SB 570 — An Act amending Title 20 (Decedents, Estates and Fiduciaries) of the Pennsylvania Consolidated Statutes, providing for End of Life Options Act; imposing duties on the Department of Health; and imposing penalties.

PRINTER'S NO.   638

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                        SENATE BILL
                        No. 570
                                                 Session of
                                                   2025

     INTRODUCED BY BOSCOLA, STREET, FONTANA AND KEARNEY,
        APRIL 11, 2025

     REFERRED TO JUDICIARY, APRIL 11, 2025


                                     AN ACT
 1   Amending Title 20 (Decedents, Estates and Fiduciaries) of the
 2      Pennsylvania Consolidated Statutes, providing for End of Life
 3      Options Act; imposing duties on the Department of Health; and
 4      imposing penalties.
 5      The General Assembly of the Commonwealth of Pennsylvania
 6   hereby enacts as follows:
 7      Section 1.    Title 20 of the Pennsylvania Consolidated
 8   Statutes is amended by adding a chapter to read:
 9                                 CHAPTER 54B
10                           END OF LIFE OPTIONS ACT
11   Sec.
12   54B01.   Definitions.
13   54B02.   Qualified patient requirements.
14   54B03.   Request for medication.
15   54B04.   Right and opportunity to rescind request.
16   54B05.   Form of written request.
17   54B06.   Waiting periods.
18   54B07.   Attending provider responsibilities.
19   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 or annuity policies.
 7   54B15.   Disposal of unused medication.
 8   54B16.   Health care provider participation, notification and
 9               permissible sanctions.
10   54B17.   Claims by governmental entity for costs incurred.
11   54B18.   Construction.
12   54B19.   Immunity.
13   54B20.   Liability.
14   54B21.   Prohibitions and penalties.
15   § 54B01.   Definitions.
16      The following words and phrases when used in this chapter
17   shall have the meanings given to them in this section unless the
18   context clearly indicates otherwise:
19      "Attending provider."   The provider who has primary
20   responsibility for the care of a patient with a terminal illness
21   and treatment of the patient's terminal illness.
22      "Capable."    The ability of a patient to make and communicate
23   informed health care decisions without impaired judgment to
24   health care providers, including communication through
25   individuals familiar with the patient's manner of communicating,
26   as determined by a court or a patient's attending provider,
27   consulting provider, mental health care professional or clinical
28   social worker.
29      "Confirmation of terminal illness."    A written confirmation
30   from a consulting provider of a patient's terminal illness.

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

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

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

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 1            (3)   Make a written request to the attending provider in
 2      the form required under section 54B05 (relating to form of
 3      written request).
 4      (c)     Requester.--Oral and written requests for medication
 5   under this chapter must be made by a qualified patient and may
 6   not be made by any other individual, including a terminally ill
 7   individual's qualified power of attorney, attorney-in-fact for
 8   health care or via advance health care directive.
 9   § 54B04.    Right and opportunity to rescind request.
10      (a)     Rescission.--A qualified patient may rescind the request
11   to end the qualified patient's life at any time and in any
12   manner without regard to mental state.
13      (b)     Opportunity required.--At the time a qualified patient
14   makes the qualified patient's second oral request, the attending
15   provider must offer the qualified patient an opportunity to
16   rescind the request.
17      (c)     Prohibition.--A prescription for end-of-life medication
18   under this chapter may not be written without the attending
19   provider offering the qualified patient an opportunity to
20   rescind the request.
21   § 54B05.    Form of written request.
22      (a)     Signature, date and attestation.--A valid request for
23   end-of-life medication under this chapter shall be in
24   substantially the form under subsection (e), signed and dated by
25   the qualified patient and witnessed by at least two individuals
26   who, in the presence of the qualified patient, attest that to
27   the best of the witness's knowledge and belief the qualified
28   patient is capable, acting voluntarily and not being coerced to
29   sign the request.
30      (b)     Witness.--One of the witnesses shall be an individual

