Illinois General Assembly - Full Text of SB3499
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Full Text of SB3499  103rd General Assembly



State of Illinois
2023 and 2024


Introduced 2/9/2024, by Sen. Linda Holmes


New Act

    Creates the End-of-Life Options for Terminally Ill Patients Act. Authorizes a qualified patient with a terminal disease to request that a physician prescribe aid-in-dying medication that will allow the patient to end the patient's life in a peaceful manner. Contains provisions concerning: the procedures and forms to be used to request aid-in-dying medication; the responsibilities of attending and consulting physicians; the referral of patients for determinations of mental capacity; the residency of qualified patients; the safe disposal of unused medications; the obligations of health care entities; the immunities granted for actions taken in good faith reliance upon the Act; the reporting requirements of physicians; the effect of the Act on the construction of wills, contracts, and statutes; the effect of the Act on insurance policies and annuities; the procedures for the completion of death certificates; the liabilities and penalties provided by the Act; the construction of the Act; the definitions of terms used in the Act; and other matters. Effective 6 months after becoming law.

LRB103 38464 RPS 68600 b





SB3499LRB103 38464 RPS 68600 b

1    AN ACT concerning health.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 1. Short title. This Act may be cited as the
5End-of-Life Options for Terminally Ill Patients Act.
6    Section 5. Definitions. As used in this Act:
7    "Adult" means an individual 18 years of age or older.
8    "Advanced practice registered nurse" means an advanced
9practice registered nurse licensed under the Nurse Practice
10Act who is certified as a psychiatric mental health
12    "Aid in dying" means an end-of-life care option that
13allows a qualified patient to obtain a prescription for
14medication pursuant to this Act.
15    "Attending physician" means the physician who has primary
16responsibility for the care of the patient and treatment of
17the patient's terminal disease.
18    "Clinical psychologist" means a psychologist licensed
19under the Clinical Psychologist Licensing Act.
20    "Clinical social worker" means a person licensed under the
21Clinical Social Work and Social Work Practice Act.
22    "Coercion or undue influence" means the willful attempt,
23whether by deception, intimidation, or any other means to:



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1        (1) cause a patient to request, obtain, or
2    self-administer medication pursuant to this Act with
3    intent to cause the death of the patient; or
4        (2) prevent a qualified patient, in a manner that
5    conflicts with the Health Care Right of Conscience Act,
6    from obtaining or self-administering medication pursuant
7    to this Act.
8    "Consulting physician" means a physician who is qualified
9by specialty or experience to make a professional diagnosis
10and prognosis regarding the patient's disease.
11    "Department" means the Department of Public Health.
12    "Health care entity" means a hospital or hospital
13affiliate, nursing home, hospice or any other facility
14licensed under any of the following Acts: the Ambulatory
15Surgical Treatment Center Act; the Home Health, Home Services,
16and Home Nursing Agency Licensing Act; the Hospice Program
17Licensing Act; the Hospital Licensing Act; the Nursing Home
18Care Act; or the University of Illinois Hospital Act. "Health
19care entity" does not include a physician.
20    "Health care professional" means a physician, pharmacist,
21or licensed mental health professional.
22    "Informed decision" means a decision by a patient with
23mental capacity and a terminal disease to request and obtain a
24prescription for medication pursuant to this Act, that the
25qualified patient may self-administer to bring about a
26peaceful death, after being fully informed by the attending



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1physician and consulting physician of:
2        (1) the patient's diagnosis and prognosis;
3        (2) the potential risks and benefits associated with
4    taking the medication to be prescribed;
5        (3) the probable result of taking the medication to be
6    prescribed;
7        (4) the feasible end-of-life care and treatment
8    options for the patient's terminal disease, including, but
9    not limited to, comfort care, palliative care, hospice
10    care, and pain control, and the risks and benefits of
11    each;
12        (5) the patient's right to withdraw a request pursuant
13    this Act, or consent for any other treatment, at any time;
14    and
15        (6) the patient's right to choose not to obtain the
16    drug or to choose to obtain the drug but not to ingest it.
17    "Licensed mental health care professional" means a
18psychiatrist, clinical psychologist, clinical social worker,
19or advanced practice registered nurse.
20    "Mental capacity" means that, in the opinion of the
21attending physician or the consulting physician or, if the
22opinion of a licensed mental health care professional is
23required under Section 40, the licensed mental health care
24professional, the patient requesting medication pursuant to
25this Act has the ability to make and communicate an informed



