House
File
65
-
Introduced
HOUSE
FILE
65
BY
MEYER
,
COHOON
,
WINCKLER
,
STUTSMAN
,
MASCHER
,
BROWN-POWERS
,
WOLFE
,
ANDERSON
,
and
WESSEL-KROESCHELL
A
BILL
FOR
An
Act
creating
the
Iowa
death
with
dignity
Act
and
providing
1
penalties.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
TLSB
1385YH
(8)
86
pf/nh
H.F.
65
Section
1.
NEW
SECTION
.
142E.1
Short
title.
1
This
chapter
shall
be
known
and
may
be
cited
as
the
“Iowa
2
Death
with
Dignity
Act”
.
3
Sec.
2.
NEW
SECTION
.
142E.2
Definitions.
4
As
used
in
this
chapter,
unless
the
context
otherwise
5
requires:
6
1.
“Adult”
means
an
individual
who
is
eighteen
years
of
age
7
or
older.
8
2.
“Attending
physician”
means
the
physician
who
has
primary
9
responsibility
for
the
care
of
the
patient
and
treatment
of
the
10
patient’s
terminal
disease.
11
3.
“Competent”
means
that
in
the
opinion
of
a
court
or
in
12
the
opinion
of
the
patient’s
attending
physician
or
consulting
13
physician,
psychiatrist,
or
psychologist,
a
patient
has
the
14
ability
to
make
and
communicate
health
care
decisions
to
15
health
care
providers,
including
communication
through
persons
16
familiar
with
the
patient’s
manner
of
communicating
if
those
17
persons
are
available.
18
4.
“Consulting
physician”
means
a
physician
who
is
qualified
19
by
specialty
or
experience
to
make
a
professional
diagnosis
and
20
prognosis
regarding
the
patient’s
disease.
21
5.
“Counseling”
means
one
or
more
consultations
as
necessary
22
between
a
licensed
psychiatrist
or
psychologist
and
a
patient
23
for
the
purpose
of
determining
that
the
patient
is
competent
24
and
not
suffering
from
a
psychiatric
or
psychological
disorder
25
or
depression
causing
impaired
judgment.
26
6.
“Department”
means
the
department
of
public
health.
27
7.
“Health
care
facility”
means
a
health
care
facility
as
28
defined
in
section
135C.1.
29
8.
“Health
care
provider”
means
a
person
licensed,
30
certified,
or
otherwise
authorized
or
permitted
by
the
law
of
31
this
state
to
administer
health
care
or
dispense
medication
in
32
the
ordinary
course
of
business
or
practice
of
a
profession,
33
and
includes
a
health
care
facility.
34
9.
“Informed
decision”
means
a
decision
by
a
qualified
35
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65
patient
to
request
and
obtain
a
prescription
to
end
the
1
patient’s
life
that
is
based
on
an
appreciation
of
the
relevant
2
facts
and
after
being
fully
informed
by
the
attending
physician
3
of
all
of
the
following:
4
a.
The
patient’s
medical
diagnosis.
5
b.
The
patient’s
prognosis.
6
c.
The
potential
risks
associated
with
taking
the
medication
7
to
be
prescribed.
8
d.
The
probable
result
of
taking
the
medication
to
be
9
prescribed.
10
e.
The
feasible
alternatives,
including
but
not
limited
to
11
comfort
care,
hospice
care,
and
pain
control.
12
10.
“Long-term
care
facility”
means
a
long-term
care
unit
13
of
a
hospital,
a
health
care
facility,
an
elder
group
home
as
14
defined
in
section
231B.1,
or
an
assisted
living
program
as
15
defined
in
section
231C.2.
16
11.
“Medically
confirmed”
means
the
medical
opinion
of
17
the
attending
physician
has
been
confirmed
by
a
consulting
18
physician
who
has
examined
the
patient
and
the
patient’s
19
relevant
medical
records.
20
12.
“Patient”
means
a
person
who
is
under
the
care
of
a
21
physician.
22
13.
“Physician”
means
a
person
licensed
to
practice
medicine
23
and
surgery
or
osteopathic
medicine
and
surgery
under
chapter
24
148.
25
14.
“Qualified
patient”
means
a
competent
adult
who
is
a
26
resident
of
Iowa
and
has
satisfied
the
requirements
of
this
27
chapter
to
obtain
a
prescription
for
medication
to
end
the
28
individual’s
life.
29
15.
“Self-administer”
means
a
qualified
patient’s
act
of
30
ingesting
medication
to
end
the
patient’s
life.