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

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 1   which has been medically confirmed by a consulting provider.
 2      I have been fully informed of my diagnosis and prognosis, the
 3   nature of medication to be prescribed and potential associated
 4   risks, the expected result and the feasible alternatives,
 5   including comfort care, hospice care, palliative care and pain
 6   control.
 7      I request that my attending provider prescribe medication
 8   that will end my life in a compassionate, humane and dignified
 9   manner.
10      INITIAL ONE:
11             ( )   I have informed my family or significant other of my
12      decision and have taken their opinions into consideration.
13             ( )   I have decided not to inform my family or
14      significant other of my decision.
15             ( )   I have no family or significant other to inform of
16      my decision.
17      I understand that I have the right to rescind this request at
18   any time.
19      I understand that this request will supersede any provision
20   of an advance directive in conflict with the provisions of this
21   request.
22      I understand the full import of this request and I expect to
23   die when I take the medication to be prescribed. I further
24   understand that although most deaths occur within three hours,
25   my death may take longer and my provider has counseled me about
26   this possibility.
27      I am not being coerced by another individual to make this
28   decision.
29      I make this request voluntarily and without reservation, and
30   I accept full moral responsibility for my actions.

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

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 1   facility, one of the witnesses shall be a person designated by
 2   the facility.
 3   § 54B06.    Waiting periods.
 4      (a)     Time frame.--Except as provided under subsection (b),
 5   the following apply:
 6            (1)   At least 15 days shall elapse between the qualified
 7      patient's initial oral request and the writing of a
 8      prescription for end-of-life medication under this chapter.
 9            (2)   At least 48 hours shall elapse between the qualified
10      patient's written request and the writing of a prescription
11      for end-of-life medication under this chapter.
12      (b)     Exceptions.--
13            (1)   If the qualified patient's attending provider has
14      determined, and a medical confirmation is received under
15      section 54B08 (relating to confirmation of terminal illness),
16      that the qualified patient will, within reasonable medical
17      judgment, die within 15 days of making the initial oral
18      request, the qualified patient may reiterate the second oral
19      request to the attending provider at any time after making
20      the initial oral request.
21            (2)   If the qualified patient's attending provider has
22      determined, and a medical confirmation is received under
23      section 54B08, that the qualified patient will, within
24      reasonable medical judgment, die before the expiration of at
25      least one of the waiting periods described under subsection
26      (a), the prescription for end-of-life medication under this
27      chapter may be written at any time following the later of the
28      qualified patient's written request or second oral request.
29   § 54B07.    Attending provider responsibilities.
30      (a)     Responsibilities.--Upon request of a patient, an

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

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 1    to rescind request) and offer the patient an opportunity to
 2    rescind at the end of the 15-day waiting period or at the
 3    time the patient makes the patient's second oral request
 4    under section 54B06 (relating to waiting periods).
 5          (8)    Immediately prior to writing a prescription for end-
 6    of-life medication under this chapter, verify the patient is
 7    making an informed decision.
 8          (9)    Fulfill the medical record documentation
 9    requirements under section 54B11 (relating to medical record
10    documentation requirements).
11          (10)    If the patient fulfills all the requirements under
12    this chapter, approve the qualified patient's request to
13    receive end-of-life medication.
14          (11)    (i)     Dispense end-of-life medications directly,
15          including ancillary medications intended to facilitate
16          the desired effect to minimize the qualified patient's
17          discomfort if the attending provider is authorized to
18          prescribe medications in this Commonwealth, has a current
19          Drug Enforcement Administration certificate and complies
20          with applicable administrative rules; or
21                 (ii)    with the qualified patient's written consent:
22                        (A)   contact a pharmacist and inform the
23                 pharmacist of the prescription; and
24                        (B)   deliver the written prescription personally,
25                 electronically, by facsimile or by mail to the
26                 pharmacist, who shall dispense the end-of-life
27                 medications to the qualified patient, the attending
28                 provider or an expressly identified agent of the
29                 qualified patient.
30    (b)   Death certificate.--The attending provider may sign the

