HB 1109 — An Act amending Title 20 (Decedents, Estates and Fiduciaries) of the Pennsylvania Consolidated Statutes, providing for compassionate aid in dying; and imposing penalties.

PRINTER'S NO.   1233

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                         HOUSE BILL
                         No. 1109
                                                Session of
                                                  2025

     INTRODUCED BY HILL-EVANS, KHAN, SHUSTERMAN, RABB, GIRAL,
        SANCHEZ, MADDEN, MAYES, KRAJEWSKI, PROBST, CERRATO,
        D. WILLIAMS AND GREEN, APRIL 3, 2025

     REFERRED TO COMMITTEE ON JUDICIARY, APRIL 3, 2025


                                    AN ACT
 1   Amending Title 20 (Decedents, Estates and Fiduciaries) of the
 2      Pennsylvania Consolidated Statutes, providing for
 3      compassionate aid in dying; and imposing penalties.
 4      The General Assembly of the Commonwealth of Pennsylvania
 5   hereby enacts as follows:
 6      Section 1.    Title 20 of the Pennsylvania Consolidated
 7   Statutes is amended by adding a chapter to read:
 8                               CHAPTER 54B
 9                        COMPASSIONATE AID IN DYING
10   Sec.
11   54B01.   Definitions.
12   54B02.   Qualified patient requirements.
13   54B03.   Request for medication.
14   54B04.   Right and opportunity to rescind request.
15   54B05.   Form of written request.
16   54B06.   Waiting periods.
17   54B07.   Attending provider responsibilities.
18   54B08.   Confirmation of terminal illness.
 1   54B09.   Counseling referral.
 2   54B10.   Family notification.
 3   54B11.   Medical record documentation requirements.
 4   54B12.   Reporting requirements.
 5   54B13.   Effect on construction of wills and contracts.
 6   54B14.   Insurance and annuity policies.
 7   54B15.   Health care provider participation, notification and
 8               permissible sanctions.
 9   54B16.   Claims by governmental entity for costs incurred.
10   54B17.   Construction.
11   54B18.   Immunity.
12   54B19.   Liability.
13   54B20.   Prohibitions and penalties.
14   § 54B01.   Definitions.
15      The following words and phrases when used in this chapter
16   shall have the meanings given to them in this section unless the
17   context clearly indicates otherwise:
18      "Attending provider."    A provider who has primary
19   responsibility for the care of a patient with a terminal illness
20   and treatment of the patient's terminal illness.
21      "Capable."    The ability of a patient to make and communicate
22   informed health care decisions without impaired judgment to
23   health care providers, including communication through
24   individuals familiar with the patient's manner of communicating,
25   as determined by a court or a patient's attending provider,
26   consulting provider, mental health care professional or clinical
27   social worker.
28      "Confirmation of terminal illness."     A written confirmation
29   from a consulting provider of a patient's terminal illness.
30      "Consulting provider."    A provider who is qualified by

20250HB1109PN1233                    - 2 -
 1   specialty or experience to make a professional diagnosis and
 2   prognosis regarding a patient's terminal illness.
 3      "Counseling."     One or more consultations between a mental
 4   health care provider and a patient for the purpose of
 5   determining if the patient is capable.
 6      "Department."     The Department of Health of the Commonwealth.
 7      "End-of-life medication."     A medication determined and
 8   prescribed by an attending provider to a qualified patient for
 9   the purpose of ending the qualified patient's life, which the
10   qualified patient may administer.
11      "Health care facility."     A health care facility as defined in
12   section 802.1 of the act of July 19, 1979 (P.L.130, No.48),
13   known as the Health Care Facilities Act.
14      "Health care provider."     A person licensed, certified or
15   otherwise authorized or permitted by the laws of this
16   Commonwealth to administer health care services or dispense
17   medication in the ordinary course of business or practice of a
18   profession.
19      "Informed decision."     A decision by a patient to request and
20   obtain a prescription for end-of-life medication that is based
21   on an appreciation of the relevant facts after being fully
22   informed by the attending provider of the information required
23   under section 54B07 (relating to attending provider
24   responsibilities).
25      "Long-term care facility."     A long-term care nursing facility
26   as defined in section 802.1 of the Health Care Facilities Act.
27      "Medical confirmation."     Confirmation by a consulting
28   provider who has examined a patient and the patient's relevant
29   medical records that the patient has a terminal illness, is
30   capable and is voluntarily making an informed decision.

