AB417,12,88 (print) Name: ....
AB417,12,99 Address: ....
AB417,12,1010 Signature: ....
AB417,12,1111 Witness No. 3:
AB417,12,1212 (print) Name: ....
AB417,12,1313 Address: ....
AB417,12,1414 Signature: ....
AB417,12,1815 If the requester is a patient in a health care facility, at least one of the above
16witnesses must be a patients' advocate designated by the board on aging and
17long-term care. A patients' advocate who is a witness should print "patients'
18advocate" after the printing of his or her name above.
AB417,12,20 19156.17 Revocation of request for medication. (1) A requester may revoke
20his or her request for medication at any time by doing any of the following:
AB417,12,2321 (a) Canceling, defacing, obliterating, burning, tearing, or otherwise destroying
22the request for medication or directing another in the presence of the requester to
23destroy, in the same manner, the request for medication.
AB417,12,2524 (b) Executing a statement, in writing, that is signed and dated by the requester,
25expressing the requester's intent to revoke the request for medication.
AB417,13,2
1(c) Orally expressing the requester's intent to revoke the request for
2medication, in the presence of 2 witnesses.
AB417,13,33 (d) Making a subsequent request for medication.
AB417,13,7 4(2) The requester's health care provider shall, upon notification of revocation
5of the requester's request for medication, record in the requester's medical record the
6time, date, and place of the revocation and the time, date, and place, if different, of
7the notification to the health care provider of the revocation.
AB417,13,14 8156.19 Designation of patients' advocates. The board on aging and
9long-term care shall designate staff of the long-term care ombudsman program as
10patients' advocates. A person so designated shall serve as a witness to a request for
11medication of a requester who is a patient or resident of a nursing home or
12community-based residential facility, as required under s. 156.05 (2) (b), and shall
13speak on behalf of the requester to ensure that his or her needs or wants are
14communicated to and addressed by his or her attending physician.
AB417,13,17 15156.21 Duties and immunities. (1) No health care facility or health care
16provider may be charged with a crime, held civilly liable, or charged with
17unprofessional conduct for any of the following:
AB417,13,2218 (a) Failing to fulfill a request for medication, except that failure of an attending
19physician to fulfill a request for medication constitutes unprofessional conduct if the
20attending physician refuses or fails to make a good faith attempt to transfer the
21requester's care and treatment to another physician who will act as attending
22physician under this chapter and fulfill the request for medication.
AB417,13,2423 (b) In the absence of actual knowledge of a revocation, fulfilling a request for
24medication that is in compliance with this chapter.
AB417,14,3
1(c) Acting contrary to or failing to act on a revocation of a request for medication,
2unless the health care facility or health care provider has actual knowledge of the
3revocation.
AB417,14,7 4(2) In the absence of actual notice to the contrary, a health care facility or health
5care provider may presume that a requester was authorized to make his or her
6request for medication under the requirements of this chapter and that the request
7for medication is valid.
AB417,14,10 8(3) (a) No person who acts in good faith as a witness to a request for medication
9under this chapter may be held civilly or criminally liable for a death that results
10from taking medication under a fulfilled request for medication under this chapter.
AB417,14,1211 (b) Paragraph (a) does not apply to a person who acts as a witness in violation
12of s. 156.05 (2) (a).
AB417,14,16 13156.23 General provisions. (1) (a) The making of a request for medication
14under this chapter does not, for any purpose, constitute attempted suicide. Taking
15medication under a fulfilled request for medication under this chapter does not, for
16any purpose, constitute suicide.
AB417,14,1917 (b) Paragraph (a) does not prohibit an insurer from making a determination
18that a requester has attempted suicide or committed suicide if the requester has so
19acted, apart from the request for medication.
AB417,14,22 20(2) The making of a request for medication under this chapter does not revoke
21or otherwise modify a power of attorney for health care or living will that the
22requester may have executed.
AB417,15,2 23(3) No individual may be required to make a request for medication as a
24condition for receipt of health care or admission to a health care facility. The making

1of a request for medication is not a bar to the receipt of health care or the admission
2to a health care facility.
AB417,15,4 3(4) A request for medication that is in its original form or is a legible photocopy
4or electronic facsimile copy is presumed to be valid.