20250SB0570PN0638                       - 12 -
 1   qualified patient's death certificate.
 2   § 54B08.   Confirmation of terminal illness.
 3      A confirmation of terminal illness must be received before a
 4   patient is determined to be a qualified patient under this
 5   chapter. The consulting provider performing the confirmation of
 6   terminal illness shall physically examine a patient requesting
 7   end-of-life medication under section 54B03 (relating to request
 8   for medication) and the patient's relevant medical records to
 9   confirm the attending provider's diagnosis that the patient is
10   suffering from a terminal illness. The consulting provider must
11   also verify the patient is:
12          (1)   Capable.
13          (2)   Acting voluntarily.
14          (3)   Making an informed decision.
15   § 54B09.   Counseling referral.
16      If the opinion of the attending provider or the consulting
17   provider is that the patient may not be capable at the time a
18   written request is made under section 54B03 (relating to request
19   for medication), either the attending provider or consulting
20   provider shall refer the patient to a mental health care
21   provider for counseling. End-of-life medication may not be
22   prescribed until the mental health care provider performing the
23   counseling determines that the patient is capable and able to
24   make a voluntary informed decision without impaired judgment.
25   § 54B10.   Family notification.
26      The attending provider must recommend that the qualified
27   patient notify the next of kin or an individual with whom the
28   qualified patient has a significant relationship of the
29   qualified patient's request for end-of-life medication under
30   this chapter. An attending provider may not deny a request for

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 1   end-of-life medication solely because a qualified patient
 2   declines or is unable to notify the next of kin or an individual
 3   with whom the qualified patient has a significant relationship.
 4   § 54B11.   Medical record documentation requirements.
 5      The following shall be documented or filed in the qualified
 6   patient's medical record:
 7          (1)   All oral requests by a qualified patient for end-of-
 8      life medication.
 9          (2)   All written requests by a qualified patient for end-
10      of-life medication.
11          (3)   The attending provider's diagnosis of terminal
12      illness and determination that the qualified patient is
13      capable, acting voluntarily and making an informed decision.
14          (4)   All medical confirmations of terminal illness.
15          (5)   Documentation that the qualified patient is capable
16      and acting voluntarily and has made an informed decision.
17          (6)   A report of the outcome and determinations made
18      during counseling.
19          (7)   A certification of the imminence of the qualified
20      patient's death.
21          (8)   Documentation of the attending provider's offer to
22      the qualified patient to rescind the qualified patient's
23      request at the time of the qualified patient's second oral
24      request under section 54B03 (relating to request for
25      medication).
26          (9)   Documentation by the attending provider that the
27      requirements under this chapter have been met and the steps
28      taken to carry out the request, including a notation of the
29      end-of-life medication prescribed.
30   § 54B12.   Reporting requirements.

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 1      (a)     Review and rulemaking.--The department shall:
 2            (1)   Annually review a sample of records maintained under
 3      this chapter.
 4            (2)   Require a health care provider to file a copy of the
 5      prescription or the dispensing record with the department
 6      upon writing the prescription or dispensing end-of-life
 7      medication under this chapter.
 8            (3)   Promulgate rules to facilitate the collection of
 9      information regarding compliance with this chapter.
10      (b)     Records.--Except as otherwise provided by law, the
11   information collected is not a public record and may not be made
12   available for inspection by the public.
13      (c)     Report.--The department shall generate and make
14   available to the public, to the extent doing so would not be
15   reasonably expected to violate the privacy of any person, an
16   annual statistical report of information collected under
17   subsection (a).
18   § 54B13.    Effect on construction of wills and contracts.
19      (a)     Effect on existing agreements.--No provision in a
20   contract, will or other agreement, whether written or oral,
21   shall be valid to the extent that the provision would condition
22   or restrict an individual's decision to make or rescind a
23   request for end-of-life medication.
24      (b)     Obligations under an existing contract.--No obligation
25   under an existing contract shall be affected by an individual's
26   making or rescinding of a request for end-of-life medication.
27   § 54B14.    Insurance or annuity policies.
28      The sale, procurement or issuance of a life, health or
29   accident insurance or annuity policy or the rate charged for a
30   policy shall not be conditioned upon or affected by the making