SB3499- 4 -LRB103 38464 RPS 68600 b

1    "Oral request" means an affirmative statement that
2demonstrates a contemporaneous affirmatively stated desire by
3the patient seeking aid in dying.
4    "Pharmacist" means an individual licensed to engage in the
5practice of pharmacy under the Pharmacy Practice Act.
6    "Physician" means a person licensed to practice medicine
7in all of its branches under the Medical Practice Act of 1987.
8    "Psychiatrist" means a physician who has successfully
9completed a residency program in psychiatry accredited by
10either the Accreditation Council for Graduate Medical
11Education or the American Osteopathic Association.
12    "Qualified patient" means an adult Illinois resident with
13the mental capacity to make medical decisions who has
14satisfied the requirements of this Act in order to obtain a
15prescription for medication to bring about a peaceful death.
16No person will be considered a "qualified patient" under this
17Act solely because of advanced age, disability, or a mental
18health condition, including depression.
19    "Self-administer" means an affirmative, conscious,
20voluntary action, performed by a qualified patient, to ingest
21medication prescribed pursuant to this Act to bring about the
22patient's peaceful death. Self-administration does not include
23administration by parenteral injection or infusion.
24    "Terminal disease" means an incurable and irreversible
25disease that will, within reasonable medical judgment, result
26in death within 6 months. The existence of a terminal disease,



SB3499- 5 -LRB103 38464 RPS 68600 b

1as determined after in-person examination by the patient's
2physician and concurrence by another physician, shall be
3documented in writing in the patient's medical record. A
4diagnosis of a major depressive disorder, as defined in the
5current edition of the Diagnostic and Statistical Manual of
6Mental Disorders, alone does not qualify as a terminal
8    Section 10. Informed consent.
9    (a) Nothing in this Act may be construed to limit the
10amount of information provided to a patient to ensure the
11patient can make a fully informed health care decision.
12    (b) An attending physician must provide sufficient
13information to a patient regarding all appropriate end-of-life
14care options, including comfort care, hospice care, palliative
15care, and pain control, as well as the foreseeable risks and
16benefits of each, so that the patient can make a voluntary and
17affirmative decision regarding the patient's end-of-life care.
18    (c) If a patient requests for the patient's medical
19records to be transmitted to an alternative physician, the
20patient's medical records shall be transmitted without undue
22    Section 15. Standard of care. Nothing contained in this
23Act shall be interpreted to lower the applicable standard of
24care for the health care professionals participating under



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1this Act.
2    Section 20. Qualification.
3    (a) A qualified patient with a terminal disease may
4request a prescription for medication under this Act in the
5following manner:
6        (1) The qualified patient may orally request a
7    prescription for medication under this Act from the
8    patient's attending physician.
9        (2) The oral request from the qualified patient shall
10    be documented by the attending physician.
11        (3) The qualified patient shall provide a written
12    request in accordance with this Act to the patient's
13    attending physician after making the initial oral request.
14        (4) The qualified patient shall repeat the oral
15    request to the patient's attending physician no less than
16    5 days after making the initial oral request.
17    (b) The attending and consulting physicians of a qualified
18patient shall have met all the requirements of Sections 30 and
20    (c) Notwithstanding subsection (a), if the individual's
21attending physician has medically determined that the
22individual will, within reasonable medical judgment, die
23within 5 days after making the initial oral request under this
24Section, the individual may satisfy the requirements of this
25Section by providing a written request and reiterating the