31
16.
“Terminal
disease”
means
an
incurable
and
irreversible
32
disease
that
has
been
medically
confirmed
and
that
will,
within
33
reasonable
medical
judgment,
produce
death
within
six
months.
34
Sec.
3.
NEW
SECTION
.
142E.3
Request
for
medication.
35
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1.
An
adult
patient
who
is
competent,
is
a
resident
of
1
this
state,
has
been
determined
by
the
patient’s
attending
2
physician
and
consulting
physician
to
be
suffering
from
a
3
terminal
disease,
and
has
voluntarily
expressed
a
wish
to
die,
4
may
make
a
written
request
for
medication
that
the
patient
may
5
self-administer
to
end
the
patient’s
life
in
accordance
with
6
this
chapter.
7
2.
A
person
shall
not
qualify
to
make
a
written
request
8
under
this
section
solely
because
of
age
or
disability.
9
Sec.
4.
NEW
SECTION
.
142E.4
Oral
and
written
requests
——
10
right
to
rescind.
11
1.
To
receive
a
prescription
for
medication
that
a
qualified
12
patient
may
self-administer
to
end
the
qualified
patient’s
life
13
pursuant
to
this
chapter,
the
qualified
patient
shall
make
an
14
initial
oral
request,
followed
by
a
subsequent
oral
request
15
at
least
fifteen
days
after
the
initial
oral
request,
and
a
16
written
request
to
the
qualified
patient’s
attending
physician.
17
2.
At
least
fifteen
days
shall
elapse
between
a
qualified
18
patient’s
initial
oral
request
and
the
writing
of
a
19
prescription
under
this
chapter.
20
3.
At
least
forty-eight
hours
shall
elapse
between
the
21
submission
of
a
qualified
patient’s
written
request
and
the
22
writing
of
a
prescription
under
this
chapter.
23
4.
a.
At
the
time
the
qualified
patient
makes
the
second
24
oral
request,
the
attending
physician
shall
offer
the
qualified
25
patient
an
opportunity
to
rescind
the
request.
26
b.
A
patient
may
rescind
a
request
for
a
prescription
for
27
medication
under
this
chapter
at
any
time
and
in
any
manner
28
without
regard
to
the
patient’s
mental
state.
A
prescription
29
for
medication
under
this
chapter
shall
not
be
written
prior
30
to
the
attending
physician
offering
the
qualified
patient
an
31
opportunity
to
rescind
the
request.
32
Sec.
5.
NEW
SECTION
.
142E.5
Procedure
for
request
——
33
witnesses.
34
1.
A
qualified
patient
who
is
unable
to
orally
communicate
35
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65
may
make
a
valid
oral
request
under
this
chapter
by
reducing
1
the
oral
request
to
writing
for
submission
to
the
qualified
2
patient’s
attending
physician.
Such
writing
is
not
subject
3
to
the
requirements
otherwise
applicable
to
a
written
request
4
under
this
chapter.
5
2.
a.
A
valid
written
request
for
medication
under
this
6
chapter
shall
be
in
substantially
the
form
described
in
section
7
142E.17,
shall
be
signed
and
dated
by
the
patient,
and
shall
8
be
witnessed
by
at
least
two
individuals
who,
in
the
presence
9
of
the
patient,
attest
that
to
the
best
of
their
knowledge
and
10
belief
the
patient
is
competent,
acting
voluntarily,
and
is
not
11
being
coerced
to
sign
the
request.
12
b.
One
of
the
witnesses
shall
be
a
person
who
is
not
any
of
13
the
following:
14
(1)
A
relative
of
the
patient
by
blood,
marriage,
or
15
adoption.
16
(2)
A
person
who
at
the
time
the
request
is
signed
would
be
17
entitled
to
any
portion
of
the
estate
of
the
patient
upon
death
18
under
any
will
or
by
operation
of
law.
19
(3)
An
owner,
operator,
or
employee
of
a
long-term
care
20
facility
where
the
patient
is
receiving
medical
treatment
or
21
is
a
resident.
22
c.
The
patient’s
attending
physician
at
the
time
the
request
23
is
signed
shall
not
be
a
witness.
24
d.
If
the
patient
is
a
patient
in
a
long-term
care
facility
25
at
the
time
the
written
request
is
made,
one
of
the
witnesses
26
shall
be
an
individual
designated
by
the
facility
and
having
27
the
qualifications
specified
by
the
department
by
rule.
