April 30, 2007 - Introduced by Representatives Boyle, Berceau and Pocan,
cosponsored by Senators Risser, Jauch and Carpenter. Referred to
Committee on Judiciary and Ethics.
AB298,1,4 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
3statutes; 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:
AB298, s. 1 1Section 1. 16.009 (2) (q) of the statutes is created to read:
AB298,3,22 16.009 (2) (q) Designate patients' advocates under s. 156.19.
AB298, s. 2 3Section 2. 146.82 (2) (a) 8m. of the statutes is created to read:
AB298,3,44 146.82 (2) (a) 8m. To the department under s. 156.07 (8) (g).
AB298, s. 3 5Section 3. Chapter 156 of the statutes is created to read:
AB298,3,76 Chapter 156
7 Death with dignity
AB298,3,8 8156.01 Definitions. In this chapter:
AB298,3,10 9(1) "Attending physician" means a physician who has primary responsibility
10for the care of the requester and treatment of the requester's terminal disease.
AB298,3,12 11(2) "Comfort care" means palliative care, as defined in s. 50.90 (3), or supportive
12care, as defined in s. 50.90 (4).
AB298,3,15 13(3) "Consulting physician" means a physician who is qualified by specialty or
14experience to make a professional diagnosis and prognosis with respect to the
15requester's disease.
AB298,3,16 16(4) "Department" means the department of health and family services.
AB298,3,17 17(5) "Health care facility" has the meaning given in s. 155.01 (6).
AB298,3,18 18(6) "Health care provider" has the meaning given in s. 155.01 (7).
AB298,3,21 19(7) "Incapacity" means the inability to receive and evaluate information
20effectively or to communicate decisions to such an extent that the individual lacks
21the capacity to manage his or her health care decisions.
AB298,4,4
1(8) "Informed decision" means a decision by an individual, to request and
2obtain medication under a prescription so as to end his or her life in a humane and
3dignified manner, that is based on an appreciation of the relevant facts and is made
4after having been fully informed by the attending physician of all of the following:
AB298,4,55 (a) The individual's medical diagnosis.
AB298,4,66 (b) The individual's prognosis.
AB298,4,77 (c) The potential risks associated with taking the medication to be prescribed.
AB298,4,88 (d) The probable result of taking the medication to be prescribed.
AB298,4,109 (e) The feasible alternatives, including comfort care, care of a hospice, and pain
10control.
AB298,4,11 11(9) "Multipurpose senior center" has the meaning given in s. 155.01 (9).
AB298,4,12 12(10) "Patient health care records" has the meaning given in s. 146.81 (4).
AB298,4,13 13(11) "Physician" has the meaning given in s. 448.01 (5).
AB298,4,15 14(12) "Request for medication" means a request made under s. 156.03 that meets
15the requirements of s. 156.05.
AB298,4,18 16(13) "Requester" means an individual who requests medication under the
17requirements of this chapter for the purpose of ending his or her life in a humane and
18dignified manner.
AB298,4,19 19(14) "Residence" has the meaning given in s. 46.27 (1) (d).
AB298,4,23 20(15) "Responsible person" means the attending physician, a health care
21provider serving the requester, an inpatient health care facility in which the
22requester is located, or the requester's spouse, child, parent, brother, sister,
23grandparent, or grandchild.
AB298,5,3
1(16) "Social worker" means a person certified as a social worker, advanced
2practice social worker, independent social worker, or independent clinical social
3worker under s. 457.08.
AB298,5,6 4(17) "Terminal disease" means an incurable and irreversible disease that has
5been diagnosed by an individual's attending physician and medically confirmed and
6that will, within reasonable medical judgment, cause death within 6 months.
AB298,5,12 7156.03 Authorization to make request. An individual who is of sound mind,
8has attained age 18, has residence in this state, does not have incapacity, and has a
9terminal disease may voluntarily make a request for medication for the purpose of
10ending his or her life in a humane and dignified manner. An individual for whom an
11adjudication of incompetence and appointment of a guardian of the person is in effect
12under ch. 54 is presumed not to be of sound mind for purposes of this section.
AB298,5,14 13156.05 Valid request for medication; requirements. (1) A request for
14medication under s. 156.03 is valid only if it is all of the following:
AB298,5,1515 (a) In writing.
AB298,5,1716 (b) Dated and signed by the requester or, at the express direction and in the
17presence of the requester, by an individual who has attained age 18.
AB298,5,1818 (c) Signed in the presence of 3 witnesses who meet the requirements of sub. (2).
AB298,5,1919 (d) Made voluntarily.
AB298,5,2020 (e) Substantially in the form specified in s. 156.15.
AB298,5,2421 (f) Filed in the requester's patient health care record in the custody of the
22requester's attending physician and, if the requester is an inpatient of a health care
23facility, in the requester's patient health care record in the custody of the health care
24facility.
AB298,6,3
1(2) (a) A witness to the making of a valid request for medication shall be an
2individual who has attained age 18. No witness to the making of a valid request for
3medication may, at the time of the witnessing, be any of the following:
AB298,6,44 1. Related to the requester by blood, marriage, or adoption.
AB298,6,65 2. An individual who has knowledge that he or she is entitled to or has a claim
6on any portion of the requester's estate.
AB298,6,77 3. Directly financially responsible for the requester's health care.
AB298,6,118 4. An individual who is a health care provider who is serving the requester at
9the time of the witnessing; an employee, other than a chaplain or a social worker, of
10the health care provider; or an employee, other than a chaplain or a social worker,
11of a health care facility in which the requester is a patient.
