Massachusetts

House Bill 1194 (2017)

Massachusetts End of Life Options Act

Introduction

The following protection of conscience provisions are included in a bill to legalize assisted suicide in Massachusetts for residents who are at least 18 years old and diagnosed with a terminal illness with a life expectancy of six months or less. An identical provision is included in Senate Bill 1225 (2017).

Assuming that "participation" includes referral, what the proposed bill proposes is a patient-initiated transfer of care that is the norm in other jurisdictions (except parts of Canada) where euthanasia or assisted suicide is legal. Objecting physicians generally do not object to transferring care to a physician whom the patient has found. However, the text of the bill is ambiguous because Section 4(b)iv implies that physicians are, in fact, expected to refer patients to a willing colleague.

Both bills were referred to the committee on Public Health in January, 2017 and did not proceed further.

[Administrator]

Section 15. Provider Participation

(1) A health care provider may choose whether to voluntarily participate in providing to a qualified patient medication pursuant to this act and is not under any duty, whether by contract, by statute, or by any other legal requirement, to participate in providing a qualified patient with the medication.

(2) A health care provider or professional organization or association may not subject an individual to censure, discipline, suspension, loss of license, loss of privileges, loss of membership, or other penalty for participating or refusing to participate in providing medication to a qualified patient pursuant to this chapter.

(3) If a health care provider is unable or unwilling to carry out a patient's request under this chapter and the patient transfers 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.

(4) (a) Health care providers shall maintain and disclose to consumers upon request their written policies outlining the extent to which they refuse to participate in providing to a qualified patient any medication pursuant to this act.

(b) The required consumer disclosure shall at minimum:

(i) include information about the Massachusetts End of Life Options Act;

(ii) identify the specific services in which they refuse to participate;

(iii) clarify any difference between institution-wide objections and those that may be raised by individual licensed providers who are employed or work on contract with the provider;

(iv) describe the mechanism the provider will use to provide patients a referral to another provider or provider in the provider’s service area who is willing to perform the specific health care service;

(v) describe the provider’s policies and procedures relating to transferring patients to other providers who will implement the health care decision;

(vi) inform consumers that the cost of such transfer will be borne by the transferring provider;

(vii) describe the internal and external consumer complaint processes available to patients affected by the provider’s objections.

(i) to any individual upon the request;

(ii) to a patient or resident or their authorized appointed health care agents, guardians, surrogate decision-maker upon admission or at the time of initial receipt of health care.