SB3499- 7 -LRB103 38464 RPS 68600 b

1oral request to the attending physician at any time after
2making the initial oral request.
3    (d) At the time the patient makes the second oral request,
4the attending physician shall offer the patient an opportunity
5to rescind the request.
6    (e) Oral and written requests for aid in dying may be made
7only by the patient and shall not be made by the patient's
8surrogate decision-maker, health care proxy, health care
9agent, attorney-in-fact for health care, nor via advance
10health care directive.
11    (f) If a requesting patient decides to transfer care to an
12alternative physician, the records custodian shall, upon
13written request, transmit, without undue delay, the patient's
14medical records, including written documentation of the dates
15of the patient's requests concerning aid in dying.
16    (g) A transfer of care or medical records does not toll or
17restart any waiting period.
18    Section 25. Form of written request.
19    (a) A written request for medication under this Act shall
20be in substantially the form below, signed and dated by the
21requesting patient, and witnessed in the presence of the
22patient by at least 2 witnesses who attest that to the best of
23their knowledge and belief the patient has mental capacity, is
24acting voluntarily, and is not being coerced or unduly
25influenced to sign the request.



SB3499- 8 -LRB103 38464 RPS 68600 b

1    (b) One of the witnesses required under this Section must
2be a person who is not:
3        (1) a relative of the patient by blood, marriage,
4    civil union, registered domestic partnership, or adoption;
5        (2) a person who, at the time the request is signed,
6    would be entitled to any portion of the estate of the
7    qualified patient upon death, under any will or by
8    operation of law; or
9        (3) an owner, operator, or employee of a health care
10    entity where the qualified patient is receiving medical
11    treatment or is a resident.
12    (c) The patient's attending physician at the time the
13request is signed shall not be a witness.
14    (d) If a person uses an interpreter, the interpreter shall
15not be a witness.
16    (e) The written request for medication under this Act
17shall be substantially as follows:
"Request for Medication to End My Life in a Peaceful Manner

19    I, ............... (insert name of patient), am an adult
20of sound mind, and a resident of Illinois. I have been
21diagnosed with ..............., (insert name of condition) and
22given a terminal disease prognosis of 6 months or less to live
23by my attending physician.
24    I affirm that my terminal disease diagnosis was given or



SB3499- 9 -LRB103 38464 RPS 68600 b

1confirmed during at least one in-person visit to a health care
3    I have been fully informed of the feasible alternatives
4and concurrent or additional treatment opportunities for my
5terminal disease, including, but not limited to, comfort care,
6palliative care, hospice care, or pain control, as well as the
7potential risks and benefits of each. I have been offered,
8have received, or have been offered and received resources or
9referrals to pursue these alternatives and concurrent or
10additional treatment opportunities for my terminal disease.
11    I have been fully informed of the nature of the medication
12to be prescribed, including the risks and benefits, and I
13understand that the likely outcome of self-administering the
14medication is death.
15    I understand that I can rescind this request at any time,
16that I am under no obligation to fill the prescription once
17written, and that I have no duty to self-administer the
18medication if I obtain it.
19    I request that my attending physician furnish a
20prescription for medication that will end my life if I choose
21to self-administer it, and I authorize my attending physician
22to transmit the prescription to a pharmacist to dispense the
23medication at a time of my choosing.
24    I make this request voluntarily, free from coercion or
25undue influence.
26Dated: ................



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1            Signed..................................
3Dated: ................
4            Signed...............................
(witness #1)
6Dated: ................
7            Signed..............................
(witness #2)"

9(f) The interpreter attachment for a written request for
10medication under this Act shall be substantially as follows:
"Request for Medication to End My Life in a Peaceful Manner
Interpreter Attachment

13    I, ...............(insert name of interpreter), am fluent
14in English and ...............(insert language of patient,
15including sign language).
16    On .......(insert date) at approximately .......(insert
17time), I read the "Request for Medication to End My Life in a
18Peaceful Manner" form to ...............(insert name of
19patient) in ...............(insert language of patient).
20    ...............(insert name of patient) affirmed to me
21that they understand the content of this form, that they
22desire to sign this form under their own power and volition,
23and that they requested to sign the form after consultations