20250HB1109PN1233                    - 3 -
 1      "Mental health care provider."      A person who is licensed,
 2   certified or otherwise authorized by the laws of this
 3   Commonwealth to administer or provide mental health care in the
 4   ordinary course of business or practice of a profession.
 5      "Participate under this chapter."      To perform the duties of
 6   an attending provider under section 54B07, the consulting
 7   provider function under section 54B08 (relating to confirmation
 8   of terminal illness) or the consultation function under section
 9   54B09 (relating to counseling referral). The term does not
10   include:
11          (1)   making an initial determination that a patient has a
12      terminal illness and informing the patient of the medical
13      prognosis;
14          (2)   providing information about end-of-life medication
15      and related information to a patient upon request;
16          (3)   providing, upon the request of the patient, a
17      referral to another provider; or
18          (4)   contracting by a patient with the patient's
19      attending provider and consulting provider to act outside of
20      the course and scope of the health care provider's capacity
21      as an employee or independent contractor of the sanctioning
22      health care provider.
23      "Patient."    An individual who is:
24          (1)   eighteen years of age or older; and
25          (2)   under the care of an attending provider.
26      "Provider."   The following:
27          (1)   A doctor of medicine or osteopathy licensed to
28      practice by the State Board of Medicine or State Board of
29      Osteopathic Medicine.
30          (2)   An advanced practice registered nurse practitioner

20250HB1109PN1233                   - 4 -
 1      licensed to practice by the State Board of Nursing.
 2      "Qualified patient."     A patient who meets the requirements of
 3   section 54B02 (relating to qualified patient requirements).
 4      "Terminal illness."     An incurable and irreversible illness
 5   that will, within reasonable medical judgment, produce death
 6   within six months.
 7   § 54B02.    Qualified patient requirements.
 8      To qualify to receive end-of-life medication under this
 9   chapter, a patient must:
10            (1)   Have a terminal illness, as determined by an
11      attending provider and a consulting provider.
12            (2)   Be capable of making an informed decision, as
13      determined under sections 54B07 (relating to attending
14      provider responsibilities) and 54B08(3) (relating to
15      confirmation of terminal illness).
16            (3)   Be a resident of this Commonwealth.
17   § 54B03.    Request for medication.
18      (a)     Request.--A qualified patient may make a request under
19   subsection (b) for end-of-life medication for the purpose of
20   ending the qualified patient's life in a compassionate, humane
21   and dignified manner under this chapter.
22      (b)     Request requirements.--In order to receive a
23   prescription for end-of-life medication, a qualified patient
24   must:
25            (1)   Make an oral request to the attending provider.
26            (2)   Except as provided for under section 54B06 (relating
27      to waiting periods), reiterate the oral request by making a
28      second oral request to the attending provider no less than 15
29      days after making the initial oral request.
30            (3)   Make a written request to the attending provider in

20250HB1109PN1233                    - 5 -
 1      the form required under section 54B05 (relating to form of
 2      written request).
 3   § 54B04.    Right and opportunity to rescind request.
 4      (a)     Rescission.--A qualified patient may rescind the request
 5   to end the qualified patient's life at any time and in any
 6   manner without regard to mental state.
 7      (b)     Opportunity required.--At the time a qualified patient
 8   makes the qualified patient's second oral request under section
 9   54B06 (relating to waiting periods), the attending provider must
10   offer the qualified patient an opportunity to rescind the
11   request.
12      (c)     Prohibition.--A prescription for end-of-life medication
13   under this chapter may not be written without the attending
14   provider offering the qualified patient an opportunity to
15   rescind the request.
16   § 54B05.    Form of written request.
17      (a)     Signature, date and attestation.--A valid request for
18   end-of-life medication under this chapter shall be in
19   substantially the form under subsection (e), signed and dated by
20   the qualified patient and witnessed by at least two individuals
21   who, in the presence of the qualified patient, attest to the
22   best of the witnesses' knowledge and belief that the qualified
23   patient is capable, acting voluntarily and not being coerced to
24   sign the request.
25      (b)     Witness.--One of the witnesses shall be an individual
26   who is not:
27            (1)   a relative of the qualified patient by blood,
28      marriage or adoption;
29            (2)   someone with whom the qualified patient has had a
30      significant relationship;

