X-Message-Number: 11823
Date: Wed, 26 May 1999 09:42:48 -0700
From: David Brandt-Erichsen <>
Subject: Oregon law amended

Changes to the Oregon Death with Dignity Act have passed both the House and
Senate in Oregon and are expected to be signed by the Governor.  These
changes are given below.  For a copy of the existing Oregon law, go to:

http://www.azstarnet.com/~davidbe/hemlock/oregon.htm

OREGON LAW CHANGES

70th OREGON LEGISLATIVE ASSEMBLY--1999 Regular Session

NOTE:  Matter within  { +  braces and plus signs + } in an
amended section is new. Matter within  { -  braces and minus
signs - } is existing law to be omitted. New sections are within
 { +  braces and plus signs + } .

Senate Bill 491

Sponsored by COMMITTEE ON JUDICIARY

A BILL FOR AN ACT
Relating to Oregon Death with Dignity Act; amending ORS 127.800,
  127.805, 127.815, 127.825, 127.830, 127.835, 127.855, 127.860,
  127.865, 127.885 and 127.897; and declaring an emergency.

Be It Enacted by the People of the State of Oregon:

  SECTION 1. ORS 127.800 is amended to read:
  127.800. s1.01. Definitions. The following words and phrases,
whenever used in ORS 127.800 to 127.897,   { - shall - }  have
the following meanings:
  (1) 'Adult' means an individual who is 18 years of age or
older.
  (2) 'Attending physician' means the physician who has primary
responsibility for the care of the patient and treatment of the
patient's terminal disease.
   { +  (3) 'Capable' means that in the opinion of a court or in
the opinion of the patient's attending physician or consulting
physician, psychiatrist or psychologist, a patient has the
ability to make and communicate health care decisions to health
care providers, including communication through persons familiar
with the patient's manner of communicating if those persons are
available. + }
    { - (3) - }   { + (4) + } 'Consulting physician' means a
physician who is qualified by specialty or experience to make a
professional diagnosis and prognosis regarding the patient's
disease.
    { - (4) - }   { + (5) + } 'Counseling' means   { - a
consultation - }   { + one or more consultations as necessary + }
between a state licensed psychiatrist or psychologist and a
patient for the purpose of determining
  { - whether - }   { + that + } the patient is  { + capable and
not + } suffering from a psychiatric or psychological disorder
 { - , - }  or depression causing impaired judgment.
    { - (5) - }   { + (6) + } 'Health care provider' means a
person licensed, certified  { - , - }  or otherwise authorized or
permitted by the law of this state to administer health care
 { + or provide medication + } in the ordinary course of business
or practice of a profession, and includes a health care facility.
    { - (6) 'Incapable' means that in the opinion of a court or
in the opinion of the patient's attending physician or consulting
physician, a patient lacks the ability to make and communicate
health care decisions to health care providers, including
communication through persons familiar with the patient's manner
of communicating if those persons are available. Capable means
not incapable. - }
  (7) 'Informed decision' means a decision by a qualified
patient, to request 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;  { + and + }
  (e) The feasible alternatives, including, but not limited to,
comfort care, hospice care { + , + }   { - and - }  pain
control { + , refusal of nutrition and hydration and
discontinuation of life-sustaining treatment + }.
  (8) 'Medically confirmed' means the medical opinion of the
attending physician has been confirmed by a consulting physician
who has examined the patient and the patient's relevant medical
records.
  (9) 'Patient' means a person who is under the care of a
physician.
  (10) 'Physician' means a doctor of medicine or osteopathy
licensed to practice medicine by the Board of Medical Examiners
for the State of Oregon.
  (11) 'Qualified patient' means a capable adult who is a
resident of Oregon and has satisfied the requirements of ORS
127.800 to 127.897 in order to obtain a prescription for
medication to end his or her life in a humane and dignified
manner.
   { +  (12) 'Resident' means a person domiciled in Oregon. + }
    { - (12) - }   { + (13) + } 'Terminal disease' means an
incurable and irreversible disease that has been medically
confirmed and will, within reasonable medical judgment, produce
death within six   { - (6) - } months.

