Autonomy as a Constitutional Right - The Law in Books

Autonomy as a Constitutional Right - The Law in Books - A....

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Unformatted text preview: A. THE LAW IN BOOKS OREGON DEATH WITH DIGNITY ACT SECTION 1. GENERAL PROVISIONS § 1.01 DEFINITIONS The following words and phrases, whenever used in this Act, shall have the following meanings: . . . (7) “Informed decision” means a decision by a qualified patient, to re- quest and obtain a prescription to end his or her life in a humane and dignified manner, that is based on an appreciation of the relevant facts and after being fully informed by the attending physician of: (a) his or her medical diagnosis; (b) his or her prognosis; (c) the potential risks associated with taking the medication to be prescribed; (d) the probable result of taking the medication to be prescribed; (e) the feasible alternatives, including, but not limited to, comfort care, hospice care and pain control. . . . 2. "The bodies of those who killed themselves were, in many countries, buried at night and at a crossroads. The greater traffic over such crossroads was thought to ‘keep the corpses down,’ and the intersection of paths, it was believed, would make it more difficult for the spirit to find its way home. In early Massachusetts, cartloads of stones were unloaded at the crossroads where a suicide had been buried.” Kay Redfield Jamison, Night Falls Fast: Understanding Suicide 15 (Vintage Books, 2000). 348 AUTONOMY AS A CONSTITUTIONAL RIGHT CH. 3 (12) “Terminal disease” means an incurable and irreversibie disease that has been medically confirmed and will, within reasonable medical judg- ment, produce death within six (6) months. SECTION 2. WRITTEN REQUEST FOR MEDICATION TO END ONE’S LIFE IN A HUMANE AND DIGNIFIED MANNER § 2.01 WHO MAY INITIATE A WRITTEN REQUEST FOR MEDI- CATION An adult who is capable, is a resident of Oregon, and has been determined by the attending physician and consulting physician to be suffering from a terminal diseasc, and who has voluntarily expressed his or her wish to die, may make a written request for medication for the purpose of ending his or her life in a humane and dignified manner in accordance with this Act. § 2.02 FORM OF THE WRITTEN REQUEST (1) A valid request for medication under this Act shall be in substan- tially the form described in Section 6 of this Act, signed and dated by the patient and witnessed by at least two individuals who, in the presence of the patient, attest that to the best of their knowledge and belief the patient is capable, acting voluntarily, and is not being coerced to sign the request. (2) One of the witnesses shall be a person who is not: (a) A relative of the patient by blood, marriage or adoption; (b) A person who at the time the request is signed would be entitled to any portion of the estate of the qualified patient upon death under any will or by operation of law; or (0) An owner, operator or employee of a health care facility where the qualified patient is receiving medical treatment or is a resident. (8) The patient’s attending physician at the time the request is signed shall not be a witness. (4) If the patient is a patient in a long term care facility at the time the written request is made, one of the witnesses shall be an individual designated by the facility and having the qualifications specified by the Department of Human Resources by rule. SECTION 3. SAFEGUARDS § 3.01 ATTENDING PHYSICIAN RESPONSIBILITIES The attending physician shall: (1) Make the initial determination of whether a patient has a termi- nal disease, is capable, and has made the request voluntarily; (2) Inform the patient of: (a) his or her medical diagnosis; SEC. 3 ASSISTED Somme DECRIMINALIZED 349 (b) his or her prognosis; . (c) the potential risks associated with taking the medication to be prescribed; (d) the probable result of taking the medication to be prescribed; (e) the feasible alternatives, including, but not limited to, comfort care, hospice care and pain control. (3) Refer the patient to a consulting physician for medical confirma- tion of the diagnosis, and for a determination that the patient is capable and acting voluntarily; ‘ (4) Refer the patient for counseling if appropriate pursuant to Section 3.03; {5) Request that the patient notify next of kin; (6) Inform the patient that he or she has an opportunity to rescind the request at any time and in any manner, and offer the patient an opportunity to rescind at the end of the 15 day waiting period pursuant to Section 3.06; (7) Verify, immediately prior to writing the prescription for medi- cation under this Act, that the patient is making an informed decision: (8) Fulfill the medical record documentation requirements of Section 3.09; (9) Ensure that all appropriate steps are carried out in accordance with this Act prior to writing a prescription for medication to enable a qualified patient to end his or her life in a humane and dignified manner. § 3.02 CONSULTING PHYSICIAN CONFIRMATION Before a patient is qualified under this Act, a