Sep 27, 2012: Introduced, Referred to Assembly Health and Senior Services Committee
Feb 7, 2013: Reported out of Assembly Committee, 2nd Reading
This bill, which is designated as the "New Jersey Death with Dignity Act," would allow an adult New Jersey resident, who has the capacity to make health care decisions and who has been determined by that individual's attending and consulting physicians to be suffering from a terminal disease that will cause death within six months, to obtain medication that the patient may self-administer to end his life in a humane and dignified manner. The bill provides that a patient may make a written request for medication that the patient may self-administer in order to end that individual's life in a humane and dignified manner in accordance with this bill if the patient: (1) is an adult resident of New Jersey; (2) is capable and has been determined by the patient's attending physician and consulting physician to be suffering from a terminal disease; and (3) has voluntarily expressed a wish to die. A person is not to be considered a "qualified patient" (that is, eligible to obtain a prescription for medication as provided in this bill) solely because of the person's age or disability. A valid request for medication under the bill is to be in substantially the form set forth in the bill, signed and dated by the patient and witnessed by at least two individuals who, in the patient's presence, attest that, to the best of their knowledge and belief, the patient is capable and is acting voluntarily to sign the request. At least one of the witnesses must be a person who is not: (1) a relative of the patient by blood, marriage, or adoption; (2) at the time the request is signed, entitled to any portion of the estate of the qualified patient upon the patient's death under any will or by operation of law; and (3) an owner, operator, or employee of a health care facility where the qualified patient is receiving medical treatment or is a resident. The patient's attending physician at the time the request is signed is not permitted to serve as a witness. The attending physician is to ensure that all appropriate steps are carried out in accordance with the bill before writing a prescription for medication to enable a qualified patient to end the patient's life in a humane and dignified manner. The attending physician is to dispense medication directly, including ancillary medication intended to facilitate the desired effect to minimize the patient's discomfort, if the attending physician is authorized under law to dispense and has a current federal Drug Enforcement Administration certificate of registration; or, with the patient's written consent, contact a pharmacist to inform the latter of the prescription; and transmit the written prescription personally, by mail, or by otherwise permissible electronic communication to the pharmacist, who is to dispense the medication directly to either the patient, the attending physician, or an expressly identified agent of the patient. Medication is not to be dispensed to the patient by mail or other form of courier. The attending physician may sign the patient's death certificate, which is to list the underlying terminal disease as the cause of death. A person is not to be considered a qualified patient until a consulting physician has: (1) examined that person and the person's relevant medical records; (2) confirmed, in writing, the attending physician's diagnosis that the person is suffering from a terminal disease; and (3) verified that the person is capable, is acting voluntarily, and has made an informed decision to request medication to end the person's life in a humane and dignified manner. If, in the opinion of the attending physician or the consulting physician, a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment, either physician is to refer the patient for counseling. Medication to end a patient's life in a humane and dignified manner is not to be prescribed unless the person performing the counseling determines that the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment. A patient is not to receive a prescription for the medication unless the patient has made an informed decision. Immediately before writing the prescription, the attending physician is to verify that the patient is making an informed decision. A patient is not to receive a prescription for the medication unless the attending physician has recommended that the patient notify the patient's next of kin of the patient's request for the medication, except that the patient's request is not to be denied because the patient declines or is unable to notify the patient's next of kin. In order to receive the prescription, the patient must make an oral request and a written request, and reiterate the oral request to the patient's attending physician at least 15 days after making the initial oral request. At the time the patient makes a second oral request, the attending physician is to offer the patient an opportunity to rescind the request. At least 15 days must elapse between the patient's initial oral request and the writing of a prescription, and at least 48 hours between the time the patient signs the written request and the writing of a prescription. A qualified patient may rescind the request at any time and in any manner without regard to the patient's mental state. The attending physician is not to write a prescription for medication without offering the patient an opportunity to rescind the request. The following items are to be documented in the patient's medical record: (1) the oral requests and the written request by the patient to the attending physician for medication