  SECTION 2. ORS 127.805 is amended to read:
  127.805. s2.01. Who may initiate a written request for
medication.  { + (1) + } 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 disease, 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 ORS
127.800 to 127.897.
   { +  (2) No person shall qualify under the provisions of ORS
127.800 to 127.897 solely because of age or disability. + }

  SECTION 3. ORS 127.815 is amended to read:
  127.815. s3.01. Attending physician responsibilities. The
attending physician shall:
  (1) Make the initial determination of whether a patient has a
terminal disease, is capable, and has made the request
voluntarily;
   { +  (2) Verify that the patient is a resident of Oregon; + }
    { - (2) - }   { + (3) To ensure that the patient is making an
informed decision, + } inform the patient 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;  { + and + }
  (e) The feasible alternatives, including, but not limited to,
comfort care, hospice care { + , + }   { - and - }  pain
control { + , refusal of nutrition and hydration and
discontinuation of life-sustaining treatment; + }  { - . - }
    { - (3) - }   { + (4) + } Refer the patient to a consulting
physician for medical confirmation of the diagnosis, and for a
determination that the patient is capable and acting voluntarily;
    { - (4) - }   { + (5) + } Refer the patient for counseling
 { - if appropriate - } pursuant to ORS 127.825;
    { - (5) - }   { + (6) + }   { - Request - }
 { + Recommend + } that the patient notify next of kin;
    { - (6) - }   { + (7) + } 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 ORS 127.840;
    { - (7) - }   { + (8) + } Verify, immediately prior to
writing the prescription for medication under ORS 127.800 to
127.897, that the patient is making an informed decision
 { - : - }  { + ; + }
    { - (8) - }   { + (9) + } Fulfill the medical record
documentation requirements of ORS 127.855;
    { - (9) - }   { + (10) + } Ensure that all appropriate steps
are carried out in accordance with ORS 127.800 to 127.897 prior
to writing a prescription for medication to enable a qualified
patient to end his or her life in a humane and dignified manner
 { - . - }  { + ; + }
   { +  (11) Indicate on the face of any prescription that the
prescription is 'written pursuant to ORS 127.800 et seq.'; and
  (12) Notwithstanding any other law, complete and sign the
patient's death certificate. + }

  SECTION 4. ORS 127.825 is amended to read:
  127.825. s3.03. Counseling referral.   { - If in the opinion of
the attending physician or the consulting physician - }   { + To
ensure that + } a patient   { - may be - }   { + is not + }
suffering from a psychiatric or psychological disorder  { - , - }
or depression causing impaired judgment,
  { - either - }   { + the attending + } 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 performing the counseling determines that the patient is
not suffering from a psychiatric or psychological disorder
 { - , - }  or depression causing impaired judgment.

  SECTION 5. ORS 127.830 is amended to read:
  127.830. s3.04. Informed decision.  { + (1) + } 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 informed
decision   { - as defined in ORS 127.800 (7) - } . Immediately
prior to writing a prescription for medication under ORS 127.800
to 127.897, the attending physician shall verify that the patient
is making an informed decision.
   { +  (2) Another adult individual designated by the patient
shall be present when the patient takes the medication prescribed
pursuant to ORS 127.800 to 127.897. If the patient does not
designate such an individual or the individual is unable or
unwilling to be present, the attending physician or a health care
provider designated by the attending physician shall be present
when the patient takes the medication. If the attending physician
does not intend to be present when the patient takes the
medication, the physician shall ensure that the medication is
delivered to the individual who does intend to be present at the
location at which the patient intends to take the medication.
  (3) The patient may take the medication prescribed pursuant to
ORS 127.800 to 127.897 at any of the following locations:
  (a) A health care facility;
  (b) The patient's home;
  (c) The private home of an individual who has expressed consent
to the attending physician; or
  (d) The medical office or clinic of the attending
physician. + }

  SECTION 6. ORS 127.835 is amended to read:
  127.835. s3.05. Family notification.  { + (1) + } The attending
physician shall   { - ask - }   { + recommend that + } the
patient   { - to - }  notify  { + the + } next of kin of his or
her request for medication pursuant to ORS 127.800 to 127.897. A
patient who declines or is unable to notify next of kin shall not
have his or her request denied for that reason.
   { +  (2) If an Oregon court has appointed a guardian,
conservator or other fiduciary on behalf of the patient pursuant
to a protective proceeding under ORS chapter 125 prior to the
patient's initial request for medication pursuant to ORS 127.800
to 127.897 and the attending physician is aware that the court
has appointed such a fiduciary, the attending physician shall
notify the fiduciary of the patient's request for medication
pursuant to ORS 127.800 to 127.897. + }

  SECTION 7. ORS 127.855 is amended to read:
  127.855. s3.09. Medical record documentation requirements.  The
following shall be documented or filed in the patient's medical
record:
  (1) 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
verification that the patient is capable, acting voluntarily and
has made an informed decision;
  (5) A report of the outcome and determinations made during
counseling  { - , if performed - } ;
  (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 ORS 127.840; and
  (7) A note by the attending physician indicating that all
requirements under ORS 127.800 to 127.897 have been met and
indicating the steps taken to carry out the request, including a
notation of the medication prescribed.