consulting physician shall examine the patient and his or her relevant medical records and confirm, in writing, the attending physician’s diagnosis that the patient is suffering from a terminal diseasc, and verify that the patient is capable, is acting voluntarily and has made an informed decision. § 3.03 COUNSELING REFERRAL If in the opinion of the attending physician or the consulting physi- cian a patient may be suffering from a psychiatric or psychological disorder, or depression causing impaired judgment, either physician shall refer the patient for counseling. No medication to end a patient’s life in a humane and dignified manner shall be prescribed until the person per- forming the counseling determines that the patient is not suffering from a psychiatric or psychological disorder, or depression causing impaired judg- ment. § 3.04 INFORMED DECISION No person shall receive a prescription for medication to end his or her life in a humane and dignified manner unless he or she has made an 350 AUTONOMY AS A CONSTITUTIONAL RIGHT CH. 3 informed decision as defined in Section 1131(7). Immediately prior to writing a prescription for medication under this Act, the attending physi- cian shall verify that the patient is making an informed decision. § 3.05 FAMILY NOTIFICATION The attending physician shall ask the patient to notify next of kin of his or her request for medication pursuant to this Act. A patient who declines or is unable to notify next of kin shall not have his or her request denied for that reason. § 3.06 WRITTEN AND ORAL REQUESTS . . . [A] qualified patient shall have made an oral request and a written request, and reiterate the oral request to his or her attending physician no less than fifteen (15) days after making the initial oral request. At the time [of the] second oral request, the attending physician shall offer the patient an opportunity to rescind the request. § 3.07 RIGHT TO RESCIND REQUEST A patient may rescind his or her request at any time and in any manner without'regard' to his or her mental state. No prescription for medication under this Act may be written without the attending physician offering the qualified patient an opportunity to rescind the request. § 3.08 WAITING PERIODS No less than fifteen (15) days shall elapse between the patient’s initial oral request and the writing of a prescription under this Act. No less than 48 hours shall elapse betwsen the patient’s written request and the writing of a prescription under this Act. § 3.09 MEDICAL RECORD DOCUMENTATION REQUIRE- ' MENTS The following shall be documented or filed in the patient’s medical record: (I) All oral requests by a patient for medication to end his or her life in a humane and dignified manner; (2) All written requests by a patient for medication to end his or her life in a humane and dignified manner; , (3) The attending physician’s diagnosis and prognosis, determination that the patient is capable, acting voluntarily and has made an informed decision; (4) The consulting physician’s diagnosis and prognosis, and verifica— tion that the patient is capable, acting voluntarily and has made an informed decision; (5) A report of the outcome and determinations made during counsel- ing, if performed; SEC. 3 ASSISTED SUICIDE DEcnm-IINALIZED 351 (6) The attending physician’s offer to the patient to rescind his or her request at the time of the patient’s second oral request pursuant to Section 3.06; and (7) A note by the attending physician indicating that all requirements under this Act have been met and indicating the steps taken to carry out the request, including a notation of the medication prescribed. § 3.10 RESIDENCY REQUIREMENT Only requests made by Oregon residents, under this Act, Shall be granted. . . . § 3.14 CONSTRUCTION OF ACT Nothing in this Act shall be construed to authorize a physician or any other person to end a patient’s life by lethal injection, mercy killing or active euthanasia. . . . SECTION 4. IMMUNITIES LIABILITIES § 4.01 IMZMUNITIES Except as provided in Section 4.02: (1) No person shall be subject to civil or criminal liability or profes- sional disciplinary action for participating in good faith compliance with this Act. . . . (2) No professional organization or association, or health care provid— er, may 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 Act. (3) No request by a patient for or provision by an attending physician of medication in good faith compliance with the provisions of this Act Shall constitute neglect for any purpose of law or provide the sole basis for the appointment of a guardian. . . . (4) No health care provider shall be under any duty, whether by contract, by statute or by any other legal requirement to participate in the provision to a qualified patient of medication to end his or her life in a humane and dignified manner. . . . § 4.02 LIABILITIES... (2) A person who coerces or exerts undue influence on a patient to request medication for the purpose of ending the patient’s life, or to destroy a rescission of such a request, shall be guilty of a Class A felony. . . . SECTION 