2007 - 2008 LEGISLATURE
April 19, 2007 - Introduced by Senators Risser, Jauch and Carpenter, cosponsored
by Representatives Boyle, Berceau and Pocan. Referred to Committee on
Public Health, Senior Issues, Long Term Care and Privacy.
1An Act to repeal
979.01 (1r); to amend
979.01 (1) (intro.) and 979.01 (1g); and 2to create
16.009 (2) (q), 146.82 (2) (a) 8m., chapter 156 and 979.01 (1j) of the 3
statutes; relating to: permitting certain individuals to make written requests
4for medication for the purpose of ending 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, medication from his or her attending physician for the
purpose of ending the individual's 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 orally ask his or her attending physician for the
medication. 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 orally ask of his or
her attending physician a second time 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 valid 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:
SB151, s. 1
16.009 (2) (q) of the statutes is created to read:
(q) Designate patients' advocates under s. 156.19.
SB151, 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).
SB151, 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 10
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 12
care, as defined in s. 50.90 (4).
"Consulting physician" means a physician who is qualified by specialty or 14
experience to make a professional diagnosis and prognosis with respect to the 15
"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 20
effectively or to communicate decisions to such an extent that the individual lacks 21
the capacity to manage his or her health care decisions.
"Informed decision" means a decision by an individual, to request and 2
obtain medication under a prescription so as to end his or her life in a humane and 3
dignified manner, that is based on an appreciation of the relevant facts and is made 4
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 10
"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 request made under s. 156.03 that meets 15
the requirements of s. 156.05.
"Requester" means an individual who requests medication under the 17
requirements of this chapter for the purpose of ending his or her life in a humane and 18
"Residence" has the meaning given in s. 46.27 (1) (d).
"Responsible person" means the attending physician, a health care 21
provider serving the requester, an inpatient health care facility in which the 22
requester is located, or the requester's spouse, child, parent, brother, sister, 23
grandparent, or grandchild.
"Social worker" means a person certified as a social worker, advanced 2
practice social worker, independent social worker, or independent clinical social 3
worker under s. 457.08.
"Terminal disease" means an incurable and irreversible disease that has 5
been diagnosed by an individual's attending physician and medically confirmed and 6
that will, within reasonable medical judgment, cause death within 6 months.
7156.03 Authorization to make request.
An individual who is of sound mind, 8
has attained age 18, has residence in this state, does not have incapacity, and has a 9
terminal disease may voluntarily make a request for medication for the purpose of 10
ending his or her life in a humane and dignified manner. An individual for whom an 11
adjudication of incompetence and appointment of a guardian of the person is in effect 12
under ch. 54 is presumed not to be of sound mind for purposes of this section.
13156.05 Valid request for medication; requirements. (1)
A request for 14
medication under s. 156.03 is valid only if it is all of the following:
(a) In writing.
(b) Dated and signed by the requester or, at the express direction and in the 17
presence of the requester, by an individual who has attained age 18.