2003 - 2004 LEGISLATURE
May 14, 2003 - Introduced by Senators Risser and Carpenter, cosponsored by
Representatives Boyle, Sherman, Pocan and
Berceau. Referred to
Committee on Judiciary, Corrections and Privacy.
1An Act to amend
979.01 (1) (intro.); and to create
16.009 (2) (q), 146.82 (2) (a) 2
8m., chapter 156 and 979.01 (1t) of the statutes; relating to: permitting certain
3individuals to make written requests for medication for the purpose of ending
4their 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.
Under the bill, the following requirements must be met before an individual's
attending physician may issue a prescription in response to the individual's request
1. The requester must first make the request orally. Then, not fewer than 15
days later, the requester must again, voluntarily, 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, 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
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.
However, the bill also 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.
Because this bill creates a new crime or revises a penalty for an existing crime,
the Joint Review Committee on Criminal Penalties may be requested to prepare a
report concerning the proposed penalty and the costs or savings that are likely to
result if the bill is enacted.
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:
SB169, s. 1
16.009 (2) (q) of the statutes is created to read:
(q) Designate patients' advocates under s. 156.19.
SB169, 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 5
patient health care record under this subdivision shall be limited to the information 6
requested by the department under s. 156.25.
SB169, 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 12
for the care of a 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 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).
"Hospice care" has the meaning given in s. 50.94 (1) (a).
"Incapacity" means the inability to receive and evaluate information 2
effectively or to communicate decisions to such an extent that the individual lacks 3
the capacity to manage his or her health care decisions.
"Informed decision" means a determination by an individual, to request and 5
obtain medication under a prescription so as to end his or her life in a humane and 6
dignified manner, that is based on the individual's appreciation of the relevant facts 7
and is made after the individual has been fully informed by the attending physician 8
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 to the decision, including comfort care, hospice 14
care, and pain control.
"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).
"Prescription" has the meaning given in s. 450.01 (19).
"Requester" means an individual who requests medication under the 20
requirements of this chapter for the purpose of ending his or her life in a humane and 21
"Request for medication" means a document made under the requirements 23
of s. 156.05.
"Residence" has the meaning given in s. 46.27 (1) (d).
"Responsible person" means the attending physician, a health care 2
professional working with the requester, an inpatient health care facility in which 3
the requester is located, or the requester's spouse, child, parent, brother, sister, 4
grandparent, or grandchild.
"Social worker" means a person certified as a social worker, advanced 6
practice social worker, independent social worker, or independent clinical social 7
worker under s. 457.08.
"Terminal disease" means an incurable and irreversible disease that has 9
been diagnosed by an individual's attending physician, has been medically 10
confirmed, and will, within reasonable medical judgment, cause death within 6 11
12156.03 Authorization to make request.
An individual who is of sound mind, 13
has attained age 18, has residence in this state, does not have incapacity, and has a 14
terminal disease may voluntarily make a request for medication for the purpose of 15
ending his or her life in a humane and dignified manner. An individual for whom an 16
adjudication of incompetence and appointment of a guardian of the person is in effect 17
under ch. 880 is presumed not to be of sound mind for purposes of this section.
18156.05 Valid request for medication; requirements. (1)
A valid request 19
for medication shall be, for the purposes of s. 156.03, all of the following: