State of Illinois
90th General Assembly
Legislation

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90_SB0948

      New Act
          Creates  the  Death  with   Dignity   Act.    Establishes
      procedures  by  which  a  terminally  ill patient may request
      cessation of hydration and all medical procedures to  prolong
      life in order to enable the patient to end his or her life in
      a  dignified  and  humane  manner.   Imposes  duties  on  the
      patient's  attending  physician.   Provides for immunity from
      civil and criminal liability  and  professional  disciplinary
      action  for  acting  in  good  faith compliance with the Act.
      Makes it a Class 1 felony (i) to alter or forge  a  patient's
      request  under  the  Act or to conceal or destroy a patient's
      rescission of a request or (ii)  to  coerce  or  exert  undue
      influence  on  a  patient  to  make  or  destroy  a  request.
      Requires  the Department of Human Services to collect certain
      information.
                                                     LRB9002618DJcd
                                               LRB9002618DJcd
 1        AN ACT to provide for death with dignity.
 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:
 4        Section  1.   Short  title.  This Act may be cited as the
 5    Death with Dignity Act.
 6        Section 5.  Definitions.  In this Act, unless the context
 7    requires otherwise:
 8        "Adult" means a person who is (i)  18  years  of  age  or
 9    older  or (ii) an emancipated minor under the Emancipation of
10    Mature Minors Act.
11        "Attending physician" means  the  physician  licensed  to
12    practice  medicine  in  all  its  branches  who  has  primary
13    responsibility  for  the care of the patient and treatment of
14    the patient's terminal disease.
15        "Consulting physician"  means  a  physician  licensed  to
16    practice  medicine  in  all  its branches who is qualified by
17    specialty or experience to make a professional diagnosis  and
18    prognosis regarding the patient's disease.
19        "Counseling"  means a consultation between a psychiatrist
20    or psychologist licensed to practice  in  this  State  and  a
21    patient for the purpose of determining whether the patient is
22    suffering from depression causing impaired judgment or from a
23    psychiatric or psychological disorder.
24        "Health  care  facility"  means  a  type  of  health care
25    provider  commonly  known  by  a  wide  variety  of   titles,
26    including,  but  not  limited to, hospitals, medical centers,
27    nursing homes, rehabilitation centers, long-term or  tertiary
28    care   facilities,   and   other  facilities  established  to
29    administer health care and provide overnight stays  in  their
30    ordinary course of business or practice.
31        "Health  care  provider" means a person that is licensed,
                            -2-                LRB9002618DJcd
 1    certified, or otherwise authorized or permitted by the law of
 2    this State to administer health care in the  ordinary  course
 3    of business or practice of a profession.  The term includes a
 4    health care facility.
 5        "Incapable"  means  that  in the opinion of a court or in
 6    the  opinion  of  the  patient's   attending   physician   or
 7    consulting physician, a patient lacks the ability to make and
 8    communicate  health  care decisions to health care providers,
 9    including communication through  persons  familiar  with  the
10    patient's  manner  of  communicating  if  those  persons  are
11    available.  "Capable" means not incapable.
12        "Informed  decision" means a decision that is (i) made by
13    a qualified  patient  to  request  and  obtain  cessation  of
14    hydration  and  all  medical  procedures to prolong life as a
15    means to end his or  her  life  in  a  humane  and  dignified
16    manner,  (ii)  based  on  the  patient's  appreciation of the
17    relevant facts, and (iii) made after  the  patient  is  fully
18    informed of all of the following by the attending physician:
19             (1)  The patient's medical diagnosis.
20             (2)  The patient's prognosis.
21             (3)  The  probable  result  of ceasing hydration and
22        all medical procedures to prolong life.
23             (4)  The feasible alternatives to ceasing  hydration
24        and all medical procedures to prolong life, including but
25        not  limited  to  comfort  care,  hospice  care, and pain
26        control.
27        "Medically confirmed" means that the medical  opinion  of
28    the  attending  physician  has been confirmed by a consulting
29    physician who has examined  the  patient  and  the  patient's
30    relevant medical records.
31        "Patient"  means  a  person  who  is  under the care of a
32    physician licensed to practice medicine in all its branches.
33        "Qualified patient"  means  a  capable  adult  who  is  a
34    resident  of  Illinois and who has satisfied the requirements
                            -3-                LRB9002618DJcd
 1    of this Act in order to obtain cessation of hydration and all
 2    medical procedures to prolong life as a means to end  his  or
 3    her life in a humane and dignified manner.
 4        "Request  under  this  Act" or "request" means a person's
 5    request for cessation of hydration and all medical procedures
 6    to prolong life as a means to end his or her life in a humane
 7    and dignified manner, as authorized under Section 10.
 8        "Terminal disease" means an  incurable  and  irreversible
 9    disease  that  has  been  medically  confirmed and that will,
10    within reasonable medical judgment, produce  death  within  6
11    months.