SB3499- 11 -LRB103 38464 RPS 68600 b

1with an attending physician and a consulting physician.
2    Under penalty of perjury, I declare that I am fluent in
3English and ...............(language of patient, including
4sign language) and that the contents of this form, to the best
5of my knowledge, are true and correct. Executed at
6..................................(insert name of city,
7county, and state) on .......(date).
8Interpreter's signature: ....................................
9Interpreter's printed name: .................................
10Interpreter's address: ......................................".
11    Section 30. Attending physician responsibilities.
12    (a) Following the request of a patient for aid in dying,
13the attending physician shall conduct an evaluation of the
14patient and:
15        (1) determine whether the patient has a terminal
16    disease or has been diagnosed as having a terminal
17    disease;
18        (2) determine whether a patient has mental capacity;
19        (3) confirm that the patient's request does not arise
20    from coercion or undue influence;
21        (4) inform the patient of:
22            (A) the diagnosis;
23            (B) the prognosis;
24            (C) the potential risks, benefits, and probable
25        result of self-administering the prescribed medication



SB3499- 12 -LRB103 38464 RPS 68600 b

1        to bring about a peaceful death;
2            (D) the potential benefits and risks of feasible
3        alternatives, including, but not limited to,
4        concurrent or additional treatment options for the
5        patient's terminal disease, comfort care, palliative
6        care, hospice care, and pain control; and
7            (E) the patient's right to rescind the request for
8        medication pursuant to this Act at any time;
9        (5) inform the patient that there is no obligation to
10    fill the prescription nor an obligation to self-administer
11    the medication, if it is obtained;
12        (6) provide the patient with a referral for comfort
13    care, palliative care, hospice care, pain control, or
14    other end-of-life treatment options as requested by the
15    patient and as clinically indicated;
16        (7) refer the patient to a consulting physician for
17    medical confirmation that the patient requesting
18    medication pursuant to this Act:
19            (A) has a terminal disease with a prognosis of 6
20        months or less to live; and
21            (B) has mental capacity.
22        (8) include the consulting physician's written
23    determination in the patient's medical record;
24        (9) refer the patient to a licensed mental health
25    professional in accordance with Section 40 if the
26    attending physician observes signs that the individual may



SB3499- 13 -LRB103 38464 RPS 68600 b

1    not be capable of making an informed decision;
2        (10) include the licensed mental health professional's
3    written determination in the patient's medical record, if
4    such determination was requested;
5        (11) inform the patient of the benefits of notifying
6    the next of kin of the patient's decision to request
7    medication pursuant to this Act;
8        (12) fulfill the medical record documentation
9    requirements;
10        (13) ensure that all steps are carried out in
11    accordance with this Act before providing a prescription
12    to a qualified patient for medication pursuant to this Act
13    including:
14            (A) confirming that the patient has made an
15        informed decision to obtain a prescription for
16        medication;
17            (B) offering the patient an opportunity to rescind
18        the request for medication; and
19            (C) providing information to the patient on:
20                (I) the recommended procedure for
21            self-administering the medication to be
22            prescribed;
23                (II) the safekeeping and proper disposal of
24            unused medication in accordance with State and
25            federal law; and
26                (III) the importance of having another person



SB3499- 14 -LRB103 38464 RPS 68600 b

1            present when the patient self-administers the
2            medication to be prescribed;
3            (D) not taking the aid-in-dying medication in a
4        public place;
5        (14) deliver, in accordance with State and federal
6    law, the prescription personally, by mail, or through an
7    authorized electronic transmission to a licensed
8    pharmacist who will dispense the medication, including any
9    ancillary medications, to the qualified patient, or to a
10    person expressly designated by the qualified patient in
11    person or with a signature required on delivery, by mail
12    service, or by messenger service;
13        (15) if authorized by the Drug Enforcement
14    Administration, dispense the prescribed medication,
15    including any ancillary medications, to the qualified
16    patient or a person designated by the qualified patient;
17    and
18        (16) include, in the qualified patient's medical
19    record, the patient's diagnosis and prognosis,
20    determination of mental capacity, the date of each oral
21    request, a copy of the written request, a notation that
22    the requirements under this Section have been completed,
23    and an identification of the medication and ancillary
24    medications prescribed to the qualified patient pursuant
25    to this Act.
26    (b) Notwithstanding any other provision of law, the