28
Sec.
6.
NEW
SECTION
.
142E.6
Attending
physician
29
responsibilities.
30
1.
The
attending
physician
shall
do
all
of
the
following:
31
a.
Make
the
initial
determination
of
whether
a
patient
has
32
a
terminal
disease,
is
competent,
and
has
made
the
request
for
33
medication
under
this
chapter
voluntarily.
34
b.
Request
that
the
patient
demonstrate
residency
in
the
35
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65
state.
Factors
demonstrating
residency
in
this
state
include
1
but
are
not
limited
to:
2
(1)
Possession
of
an
Iowa
driver’s
license.
3
(2)
Registration
to
vote
in
Iowa.
4
(3)
Evidence
that
the
person
owns
or
leases
property
in
5
Iowa.
6
(4)
Filing
of
an
Iowa
tax
return
for
the
most
recent
tax
7
year.
8
c.
Verify
immediately
prior
to
writing
the
prescription
for
9
medication,
that
the
patient
is
making
an
informed
decision.
10
d.
Refer
the
patient
to
a
consulting
physician
for
medical
11
confirmation
of
the
diagnosis,
and
for
a
determination
that
the
12
patient
is
competent
and
acting
voluntarily.
13
e.
Refer
the
patient
for
counseling
if
appropriate
under
14
section
142E.8.
15
f.
Recommend
that
the
patient
notify
next
of
kin.
However,
16
a
qualified
patient’s
request
for
medication
shall
not
17
be
denied
based
on
the
qualified
patient’s
declination
or
18
inability
to
notify
next
of
kin.
19
g.
Counsel
the
patient
about
the
importance
of
having
20
another
person
present
when
the
patient
takes
the
medication
21
prescribed
and
of
not
taking
the
medication
in
a
public
place.
22
h.
Inform
the
patient
that
the
patient
has
an
opportunity
23
to
rescind
the
request
at
any
time
and
in
any
manner,
and
offer
24
the
patient
an
opportunity
to
rescind
the
request
at
the
end
of
25
the
fifteen-day
waiting
period
under
section
142E.4.
26
i.
Fulfill
the
medical
record
documentation
requirements
27
under
section
142E.9.
28
j.
Ensure
that
all
appropriate
steps
are
carried
out
in
29
accordance
with
this
chapter
prior
to
writing
a
prescription
30
for
medication
to
enable
a
qualified
patient
to
end
the
31
patient’s
life.
32
k.
Do
either
of
the
following:
33
(1)
Dispense
medications
directly,
including
ancillary
34
medications
intended
to
facilitate
the
desired
effect
to
35
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65
minimize
the
patient’s
discomfort,
if
the
attending
physician
1
is
authorized
under
law
and
rule
to
dispense
such
medication
2
and
has
a
current
valid
drug
enforcement
administration
number,
3
if
required
under
chapter
124.
4
(2)
With
the
patient’s
written
consent:
5
(a)
Contact
a
pharmacist
and
inform
the
pharmacist
of
the
6
prescription.
7
(b)
Deliver
the
written
prescription
personally,
by
8
mail,
or
by
facsimile
to
the
pharmacist
who
will
dispense
the
9
medications
to
either
the
patient,
the
attending
physician,
or
10
an
expressly
identified
agent
of
the
patient.
11
2.
Notwithstanding
any
other
provision
of
law
to
the
12
contrary,
the
attending
physician
may
sign
the
patient’s
death
13
certificate.
14
Sec.
7.
NEW
SECTION
.
142E.7
Consulting
physician
15
confirmation.
16
A
consulting
physician
shall
do
all
of
the
following
in
17
confirming
that
a
patient
is
a
qualified
patient
under
this
18
chapter:
19
1.
Examine
the
patient
and
the
patient’s
relevant
medical
20
records
and
confirm,
in
writing,
the
attending
physician’s
21
diagnosis
that
the
patient
is
suffering
from
a
terminal
22
disease.
23
2.
Verify
that
the
patient
is
competent,
acting
24
voluntarily,
and
has
made
an
informed
decision.
25
Sec.
8.
NEW
SECTION
.
142E.8
Counseling
referral.
26
1.
If,
in
the
opinion
of
the
attending
physician
or
the
27
consulting
physician,
a
patient
may
be
suffering
from
a
28
psychiatric
or
psychological
disorder
or
depression
causing
29
impaired
judgment,
either
physician
shall
refer
the
patient
for
30
counseling.
