2021 - 2022 LEGISLATURE
March 7, 2022 - Introduced by Representatives Pope,
Hesselbein, Subeck, Baldeh,
Spreitzer, Conley, Vruwink, Sinicki, Snodgrass, B. Meyers, Ohnstad and
Anderson, cosponsored by Senators Agard,
Bewley, Carpenter, Smith and
Roys. Referred to Committee on Constitution and Ethics.
1An Act to create
chapter 156 and 979.01 (1j) of the statutes; relating to:
2permitting certain qualified individuals to make a request for medication for
3the purpose of ending their lives and providing a penalty.
Analysis by the Legislative Reference Bureau
This bill permits an individual who is at least 18 years of age, mentally capable,
and has a terminal disease with a prognosis of less than six months to live to
voluntarily request a prescription for medication for the purpose of ending his or her
life. Under the bill, “terminal disease” means an incurable and irreversible disease
that has been medically confirmed and will, within reasonable medical judgment,
produce death within six months. The bill authorizes the individual's attending
provider to issue a prescription for the medication if specified requirements are met.
Under the bill, an attending or consulting provider must be a licensed physician, an
advanced practice registered nurse, or a physician assistant. Death following
self-administering medication in accordance with the requirements of the bill does
not alone constitute grounds for post-mortem inquiry and such a death may not be
designated as suicide or homicide.
The bill requires that the Department of Health Services develop and distribute
certain standard forms to be used for reporting by attending providers in the context
of requests for medication under the provisions of the bill.
The bill establishes certain requirements that must be met before an attending
provider may issue a prescription in response to an individual's request for a
prescription for medication to end his or her life. With certain exceptions for an
individual who is determined to be within 15 days of death, a qualified individual
must make an oral request and a written request, and reiterate the oral request to
his or her attending provider no less than 15 days after making the initial oral
request. The oral and written requests for medical aid in dying may only be made
by the requesting individual and not by any surrogate decision-maker, health care
proxy, attorney-in-fact for health care, or through an advance health care directive.
The written request must be substantially in the form provided in the bill. It must
be signed and dated by the individual and witnessed by at least one individual who
meets certain qualifications and attests that the individual is capable, acting
voluntarily, and is not being coerced or unduly influenced to sign the request.
The bill requires an attending provider to comply with certain requirements
with respect to requests for medication under the bill, including 1) determining
whether an individual has a terminal disease with a prognosis of six months or less
to live and is mentally capable; 2) confirming that the individual's request does not
arise from coercion or undue influence; 3) informing the individual of certain
information specified in the bill, including the potential risks, benefits, and probable
result of self-administering the prescribed medication; 4) informing the individual
that there is no obligation to fill the prescription nor an obligation to self-administer
the medication, even if obtained; 6) providing a referral for comfort care, palliative
care, hospice care, pain control, or other end-of-life treatment options as requested
or as medically indicated; 7) referring the individual to a consulting provider for
medical confirmation that the individual requesting medication under the bill both
has a terminal disease with a prognosis of six months or less to live and is mentally
capable; and 8) before providing a prescription, confirming that the individual has
made an informed decision to obtain medication under the bill, offering the
individual an opportunity to rescind the request, and educating the individual on the
recommended procedure for self-administration of the medication, the safe-keeping
and proper disposal of unused medication, the importance of having another person
present when the person self-administers the medication, and not taking the
medication in a public place. Under the bill, a consulting provider must evaluate an
individual making a request for medication under the provisions of the bill and
confirm, in writing, to the attending provider that the individual has a terminal
disease with a prognosis of six months or less to live; that the individual is mentally
capable or that the consulting provider has referred the individual to a licensed
mental health provider for further evaluation; and that the individual is acting
voluntarily, free from coercion or undue influence. The bill requires that if either the
attending provider or the consulting provider is unable to confirm that the individual
is capable of making an informed decision, the attending provider or the consulting
provider must refer the individual to a licensed mental health provider for
determination regarding mental capability.
The bill specifies that a provider may choose whether or not to practice medical
aid in dying under the provisions of the bill, but if a provider is unable or unwilling
to fulfill an individual's request for medication under the bill, the provider must still
document the date of the individual's request in the patient's medical record and, if
requested, transfer the individual's medical records to a new provider. The bill also
specifies that a health care facility may prohibit providers from qualifying,
prescribing, or dispensing medication under the provisions of the bill while
performing duties for the facility, but if it does so, it must provide advance notice to
providers and staff in writing, and then on a yearly basis. If an individual wishes
to transfer to another facility, the facility must coordinate a timely transfer. Finally,
no health care facility may prohibit a provider from fulfilling the requirements of
informed consent and meeting the medical standard of care, including by allowing
a provider to prescribe medication under the provisions of the bill outside of the scope
of the provider's employment or contract with the prohibiting facility and off the
premises of the the prohibiting facility.
The bill includes immunity for actions taken in good faith, but also includes
penalties for intentionally or knowingly 1) altering or forging an individual's request
for medication under the bill; 2) concealing or destroying a rescission of a request for
medication under the bill; or 3) coercing or exerting undue influence on an individual
with a terminal disease to request or use medication under the bill. The bill expressly
does not not limit civil liability or damages arising from negligent conduct or
Under the bill, insurance, including insurance rates, may not be conditioned on
or affected by an individual's act of making or rescinding a request for medication
under the provisions of the bill. Further, a qualified individual's act of
self-administering medication consistent with the provisions of the bill does not
invalidate any part of a life, health, or accident insurance policy, or an annuity policy.
Finally, no insurance plan may deny or alter benefits to an individual with a terminal
disease who is a covered beneficiary based on the availability of medical aid in dying,
the individual's request for medication under the provisions of the bill, or the absence
of such a request.
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
For further information see the state 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:
Chapter 156 of the statutes is created to read:
medical aid in dying
4156.01 Short title.
This chapter shall be known and may cited as the “Our 5
Care, Our Options Act."
In this chapter:
“Adult” means an individual who is 18 years of age or older.
“Attending provider” means the provider who has primary responsibility 4
for the care of an individual and treatment of that individual's terminal disease.
“Coercion or undue influence” means the willful attempt, whether by 6
deception, intimidation, or any other means, to do any of the following:
(a) Cause an individual to request, obtain, or self-administer medication under 8
this chapter with intent to cause the death of the individual.
(b) Prevent a qualified individual from obtaining or self-administering 10
medication under this chapter.
“Consulting provider” means a provider who is qualified by specialty or 12
experience to make a professional diagnosis and prognosis regarding an individual's 13
“Department” means the department of health services.
“Health care facility” means a general hospital, medical clinic, nursing 16
home, or in-patient hospice facility or any other entity regulated under ch. 50. A 17
health care facility does not include individual providers.
“Informed decision” means a decision by a qualified individual to request 19
and obtain a prescription for medication under this chapter that the qualified 20
individual may self-administer to bring about his or her peaceful death, after being 21
fully informed by the individual's attending provider of all of the following:
(a) The individual's diagnosis and prognosis.
(b) The potential risks associated with taking the medication to be prescribed.
(c) The probable result of taking the medication to be prescribed.
(d) The feasible end-of-life care and treatment options for the individual's 2
terminal disease, including comfort care, palliative care, hospice care and pain 3
control, and the risks and benefits of each.
(e) The individual's right to withdraw a request under this chapter or consent 5
for any other treatment at any time.
Notwithstanding sub. (13), “licensed mental health care provider” means 7
a psychiatrist, psychologist, clinical social worker, psychiatric nurse practitioner, 8
clinical mental health counselor, or clinical professional counselor licensed, certified, 9
or otherwise credentialed in this state.
“Medical aid in dying” means the practice of evaluating a request, 11
determining qualification, and providing a prescription to a qualified individual 12
under this chapter.
“Medically confirmed” means that a consulting provider, after performing 14
a medical evaluation, has confirmed an attending provider's medical opinion that an 15
individual is eligible to receive medication under this chapter.
“Mentally capable” means that in the opinion of an attending provider or 17
consulting provider, or a licensed mental health care provider if a determination is 18
requested under s. 156.17, an individual requesting medication under this chapter 19
has the ability to make and communicate an informed decision.
“Prognosis of six months or less” means an individual's terminal disease 21
will, within reasonable medical judgment, result in the death of that individual 22
within six months.
“Provider” means a person licensed, certified, or otherwise authorized or 24
permitted by this state to diagnose and treat medical conditions and prescribe and
dispense medication, including controlled substances, but does not include a health 2
care facility. Provider includes any of the following:
(a) A physician licensed under ch. 448.
(b) An advanced practice registered nurse, as defined in s. 154.01 (1g).
(c) A physician assistant licensed under subch. VIII of ch. 448.
“Qualified individual” means a mentally capable adult who has satisfied 7
the requirements of this chapter in order to obtain a prescription for medication to 8
bring about a peaceful death. No person will be considered a “qualified individual” 9
under this chapter solely because of advanced age or disability.
“Self-administer” means a qualified individual performs an affirmative, 11
conscious, and voluntary act to ingest medication prescribed under this chapter to 12
bring about the individual's peaceful death. Self-administration does not include 13
administration by intravenous or other parenteral injection or infusion.
“Terminal disease” means an incurable and irreversible disease that has 15
been medically confirmed and will, within reasonable medical judgment, produce 16
death within six months.
17156.05 Informed consent. (1)
Nothing in this chapter may be construed to 18
limit the information a provider must provide to an individual in order to comply 19
with the medical standard of care and with informed consent requirements under 20
If a provider is unable or unwilling to fulfill a request for medication under 22
this chapter, the provider shall proceed as required under s. 156.21 (2).