6. FORM OF THE REQUEST § 6.01 FORM OF THE REQUEST A request for a medication as authorized by this act shall he in substantially the following form: 352 AUTONOMY AS A CONSTITUTIONAL RIGHT CH. 3 REQUEST FOR MEDICATION TO END MY LIFE IN A HUMANE AND DIGNIFIED MANNER 1, I am suffering from , which my attending physician has determined is a terminal disease and which has been medically confined by a consulting physician. I have been fully informed of my diagnosis, prognosis, the nature of medication to be prescribed and potential associated risks, the expected result, and the feasible alternatives, including comfort care, hospice care and pain control. I request that my attending physician prescribe medication that will end my life in a humane and dignified manner. INITIAL ONE: I have informed my family of my decision and taken their opinions into consideration. I have decided not to inform my family of my decision. , am an adult of sound mind. I have no family to inform of my decision. I understand that I have the right to rescind this request at any time. I understand the full import of this request and I expect to die when i take the medication to be prescribed. I make this request voluntarily and without reservation, and I accept full . moral responsibility for my actions. Signed: DECLARATION OF WITNESSES We declare that the person signing this request: (a) Is personally known to us or has provided proof of identity; (1)) Signed this request in our presence; (0) Appears to be of sound mind and not under duress, fraud or undue influence; (d) Is not a patient for whom either of us is attending physician. Witness l/Date Witness 2/Date DUTCH TERMINATION OF LIFE ON REQUEST AND ASSISTED SUICIDE ACT Chapter II. Requirements of Due Care Article 2 1. The requirements of due care . . . [in the Penal Code} mean that the physician: SEC. 3 ASSISTED SUICIDE DsonmnNALIZED 353 a. holds the conviction that the request by the patient was voluntary and well-considered, b. holds the conviction that the patient’s suffering was lasting and unbearable, c. has informed the patient about the situation he was in and about his prospects, d. and the patient holds the conviction that there was no other reasonable solution for the situation he was in, e. has consulted at least one other, independent physician who has seen the patient and has given his written opinion on the‘ require- ments of due care . . . and f. has terminated a life or assisted in a suicide with due care. 2. If the patient aged sixteen years or older is no longer capable of expressing his will, but prior to reaching this condition was deemed to have a reasonable understanding of his interests and has made a written statement containing a request for termination of life, the physician may carry out this request. . . . 3. If the minor patient has attained an age between sixteen and eighteen years and may be deemed to have a reasonable understanding of his interests, the physician may carry out the patient’s request for termi- nation of' life or assisted suicide, after the parents have been involved in the decision process. 4. If the minor patient is aged between twelve and sixteen years and may be deemed to have a reasonable understanding of his interests, the physician may carry out the patient’s request, provided always that the ... parents .. . agree. . .. Chapter III. The Regional Review Committees for Termination of Life on Request and Assisted Suicide. . . . Article 3 1. There are regional committees for the review of notifications of cases of' termination of life on request and assistance in a suicide. . . . Article 8 1. The committee assesses on the basis of the [physician’s] report whether the physician . . . has acted in accordance with the requirements ofdue care. . .. Article 10 The committee is obliged to provide all information to the public prosecu- tor, at his request, which he may need: 1. for the benefit of the assessment of the physician’s actions [if the physician did not exercise due care]. . . . 2. for the benefit of a criminal investigation. . . . Chapter IV. Amendments to other Acts 354 AUTONOMY AS A CONSTITUTIONAL RIGHT CH. 3 Article 20 The Penal Code shall be amended as follows: . . . Article 293 shall read: . . . 1. A person who terminates the life of another person at that other person’s express and earnest request is liable to a term of imprisonment of not more than twelve years or a fine of the fifth category. 2. The offence . . . shall not be punishable if it has been committed by a physician who has met the requirements of due care . . . and who informs the municipal autopsist of this. . . . Article 294 shall read: 1. A person who intentionally incites another to commit suicide is liable to a term of imprisonment of not more than three years or a fine of the fourth category, where the suicide ensues. 2. . . . [Ah‘ticle 293 second paragraph applies mutatis mutandis. ...
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Autonomy as a Constitutional Right - The Law in Books - A....

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