31
2.
An
attending
physician
shall
not
prescribe
medication
to
32
end
a
patient’s
life
pursuant
to
this
chapter
until
the
person
33
performing
the
counseling
determines
and
verifies
that
the
34
patient
is
not
suffering
from
a
psychiatric
or
psychological
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disorder
or
depression
causing
impaired
judgment.
1
Sec.
9.
NEW
SECTION
.
142E.9
Medical
record
documentation
2
requirements.
3
All
of
the
following
shall
be
documented
or
filed
in
a
4
patient’s
medical
record
in
regard
to
a
request
for
medication
5
under
this
chapter:
6
1.
All
oral
requests
by
a
patient
for
medication
to
end
the
7
patient’s
life
pursuant
to
this
chapter.
8
2.
All
written
requests
by
a
patient
for
medication
to
end
9
the
patient’s
life
pursuant
to
this
chapter.
10
3.
The
attending
physician’s
diagnosis
and
prognosis
11
and
determinations
that
the
patient
is
competent,
is
acting
12
voluntarily,
and
has
made
an
informed
decision.
13
4.
The
consulting
physician’s
diagnosis
and
prognosis
14
and
verification
that
the
patient
is
competent,
is
acting
15
voluntarily,
and
has
made
an
informed
decision.
16
5.
A
report
of
the
outcome
and
determinations
made
during
17
counseling,
if
performed.
18
6.
The
attending
physician’s
offer
to
the
patient
to
rescind
19
the
patient’s
request
at
the
time
of
the
patient’s
second
oral
20
request
pursuant
to
section
142E.4.
21
7.
A
note
by
the
attending
physician
indicating
that
all
22
requirements
under
this
chapter
have
been
met
and
indicating
23
the
steps
taken
to
carry
out
the
request,
including
a
notation
24
of
the
medication
prescribed.
25
Sec.
10.
NEW
SECTION
.
142E.10
Reporting
requirements.
26
1.
a.
The
department
shall
require
any
health
care
27
provider,
upon
dispensing
medication
pursuant
to
this
chapter,
28
to
file
a
copy
of
the
dispensing
record
with
the
department.
29
b.
The
department
shall
annually
review
a
sample
of
records
30
maintained
under
this
chapter.
31
2.
The
department
shall
adopt
rules
to
facilitate
the
32
collection
of
information
regarding
compliance
with
this
33
chapter.
Except
as
otherwise
required
by
law,
the
information
34
collected
shall
not
be
a
public
record
and
shall
not
be
made
35
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65
available
for
inspection
by
the
public.
1
3.
The
department
shall
generate
and
make
available
to
the
2
public
an
annual
statistical
report
of
information
collected
3
under
subsection
2.
4
Sec.
11.
NEW
SECTION
.
142E.11
Effect
on
construction
of
5
wills,
contracts,
and
other
agreements.
6
1.
A
provision
in
a
contract,
will,
or
other
agreement,
7
whether
written
or
oral,
to
the
extent
the
provision
would
8
affect
whether
a
person
may
make
or
rescind
a
request
for
9
medication
to
end
the
person’s
life
pursuant
to
this
chapter,
10
shall
not
be
valid.
11
2.
An
obligation
owing
under
any
contract
shall
not
be
12
conditioned
or
affected
by
the
making
or
rescinding
of
a
13
request
by
a
person
for
medication
to
end
the
person’s
life
14
pursuant
to
this
chapter.
15
Sec.
12.
NEW
SECTION
.
142E.12
Insurance
or
annuity
16
policies.
17
The
sale,
procurement,
or
issuance
of
any
life,
health,
18
or
accident
insurance
or
annuity
policy
or
the
rate
charged
19
for
any
such
policy
shall
not
be
conditioned
upon
or
affected
20
by
the
making
or
rescinding
of
a
request
by
a
person
for
21
medication
that
may
be
self-administered
to
end
the
person’s
22
life
pursuant
to
this
chapter.
A
qualified
patient’s
act
of
23
self-administering
medication
to
end
the
qualified
patient’s
24
life
pursuant
to
this
chapter
shall
not
have
an
effect
upon
a
25
life,
health,
or
accident
insurance
or
annuity
policy.
26
Sec.
13.
NEW
SECTION
.
142E.13
Construction
of
chapter.
27
1.
Nothing
in
this
chapter
shall
be
construed
to
authorize
28
a
physician
or
any
other
person
to
end
a
patient’s
life
by
29
lethal
injection,
mercy
killing,
or
active
euthanasia.
An
30
action
taken
in
accordance
with
this
chapter
shall
not,
for
any
31
purpose,
constitute
suicide,
assisted
suicide,
mercy
killing,
32
or
homicide
under
the
law.
33
2.
Nothing
in
this
chapter
shall
be
interpreted
to
lessen
34
the
applicable
standard
of
care
for
an
attending
physician,
35
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consulting
physician,
psychiatrist,
psychologist,
or
other
1
health
care
provider
acting
under
this
chapter.
2
Sec.
14.
NEW
SECTION
.
142E.14
Immunities
——
basis
3
for
prohibiting
health
care
provider
from
participation
——
4
notification
——
permissible
sanctions.
5
Except
as
otherwise
provided
in
this
chapter:
6
1.
A
person
shall
not
be
subject
to
civil
or
criminal
7
liability
or
professional
disciplinary
action
for
acting
8
in
good-faith
compliance
with
this
chapter,
including
9
being
present
when
a
qualified
patient
self-administers
the
10
prescribed
medication
to
end
the
qualified
patient’s
life
11
pursuant
to
this
chapter.
12
2.
A
professional
organization
or
association,
or
13
health
care
provider,
shall
not
subject
a
person
to
censure,
14
discipline,
suspension,
loss
of
license,
loss
of
privileges,
15
loss
of
membership,
or
other
penalty
for
acting
or
refusing
to
16
act
in
good-faith
compliance
with
this
chapter.
17
3.
A
request
by
a
patient
for
or
provision
by
an
attending
18
physician
of
medication
in
good-faith
compliance
with
this
19
chapter
shall
not
constitute
neglect
under
the
law
or
provide
20
the
sole
basis
for
the
appointment
of
a
guardian
or
conservator
21
for
the
patient.
22
4.
A
health
care
provider
shall
not
be
under
any
duty,
23
whether
by
contract,
statute,
or
any
other
legal
requirement,
24
to
participate
in
the
provision
to
a
qualified
patient
of
25
medication
to
end
the
patient’s
life
pursuant
to
this
chapter.
26
If
a
health
care
provider
is
unable
or
unwilling
to
carry
out
a
27
patient’s
request
under
this
chapter
and
the
patient
transfers
28
the
patient’s
care
to
a
new
health
care
provider,
the
prior
29
health
care
provider
shall
transfer,
upon
request,
a
copy
of
30
the
patient’s
relevant
medical
records
to
the
new
health
care
31
provider.
32
5.
a.
Notwithstanding
any
other
provision
of
law
to
the
33
contrary,
a
health
care
provider
may
prohibit
another
health
34
care
provider
from
acting
under
this
chapter
on
the
premises
35
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of
the
prohibiting
provider
if
the
prohibiting
provider
has
1
notified
the
health
care
provider
of
the
prohibiting
provider’s
2
policy
regarding
actions
under
this
chapter.
Nothing
in
this
3
paragraph
shall
prevent
a
health
care
provider
from
providing
4
health
care
services
to
a
patient
that
do
not
constitute
action
5
under
this
chapter.
6
b.
Notwithstanding
the
provisions
of
this
section
to
the
7
contrary,
a
health
care
provider
may
subject
another
health
8
care
provider
to
the
following
sanctions
if
the
sanctioning
9
health
care
provider
has
notified
the
sanctioned
provider
prior
10
to
action
under
this
chapter
that
the
health
care
provider
11
prohibits
actions
under
this
chapter:
12
(1)
Loss
of
privileges,
loss
of
membership,
or
other
13
sanction
provided
pursuant
to
the
medical
staff
bylaws,
14
policies,
or
procedures
of
the
sanctioning
health
care
provider
15
if
the
sanctioned
provider
is
a
member
of
the
sanctioning
16
provider’s
medical
staff
and
acts
under
this
chapter
while
on
17
the
health
care
facility
premises
of
the
sanctioning
health
18
care
provider,
but
not
including
the
private
medical
office
of
19
a
physician
or
other
provider.
20
(2)
Termination
of
a
lease
or
other
property
contract
or
21
other
nonmonetary
remedies
provided
by
a
lease
or
contract,
22
not
including
loss
or
restriction
of
medical
staff
privileges
23
or
exclusion
from
a
provider
panel,
if
the
sanctioned
24
provider
acts
under
this
chapter
while
on
the
premises
of
the
25
sanctioning
health
care
provider
or
on
property
that
is
owned
26
by
or
under
the
direct
control
of
the
sanctioning
health
care
27
provider.
