1995 - 1996 LEGISLATURE
March 2, 1995 - Introduced by Representatives Boyle and Baldwin, cosponsored
by Senator Risser. Referred to Committee on Health.
1An Act to amend
979.01 (1) (intro.);
to repeal and recreate
chapter 154 (title); 2
and to create
16.009 (2) (p), 146.82 (2) (a) 8m., chapter 156 and 979.01 (1g) of 3
the statutes; relating to: permitting certain individuals to make written
4requests for medication for the purpose of ending their lives, and providing
Analysis by the Legislative Reference Bureau
This bill permits a person who is of sound mind and not incapacitated, is at least
18 years of age, is a resident of Wisconsin and has a terminal disease to voluntarily
make a written request to his or her attending physician for medication for the
purpose of ending his or her life in a humane and dignified manner. Further, the bill
sets forth a statutory form of a request for medication and requires that the
department of health and social services (DHSS) prepare and provide copies of the
request form for distribution to certain facilities, associations and persons.
The bill establishes the following requirements that must be met before an
individual's attending physician may write a prescription in response to the
individual's request for medication:
1. The requester must make the request orally and then, not fewer than 15 days
later, by means of a valid request form that is substantially in the form specified in
the bill, is in writing, is signed in the presence of 3 qualified witnesses and dated by
the requester, is made voluntarily and is filed in the requester's patient health care
record. After filing the request, the requester must make a 2nd oral request of his
or her attending physician for the medication.
2. The requester's attending physician must determine that the requester
meets the statutory requirements for making the request; must inform the requester
of his or her diagnosis and prognosis, the probable results of taking the prescribed
medication and the alternatives to doing so; must refer the requester to a consulting
physician for review and must, if the requester may be suffering from a psychiatric
or psychological disorder, refer the requester to a psychiatrist or psychologist for
review; must, in the requester's patient health care record, document certain
information and certify that the statutory requirements have been met regarding the
request; must ask the requester to inform his or her next of kin about the request;
must inform the requester that the request is revocable and offer him or her the
opportunity to revoke it; and must report information about the request to DHSS on
a form prescribed by DHSS.
3. A consulting physician to whom the requester is referred must medically
confirm the attending physician's diagnosis and determination that the requester
meets the statutory requirements for making the request. Any psychologist or
psychiatrist to whom the requester is referred by the attending or consulting
physician must determine and certify in writing that the requester is not suffering
from a psychiatric or psychological disorder that causes impaired judgment or from
depression that causes impaired judgment.
The bill specifies that, if the requester is a patient in a health care facility, at
least one of the witnesses to the written request for medication must be a patients'
advocate designated by the board on aging and long-term care. The bill also specifies
procedures by which a requester may revoke a request for medication and provides
that making a request for medication does not revoke or otherwise modify a living
will or health care power of attorney that a requester may have. The bill provides
that making a request for medication does not constitute attempted suicide and that
taking medication under a fulfilled request does not constitute suicide. The bill
establishes penalties for certain actions with regard to the request for medication,
but prohibits a health care facility or health care provider from being charged with
a crime, being held civilly liable or being charged with unprofessional conduct for
failing to fulfill a request (except that an attending physician who refuses to fulfill
a request and fails to make a good-faith attempt to transfer the requester to another
physician who will fulfill the request may be charged with unprofessional conduct),
for fulfilling a valid request or for acting contrary to or failing to act on a revocation
of a request unless the health care facility or health care provider has actual
knowledge of the revocation.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB174, s. 1
16.009 (2) (p) of the statutes is created to read:
(p) Designate patients' advocates under s. 156.19.
AB174, s. 2
146.82 (2) (a) 8m. of the statutes is created to read:
(a) 8m. To the department under s. 156.07 (8) (g). The release of a 2
patient health care record under this subdivision shall be limited to the information 3
requested by the department under s. 156.25.
AB174, s. 3
Chapter 154 (title) of the statutes is repealed and recreated to read:
AB174, s. 4
Chapter 156 of the statutes is created to read:
Death with dignity
In this chapter:
"Attending physician" means a physician who has primary responsibility 12
for the care of the requester and treatment of the requester's terminal disease.
"Comfort care" means palliative care, as defined in s. 50.90 (3), or supportive 14
care, as defined in s. 50.90 (4).
"Consulting physician" means a physician who is qualified by specialty or 16
experience to make a professional diagnosis and prognosis with respect to the 17
"Department" means the department of health and social services.
"Health care facility" has the meaning given in s. 155.01 (6).
"Health care provider" has the meaning given in s. 155.01 (7).
"Incapacity" means the inability to receive and evaluate information 22
effectively or to communicate decisions to such an extent that the individual lacks 23
the capacity to manage his or her health care decisions.
"Informed decision" means a decision by an individual, to request and 25
obtain a prescription to end his or her life in a humane and dignified manner, that
is based on an appreciation of the relevant facts and made after having been fully 2
informed by the attending physician of all of the following:
(a) The individual's medical diagnosis.
(b) The individual's prognosis.
(c) The potential risks associated with taking the medication to be prescribed.
(d) The probable result of taking the medication to be prescribed.
(e) The feasible alternatives, including comfort care and care of a licensed 8
"Multipurpose senior center" has the meaning given in s. 155.01 (9).
"Patient health care records" has the meaning given in s. 146.81 (4).
"Physician" has the meaning given in s. 448.01 (5).
"Request for medication" means a document made under the requirements 13
of s. 156.05.
"Requester" means an individual who requests medication under the 15
requirements of this chapter for the purpose of ending his or her life in a humane and 16
"Residence" has the meaning given in s. 46.27 (1) (d).
"Responsible person" means the attending physician, a health care 19
professional working with the requester, an inpatient health care facility in which 20
the requester is located or the requester's spouse, child, parent, brother, sister, 21
grandparent or grandchild.
"Social worker" means a person certified as a social worker, advanced 23
practice social worker, independent social worker or independent clinical social 24
worker under s. 457.08.
"Terminal disease" means an incurable and irreversible disease that has 2
been diagnosed by an individual's attending physician and medically confirmed and 3
that will, within reasonable medical judgment, cause death within 6 months.
4156.03 Authorization to make request.
An individual who is of sound mind, 5
has attained age 18, has residence in this state, does not have incapacity and has a 6
terminal disease may voluntarily make a request for medication for the purpose of 7
ending his or her life in a humane and dignified manner. An individual for whom an 8
adjudication of incompetence and appointment of a guardian of the person is in effect 9
under ch. 880 is presumed not to be of sound mind for purposes of this section.