20250HB1109PN1233                    - 6 -
 1            (3)   an individual who, at the time the request is
 2      signed, would be entitled to a portion of the estate of the
 3      qualified patient upon death under a will or by operation of
 4      law; or
 5            (4)   an owner, operator or employee of a health care
 6      facility where the qualified patient is receiving medical
 7      treatment or is a resident.
 8      (c)   Prohibition.--The qualified patient's attending
 9   provider, consulting provider or an individual who has conducted
10   an evaluation of the qualified patient at the time the request
11   is signed shall not be a witness.
12      (d)   Long-term care patient.--If the qualified patient is in
13   a long-term care facility at the time the written request is
14   made, one of the witnesses shall be an individual designated by
15   the long-term care facility and who has the qualifications
16   required by the department by rule.
17      (e)   Form.--A request for end-of-life medication as
18   authorized under this chapter shall be in substantially the
19   following form:
20                           REQUEST FOR MEDICATION
21                     TO END MY LIFE IN A COMPASSIONATE,
22                        HUMANE AND DIGNIFIED MANNER
23      I,                                   , am an adult of sound mind.
24      I am suffering from                                   , which my
25   attending provider has determined is a terminal illness and
26   which has been medically confirmed by a consulting provider.
27      I have been fully informed of my diagnosis and prognosis, the
28   nature of medication to be prescribed and potential associated
29   risks, the expected result and the feasible alternatives,
30   including comfort care, hospice care, palliative care and pain

20250HB1109PN1233                    - 7 -
 1   control.
 2      I request that my attending provider prescribe medication
 3   that will end my life in a compassionate, humane and dignified
 4   manner.
 5      INITIAL ONE:
 6             ( )   I have informed my family or significant other of my
 7      decision and have taken their opinions into consideration.
 8             ( )   I have decided not to inform my family or
 9      significant other of my decision.
10             ( )   I have no family or significant other to inform of
11      my decision.
12      I understand that I have the right to rescind this request at
13   any time.
14      I understand that this request will supersede any provision
15   of an advance directive in conflict with the provisions of this
16   request.
17      I understand the full import of this request and I expect to
18   die when I take the medication to be prescribed. I further
19   understand that although most deaths occur within three hours,
20   my death may take longer and my provider has counseled me about
21   this possibility.
22      I am not being coerced by another individual to make this
23   decision.
24      I make this request voluntarily and without reservation, and
25   I accept full moral responsibility for my actions.
26      Signed:
27      Dated:
28                           DECLARATION OF WITNESSES
29      We declare that the person signing this request:
30             (a)   Is personally known to us or has provided proof of

20250HB1109PN1233                     - 8 -
 1      identity.
 2            (b)   Signed this request in our presence on the date of
 3      the person's signature.
 4            (c)   Appears to be of sound mind and not under duress,
 5      fraud or undue influence, such as being coerced by another
 6      individual.
 7            (d)   Is not a patient for whom either of us is an
 8      attending provider.
 9      Date:
10      Witness' printed name:
11      Witness' signature:
12      Number and Street:
13      City, State and Zip Code:
14      Date:
15      Witness' printed name:
16      Witness' signature:
17      Number and Street:
18      City, State and Zip Code:
19      NOTE:    One witness shall not be a relative by blood, marriage
20   or adoption of the person signing this request, shall not be
21   someone with whom the person has a significant relationship,
22   shall not be entitled to any portion of the person's estate upon
23   death and shall not own, operate or be employed at a health care
24   facility where the person is receiving medical treatment or a
25   resident. If the patient is an inpatient at a long-term care
26   facility, one of the witnesses shall be a person designated by
27   the facility.
28   § 54B06.    Waiting periods.
29      (a)     General rule.--Except as provided under subsection (b):
30            (1)   At least 15 days shall elapse between a qualified