28
(3)
Termination
of
a
contract
or
other
nonmonetary
remedies
29
provided
by
a
contract
if
the
sanctioned
provider
acts
under
30
this
chapter
while
acting
in
the
course
and
scope
of
the
31
sanctioned
provider’s
capacity
as
an
employee
or
independent
32
contractor
of
the
sanctioning
health
care
provider.
Nothing
33
in
this
subparagraph
shall
be
construed
to
prevent
any
of
the
34
following:
35
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(a)
A
health
care
provider
from
acting
under
this
chapter
1
while
acting
outside
the
course
and
scope
of
the
provider’s
2
capacity
as
an
employee
or
independent
contractor.
3
(b)
A
patient
from
contracting
with
the
patient’s
attending
4
physician
and
consulting
physician
to
act
outside
the
course
5
and
scope
of
the
provider’s
capacity
as
an
employee
or
6
independent
contractor
of
the
sanctioning
health
care
provider.
7
c.
A
health
care
provider
that
imposes
sanctions
pursuant
to
8
paragraph
“b”
shall
follow
all
due
process
and
other
procedures
9
the
sanctioning
health
care
provider
uses
for
the
imposition
of
10
sanctions
on
other
health
care
providers
under
the
authority
of
11
the
sanctioning
health
care
provider.
12
d.
For
the
purposes
of
this
subsection:
13
(1)
“Action
under
this
chapter”
means
to
perform
the
14
duties
of
an
attending
physician,
the
consulting
physician
15
function,
or
the
counseling
function
as
specified
under
this
16
chapter.
“Action
under
this
chapter”
does
not
include
any
of
17
the
following:
18
(a)
Making
an
initial
determination
that
a
patient
has
19
a
terminal
disease
and
informing
the
patient
of
the
medical
20
prognosis.
21
(b)
Providing
information
about
this
chapter
to
a
patient
22
upon
the
request
of
the
patient.
23
(c)
Providing
a
patient,
upon
the
request
of
the
patient,
24
with
a
referral
to
another
physician.
25
(d)
A
patient
contracting
with
the
patient’s
attending
26
physician
and
consulting
physician
to
act
outside
of
the
27
course
and
scope
of
the
provider’s
capacity
as
an
employee
or
28
independent
contractor
of
the
sanctioning
health
care
provider.
29
(2)
“Notify”
means
a
separate
statement
in
writing
to
the
30
health
care
provider
specifically
informing
the
health
care
31
provider
prior
to
the
provider’s
action
under
this
chapter
of
32
the
sanctioning
health
care
provider’s
policy
about
actions
33
under
this
chapter.
34
Sec.
15.
NEW
SECTION
.
142E.15
Liabilities
——
penalties.
35
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1.
A
person
who
without
authorization
of
the
patient
1
willfully
alters
or
forges
a
request
for
medication
under
this
2
chapter
or
conceals
or
destroys
a
recision
of
a
request
for
3
medication
under
this
chapter
with
the
intent
or
effect
of
4
causing
the
patient’s
death
is
guilty
of
a
class
“A”
felony.
5
2.
A
person
who
coerces
or
exerts
undue
influence
on
a
6
patient
to
request
medication
for
the
purpose
of
ending
the
7
patient’s
life
pursuant
to
this
chapter,
or
to
destroy
a
8
recision
of
such
a
request,
is
guilty
of
a
class
“A”
felony.
9
3.
Nothing
in
this
chapter
shall
be
construed
to
limit
10
a
person’s
liability
for
civil
damages
resulting
from
the
11
person’s
negligent
conduct
or
intentional
misconduct
applicable
12
under
other
law
for
conduct
which
is
inconsistent
with
the
13
provisions
of
this
chapter.
14
4.
The
penalties
specified
in
this
section
shall
not
15
preclude
criminal
penalties
applicable
under
other
law
for
16
conduct
which
is
inconsistent
with
the
provisions
of
this
17
chapter.
18
Sec.
16.
NEW
SECTION
.
142E.16
Claims
by
governmental
entity
19
for
costs
incurred.
20
A
governmental
entity
that
incurs
costs
resulting
from
a
21
person
terminating
the
person’s
life
pursuant
to
this
chapter
22
in
a
public
place
shall
have
a
claim
against
the
estate
of
23
the
person
to
recover
such
costs
and
reasonable
attorney
fees
24
related
to
enforcing
the
claim.