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 1   or rescinding of a request, by a qualified patient, for end-of-
 2   life medication. A qualified patient's act of ingesting end-of-
 3   life medication may not have an effect upon a life, health or
 4   accident insurance or an annuity policy.
 5   § 54B15.    Disposal of unused medication.
 6      An individual who has custody or control of medication
 7   prescribed and dispensed under this chapter that remains unused
 8   after the qualified patient's death shall dispose of the
 9   medication by lawful means in accordance with Federal and State
10   guidelines.
11   § 54B16.    Health care provider participation, notification and
12                 permissible sanctions.
13      (a)     Participation not required.--No health care provider may
14   be under any duty, whether by contract, statute or other legal
15   requirement, to prescribe or administer end-of-life medication
16   to a qualified patient. If a health care provider is unable or
17   unwilling to carry out a qualified patient's request under this
18   chapter and the qualified patient transfers care to another
19   health care provider, the prior health care provider shall
20   transfer, upon request, a copy of the qualified patient's
21   relevant medical records to the new health care provider.
22      (b)     Prohibiting participation.--A health care facility may
23   prohibit a health care provider from participating under this
24   chapter if the prohibiting health care facility has notified the
25   health care provider of the prohibiting health care facility's
26   policy regarding participation under this chapter. Nothing in
27   this subsection prevents a health care provider from providing
28   health care services to a patient that does not constitute
29   participation under this chapter.
30      (c)     Notification requirement.--A health care facility shall

20250SB0570PN0638                    - 16 -
 1   give notice of the policy prohibiting participation under this
 2   chapter. A health care facility that fails to provide notice
 3   prohibiting participation under this chapter may not enforce
 4   sanctions against a health care provider under subsection (d).
 5      (d)   Sanctions.--Notwithstanding subsection (a) or section
 6   54B19 (relating to immunity), a health care facility may subject
 7   a health care provider to the sanctions under this subsection if
 8   notification was provided as required under subsection (c). The
 9   available sanctions shall include:
10            (1)   Loss of privileges, loss of membership or other
11      sanctions provided under the medical staff bylaws, policies
12      and procedures if the health care provider is a member of the
13      health care facility's medical staff and participates under
14      this chapter while on the premises, which shall not include
15      the private medical office of a provider or other health care
16      provider.
17            (2)   Termination of lease or other property contract or
18      other nonmonetary remedies provided by lease contract, not
19      including loss or restriction of medical staff privileges or
20      exclusion from the health care facility panel, if the health
21      care provider participates under this chapter while on the
22      premises of or on property that is owned by or under the
23      direct control of the health care facility.
24            (3)   Termination of contract or other nonmonetary
25      remedies provided by contract if the health care provider
26      participates under this chapter while acting in the course
27      and scope of the health care provider's capacity as an
28      employee or independent contractor of the health care
29      facility. Nothing in this paragraph may be construed to
30      prevent:

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 1                (i)    a health care provider from participating under
 2            this chapter while acting outside the course and scope of
 3            the health care provider's capacity as an employee or
 4            independent contractor; or
 5                (ii)   a patient from contracting with the patient's
 6            attending provider and consulting provider to act outside
 7            the course and scope of the health care provider's
 8            capacity as an employee or independent contractor of the
 9            health care facility.
10      (e)   Due process.--A health care facility that imposes
11   sanctions under subsection (d) shall follow all due process and
12   other procedures the health care facility may have that are
13   related to the imposition of sanctions on a health care
14   provider.
15      (f)   Unprofessional or dishonorable conduct reports.--
16   Authorized action taken under section 54B05 (relating to form of
17   written request), 54B07 (relating to attending provider
18   responsibilities), 54B08 (relating to confirmation of terminal
19   illness) or 54B09 (relating to counseling referral) may not be
20   the sole basis for a report of unprofessional or dishonorable
21   conduct to the State Board of Medicine or the State Board of
22   Osteopathic Medicine.
23      (g)   Standard of care.--No provision of this chapter may be
24   construed to allow a lower standard of care for patients in the
25   community where the patient is treated or a similar community.
26      (h)   Definitions.--As used in this section, the following
27   words and phrases shall have the meanings given to them in this
28   subsection unless the context clearly indicates otherwise:
29      "Notify."   A separate written statement to the health care
30   provider which sanctions its participation in activities covered

