Massachusetts

Initiative Petition (2011-2012)

Introduction

The following protection of conscience provisions are included in a bill to legalize assisted suicide in Massachusetts. Although Section 1 of the bill states that participation in the procedure must be "entirely voluntary," participation is defined in Section 3(d)ii to exclude referral. Thus, the bill would, if enacted, support compulsory referral for assisted suicide. Section 3(d)ii D of the bill would also require objecting institutions not only to permit referral under Section 3(d)ii, but would require them to permit physicians in their facilities to contract for off-premises provision of assisted suicide. [Administrator]

An Initiative Petition

An Act Relative to Death with Dignity

Be it enacted by the People, and by their authority, as follows:

SECTION 1.

It is hereby declared that the public welfare requires a defined and safeguarded process by which an adult Massachusetts resident who has the capacity to make health care decisions and who has been determined by his or her attending and consulting physicians to be suffering from a terminal disease that will cause death within six months may obtain medication that the patient may self administer to end his or her life in a humane and dignified manner. It is further declared that the public welfare requires that such a process be entirely voluntary on the part of all participants, including the patient, his or her physicians, and any other health care provider or facility providing services or care to the patient. This act, being necessary for the welfare of the Commonwealth and its residents, shall be liberally construed to effect the purposes thereof.

SECTION 2.

The General Laws of Massachusetts shall be amended by inserting after chapter 201F the following new chapter 201G:-

CHAPTER 201G
MASSACHUSETTS DEATH WITH DIGNITY ACT

Section 18. Immunities; permissible sanctions.

(1) Except as provided in section 19 and subsection (3) of this section:

(a) No person shall be subject to civil or criminal liability or professional disciplinary action by any regulatory agency for any actions undertaken in compliance with this chapter. This includes being present when a qualified patient takes the prescribed medication to end his or her life in a humane and dignified manner. A person who substantially complies in good faith with the provisions of this chapter shall be deemed to be in compliance with this chapter.

(b) Actions taken in accordance with this chapter shall not constitute suicide, assisted suicide, mercy killing or homicide under any criminal law of the commonwealth.

(c) A patient's request for or the provision of medication in compliance with this chapter shall not constitute neglect for any purpose of law or provide the sole basis for the appointment of a guardian or conservator; and

(2) Participation in this chapter shall be voluntary. If a health care provider is unable or unwilling to carry out a patient's request under this chapter, and the patient transfers his or her care to a new health care provider, the prior health care provider shall transfer, upon request, a copy of the patient's relevant medical records to the new health care provider.

(3) (a) A health care provider may prohibit another health care provider from participating in this chapter on the premises of the prohibiting provider if the prohibiting provider has given prior notice to all health care providers with privileges to practice on the premises of the prohibiting provider's policy regarding participation in this chapter. This subsection does not prevent a health care provider from providing health care services to a patient that do not constitute participation in this chapter.

(b) A health care provider may subject another health care provider to the sanctions stated in this paragraph (b) if the sanctioning health care provider has notified the sanctioned provider before participation in this chapter that it prohibits participation in this chapter:

(i) loss of privileges, loss of membership, or other sanctions provided under the medical staff bylaws, policies, and procedures of the sanctioning health care provider if the sanctioned provider is a member of the sanctioning provider's medical staff and participates in this chapter while on the health care facility premises of the sanctioning health care provider, but not including the private medical office of a physician or other provider;

(ii) termination of a lease or other contract for the occupancy of real property or other nonmonetary remedies provided by such lease or contract if the sanctioned provider participates in this chapter while on the premises of the sanctioning health care provider or on property that is owned by or under the direct control of the sanctioning health care provider; provided, however, that no lease or other contract made on and after January 1, 2013, shall authorize or permit nonmonetary remedies for participation in this chapter in the form of loss or restriction of medical staff privileges or exclusion from a provider panel; or

(iii) termination of a contract or other nonmonetary remedies provided by contract if the sanctioned provider participates in this chapter while acting in the course and scope of the sanctioned provider's capacity as an employee or independent contractor of the sanctioning health care provider. Nothing in this subparagraph (iii) prevents:

(A) a health care provider from participating in this chapter while acting outside the course and scope of the provider's capacity as an employee or independent contractor; or

(B) a patient from contracting with his or her attending physician and consulting physician to act outside the course and scope of the provider's capacity as an employee or independent contractor of the sanctioning health care provider.

(c) A health care provider that imposes sanctions under (b) of this subsection shall follow all otherwise applicable due process and other procedures the sanctioning health care provider may have in place that are related to the imposition of sanctions on another health care provider.

(d) For the purposes of this subsection (3), the following terms and their variants shall have the meanings given:

(i) "Notify" means a separate statement in writing to the health care provider specifically informing the health care provider before the provider's participation in this chapter of the sanctioning health care provider's policy about participation in activities covered by this chapter.

(ii) "Participate in this chapter" means to perform the duties of an attending physician under section 4, the consulting physician function under section 5, or the counseling function under section 6. "Participate in this chapter" does not include:

(A) making an initial determination that a patient has a terminal disease and informing the patient of the medical prognosis;

(B) providing information about the Massachusetts death with dignity act to a patient upon the request of the patient;

(D) a health care provider's contracting with a patient to act outside of the course and scope of the provider's capacity as an employee or independent contractor of the sanctioning health care provider.