12        Section  10.  Person  who may make request.  An adult who
13    is capable, who is a  resident  of  Illinois,  who  has  been
14    determined   by   the   attending  physician  and  consulting
15    physician to be suffering from a terminal  disease,  and  who
16    has  voluntarily  expressed his or her wish to die may make a
17    written request for cessation of hydration  and  all  medical
18    procedures  to  prolong  his  or  her life for the purpose of
19    ending his or her life in a humane and  dignified  manner  in
20    accordance with this Act.
21        Section 15.  Form of request.
22        (a)  A   valid   request  under  this  Act  shall  be  in
23    substantially the form set forth in this  Section,  shall  be
24    signed and dated by the patient, and shall be witnessed by at
25    least  2  individuals  who,  in  the presence of the patient,
26    attest that to the best of their  knowledge  and  belief  the
27    patient  is  capable,  is  acting  voluntarily  in making the
28    request, and is not being coerced to sign the request.
29        (b)  One of the witnesses shall be a person  who  is  not
30    any of the following:
31             (1)  A  relative  of the patient by blood, marriage,
32        or adoption.
                            -4-                LRB9002618DJcd
 1             (2)  A person who at the time the request is  signed
 2        would  be entitled to any portion of the patient's estate
 3        upon the patient's death under any will or  by  operation
 4        of law.
 5             (3)  An  owner,  operator,  or  employee of a health
 6        care facility where  the  patient  is  receiving  medical
 7        treatment or is a resident.
 8        (c)  The  patient's  attending  physician at the time the
 9    request is signed shall not be a witness.
10        (d)  If the patient is an  inpatient  at  a  health  care
11    facility  at the time the written request is made, one of the
12    witnesses shall be an individual designated by  the  facility
13    and  having the qualifications specified by the Department of
14    Public Health by rule.
15        (e)  A request for cessation of hydration and all medical
16    procedures to prolong life  shall  be  in  substantially  the
17    following form:
18                    REQUEST FOR ACTION TO END MY
19                LIFE IN A HUMANE AND DIGNIFIED MANNER
20        I, .........., am an adult of sound mind.
21        I  am  suffering  from  ..........,  which  my  attending
22    physician  has determined is a terminal disease and which has
23    been medically confirmed by a consulting physician.
24        I have been fully informed of my diagnosis and prognosis,
25    the nature of the action to be taken to cease  hydration  and
26    all  medical  procedures  to  prolong  my  life, the expected
27    result, and  the  feasible  alternatives,  including  comfort
28    care, hospice care, and pain control.
29        I request that my attending physician cease hydration and
30    all  medical  procedures to prolong my life as a means to end
31    my life in a humane and dignified manner.
32    INITIAL ONE:
33    ..... I have informed my family  of  my  decision  and  taken
                            -5-                LRB9002618DJcd
 1    their opinions into consideration.
 2    ..... I have decided not to inform my family of my decision.
 3    ..... I have no family to inform of my decision.
 4        I  understand  that  I  have  the  right  to rescind this
 5    request at any time.
 6        I understand the full import of this request and I expect
 7    to  die  after  cessation  of  hydration  and   all   medical
 8    procedures to prolong my life.
 9        I  make this request voluntarily and without reservation,
10    and I accept full moral responsibility for my actions.
11    Signed: ....................      Dated: ....................
12                      DECLARATION OF WITNESSES
13        We declare that the person signing this request:
14        (1)  is personally known to us or has provided  proof  of
15    identity;
16        (2)  signed this request in our presence;
17        (3)  appears  to  be  of sound mind and not under duress,
18    fraud, or undue influence; and
19        (4)  is not a patient for whom either of us serves  as  a
20    physician.
21    .................... Witness 1      Date ....................
22    .................... Witness 2      Date ....................
23        NOTE:  One  witness  shall  be an individual who is not a
24    relative (by blood, marriage,  or  adoption)  of  the  person
25    signing  this  request, is not entitled to any portion of the
26    person's estate upon death, and does not own or  operate  and
27    is not employed at a health care facility where the person is
28    a  patient  or resident.  If the patient is an inpatient at a
29    health care facility,  one  of  the  witnesses  shall  be  an
30    individual designated by the facility.
31        Section  20.   Attending physician responsibilities.  The
32    attending physician shall do all of the following:
33             (1)  Make the initial  determination  of  whether  a
                            -6-                LRB9002618DJcd
 1        patient  has a terminal disease, is capable, and has made
 2        the request under this Act voluntarily.
 3             (2)  Inform the patient of all of the following:
 4                  (A)  The patient's medical diagnosis.
 5                  (B)  The patient's prognosis.
 6                  (C)  The probable result of  ceasing  hydration
 7             and  all  medical  products to prolong the patient's
 8             life.