20250HB1109PN1233                    - 9 -
 1      patient's initial oral request and the writing of a
 2      prescription for end-of-life medication under this chapter.
 3            (2)   At least 48 hours shall elapse between the qualified
 4      patient's written request and the writing of a prescription
 5      for end-of-life medication under this chapter.
 6      (b)     Exceptions.--
 7            (1)   If a qualified patient's attending provider has
 8      determined, and a medical confirmation is received under
 9      section 54B08 (relating to confirmation of terminal illness),
10      that the qualified patient will, within reasonable medical
11      judgment, die within 15 days of making the initial oral
12      request, the qualified patient may reiterate the second oral
13      request to the attending provider at any time after making
14      the initial oral request.
15            (2)   If the qualified patient's attending provider has
16      determined, and a medical confirmation is received under
17      section 54B08, that the qualified patient will, within
18      reasonable medical judgment, die before the expiration of at
19      least one of the waiting periods described under subsection
20      (a), the attending provider may write the prescription for
21      end-of-life medication under this chapter at any time
22      following the later of the qualified patient's written
23      request or second oral request.
24   § 54B07.    Attending provider responsibilities.
25      (a)     Responsibilities.--If a patient requests end-of-life
26   medication, an attending provider shall:
27            (1)   Determine if the patient has a terminal illness, is
28      capable and has made the request for end-of-life medication
29      voluntarily.
30            (2)   Ensure that the patient is making an informed

20250HB1109PN1233                    - 10 -
 1    decision and inform the patient of:
 2              (i)    The patient's medical diagnosis.
 3              (ii)    The patient's prognosis.
 4              (iii)    The potential risks associated with taking the
 5        end-of-life medication to be prescribed.
 6              (iv)    The probable result of taking the end-of-life
 7        medication to be prescribed.
 8              (v)    The feasible alternatives, including comfort
 9        care, hospice care, palliative care and pain control.
10        (3)   Refer the patient to a consulting provider for
11    medical confirmation of the diagnosis and for a determination
12    that the patient is capable and acting voluntarily.
13        (4)   Refer the patient for counseling, if appropriate,
14    under section 54B09 (relating to counseling referral).
15        (5)   Recommend to the patient that the patient notify
16    next of kin or someone with whom the patient has a
17    significant relationship.
18        (6)   Counsel the patient about the importance of:
19              (i)    having another individual present when the
20        patient takes end-of-life medication prescribed under
21        this chapter; and
22              (ii)    not taking the end-of-life medication in a
23        public place.
24        (7)   Inform the patient that the patient has an
25    opportunity to rescind the request at any time and in any
26    manner under section 54B04 (relating to right and opportunity
27    to rescind request) and offer the patient an opportunity to
28    rescind at the end of the 15-day waiting period or at the
29    time the patient makes the patient's second oral request
30    under section 54B06 (relating to waiting periods).

20250HB1109PN1233                   - 11 -
 1            (8)    Immediately prior to writing a prescription for end-
 2      of-life medication under this chapter, verify that the
 3      patient is making an informed decision.
 4            (9)    Fulfill the medical record documentation
 5      requirements under section 54B11 (relating to medical record
 6      documentation requirements).
 7            (10)    If the patient fulfills all the requirements under
 8      this chapter, approve the qualified patient's request to
 9      receive end-of-life medication.
10            (11)    (i)     Dispense end-of-life medications directly,
11            including ancillary medications intended to facilitate
12            the desired effect to minimize the qualified patient's
13            discomfort if the attending provider is authorized to
14            prescribe medications in this Commonwealth, has a current
15            Drug Enforcement Administration certificate and complies
16            with applicable administrative rules; or
17                   (ii)    with the qualified patient's written consent:
18                          (A)   contact a pharmacist and inform the
19                   pharmacist of the prescription; and
20                          (B)   deliver the written prescription personally,
21                   electronically, by facsimile or by mail to the
22                   pharmacist, who shall dispense the end-of-life
23                   medications to the qualified patient, the attending
24                   provider or an expressly identified agent of the
25                   qualified patient.
26      (b)     Death certificate.--The attending provider may sign the
27   qualified patient's death certificate.
28   § 54B08.    Confirmation of terminal illness.
29      A patient must receive a confirmation of terminal illness
30   before the patient may be determined to be a qualified patient

