B) of the patient's competency; and
(C) that the patient is voluntarily making a request under this chapter.
(4) Request and obtain proof of the patient's Indiana residency.
(5) Inform the patient of the following to ensure that thepatient is making an informed decision:
(A) The patient's diagnosis.
(B) The patient's prognosis.
(C) The potential risks to taking the medication requested in accordance with this chapter.
(D) The probable result of taking the medication to be prescribed.
(E) The feasible alternative, concurrent, or additionaltreatment opportunities to the medication, including:
(i) alternative treatments, and the risks and benefits of each alternative;
(ii) comfort care;
(iii) hospice care; and
(iv) pain control.
(6) Recommend that the patient notify next of kin.
(7) Counsel the patient:
(A) about the importance of having another individual present when the patient takes the medication prescribed under this chapter; and
(B) not to take the medication in a public place.
(8) Inform the patient that the patient may rescind the request for medication at any time and in any manner.
(9) Offer the patient an opportunity to rescind the request at the end of the fifteen (15) day waiting period under subsection (b).
(10) Verify immediately before writing the prescription for the medication under this chapter that the patient is making an informed decision.
(11) Complete the medical record documentation required by section 8 of this chapter.
(12) Ensure that the requirements of this chapter have been met.
(13) Either:
(A) dispense any medication necessary to facilitate the desired effect and minimize the patient's discomfort if the attending physician is qualified to dispense the medication; or
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HB1020 (2020) | HB1184 (2019)
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HB1157 (2018)
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(B) prescribe the medication, contact a pharmacist to inform the pharmacist of the prescription, and transfer the prescription to the pharmacist for dispensing of the medication to the patient.
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(B) with the patient's written consent, prescribe the medication, contact a pharmacist to inform the pharmacist of the prescription, and transfer the prescription to the pharmacist for dispensing of the medication to the patient. A prescription under this clause may not be dispensed by mail or other form of courier.
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(b) An attending physician may not prescribe medication under this chapter until at least fifteen (15) days have elapsed between the patient's request and the patient's affirmation of the request for the medication.
(c) After the fifteen (15) day waiting period under subsection (b), the attending physician shall ask the patient whether the patient wants to rescind the written request. If the patient:
(1) denies the request to rescind;
(2) affirms the request for the medication; and
(3) meets the requirements of this chapter;
the attending physician may prescribe or dispense the medication after meeting the requirements of this chapter.
. . .
[Obligations of consulting physicians]*
Sec. 5. Before a patient may obtain a prescription for medication under this chapter, a consulting physician must do the following:
(1) Examine the patient and the patient's medical records.
(2) Confirm the attending physician's terminal illness diagnosis.
(3) Determine that the patient is competent and making a voluntary informed decision to request the medication under this chapter.
[Limitations and saving]*
Sec. 10. (a) Nothing in this chapter authorizes a person to end a patient's life by lethal injection, mercy killing, or active euthanasia. Actions taken in accordance with this chapter do not, for any purpose, constitute neglect, suicide, assisted suicide, mercy killing, or homicide under any law.
(b) Nothing in this chapter shall be interpreted to lower a health care provider's standard of care.
[Protection of conscience provisions]*
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HB1020 (2020) | HB1184 (2019)
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HB1157 (2018)
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Sec. 12. (a) An individual or a health care provider who in good faith provides medical care in compliance with this chapter, including:
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Sec 12.(a) A health care provider who in good faith provides assistance in the completion of a request for medication under this chapter is immune from professional, civil, and criminal liability arising from the provision of care.
HB1561 (2017)
Sec 12.(a) A health care provider who in good faith provides assistance in the completion of a request for medication under this chapter is immune from professional, civil, and criminal liability arising from the assistance.
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(1) writing or dispensing a prescription for medication under this chapter; or
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(2) being present when a qualified individual self-administers the medication under this chapter;
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is immune from professional, civil, and criminal liability arising from the provision of care.
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HB1020 (2020) | HB1184 (2019)
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HB1157 (2018) |
HB1561(2017)
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(b) Except as provided in subsection (d), a professional organization or association or a health care provider may not subject a person to censure, discipline, suspension, loss of license, loss of privileges, loss of membership, or other penalty for:
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(b) Except as provided in subsection (d), a professional organization or association or a health care provider may not subject a person to censure, discipline, suspension, loss of license, loss of privileges, loss of membership, or other penalty for participating or refusing to participate in good faith compliance with this chapter.
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(1) participating or refusing to participate in good faith compliance with this chapter; or
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(2) providing scientific and accurate information concerning medical aid in dying medication.
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(c) A health care provider may not be required to participate in the dispensing or prescribing of medication under this chapter to a patient who meets the requirements of this chapter. If a health care provider is unwilling or unable to carry out a patient's request under this chapter, the health care provider shall transfer, upon the patient's request, a copy of the patient's relevant medical records to the subsequent health care provider.
(d) A health care provider may prohibit another health care provider from participating under this chapter on the prohibiting health care provider's premises if the prohibiting health care provider has given notice of the prohibition to health care providers with privileges to practice on the prohibiting health care provider's premises. This subsection does not prohibit a health care provider from providing other health care services to the patient. The prohibiting health care provider may sanction a health care provider described in this subsection for participating under this chapter in violation of the prohibition.
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HB1020 (2020) | HB1184 (2019)
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HB1157 (2018) |
HB1561(2017)
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(e) A health care facility may not prohibit a health care provider from providing services consistent with the applicable standard of medical care, including:
(1) informing and providing information concerning medical aid in dying;
(2) being present when a qualified individual self-administers the medication, if requested by the qualified individual or representative; and
(3) referring the patient to another physician.
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* Sub-heading provided by the Protection of Conscience Project