Burzichelli & Danielsen ‘Medical Aid in Dying for the Terminally Ill Act’ Approved by the Assembly

Measure Would Create a Process to Allow Terminally Ill Patients to Choose Their End of Life Option

(TRENTON) – The Medical Aid in Dying for the Terminally Act sponsored by Assemblymen John Burzichelli and Joe Danielsen was approved today by the Assembly, 41-33. The vote moves New Jersey closer to creating a process for terminally ill patients seeking medicinal assistance to end their lives.

The bill (A-1504), first introduced in 2012, has twice been approved by the Assembly but never reached a governor’s desk.

“This is about revisiting a statute last looked at in 1978 that never took into account an individual’s right to control their body and their circumstances,” said Burzichelli (D-Gloucester/Salem/Cumberland). “Like society, medicine, palliative care and hospice services have changed dramatically since then.  While there are many choices available right now that may be right for certain people, there is one more choice, not currently available, that deserves an honest discussion.”

“There are many strong opinions on this issue, but the truth is, only these patients understand what it is like to know death is approaching,” said Danielsen (D-Somerset/Middlesex). “Yes, death is inevitable, but for these patients, it is precise. Rather than waiting for the inevitable in pain and misery, this bill gives terminally ill patients the choice to meet their end on their own terms. This is the humane approach. We cannot prevent them from dying, but we can at least allow them to do it with dignity.”

The bill establishes the Medical Aid in Dying for the Terminally Ill Act, which will 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 terminally ill, to obtain medication that the patient may self-administer to terminate the patient’s life.

The patient would be required to make two oral requests and one written request to the patient’s attending physician for the medication.  The bill requires at least 15 days to elapse between the initial oral request and the second oral request, and between the patient’s initial oral request and the writing of a prescription for the medication.  A minimum of 48 hours are to elapse between the attending physician’s receipt of the written request and the writing of a prescription for medication.

Under the bill, when a patient makes an initial oral request for medication, the attending physician is required to provide the patient with information about the risks, probable results, and alternatives to taking the medication; recommend that the patient participate in a consultation concerning treatment options, and refer the patient to a health care professional who is qualified to discuss those alternatives.  The attending physician is also required to recommend that the patient notify the patient’s next of kin of the request, but medication may not be denied if a patient declines, or is unable to, provide this notification.

The attending physician is required to refer the patient to a consulting physician for the purpose of obtaining confirmation of the attending physician’s diagnosis.  Both the attending physician and the consulting physician are required to verify that the patient has made an informed decision.  When the patient makes the second oral request, the attending physician is to offer the patient an opportunity to rescind the request and is required to notify the patient that a request may be rescinded at any time.

A patient may make a written request for medicatio so long as the patient:  is an adult resident of New Jersey; is capable; is terminally ill, and has voluntarily expressed a wish to receive a prescription for the medication.

The bill requires the written request to be signed and dated by the patient and witnessed by at least two individuals who attest, in the patient’s presence, that, to the best of their knowledge and belief, the patient is capable and is acting voluntarily.

The bill requires at least one of the witnesses to be a person who is not:

*      a relative of the qualified patient by blood, marriage, or adoption;

*      at the time the request is signed, entitled to any portion of the patient’s estate upon the patient’s death;

*      an owner, operator, or employee of a health care facility, other than a long term care facility, where the patient is receiving medical treatment or is a resident.

The patient’s attending physician may not serve as a witness.

A written request form will be required to include an indication as to whether the patient has informed the patient’s next-of-kin about the request for medication.

If the patient complies with the bill’s oral and written request requirements, establishes State residency, and is found by both the attending physician and a consulting physician to be capable, to have a terminal illness, and to be acting voluntarily, the patient will be considered to be a “qualified terminally ill patient” who is eligible to receive a prescription for medication.

If either the attending physician or the consulting physician believes that the patient may lack capacity to make health care decisions, the physician will be required to refer the patient to a mental health care professional for a consultation to determine whether the patient is capable.  If such a referral is made, the attending physician is prohibited from issuing a prescription unless the attending physician has received written notice, from the mental health care professional, affirming that the patient is capable.

The attending physician is required to ensure that all appropriate steps have been carried out, and requisite documentation submitted.

A patient’s request for, or the provision of, medication in compliance with the bill will not constitute abuse or neglect of an elderly person, and may not be used as the sole basis for the appointment of a guardian or conservator.

Any person who, without the patient’s authorization, 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, will be guilty of a crime of the second degree, which is punishable by imprisonment for a term of five to 10 years, a fine of up to $150,000, or both. The bill does not impose any limit on liability for civil damages in association with the negligence or intentional misconduct of any person.

The bill provides immunity from civil and criminal liability, from professional disciplinary action, and from censure, discipline, suspension, or loss of any licensure, certification, privileges, or membership for any action that is undertaken in compliance with the bill. Nothing in the bill is to be construed to authorize a physician or other person to end a patient’s life by lethal injection, active euthanasia, or mercy killing.

Any medication prescribed under the bill, which the patient chooses not to self-administer, is required to be disposed of by lawful means.

The bill now awaits further consideration in the Senate.