N.Y. Public Health Law § 2899-f: Attending physician responsibilities

§ 2899-f. Attending physician responsibilities. 1. Upon a patient's

request for a medical aid-in-dying prescription, the attending physician

shall examine the patient in person and the patient's relevant medical

records, provided, however, that the attending physician may waive the

in-person examination requirement and conduct the examination via

telehealth if the physician determines, within reasonable medical

judgment, and documents in the patient's medical record that requiring

an in-person visit would result in extraordinary hardship to the

patient. For purposes of this subdivision, the term "extraordinary

hardship" shall mean circumstances in which an in-person examination

would cause the patient undue pain or suffering, or would necessitate

extraordinary expense or logistical burden for medically-necessary

transportation. In such cases, the examination may be conducted via

telehealth once the attending physician affirms that all other

requirements of this article have been fulfilled. The attending

physician shall also:

(a) make a determination of whether a patient has a terminal illness

or condition, has decision-making capacity, has made an informed

decision and has made the request voluntarily of the patient's own

volition and without coercion;

(b) inform the patient of the requirement under this article for

confirmation by a consulting physician, and refer the patient to a

consulting physician upon the patient's request;

(c) inform the patient of the requirement under this article for

confirmation by a mental health professional, and refer the patient to a

mental health professional upon the patient's request;

(d) provide information and counseling under section twenty-nine

hundred ninety-seven-c of this chapter, provided, however, that if the

attending physician is not willing or does not feel qualified to provide

the patient with information and counseling under this paragraph, the

attending physician may arrange for another physician to do so, or shall

refer or transfer the patient to another physician willing to do so;

(e) ensure that the patient is making an informed decision by

discussing with the patient: (i) the patient's medical diagnosis and

prognosis; (ii) the potential risks associated with taking the

medication to be prescribed; (iii) the probable result of taking the

medication to be prescribed; (iv) the possibility that the patient may

choose to obtain the medication but not take it; (v) the feasible

alternatives and appropriate treatment options, including but not

limited to (1) information and counseling regarding palliative and

hospice care and end-of-life options appropriate to the patient,

including but not limited to: the range of options appropriate to the

patient; the prognosis, risks and benefits of the various options; and

the patient's legal rights to comprehensive pain and symptom management

at the end of life; and (2) information regarding treatment options

appropriate to the patient, including the prognosis, risks and benefits

of the various treatment options;

(f) offer to refer the patient for other appropriate treatment

options, including but not limited to palliative care and hospice care;

(g) provide health literate and culturally appropriate educational

material regarding hospice and palliative care that has been prepared by

the department in consultation with representatives of hospice and

palliative care providers from all regions of New York state, and that

is available on the department's website for access and download,

provided, however, an otherwise eligible patient cannot be denied care

under this article if these materials are not developed by the effective

date of this article;

(h) discuss with the patient the importance of:

(i) having another person present when the patient takes the

medication and the restriction that no person other than the patient may

administer the medication;

(ii) not taking the medication in a public place; and

(iii) informing the patient's family of the patient's decision to

request and take medication that will end the patient's life; a patient

who declines or is unable to notify family shall not have such patient's

request for medication denied for that reason;

(i) inform the patient that such patient may rescind the request for

medication at any time and in any manner;

(j) fulfill the medical record documentation requirements of section

twenty-eight hundred ninety-nine-j of this article; and

(k) ensure that all appropriate steps are carried out in accordance

with this article before writing a prescription for medication.

2. Upon receiving confirmation from a consulting physician and mental

health professional under section twenty-eight hundred ninety-nine-h of

this article and section twenty-eight hundred ninety-nine-i of this

article, respectively, the attending physician who determines that the

patient has a terminal illness or condition, has decision-making

capacity and has made a voluntary request for medication as provided in

this article, may personally, or by referral to another physician,

prescribe or order appropriate medication in accordance with the

patient's request under this article, and at the patient's request,

facilitate the filling of the prescription and delivery of the

medication to the patient.

3. A prescription for medication shall not be filled until five days

after the prescription has been written, unless the patient's attending

physician has medically confirmed that the qualified individual may,

within reasonable medical judgment, die before the expiration of the

waiting period identified herein, in which case, the prescription may be

filled once the attending physician affirms that all other requirements

pursuant to this article have been fulfilled. Such prescription must

indicate the date and time that the prescription for medication was

written and indicate the first allowable date and time when it may be

filled.

4. In accordance with the direction of the prescribing or ordering

physician and the consent of the patient, the patient may

self-administer the medication to themselves. A health care professional

or other person shall not administer the medication to the patient.