SB3499- 15 -LRB103 38464 RPS 68600 b

1attending physician may sign the patient's death certificate.
2    Section 35. Consulting physician responsibilities. A
3consulting physician shall:
4        (1) conduct an evaluation of the patient and review
5    the patient's relevant medical records, including the
6    evaluation pursuant to Section 40, if such evaluation was
7    necessary;
8        (2) confirm in writing to the attending physician that
9    the patient:
10            (A) has requested a prescription for aid-in-dying
11        medication;
12            (B) has a documented terminal disease;
13            (C) has mental capacity or has provided
14        documentation that the consulting health care
15        professional has referred the individual for further
16        evaluation in accordance with Section 40; and
17            (D) is acting voluntarily, free from coercion or
18        undue influence.
19    Section 40. Referral for determination that the requesting
20patient has mental capacity.
21    (a) If either the attending physician or the consulting
22physician has doubts whether the individual has mental
23capacity and if either one is unable to confirm that the
24individual is capable of making an informed decision, the



SB3499- 16 -LRB103 38464 RPS 68600 b

1attending physician or consulting physician shall refer the
2patient to a licensed mental health professional for
3determination regarding mental capability.
4    (b) The licensed mental health professional shall
5additionally determine whether the patient is suffering from a
6psychiatric or psychological disorder causing impaired
8    (c) The licensed mental health professional who evaluates
9the patient under this Section shall submit to the requesting
10attending or consulting physician a written determination of
11whether the patient has mental capacity.
12    (d) If the licensed mental health professional determines
13that the patient does not have mental capacity, or is
14suffering from a psychiatric or psychological disorder causing
15impaired judgment, the patient shall not be deemed a qualified
16patient and the attending physician shall not prescribe
17medication to the patient under this Act.
18    Section 45. Residency requirement.
19    (a) Only requests made by Illinois residents may be
20granted under this Act.
21    (b) A patient is able to establish residency through any
22one or more of the following means:
23        (1) possession of a driver's license or other
24    identification issued by the Secretary of State or State
25    of Illinois;



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1        (2) registration to vote in Illinois;
2        (3) evidence that the person owns, rents, or leases
3    property in Illinois;
4        (4) the location of any dwelling occupied by the
5    person;
6        (5) the place where any motor vehicle owned by the
7    person is registered;
8        (6) the residence address, not a post office box,
9    shown on an income tax return filed for the year preceding
10    the year in which the person initially makes an oral
11    request under this Act;
12        (7) the residence address, not a post office box, at
13    which the person's mail is received;
14        (8) the residence address, not a post office box,
15    shown on any unexpired resident hunting or fishing or
16    other licenses held by the person;
17        (9) the residence address, not a post office box,
18    shown on any driver's license held by the person;
19        (10) the receipt of any public benefit conditioned
20    upon residency; or
21        (11) any other objective facts tending to indicate a
22    person's place of residence is in Illinois.
23    Section 50. Safe disposal of unused medications. A person
24who has custody or control of medication prescribed pursuant
25to this Act after the qualified patient's death shall dispose



SB3499- 18 -LRB103 38464 RPS 68600 b

1of the medication by delivering it to the nearest qualified
2facility that properly disposes of controlled substances or,
3if none is available, by lawful means in accordance with
4applicable State and federal guidelines.
5    Section 55. No duty to provide aid in dying.
6    (a) A health care professional shall not be under any
7duty, by law or contract, to participate in the provision of
8aid-in-dying care to a patient as set forth in this Act.
9    (b) A health care professional shall not be subject to
10civil or criminal liability for participating or refusing to
11participate in the provision of aid-in-dying care to a patient
12in good faith compliance with this Act.
13    (c) A health care entity or licensing board shall not
14subject a health care professional to censure, discipline,
15suspension, loss of license, loss of privileges, loss of
16membership, or other penalty for participating or refusing to
17participate in accordance with this Act.
18    (d) A health care professional may choose not to engage in
19aid-in-dying care.
20    (e) Only willing health care professionals shall provide
21aid-in-dying care in accordance with this Act. If a health
22care professional is unable or unwilling to carry out a
23patient's request under this Act, and the patient transfers
24the patient's care to a new health care professional, the
25prior health care professional shall transmit, upon request, a