25
Sec.
17.
NEW
SECTION
.
142E.17
Form
of
written
request.
26
A
written
request
for
medication
as
authorized
by
this
27
chapter
shall
be
in
substantially
the
following
form:
28
REQUEST
FOR
MEDICATION
29
TO
END
MY
LIFE
IN
A
HUMANE
30
AND
DIGNIFIED
MANNER
31
I,
______________________,
am
an
adult
of
sound
mind.
32
I
am
suffering
from
_________,
which
my
attending
physician
has
33
determined
is
a
terminal
disease
and
which
has
been
medically
34
confirmed
by
a
consulting
physician.
35
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I
have
been
fully
informed
of
my
diagnosis,
prognosis,
the
1
nature
of
medication
to
be
prescribed
and
potential
associated
2
risks,
the
expected
result,
and
the
feasible
alternatives,
3
including
comfort
care,
hospice
care,
and
pain
control.
4
I
request
that
my
attending
physician
prescribe
medication
that
5
will
end
my
life
in
a
humane
and
dignified
manner.
6
INITIAL
ONE
OF
THE
FOLLOWING:
7
______
I
have
informed
my
family
of
my
decision
and
taken
their
8
opinions
into
consideration.
9
______
I
have
decided
not
to
inform
my
family
of
my
decision.
10
______
I
have
no
family
to
inform
of
my
decision.
11
I
understand
that
I
have
the
right
to
rescind
this
request
at
12
any
time.
13
I
understand
the
full
import
of
this
request
and
I
expect
to
14
die
when
I
take
the
medication
to
be
prescribed.
I
further
15
understand
that
although
most
deaths
occur
within
three
hours,
16
my
death
may
take
longer
and
my
physician
has
counseled
me
17
about
this
possibility.
18
I
make
this
request
voluntarily
and
without
reservation,
and
I
19
accept
full
moral
responsibility
for
my
actions.
20
Signed:
_______________
21
Dated:
_______________
22
DECLARATION
OF
WITNESSES
23
By
initialing
and
signing
below
on
or
after
the
date
the
person
24
named
above
signs,
we
declare
that
the
person
making
and
25
signing
the
above
request:
26
(a)
Is
personally
known
to
us
or
has
provided
proof
of
27
identity.
28
(b)
Signed
this
request
in
our
presence
on
the
date
of
the
29
person’s
signature.
30
(c)
Appears
to
be
of
sound
mind
and
not
under
duress,
fraud,
or
31
undue
influence.
32
(d)
Is
not
a
patient
for
whom
either
of
us
is
the
attending
33
physician.
34
Printed
name
of
Witness
1
____________________
35
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Signed
name
of
Witness
1/Date
________________________
1
Printed
name
of
Witness
2
____________________
2
Signed
name
of
Witness
2/Date
________________________
3
NOTE:
One
witness
shall
not
be
a
relative
by
blood,
marriage,
4
or
adoption
of
the
person
signing
this
request,
shall
not
be
5
entitled
to
any
portion
of
the
person’s
estate
upon
death,
6
and
shall
not
own,
operate,
or
be
employed
at
a
health
care
7
facility
where
the
person
is
a
patient
or
resident.
If
the
8
patient
is
an
inpatient
at
a
health
care
facility,
one
of
the
9
witnesses
shall
be
an
individual
designated
by
the
facility.
10
EXPLANATION
11
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
12
the
explanation’s
substance
by
the
members
of
the
general
assembly.
13
This
bill
provides
for
a
competent
adult
patient,
who
is
14
a
resident
of
the
state
of
Iowa,
who
is
terminally
ill
with
15
less
than
six
months
to
live
as
verified
by
two
physicians,
to
16
voluntarily
request
medication
that
will
end
the
person’s
life.
17
The
bill
provides
that
the
patient
must
make
an
oral
request,
a
18
subsequent
oral
request
no
less
than
15
days
after
the
initial
19
request,
and
a
written
request
for
the
medication.
There
is
20
also
a
48-hour
waiting
period
between
the
submission
of
the
21
written
request
and
the
writing
of
the
prescription.
The
bill
22
specifies
the
responsibilities
of
the
attending
physician
and
23
the
consulting
physician.
The
bill
includes
a
provision
for
24
counseling
if
the
attending
physician
deems
it
appropriate,
the
25
notification
of
next
of
kin,
the
right
to
rescind
a
request
at
26
any
time,
and
documentation
requirements.
