Montana

Senate Bill 167 (2011)

Montana Death with Dignity Act

Introduction

The following protection of conscience provisions are found in the proposed Montana Death with Dignity Act. The bill would legalize assisted suicide for any competent resident of the state who is at least 18 years of age and who has been diagnosed with "an incurable and irreversible illness" with a prognosis of death within six months. Such a person would be permitted to obtain a lethal prescription under the conditions specified in the bill.

Note:

• The protection offered extends to all health care workers and institutions, including pharmacists. [2(7)a,b]
• Objecting health care workers and institutions are not required to refer patients, but must transfer medical records if the patient finds another provider. [15(4)b]
• Protection for objectors is more limited than protection for participants. Those who participate are protected from civil and criminal liability and professional disciplinary action [15(1)]; those who refuse to participate are protected from only disciplinary action [15(2)].
• Denominational health care facilities that object to assisted suicide may not prevent physicians in their premises from referring patients for the procedure. [16(3)]
• There is no provision to prevent discrimination in hiring, employment or education.

The bill died in committee in April, 2011. 

INTRODUCED BY A. BLEWETT

A BILL FOR AN ACT ENTITLED: "AN ACT ALLOWING A TERMINALLY ILL PATIENT TO REQUEST MEDICATION TO END THE PATIENT'S LIFE; ESTABLISHING PROCEDURES; PROVIDING THE RIGHT TO RESCIND THE REQUEST; PROVIDING DEFINITIONS; PROVIDING IMMUNITY FOR PERSONS PARTICIPATING IN GOOD FAITH COMPLIANCE WITH THE PROCEDURES; PROVIDING RULEMAKING AUTHORITY; AND PROVIDING AN IMMEDIATE EFFECTIVE DATE."

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:

NEW SECTION. Section 1. Short title. [Sections 1 through 20] may be cited as the "Montana Death With Dignity Act".

NEW SECTION. Section 2. Definitions.

As used in [sections 1 through 20], the following definitions apply:

. . .

(7) (a) "Health care provider" or "provider" means a person licensed, certified, or otherwise authorized or permitted by law to administer health care or dispense medication in the ordinary course of business or practice of a profession.

(b) The term includes a health care facility as defined in 50-5-101.

. . .

NEW SECTION. Section 15. Immunities -- prohibitions on certain health care providers -- notification -- permissible sanctions.

(1) A person is not subject to civil or criminal liability or professional disciplinary action for participating in good faith compliance with [sections 1 through 20], including an individual who is present when a qualified patient takes the prescribed medication to end the qualified patient's life in a humane and dignified manner.

(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 good faith compliance with [sections 1 through 20].

(3) . . .

(4) (a) A health care provider may choose whether to participate in providing to a qualified patient any medication to end the patient's life in a humane and dignified manner 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.

(b) If a health care provider is unable or unwilling to carry out a patient's request under [sections 1 through 20] 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.

(5) (a) Unless otherwise required by law, a health care provider may prohibit another health care provider from participating in [sections 1 through 20] on the premises of the prohibiting provider if the prohibiting provider has notified the health care provider in writing of the prohibiting provider's policy against participating in [sections 1 through 20]. Nothing in this subsection (5) prevents a health care provider from providing a patient with health care services that do not constitute participation in [sections 1 through 20].

(b) Notwithstanding the provisions of subsections (1) through (4), a health care provider may subject another health care provider to the following sanctions if the sanctioning health care provider has notified the sanctioned provider prior to participation in activities under [section 1 through 20] that the sanctioning provider prohibits participation in activities under [sections 1 through 20]:

(i) loss of privileges, loss of membership, or any other sanction provided pursuant to 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 [sections 1 through 20] 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 lease or other property contract or other nonmonetary remedies provided by lease contract, not including loss or restriction of medical staff privileges or exclusion from a provider panel, if the sanctioned provider participates in activities under [sections 1 through 20] 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; or

(iii) termination of contract or other nonmonetary remedies provided by contract if the sanctioned provider participates in activities under [sections 1 through 20] 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.

(c) The provisions of subsection (5)(b) may not be construed to prevent:

(i) a health care provider from participating in activities under [sections 1 through 20] while acting outside the course and scope of the provider's capacity as an employee or independent contractor; or

(ii) a patient from contracting with the patient's attending physician or 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.

(d) A health care provider that imposes sanctions pursuant to subsection (5)(b) shall follow all due process and other established procedures of the sanctioning health care provider that are related to the imposition of sanctions on any other health care provider.

(6) For purposes of this section, "participating in [sections 1 through 20]" means to perform:

(a) the duties of an attending physician pursuant to [section 6];

(b) the duties of a consulting physician pursuant to [section 7]; or

(c) the counseling function pursuant to [section 8].

(7) Suspension or termination of staff membership or privileges under subsection (5) is not reportable to a licensing board provided for in Title 37. Action taken pursuant to [section 4, 6, 7, or 8] may not be the sole basis for a report of unprofessional conduct under 37-1-308.

NEW SECTION. Section 16. Nonsanctionable activities.

A health care provider may not be sanctioned under [section 15] for:

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

(2) providing information about the Montana Death With Dignity Act to a patient upon the request of the patient;

(3) providing a patient, upon the request of the patient, with a referral to another physician; or

(4) contracting with a patient to act outside the course and scope of the provider's capacity as an employee or independent contractor of a health care provider that prohibits activities under [sections 1 through 20].