Senate Study Bill 1192 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON JUDICIARY BILL BY CHAIRPERSON ZAUN) A BILL FOR An Act relating to medical certification of a suicide on a 1 death certificate and providing for licensee discipline. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 2507XC (2) 90 pf/rh

S.F. _____ Section 1. Section 144.28, Code 2023, is amended to read as 1 follows: 2 144.28 Medical certification —— licensee discipline . 3 1. a. For the purposes of this section , “nonnatural cause 4 of death” : 5 (1) “Nonnatural cause of death” means the death is a 6 direct or indirect result of physical, chemical, thermal, or 7 electrical trauma, or drug or alcohol intoxication or other 8 poisoning , or is a suicide . 9 (2) “Suicide” means the act or instance of intentionally 10 taking one’s own life. 11 b. Unless there is a nonnatural cause of death, the medical 12 certification shall be completed and signed by the physician, 13 physician assistant, or advanced registered nurse practitioner 14 in charge of the patient’s care for the illness or condition 15 which resulted in death within seventy-two hours after 16 receipt of the death certificate from the funeral director or 17 individual who initially assumes custody of the body. 18 c. (1) If there is a nonnatural cause of death, the county 19 or state medical examiner shall be notified and shall conduct 20 an inquiry. 21 (2) If the nonnatural cause of death is determined to be 22 a suicide, the person completing the medical certification of 23 cause of death shall do all of the following: 24 (a) List the lethal drug, overdose, or other means of 25 suicide that caused or contributed to the death among the chain 26 of events under cause of death or under significant conditions 27 contributing to death. 28 (b) If a lethal drug, overdose, or other means of suicide is 29 listed in the chain of events under cause of death, indicate 30 suicide as the manner of death. 31 d. If the decedent was an infant or child and the cause 32 of death is not known, a medical examiner’s inquiry shall be 33 conducted and an autopsy performed as necessary to exclude a 34 nonnatural cause of death. 35 -1- LSB 2507XC (2) 90 pf/rh 1/ 3

S.F. _____ e. If upon inquiry into a death, the county or state medical 1 examiner determines that a preexisting natural disease or 2 condition was the likely cause of death and that the death does 3 not affect the public interest as described in section 331.802, 4 subsection 3 , the medical examiner may elect to defer to the 5 physician, physician assistant, or advanced registered nurse 6 practitioner in charge of the patient’s preexisting condition 7 the certification of the cause of death. 8 f. When an inquiry is required by the county or state 9 medical examiner, the medical examiner shall investigate 10 the cause and manner of death and shall complete and sign 11 the medical certification within seventy-two hours after 12 determination of the cause and manner of death. 13 2. The person completing the medical certification of cause 14 of death shall attest to its accuracy either by signature or by 15 an electronic process approved by rule. 16 3. A person completing the medical certification of cause of 17 death who knowingly omits listing a lethal drug, overdose, or 18 other means of suicide or improperly states the manner of death 19 in violation of this section commits unprofessional conduct and 20 is subject to licensee discipline by the appropriate licensing 21 board or department. 22 EXPLANATION 23 The inclusion of this explanation does not constitute agreement with 24 the explanation’s substance by the members of the general assembly. 25 This bill relates to information regarding suicide in a 26 medical certification for a nonnatural cause of death. 27 The bill provides that a nonnatural cause of death, in 28 addition to a death that is a direct or indirect result of 29 physical, chemical, thermal, or electrical trauma, or drug or 30 alcohol intoxication or other poisoning, explicitly includes 31 a suicide. Suicide is defined as the act or instance of 32 intentionally taking one’s own life. 33 Under current law, if there is a nonnatural cause of death, 34 the county or state medical examiner shall be notified and 35 -2- LSB 2507XC (2) 90 pf/rh 2/ 3

S.F. _____ shall conduct an inquiry. The bill provides that if the 1 nonnatural cause of death is determined to be a suicide, the 2 person completing the medical certification of cause of death 3 shall list the lethal drug, overdose, or other means of suicide 4 that caused or contributed to the death among the chain of 5 events under cause of death or under significant conditions 6 contributing to death; and if a lethal drug, overdose, or other 7 means of suicide is listed in the chain of events under cause 8 of death, the person shall indicate suicide as the manner of 9 death. 10 The bill also provides that a person completing the medical 11 certification of cause of death who knowingly omits listing a 12 lethal drug, overdose, or other means of suicide or improperly 13 states the manner of death in violation of this Code section, 14 commits unprofessional conduct and is subject to licensee 15 discipline by the appropriate licensing board or department. 16 -3- LSB 2507XC (2) 90 pf/rh 3/ 3