AB417,15,8 5(5) Nothing in this chapter may be construed to condone, authorize, approve,
6or permit any affirmative or deliberate act to end life other than through taking
7medication that is prescribed under a request for medication as provided in this
8chapter.
AB417,15,12 9156.25 Record review. The department shall annually examine a sampling
10of patient health care records of requesters for whom medication was prescribed as
11requested under a request for medication and about whom the department has
12received information under s. 156.07 (8) (g).
AB417,15,16 13156.27 Penalties. (1) Any person who willfully conceals, cancels, defaces,
14obliterates, or damages the request for medication of another without the requester's
15consent may be fined not more than $500 or imprisoned for not more than 30 days
16or both.
AB417,15,21 17(2) Any person who, with the intent to cause a requester to take medication that
18is prescribed under a request for medication contrary to the wishes of the requester,
19illegally falsifies or forges the request for medication of another or conceals a
20revocation under s. 156.17 (1) (a) or (b) shall be fined not more than $10,000 or
21imprisoned for not more than 10 years or both.
AB417,16,2 22(3) Any responsible person who, with the intent to cause a requester to take
23medication that is prescribed under a request for medication contrary to the wishes
24of the requester, conceals personal knowledge of a revocation under s. 156.17 shall

1be fined not more than $10,000 or, except for a health care facility, imprisoned for not
2more than 10 years or both.
AB417, s. 4 3Section 4. 979.01 (1) of the statutes is renumbered 979.01 (1) (intro.) and
4amended to read:
AB417,16,115 979.01 (1) (intro.) All Except as provided in sub. (1j), all physicians, authorities
6of hospitals, sanatoriums, public and private institutions, convalescent homes,
7authorities of any institution of a like nature, and other persons having knowledge
8of the death of any person who has died under any of the following circumstances,
9shall immediately report the death to the sheriff, police chief, and medical examiner
10or coroner of the county and to the police chief of any community where the death took
11place.:
AB417, s. 5 12Section 5. 979.01 (1g) (intro.) of the statutes is renumbered 979.01 (1g) and
13amended to read:
AB417,16,1814 979.01 (1g) A sheriff or police chief shall, immediately upon notification of a
15death under sub. (1), notify the coroner or the medical examiner and the coroner or
16medical examiner of the county where death took place
, if the crime, injury or event
17occurred in another county, shall immediately report all of the following the death
18to the coroner or medical examiner of that county:.
AB417, s. 6 19Section 6. 979.01 (1g) (a) of the statutes is renumbered 979.01 (1) (a).
AB417, s. 7 20Section 7. 979.01 (1g) (b) of the statutes is renumbered 979.01 (1) (b).
AB417, s. 8 21Section 8. 979.01 (1g) (c) of the statutes is renumbered 979.01 (1) (c).
AB417, s. 9 22Section 9. 979.01 (1g) (d) of the statutes is renumbered 979.01 (1) (d).
AB417, s. 10 23Section 10. 979.01 (1g) (e) of the statutes is renumbered 979.01 (1) (e).
AB417, s. 11 24Section 11. 979.01 (1g) (f) of the statutes is renumbered 979.01 (1) (f).
AB417, s. 12 25Section 12. 979.01 (1g) (g) of the statutes is renumbered 979.01 (1) (g).
AB417, s. 13
1Section 13. 979.01 (1g) (h) of the statutes is renumbered 979.01 (1) (h).
AB417, s. 14 2Section 14. 979.01 (1g) (i) of the statutes is renumbered 979.01 (1) (i).
AB417, s. 15 3Section 15. 979.01 (1j) of the statutes is created to read:
AB417,17,64 979.01 (1j) Subsection (1) does not apply to a death that results from taking
5medication under a fulfilled request for medication that is in accordance with the
6requirements of ch. 156.
AB417, s. 16 7Section 16. 979.01 (1m) of the statutes is amended to read:
AB417,17,98 979.01 (1m) The coroner or medical examiner receiving notification under sub.
9(1) or (1g) shall immediately notify the district attorney.
AB417, s. 17 10Section 17. 979.01 (1r) of the statutes is repealed.
AB417,17,1111 (End)
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