SB3499- 19 -LRB103 38464 RPS 68600 b

1copy of the patient's relevant medical records to the new
2health care professional without undue delay.
3    (f) A health care professional shall not engage in false,
4misleading, or deceptive practices relating to a willingness
5to qualify a patient or provide aid-in-dying care.
6Intentionally misleading a patient constitutes coercion.
7    (g) The provisions of the Health Care Right of Conscience
8Act apply to this Act and are incorporated by reference.
9    Section 60. Health care entity permissible prohibitions
10and duties.
11    (a) A health care entity may prohibit health care
12professionals from practicing aid-in-dying care while
13performing duties for the entity. A prohibiting entity must
14provide advance notice in writing to health care professionals
15and staff at the time of hiring, contracting with, or
16privileging and on a yearly basis thereafter.
17    (b) If a patient wishes to transfer care to another health
18care entity, the prohibiting entity shall coordinate a timely
19transfer of care, including transmitting, without undue delay,
20the patient's medical records that include notation of the
21date the patient first made a request concerning aid-in-dying
23    (c) No health care entity shall prohibit a health care
24professional from:
25        (1) providing information to a patient regarding the



SB3499- 20 -LRB103 38464 RPS 68600 b

1    patient's health status, including, but not limited to,
2    diagnosis, prognosis, recommended treatment and treatment
3    alternatives, and the risks and benefits of each;
4        (2) providing information regarding health care
5    services available pursuant to this Act, information about
6    relevant community resources, and how to access those
7    resources for obtaining care of the patient's choice;
8        (3) practicing aid-in-dying care outside the scope of
9    the health care professional's employment or contract with
10    the prohibiting entity and off the premises of the
11    prohibiting entity; or
12        (4) being present, if outside the scope of the health
13    care professional's employment or contractual duties, when
14    a qualified patient self-administers medication prescribed
15    pursuant to this Act or at the time of death, if requested
16    by the qualified patient or their representative.
17    (d) A health care entity shall not engage in false,
18misleading, or deceptive practices relating to its policy
19around end-of-life care services, including whether it has a
20policy that prohibits affiliated health care professionals
21from practicing aid-in-dying care; or intentionally denying a
22patient access to medication pursuant to this Act by
23intentionally failing to transfer a patient and the patient's
24medical records to another health care professional in a
25timely manner. Intentionally misleading a patient or deploying
26misinformation to obstruct access to services pursuant to this



SB3499- 21 -LRB103 38464 RPS 68600 b

1Act constitutes coercion or undue influence.
2    (e) The provisions of the Health Care Right of Conscience
3Act apply to this Act and are incorporated by reference.
4    (f) If any part of this Section is found to be in conflict
5with federal requirements which are a prescribed condition to
6receipt of federal funds, the conflicting part of this Section
7is inoperative solely to the extent of the conflict with
8respect to the entity directly affected, and such finding or
9determination shall not affect the operation of the remainder
10of the Section or this Act.
11    Section 65. Immunities for actions in good faith;
12prohibition against reprisals.
13    (a) A health care professional or health care entity shall
14not be subject to civil or criminal liability, licensing
15sanctions, or other professional disciplinary action for
16actions taken in good faith compliance with this Act.
17    (b) If a health care professional or health care entity is
18unable or unwilling to carry out an individual's request for
19aid in dying, the professional or entity shall, at a minimum:
20        (1) inform the individual of the professional's or
21    entity's inability or unwillingness;
22        (2) refer the individual either to a health care
23    professional who is able and willing to evaluate and
24    qualify the individual or to another individual or entity
25    to assist the requesting individual in seeking aid in



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1    dying, in accordance with the Health Care Right of
2    Conscience Act; and
3        (3) note, in the medical record, the individual's date
4    of request and health care professional's notice to the
5    individual of the health care professional's unwillingness
6    or inability to carry out the individual's request.
7    (c) A health care entity or licensing board shall not
8subject a health care professional to censure, discipline,
9suspension, loss of license, loss of privileges, loss of
10membership, or other penalty for engaging in good faith
11compliance with this Act.
12    (d) A health care professional, health care entity, or
13licensing board shall not subject a health care professional
14to discharge, demotion, censure, discipline, suspension, loss
15of license, loss of privileges, loss of membership,
16discrimination, or any other penalty for providing
17aid-in-dying care in accordance with the standard of care and
18in good faith under this Act when:
19        (1) engaged in the outside practice of medicine and
20    off of the objecting health care entity's premises; or
21        (2) providing scientific and accurate information
22    about aid-in-dying care to a patient when discussing
23    end-of-life care options.
24    (e) A physician is not subject to civil or criminal
25liability or professional discipline if, at the request of the
26qualified patient, the physician is present outside the scope