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 1   by this chapter before the participation occurs.
 2   § 54B17.   Claims by governmental entity for costs incurred.
 3      A governmental entity that incurs costs resulting from a
 4   qualified patient ending the qualified patient's life under this
 5   chapter in a public place shall have a claim against the estate
 6   of the individual to recover costs and reasonable attorney fees
 7   related to enforcing the claim.
 8   § 54B18.   Construction.
 9      Nothing under this chapter may be construed to authorize a
10   provider or any other individual to end a patient's life by
11   lethal injection, mercy killing or active euthanasia. Actions
12   taken in accordance with this chapter shall not constitute
13   suicide, assisted suicide, mercy killing or homicide under the
14   law.
15   § 54B19.   Immunity.
16      Except as provided in section 54B20 (relating to liability):
17          (1)   An individual may not be subject to civil or
18      criminal liability or professional disciplinary action for
19      participating in good faith compliance with this chapter.
20      This includes being present when a qualified patient takes
21      the prescribed end-of-life medication.
22          (2)   A professional organization or association, health
23      care facility or health care provider may not subject an
24      individual to censure, discipline, suspension, loss of
25      license, loss of privileges, loss of membership or other
26      penalty for participating in good faith or refusing to
27      participate under this chapter.
28          (3)   A request by a patient for or provision by an
29      attending provider of end-of-life medication in good faith
30      compliance with this chapter does not constitute negligence

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 1      for any purpose of law or provide the sole basis for the
 2      appointment of a guardian or conservator.
 3   § 54B20.    Liability.
 4      (a)     Mishandling instrument.--An individual who, without
 5   authorization of the patient, willfully alters or forges a
 6   request for end-of-life medication or conceals or destroys a
 7   rescission of that request with the intent or effect of causing
 8   the patient's death shall not be immune from criminal liability
 9   under section 54B19 (relating to immunity).
10      (b)     Undue influence.--An individual, including an attending
11   provider, who coerces or exerts undue influence on a patient to
12   request end-of-life medication for the purpose of ending the
13   patient's life or to destroy a rescission of a request shall not
14   be immune from criminal liability under section 54B19.
15      (c)     Civil damages.--Nothing under this chapter limits
16   liability for civil damages resulting from negligent or
17   intentional misconduct or coercion by an individual, including
18   an attending provider.
19   § 54B21.    Prohibitions and penalties.
20      (a)     Intent to hasten death.--An individual who, without
21   authorization of the patient, willfully alters, forges, conceals
22   or destroys an instrument, the reinstatement or revocation of an
23   instrument or any other evidence or document reflecting the
24   patient's desires and interests with the intent and effect of
25   causing a withholding or withdrawal of life-sustaining
26   procedures or of artificially administered nutrition and
27   hydration which hastens the death of the patient, commits a
28   felony of the first degree.
29      (b)     Intent to affect health care decision.--Except as
30   provided in subsection (a), an individual who, without

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1   authorization of the patient, willfully alters, forges, conceals
2   or destroys an instrument, the reinstatement or revocation of an
3   instrument or any other evidence or document reflecting the
4   patient's desires and interests with the intent or effect of
5   affecting a health care decision, commits a misdemeanor of the
6   first degree.
7      Section 2.   This act shall take effect in 120 days.




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