 9                  (D)  The  feasible  alternatives   to   ceasing
10             hydration  and all medical procedures to prolong the
11             patient's life, including but not limited to comfort
12             care, hospice care, and pain control.
13             (3)  Refer the patient to a consulting physician for
14        medical  confirmation  of  the  diagnosis   and   for   a
15        determination  that  the  patient  is  capable and acting
16        voluntarily in making a request under this Act.
17             (4)  Refer   the   patient   for   counseling,    if
18        appropriate, pursuant to Section 30.
19             (5)  Request that the patient notify his or her next
20        of kin.
21             (6)  Inform  the  patient  that  he  or  she  has an
22        opportunity to rescind the request under this Act at  any
23        time and in any manner.
24             (7)  Verify  that  the patient is making an informed
25        decision.
26             (8)  Fulfill  the   medical   record   documentation
27        requirements of Section 60.
28             (9)  Ensure  that  all appropriate steps are carried
29        out in accordance with this Act  before  authorizing  the
30        cessation  of  hydration  and  all  medical procedures to
31        prolong the patient's life in order to enable the patient
32        to end his or her life in a humane and dignified manner.
33        Section 25.  Consulting physician confirmation.  Before a
                            -7-                LRB9002618DJcd
 1    patient is considered qualified under this Act, a  consulting
 2    physician  shall  examine the patient and his or her relevant
 3    medical records and (i) confirm, in  writing,  the  attending
 4    physician's  diagnosis  that  the patient is suffering from a
 5    terminal disease and (ii) verify that the patient is capable,
 6    is acting voluntarily in making a request under this Act, and
 7    has made an informed decision in making that request.
 8        Section 30.  Counseling referral.  If in the  opinion  of
 9    the attending physician or the consulting physician a patient
10    may be suffering from depression causing impaired judgment or
11    from   a   psychiatric   or  psychological  disorder,  either
12    physician shall refer the patient for counseling.  No  action
13    to cease hydration and all medical procedures to prolong life
14    as  a means to end a patient's life in a humane and dignified
15    manner  shall  be  taken  until  the  person  performing  the
16    counseling determines that the patient is not suffering  from
17    depression causing impaired judgment or from a psychiatric or
18    psychological disorder.
19        Section  35.  Illinois  residence  required.   A person's
20    request under this Act shall not be granted unless the person
21    is a resident of Illinois.
22        Section  40.  Informed  decision  required.   A  person's
23    request under this Act shall not be granted unless the person
24    has made an  informed  decision  as  defined  in  Section  5.
25    Immediately  before  taking action to cease hydration and all
26    medical procedures to prolong  life  as  a  means  to  end  a
27    patient's  life  in  a humane and dignified manner under this
28    Act, the attending physician shall verify that the patient is
29    making an informed decision.
30        Section   45.  Family   notification.    The    attending
                            -8-                LRB9002618DJcd
 1    physician  shall ask the patient to notify the patient's next
 2    of kin of his or her request under this Act.  A  patient  who
 3    declines  or is unable to notify his or her next of kin shall
 4    not have his or her request denied for that reason.
 5        Section 50. Written and oral requests.  In  order  for  a
 6    qualified patient's request under this Act to be granted, the
 7    patient shall have made an oral request and a written request
 8    and  shall  have  repeated  the  oral  request  to his or her
 9    attending physician. At the time the qualified patient  makes
10    his or her second oral request, the attending physician shall
11    offer the patient an opportunity to rescind the request.
12        Section  55.  Right  to  rescind  request.  A patient may
13    rescind his or her request under this Act at any time and  in
14    any  manner  without  regard  to  his or her mental state. No
15    action to cease  hydration  and  all  medical  procedures  to
16    prolong life in order to enable the patient to end his or her
17    life  in  a  humane and dignified manner may be taken without
18    the attending physician offering the patient  an  opportunity
19    to rescind the request.
20        Section  60.  Medical  record documentation requirements.
21    The following shall be documented or filed in  the  patient's
22    medical record:
23             (1)  All  oral  requests  under  this  Act made by a
24        patient.
25             (2)  All written requests under this Act made  by  a
26        patient.
27             (3)  The   attending   physician's   diagnosis   and
28        prognosis  and  determination that the patient is capable
29        and acting voluntarily in making a request under this Act
30        and has made an informed decision in making that request.
31             (4)  The  consulting   physician's   diagnosis   and
                            -9-                LRB9002618DJcd
 1        prognosis  and  verification  that the patient is capable
 2        and acting voluntarily in making a request under this Act
 3        and has made an informed decision in making that request.
 4             (5)  A report of the outcome and determinations made
 5        during counseling, if performed.
 6             (6)  The   attending   physician's   offer   of   an
 7        opportunity to the patient to rescind his or her  request
 8        at the time of the patient's second oral request pursuant
 9        to Section 50.