20250HB1109PN1233                         - 12 -
 1   under this chapter. The consulting provider performing the
 2   confirmation of terminal illness shall physically examine a
 3   patient requesting end-of-life medication under section 54B03
 4   (relating to request for medication) and the patient's relevant
 5   medical records to confirm the attending provider's diagnosis
 6   that the patient is suffering from a terminal illness. The
 7   consulting provider must also verify the patient is:
 8          (1)   Capable.
 9          (2)   Acting voluntarily.
10          (3)   Making an informed decision.
11   § 54B09.   Counseling referral.
12      If the opinion of the attending provider or the consulting
13   provider is that the patient may not be capable, at the time a
14   written request is made under section 54B03 (relating to request
15   for medication), either the attending provider or consulting
16   provider shall refer the patient to a mental health care
17   provider for counseling. End-of-life medication may not be
18   prescribed until the mental health care provider performing the
19   counseling determines that the patient is capable and able to
20   make a voluntary informed decision without impaired judgment.
21   § 54B10.   Family notification.
22      The attending provider shall recommend that the qualified
23   patient notify the next of kin or an individual with whom the
24   qualified patient has a significant relationship of the
25   qualified patient's request for end-of-life medication under
26   this chapter. An attending provider may not deny a request for
27   end-of-life medication solely because a qualified patient
28   declines or is unable to notify the next of kin or an individual
29   with whom the qualified patient has a significant relationship.
30   § 54B11.   Medical record documentation requirements.

20250HB1109PN1233                  - 13 -
 1      The following shall be documented or filed in the qualified
 2   patient's medical record:
 3            (1)   All oral requests by a qualified patient for end-of-
 4      life medication.
 5            (2)   All written requests by a qualified patient for end-
 6      of-life medication.
 7            (3)   The attending provider's diagnosis of terminal
 8      illness and determination that the qualified patient is
 9      capable, acting voluntarily and making an informed decision.
10            (4)   All medical confirmations of terminal illness.
11            (5)   Documentation that the qualified patient is capable
12      and acting voluntarily and has made an informed decision.
13            (6)   A report of the outcome and determinations made
14      during counseling.
15            (7)   A certification of the imminence of the qualified
16      patient's death.
17            (8)   Documentation of the attending provider's offer to
18      the qualified patient to rescind the qualified patient's
19      request at the time of the qualified patient's second oral
20      request under section 54B03 (relating to request for
21      medication).
22            (9)   Documentation by the attending provider that the
23      requirements under this chapter have been met and the steps
24      taken to carry out the request, including a notation of the
25      end-of-life medication prescribed.
26   § 54B12.    Reporting requirements.
27      (a)     Review and rulemaking.--The department shall:
28            (1)   Annually review a sample of records maintained under
29      this chapter.
30            (2)   Require a health care provider to file a copy of the

20250HB1109PN1233                    - 14 -
 1      prescription or the dispensing record with the department
 2      upon writing the prescription or dispensing end-of-life
 3      medication under this chapter.
 4            (3)   Issue guidelines and promulgate regulations to
 5      facilitate the collection of information regarding compliance
 6      with this chapter.
 7      (b)     Records.--Information collected under subsection (a)
 8   shall not be a public record and may not be made available for
 9   inspection by the public.
10      (c)     Report.--The department shall generate and make
11   available to the public, to the extent that doing so would not
12   be reasonably expected to violate the privacy of any person, an
13   annual statistical report of information collected under
14   subsection (a).
15   § 54B13.    Effect on construction of wills and contracts.
16      (a)     Effect on existing agreements.--A provision in a
17   contract, will or other agreement, whether written or oral,
18   shall not be valid to the extent that the provision would
19   condition or restrict an individual's decision to make or
20   rescind a request for end-of-life medication.
21      (b)     Obligations under an existing contract.--An obligation
22   under an existing contract shall not be affected by an
23   individual's making or rescinding of a request for end-of-life
24   medication.
25   § 54B14.    Insurance and annuity policies.
26      The sale, procurement or issuance of a life, health or
27   accident insurance or annuity policy or the rate charged for a
28   policy shall not be conditioned upon or affected by the making
29   or rescinding of a request by a qualified patient for end-of-
30   life medication. A qualified patient's act of ingesting end-of-