to end the patient's life in a humane and dignified manner; (2) the attending physician's diagnosis and prognosis, and determination that the patient is capable, is acting voluntarily, and has made an informed decision; (3) the consulting physician's diagnosis and prognosis, and verification that the patient is capable, is acting voluntarily, and has made an informed decision; (4) a report of the outcome and determinations made during counseling of the patient pursuant to the bill; (5) the attending physician's offer to the patient to rescind the patient's request at the time of the patient's second oral request; and (6) a note by the attending physician indicating that all requirements under the bill have been met and indicating the steps taken to carry out the patient's request for medication, including a notation of the medication prescribed. A request for medication is not to be granted unless the qualified patient has demonstrated that individual's New Jersey residency to the attending physician as set forth in the bill. The Director of the Division of Consumer Affairs (DCA) in the Department of Law and Public Safety is to require that a health care provider report the following information to DCA on a form and in a manner prescribed by regulation of the commissioner: (1) No later than 30 days after the dispensing of medication pursuant to this bill, the provider who dispensed the medication is to file a copy of the dispensing record with DCA, and otherwise facilitate the collection of such information as the director may require regarding compliance with the bill. (2) No later than 30 days after the date of the patient's death, the provider who prescribed the medication is to transmit to DCA such documentation of the patient's death as the director requires. Any information collected by DCA that contains material or data that could be used to identify an individual patient or health care provider shall not be included under materials available to public inspection. DCA is to prepare and make available to the public on its Internet website an annual statistical report of information collected pursuant to the bill. Nothing in this bill is to be construed to: authorize a physician or any other person to end a patient's life by lethal injection, active euthanasia, or mercy killing; or lower the applicable standard of care to be provided by a health care professional who takes any action in accordance with the provisions of the bill. A person is not subject to civil or criminal liability or professional disciplinary action for any action taken in compliance with the bill, including being present when a qualified patient takes medication to end the patient's life in a humane and dignified manner. Any action taken in accordance with the bill will not constitute suicide, assisted suicide, mercy killing, or homicide under any criminal law of this State. A patient's request for, or the provision of, medication in compliance with the bill will not constitute neglect for any purpose of law or provide the sole basis for the appointment of a guardian or conservator. Any action taken by a health care professional to carry out the provisions of this bill is voluntary on the part of that individual. A person who, without authorization of the patient, willfully alters or forges a request for medication pursuant to the bill, or conceals or destroys a rescission of that request with the intent or effect of causing the patient's death, is guilty of a crime of the second degree (punishable by imprisonment for a term of five to 10 years, or a fine of up to $150,000, or both). A person who coerces or exerts undue influence on a patient to request medication to end the patient's life, or to destroy a rescission of a request, is guilty of a crime of the third degree (punishable by imprisonment for a term of three to five years, or a fine of up to $15,000, or both). A health care facility may adopt a written policy to prohibit a health care professional from carrying out the provisions of the bill on the premises owned by, or under the direct control of, the facility if the facility has given prior written notice of the written policy to all health care professionals with privileges to practice on those premises. A health care professional who violates the written policy, after being notified in writing of that policy, is subject to such disciplinary action by the health care facility that adopted the written policy as is set forth in the bill. The bill amends section 1 of P.L.1991, c.270 (C.2A:62A-16) to stipulate that when a qualified patient requests medication that the patient may self-administer in order to end the patient's life in a humane and dignified manner in accordance with the provisions of this bill, a health care professional licensed in this State would not be required to take any of the actions set forth in that statute that apply if a health care professional believes a patient intends to carry out an act of imminent, serious physical violence against a readily identifiable individual or against himself (that is, to arrange for the patient to be admitted voluntarily to a psychiatric facility, or initiate procedures for involuntary commitment to treatment of the patient, or advise a local law enforcement authority). The bill also amends N.J.S.2C:11-6 (which makes it a crime to purposely aid a person to commit suicide) to stipulate that any action taken in accordance with the provisions of this bill does not constitute suicide or assisted suicide. The bill will only become operative if approved by the voters in a Statewide referendum and would take effect on the first day of the third month next following voter approval.