10             (7)  A  note  by  the attending physician indicating
11        that all requirements under this Act have  been  met  and
12        indicating  the  steps  taken  to carry out the patient's
13        request.
14        Section 65.   Department  of  Human  Services  review  of
15    records;   statistical   report.   The  Department  of  Human
16    Services, in its capacity as  the  successor  agency  to  the
17    Department  of  Mental Health and Developmental Disabilities,
18    shall do the following:
19             (1)  Annually  review  a  sample  of   the   records
20        maintained under this Act.
21             (2)  Adopt  rules  to  facilitate  the collection of
22        information regarding  compliance  with  this  Act.   The
23        information  collected  shall  not be a public record and
24        may not be made available for inspection by the public.
25             (3)  Generate and make available to  the  public  an
26        annual  statistical  report  summarizing  the information
27        collected under paragraph  (2).   The  report  shall  not
28        contain   any   information   that   either  directly  or
29        indirectly identifies individual patients.
30        Section 70.  Immunities. Except as provided in this Act:
31             (1)  A person is not subject to  civil  or  criminal
32        liability  or professional disciplinary action for acting
                            -10-               LRB9002618DJcd
 1        in good faith compliance with this  Act.   This  includes
 2        being  present  when hydration and all medical procedures
 3        to prolong life are ceased in  response  to  a  qualified
 4        patient's request under this Act.
 5             (3)  A request under this Act by a patient or action
 6        taken  by  an  attending physician to cease hydration and
 7        all medical procedures to  prolong  life  in  good  faith
 8        compliance  with  the  provisions  of  this  Act does not
 9        constitute neglect for any purpose of law or provide  the
10        sole   basis   for  the  appointment  of  a  guardian  or
11        conservator.
12             (4)  A health care provider is not under  any  duty,
13        whether  by  contract,  by statute, or by any other legal
14        requirement, to participate in the cessation of hydration
15        and  all  medical  procedures  to  prolong  a   qualified
16        patient's  life in order to enable the patient to end his
17        or her life in a humane and dignified manner as  provided
18        in  this  Act.   If  a  health care provider is unable or
19        unwilling to carry  out  a  qualified  patient's  request
20        under  this Act and the patient transfers his or her care
21        to a new health care  provider,  the  prior  health  care
22        provider  shall  transfer,  upon  request,  a copy of the
23        patient's relevant medical records to the new health care
24        provider.
25        Section 75.  Penalties and other liability.
26        (a)  A person who without authorization  of  the  patient
27    willfully  alters  or forges the patient's request under this
28    Act or conceals or destroys a rescission of that request with
29    the intent or effect of causing the patient's death is guilty
30    of a Class 1 felony.
31        (b)  A person who coerces or exerts undue influence on  a
32    patient  to  make a request under this Act for the purpose of
33    ending the patient's life or to destroy a rescission of  such
                            -11-               LRB9002618DJcd
 1    a request is guilty of a Class 1 felony.
 2        (c)  Nothing  in  this  Act  limits further liability for
 3    civil damages  resulting  from  other  negligent  conduct  or
 4    intentional misconduct by any person.
 5        (d)  The  penalties  in this Act do not preclude criminal
 6    penalties applicable under other laws  for  conduct  that  is
 7    inconsistent with this Act.
 8        Section   80.    Effect  on  construction  of  wills  and
 9    contracts.
10        (a)  A provision in a contract, will, or other agreement,
11    whether written or oral, is not valid to the extent that  the
12    provision would affect whether a person may make or rescind a
13    request under this Act.
14        (b)  An  obligation  owing  under  any currently existing
15    contract may not be conditioned or affected by the making  or
16    rescinding of a request by a person under this Act.
17        Section  85.   Insurance  or  annuity policies. The sale,
18    procurement, or issuance of any life or accident  and  health
19    insurance  policy  or  annuity policy or the rate charged for
20    any policy may not be  conditioned  on  or  affected  by  the
21    making or rescinding of a request by a person under this Act.
22    Action taken to cease hydration and all medical procedures to
23    prolong  life  in  response  to a qualified patient's request
24    under this Act in order to enable the patient to end  his  or
25    her  life  in a humane and dignified manner shall not have an
26    effect upon a life or accident and health insurance policy or
27    annuity policy.
28        Section 90. Construction of Act.   Nothing  in  this  Act
29    shall  be  construed  to  authorize  a physician or any other
30    person to end a patient's life  by  lethal  injection,  mercy
31    killing,  or  active euthanasia.  Actions taken in accordance
                            -12-               LRB9002618DJcd
 1    with this Act do not, for any  purpose,  constitute  suicide,
 2    mercy killing, or homicide under the law.
 3        Section  95.   Severability.   The provisions of this Act
 4    are severable under Section 1.31 of the Statute on Statutes.

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