20250HB1109PN1233                    - 15 -
 1   life medication may not have an effect upon a life, health or
 2   accident insurance or an annuity policy.
 3   § 54B15.    Health care provider participation, notification and
 4                 permissible sanctions.
 5      (a)     Participation not required.--A health care provider may
 6   not be under any duty, whether by contract, statute or other
 7   legal requirement, to prescribe or administer end-of-life
 8   medication to a qualified patient. If a health care provider is
 9   unable or unwilling to carry out a qualified patient's request
10   under this chapter and the qualified patient transfers care to
11   another health care provider, the prior health care provider
12   shall transfer, upon request, a copy of the qualified patient's
13   relevant medical records to the new health care provider.
14      (b)     Prohibiting participation.--A health care facility may
15   prohibit a health care provider from participating in actions
16   under this chapter if the prohibiting health care facility has
17   notified the health care provider of the prohibiting health care
18   facility's policy regarding participation under this chapter.
19   Nothing in this subsection shall prevent a health care provider
20   from providing health care services to a patient that does not
21   constitute participation under this chapter.
22      (c)     Notification requirement.--A health care facility shall
23   notify a health care provider of a policy prohibiting
24   participation under this chapter. A health care facility that
25   fails to provide notice prohibiting participation under this
26   chapter may not enforce sanctions against a health care provider
27   under subsection (d).
28      (d)     Sanctions.--Notwithstanding subsection (a) or section
29   54B18 (relating to immunity), a health care facility may subject
30   a health care provider to the sanctions under this subsection if

20250HB1109PN1233                    - 16 -
 1   the health care provider violated the health care facility's
 2   policy prohibiting participation under this chapter and
 3   notification was provided as required under subsection (c). The
 4   available sanctions shall include:
 5          (1)     Loss of privileges, loss of membership or other
 6      sanctions provided under the medical staff bylaws, policies
 7      and procedures if the health care provider is a member of the
 8      health care facility's medical staff and participates under
 9      this chapter while on the premises, which shall not include
10      the private medical office of a provider or other health care
11      provider.
12          (2)     Termination of lease or other property contract or
13      other nonmonetary remedies provided by lease contract, not
14      including loss or restriction of medical staff privileges or
15      exclusion from the health care facility panel, if the health
16      care provider participates under this chapter while on the
17      premises of or on property that is owned by or under the
18      direct control of the health care facility.
19          (3)     Termination of contract or other nonmonetary
20      remedies provided by contract if the health care provider
21      participates under this chapter while acting in the course
22      and scope of the health care provider's capacity as an
23      employee or independent contractor of the health care
24      facility. Nothing in this paragraph may be construed to
25      prevent:
26                 (i)    a health care provider from participating under
27          this chapter while acting outside the course and scope of
28          the health care provider's capacity as an employee or
29          independent contractor; or
30                 (ii)   a patient from contracting with the patient's