  SECTION 8. ORS 127.860 is amended to read:
  127.860. s3.10. Residency requirement. Only requests made by
Oregon residents  { - , - }  under ORS 127.800 to 127.897
 { - , - }  shall be granted.  { + Factors demonstrating Oregon
residency include but are not limited to:
  (1) Possession of an Oregon driver license;
  (2) Registration to vote in Oregon;
  (3) Evidence that the person owns or leases property in Oregon;
or
  (4) Filing of an Oregon tax return for the most recent tax
year. + }

  SECTION 9. ORS 127.865 is amended to read:
  127.865. s3.11. Reporting requirements. (1) The Health Division
shall annually review a sample of records maintained pursuant to
ORS 127.800 to 127.897.
  (2) { + (a) + } The Health Division shall make rules to
facilitate the collection of information regarding compliance
with ORS 127.800 to 127.897. The information collected
 { - shall not be a public record and may not be made available
for inspection by the public - }  { +  is not a public record and
may be made available only to the following:
  (A) The Board of Medical Examiners;
  (B) The office of the district attorney;
  (C) Law enforcement officers; and
  (D) The State Medical Examiner.
  (b) Information collected pursuant to this subsection is
admissible as evidence in a judicial or administrative
proceeding + }.
  (3) The   { - Health - }  division shall generate and make
available to the public an annual statistical report of
information collected under subsection (2) of this section.
   { +  (4) The Assistant Director for Health shall appoint an
advisory panel to the division. The advisory panel shall evaluate
the information collected pursuant to this section and advise the
assistant director regarding the appropriate course of action to
be taken in response to evidence of noncompliance with ORS
127.800 to 127.897. The panel shall be composed of
representatives of the division, district attorney offices, the
Board of Medical Examiners and other representatives as the
assistant director may designate. + }

  SECTION 10. ORS 127.885 is amended to read:
  127.885. s4.01. Immunities. Except as provided in ORS 127.890:
  (1) No person shall be subject to civil or criminal liability
or professional disciplinary action for participating in good
faith compliance with ORS 127.800 to 127.897. This includes being
present when a qualified patient takes the prescribed medication
to end his or her life in a humane and dignified manner.
  (2) No professional organization or association, or health care
provider, 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 ORS 127.800 to 127.897.
  (3) No request by a patient for or provision by an attending
physician of medication in good faith compliance with the
provisions of ORS 127.800 to 127.897 shall constitute neglect for
any purpose of law or provide the sole basis for the appointment
of a guardian or conservator.
  (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. If a
health care provider is unable or unwilling to carry out a
patient's request under ORS 127.800 to 127.897, and the patient
transfers his or her care to a new health care provider, the
prior health care provider shall transfer, upon request, a copy
of the patient's relevant medical records to the new health care
provider.
   { +  (5) Notwithstanding the provisions of this section, a
physician or other health care provider may be subject to civil
liability, censure, discipline, loss of privileges, loss of
membership or other penalty if the physician participates in ORS
127.800 to 127.897 while on the premises of a health care
facility that has indicated that it prohibits participation in
ORS 127.800 to 127.897 on its premises. + }
  SECTION 11. ORS 127.897 is amended to read:
  127.897. s6.01. Form of the request. A request for a medication
as authorized by ORS 127.800 to 127.897 shall be in substantially
the following form:
____________________________________________
REQUEST FOR MEDICATION
TO END MY LIFE IN A HUMANE
AND DIGNIFIED MANNER

  I, _______________, am an adult of sound mind.
  I am suffering from ______, which my attending physician has
determined is a terminal disease and which has been medically
confirmed 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 { + , refusal of nutrition and hydration and
discontinuation of life-sustaining treatment + }.
  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.
  ____ 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 further
understand that although most deaths occur within three hours, my
death may take longer and my physician has counseled me about
this possibility. + }
  I make this request voluntarily and without reservation, and I
accept full moral responsibility for my actions.

  Signed: __________

  Dated: __________

                    DECLARATION OF WITNESSES

  We declare that the person signing this request:
  (a) Is personally known to us or has provided proof of
identity;
  (b) Signed this request in our presence;
  (c) 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 1/Date

  _________ Witness 2/Date

  NOTE: One witness shall not be a relative (by blood, marriage
or adoption) of the person signing this request, shall not be
entitled to any portion of the person's estate upon death and
shall not own, operate or be employed at a health care facility
where the person is a patient or resident. If the patient is an
inpatient at a health care facility, one of the witnesses shall
be an individual designated by the facility.
___________________________________________________

  SECTION 12.  { + This 1999 Act being necessary for the
immediate preservation of the public peace, health and safety, an
emergency is declared to exist, and this 1999 Act takes effect on
its passage. + }

-----------------------------------------------------------------------
This message from Arizonans for Death with Dignity
David Brandt-Erichsen, AzDD website manager

http://www.hemlock.org/hemlock/arizona or
http://www.azstarnet.com/~davidbe/hemlock 

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