The
bill
provides
27
for
the
effect
of
a
request
for
medication
to
end
the
person’s
28
life
on
the
construction
of
wills,
contracts,
and
statutes
as
29
well
as
on
insurance
and
annuity
policies.
30
The
bill
provides
that
the
provisions
of
the
bill
are
not
31
to
be
construed
to
authorize
a
physician
or
any
other
person
32
to
end
a
patient’s
life
by
lethal
injection,
mercy
killing,
33
or
active
euthanasia,
and
that
actions
taken
in
accordance
34
with
the
bill
shall
not,
for
any
purpose,
constitute
suicide,
35
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16
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65
assisted
suicide,
mercy
killing,
or
homicide
under
the
1
law.
Additionally,
the
provisions
of
the
bill
are
not
to
be
2
interpreted
to
lessen
the
applicable
standard
of
care
for
the
3
attending
physician,
consulting
physician,
psychiatrist,
or
4
psychologist,
or
other
health
care
provider
acting
under
the
5
bill.
6
The
bill
provides
immunities
for
a
person
who
acts
in
7
good-faith
compliance
with
the
bill,
including
being
present
8
when
a
patient
takes
the
prescribed
medication
to
end
the
9
patient’s
life.
10
The
bill
provides
that
a
professional
organization
or
11
association,
or
health
care
provider,
shall
not
subject
a
12
person
to
censure,
discipline,
suspension,
loss
of
license,
13
loss
of
privileges,
loss
of
membership,
or
other
penalty
for
14
acting
or
refusing
to
act
in
good-faith
compliance
with
the
15
bill,
but
does
provide
for
prohibitions
by
a
health
care
16
provider
on
the
premises
of
the
health
care
provider
relative
17
to
the
bill.
The
bill
provides
that
a
request
by
a
patient
18
for
or
provision
by
an
attending
physician
of
medication
in
19
good-faith
compliance
with
the
bill
does
not
constitute
neglect
20
under
the
law
or
provide
the
sole
basis
for
the
appointment
21
of
a
guardian
or
conservator
for
the
patient.
Under
the
22
bill,
a
health
care
provider
is
not
to
be
under
any
duty,
23
whether
by
contract,
statute,
or
any
other
legal
requirement
24
to
participate
in
the
provision
to
a
patient
of
medication
to
25
end
the
patient’s
life.
If
a
health
care
provider
is
unable
26
or
unwilling
to
carry
out
a
patient’s
request
under
the
bill,
27
however,
and
the
patient
transfers
the
patient’s
care
to
a
28
new
health
care
provider,
the
prior
health
care
provider
is
29
required
to
transfer,
upon
request,
a
copy
of
the
patient’s
30
relevant
medical
records
to
the
new
health
care
provider.
31
The
bill
provides
that
a
person
who
without
authorization
of
32
the
patient
willfully
alters
or
forges
a
request
for
medication
33
under
the
bill
or
conceals
or
destroys
a
recision
of
such
a
34
request
with
the
intent
or
effect
of
causing
the
patient’s
35
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16
H.F.
65
death
is
guilty
of
a
class
“A”
felony.
Additionally,
a
person
1
who
coerces
or
exerts
undue
influence
on
a
patient
to
request
2
medication
for
the
purpose
of
ending
the
patient’s
life
under
3
the
bill,
or
to
destroy
a
recision
of
such
a
request,
is
guilty
4
of
a
class
“A”
felony.
A
class
“A”
felony
is
punishable
by
5
confinement
for
life
without
possibility
of
parole.
6
The
bill
provides
that
the
provisions
of
the
bill
are
7
not
to
be
construed
to
limit
a
person’s
liability
for
civil
8
damages
resulting
from
other
negligent
conduct
or
intentional
9
misconduct
by
the
person
and
that
the
penalties
specified
in
10
the
bill
shall
not
preclude
criminal
penalties
applicable
under
11
other
law
for
conduct
which
is
inconsistent
with
the
provisions
12
of
the
bill.
13
The
bill
provides
that
if
a
governmental
entity
incurs
costs
14
resulting
from
a
person
terminating
the
person’s
life
under
the
15
bill
in
a
public
place,
the
governmental
entity
has
a
claim
16
against
the
estate
of
the
person
to
recover
such
costs
and
17
reasonable
attorney
fees
related
to
enforcing
the
claim.
18
The
bill
also
provides
the
form
for
the
request
for
19
medication
to
end
a
person’s
life.
20
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16