AB298,6,1412 (b) If a requester is a resident of a nursing home or community-based
13residential facility, at least one of the witnesses to the request shall be a patients'
14advocate designated under s. 156.19.
AB298,6,16 15156.07 Attending physician; responsibilities and limitations. The
16attending physician shall do all of the following:
AB298,6,18 17(1) Determine whether the requester has a terminal disease, does not have
18incapacity, and is making a request under s. 156.03 voluntarily.
AB298,6,19 19(2) Inform the requester of all of the following:
AB298,6,2020 (a) The requester's medical diagnosis.
AB298,6,2121 (b) The requester's prognosis.
AB298,6,2222 (c) The potential risks associated with taking the medication to be prescribed.
AB298,6,2323 (d) The probable result of taking the medication to be prescribed.
AB298,6,2524 (e) The feasible alternatives to taking the medication to be prescribed,
25including comfort care, care of a hospice, and pain control.
AB298,7,2
1(3) Refer the requester to a consulting physician under the requirements of s.
2156.09.
AB298,7,4 3(4) Refer the requester for review and counseling if the referral is determined
4to be appropriate under s. 156.11.
AB298,7,6 5(5) Ask the requester to notify his or her next of kin with respect to the request
6for medication.
AB298,7,10 7(6) Inform the requester that he or she may revoke the request for medication
8at any time; explain the methods of revocation that are specified under s. 156.17 (1);
9and offer the requester an opportunity to revoke the request at the time, if any, that
10the requester orally asks for medication under s. 156.13 (3) (c).
AB298,7,12 11(7) Before writing a prescription that fulfills a request for medication, verify
12that all of the following have occurred:
AB298,7,1313 (a) The requester has fulfilled the requirements of s. 156.13 (3).
AB298,7,1514 (b) No fewer than 48 hours have elapsed since the requester made a request
15for medication.
AB298,7,1616 (c) The requester has made an informed decision.
AB298,7,18 17(8) Document or file all of the following in the requester's patient health care
18record:
AB298,7,2019 (a) All occasions which the requester orally asks for medication under s. 156.13
20(3) and all requests for medication that are made by the requester.
AB298,7,2321 (b) The attending physician's diagnosis of and prognosis for the requester and
22determination as to whether the requester is incapacitated, is acting voluntarily, and
23has made an informed decision.
AB298,8,3
1(c) The consulting physician's diagnosis of and prognosis for the requester and
2determination as to whether the requester is incapacitated, is acting voluntarily, and
3has made an informed decision.
AB298,8,54 (d) A certification of the outcome and determinations made during any review
5and counseling for which the requester was referred under s. 156.11.
AB298,8,76 (e) A certification as to whether the attending physician offered the requester
7an opportunity to revoke the request for medication, as required under sub. (6).
AB298,8,88 (f) Evidence of a revocation, if made, as specified in s. 156.17 (2).
AB298,8,199 (g) A certification as to whether the requirements of this chapter are met and
10indicating the steps taken to fulfill the request for medication, including a notation
11of any medication that is prescribed. The attending physician shall report the
12information under this paragraph to the department on a form prescribed by the
13department. Information reported to the department under this paragraph that
14could identify the requester, the attending physician, the consulting physician, or the
15psychiatrist or psychologist to whom referral was made under s. 156.11, if any, is
16confidential and may not be disclosed by the department except under an
17investigation of an alleged violation of this chapter. The report of information under
18this paragraph is not a violation of any person's responsibility for maintaining the
19confidentiality of patient health care records under s. 146.82.
AB298,9,2 20(9) If the attending physician refuses to fulfill the requester's request for
21medication under this chapter, the attending physician shall make a good faith
22attempt to transfer the requester's care and treatment to another physician who will
23act as the attending physician under this chapter and will fulfill the requester's
24request for medication. If a transfer is made, the attending physician to whom the

1requester's care and treatment is transferred shall comply with the requirements of
2this section.
AB298,9,8 3156.09 Consulting physician. Before an attending physician may fulfill a
4request for medication under this chapter, a consulting physician shall examine the
5requester and his or her relevant patient health care records and shall medically
6confirm the attending physician's determinations that the requester suffers from a
7terminal disease, does not have incapacity, is making a request for medication
8voluntarily, and has made an informed decision.
AB298,9,19 9156.11 Referral for review and counseling. If in the opinion of the
10attending physician or the consulting physician a requester may be suffering from
11a psychiatric or psychological disorder, including depression, that causes impaired
12judgment, the attending physician or consulting physician shall refer the requester
13for review and counseling to a physician specializing in psychiatry or a licensed
14psychologist, as defined in s. 455.01 (4). No request for medication may be fulfilled
15under this chapter unless the physician specializing in psychiatry, or the
16psychologist, to whom referral was made, determines and certifies in writing that the
17requester is not suffering from a psychiatric or psychological disorder, including
18depression, that causes impaired judgment. The certification, if any, shall be filed
19in the requester's patient health care record under s. 156.07 (8).
AB298,9,22 20156.13 Requester rights, responsibilities, and limitations. (1) No
21requester may receive a prescription that fulfills a request for medication unless he
22or she has made an informed decision.
AB298,9,25 23(2) No requester may be required to notify his or her next of kin regarding his
24or her request for medication, and no request for medication may be denied because
25the requester has failed to notify his or her next of kin.
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