1999 - 2000 LEGISLATURE
April 22, 1999 - Introduced by Representatives Boyle, Carpenter, Pocan and
Travis, cosponsored by Senators Risser and Jauch. Referred to Committee on
1An Act to amend
979.01 (1) (intro.); and to create
16.009 (2) (p), 146.82 (2) (a) 2
8m., chapter 156 and 979.01 (1g) of the statutes; relating to: permitting
3certain individuals to make written requests for medication for the purpose of
4ending their lives, and providing penalties.
Analysis by the Legislative Reference Bureau
This bill permits an individual who is of sound mind, is not incapacitated, is at
least 18 years of age, is a resident of Wisconsin and has a terminal disease to request
voluntarily, in writing, his or her attending physician for medication for the purpose
of ending his or her life in a humane and dignified manner. The bill authorizes the
individual's attending physician to issue a prescription for the medication if specified
requirements are met. Further, the bill creates a statutory request form for
medication and requires that the department of health and family services (DHFS)
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 issue a prescription in response to the
individual's request for medication:
1. First, the requester must make the request orally. Then, not fewer than 15
days later, the requester must again request the medication, using a valid request
form that is substantially in the form specified in the bill, is in writing, is signed in
the presence of three qualified witnesses and dated by the requester, is made
voluntarily and is filed in the requester's patient health care record. After the
request is filed, the requester must make a second oral request of his or her attending
physician for the medication.
2. The requester's attending physician must determine that the requester
meets the 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 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 DHFS on a form
prescribed by DHFS.
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 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 a 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:
AB297, s. 1
16.009 (2) (p) of the statutes is created to read:
(p) Designate patients' advocates under s. 156.19.
AB297, 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 4
patient health care record under this subdivision shall be limited to the information 5
requested by the department under s. 156.25.
AB297, s. 3
Chapter 156 of the statutes is created to read:
Death with dignity
In this chapter:
"Attending physician" means a physician who has primary responsibility 11
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 13
care, as defined in s. 50.90 (4).
"Consulting physician" means a physician who is qualified by specialty or 15
experience to make a professional diagnosis and prognosis with respect to the 16
"Department" means the department of health and family 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 21
effectively or to communicate decisions to such an extent that the individual lacks 22
the capacity to manage his or her health care decisions.
"Informed decision" means a decision by an individual, to request and 24
obtain medication under a prescription so as to end his or her life in a humane and
dignified manner, that is based on an appreciation of the relevant facts and is made 2
after having been fully 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, care of a hospice and pain 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.
10156.05 Valid request for medication; requirements. (1)
A valid request 11
for medication shall be, for the purposes of s. 156.03, all of the following:
(a) In writing.
(b) Dated and signed by the requester or, at the express direction and in the 14
presence of the requester, by an individual who has attained age 18.
(c) Signed in the presence of 3 witnesses who meet the requirements of sub. (2).