20250HB1109PN1233                      - 17 -
 1             attending provider and consulting provider to act outside
 2             the course and scope of the health care provider's
 3             capacity as an employee or independent contractor of the
 4             health care facility.
 5      (e)     Due process.--A health care facility that imposes
 6   sanctions under subsection (d) shall follow all due process and
 7   other procedures that the health care facility may have that are
 8   related to the imposition of sanctions on a health care
 9   provider.
10      (f)     Unprofessional or dishonorable conduct reports.--
11   Authorized action taken under section 54B05 (relating to form of
12   written request), 54B07 (relating to attending provider
13   responsibilities), 54B08 (relating to confirmation of terminal
14   illness) or 54B09 (relating to counseling referral) may not be
15   the sole basis for a report of unprofessional or dishonorable
16   conduct to the State Board of Medicine or the State Board of
17   Osteopathic Medicine.
18      (g)     Standard of care.--Nothing under this chapter may be
19   construed to allow a lower standard of care for a patient in the
20   community where the patient is treated, or a similar community.
21      (h)     Definition.--As used in this section, the term "notify"
22   means a separate written statement to a health care provider
23   that sanctions the health care provider's participation in
24   activities covered by this chapter before the participation
25   occurs.
26   § 54B16.    Claims by governmental entity for costs incurred.
27      A governmental entity that incurs costs resulting from a
28   qualified patient ending the qualified patient's life under this
29   chapter in a public place shall have a claim against the estate
30   of the individual to recover costs and reasonable attorney fees

20250HB1109PN1233                      - 18 -
 1   related to enforcing the claim.
 2   § 54B17.    Construction.
 3      Nothing under this chapter may be construed to authorize a
 4   provider or any other individual to end a patient's life by
 5   lethal injection, mercy killing or active euthanasia. Actions
 6   taken in accordance with this chapter shall not constitute
 7   suicide, assisted suicide, mercy killing or homicide under the
 8   laws of this Commonwealth.
 9   § 54B18.    Immunity.
10      Except as provided in section 54B19 (relating to liability):
11            (1)   An individual may not be subject to civil or
12      criminal liability or professional disciplinary action for
13      participating in good faith compliance with this chapter.
14      This includes being present when a qualified patient takes
15      the prescribed end-of-life medication.
16            (2)   A professional organization or association, health
17      care facility or health care provider may not subject an
18      individual to censure, discipline, suspension, loss of
19      license, loss of privileges, loss of membership or other
20      penalty for participating in good faith or refusing to
21      participate under this chapter.
22            (3)   A request by a patient for or provision by an
23      attending provider of end-of-life medication in good faith
24      compliance with this chapter shall not constitute negligence
25      for any purpose under law or provide the sole basis for the
26      appointment of a guardian or conservator.
27   § 54B19.    Liability.
28      (a)     Mishandling instrument.--An individual who, without
29   authorization of the patient, willfully alters or forges a
30   request for end-of-life medication or conceals or destroys a

20250HB1109PN1233                    - 19 -
 1   rescission of that request with the intent or effect of causing
 2   the patient's death shall not be immune from criminal liability
 3   under section 54B18 (relating to immunity).
 4      (b)     Undue influence.--An individual, including an attending
 5   provider, who coerces or exerts undue influence on a patient to
 6   request end-of-life medication for the purpose of ending the
 7   patient's life or to destroy a rescission of a request shall not
 8   be immune from criminal liability under section 54B18.
 9      (c)     Civil damages.--Nothing under this chapter shall be
10   construed to limit liability for civil damages resulting from
11   negligent or intentional misconduct or coercion by an
12   individual, including an attending provider.
13   § 54B20.    Prohibitions and penalties.
14      (a)     Intent to hasten death.--An individual who, without
15   authorization of a patient, willfully alters, forges, conceals
16   or destroys an instrument, the reinstatement or revocation of an
17   instrument or any other evidence or document reflecting the
18   patient's desires and interests with the intent and effect of
19   causing a withholding or withdrawal of life-sustaining
20   procedures or of artificially administered nutrition and
21   hydration that hastens the death of the patient commits a felony
22   of the first degree.
23      (b)     Intent to affect health care decision.--Except as
24   provided in subsection (a), an individual who, without
25   authorization of the patient, willfully alters, forges, conceals
26   or destroys an instrument, the reinstatement or revocation of an
27   instrument or any other evidence or document reflecting the
28   patient's desires and interests with the intent or effect of
29   affecting a health care decision commits a misdemeanor of the
30   first degree.

20250HB1109PN1233                    - 20 -
1     Section 2.    This act shall take effect in 120 days.




20250HB1109PN1233                 - 21 -