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1of the physician's employment contract and off the entity's
2premises, when the qualified patient self-administers
3medication pursuant to this Act, or at the time of death.
4    (f) A physician who is present at self-administration may,
5without civil or criminal liability, assist the qualified
6patient by preparing the medication prescribed pursuant to
7this Act.
8    (g) A request by a patient for aid in dying does not alone
9constitute grounds for neglect or elder abuse for any purpose
10of law, nor shall it be the sole basis for appointment of a
12    (h) This Section does not limit civil liability for
13intentional misconduct.
14    Section 70. Reporting requirements.
15    (a) Within 45 days after the effective date of this Act,
16the Department shall create and post to its website an
17Attending Physician Checklist Form and Attending Physician
18Follow-Up Form to facilitate collection of the information
19described in this Section. Failure to create or post the
20Attending Physician Checklist Form, the Attending Physician
21Follow-Up Form, or both shall not suspend the effective date
22of this Act.
23    (b) Within 30 calendar days of providing a prescription
24for medication pursuant to this Act, the attending physician
25shall submit to the Department an Attending Physician



SB3499- 24 -LRB103 38464 RPS 68600 b

1Checklist Form with the following information:
2        (1) the qualifying patient's name and date of birth;
3        (2) the qualifying patient's terminal diagnosis and
4    prognosis;
5        (3) notice that the requirements under this Act were
6    completed; and
7        (4) notice that medication has been prescribed
8    pursuant to this Act.
9    (c) Within 60 calendar days of notification of a qualified
10patient's death from self-administration of medication
11prescribed pursuant to this Act, the attending physician shall
12submit to the Department, an Attending Physician Follow-Up
13Form with the following information:
14        (1) the qualified patient's name and date of birth;
15        (2) the date of the qualified patient's death; and
16        (3) a notation of whether the qualified patient was
17    enrolled in hospice services at the time of the qualified
18    patient's death.
19    (d) The Department shall collect and annually review the
20forms filed pursuant to Section to ensure compliance. If a
21physician required to report information to the Department
22under this Act provides an inadequate or incomplete report,
23the Department shall contact the physician to request an
24adequate or complete report. The information collected shall
25be confidential and shall be collected in a manner that
26protects the privacy of the patient, the patient's family, and



SB3499- 25 -LRB103 38464 RPS 68600 b

1any health care professional involved with the patient under
2the provisions of this Act. The information shall be
3privileged and strictly confidential, and shall not be
4disclosed, discoverable, or compelled to be produced in any
5civil, criminal, administrative, or other proceeding.
6    (e) One year after the effective date of this Act, and each
7year thereafter, the Department shall create and post on its
8website a public statistical report of nonidentifying
9information. The report shall be limited to:
10        (1) the number of prescriptions for medication written
11    pursuant to this Act;
12        (2) the number of physicians who wrote prescriptions
13    for medication pursuant to this Act;
14        (3) the number of qualified patients who died
15    following self-administration of medication prescribed and
16    dispensed pursuant to this Act; and
17        (4) the number of people who died due to using an
18    aid-in-dying drug, with demographic percentages organized
19    by the following characteristics:
20            (A) age at death;
21            (B) education level;
22            (C) race;
23            (D) gender;
24            (E) type of insurance, including whether the
25        patient had insurance;
26            (F) underlying illness; and



SB3499- 26 -LRB103 38464 RPS 68600 b

1            (G) enrollment in hospice.
2    (f) Except as otherwise required by law, the information
3collected by the Department is not a public record and is not
4available for public inspection.
5    (g) Willful failure or refusal to timely submit records
6required under this Act may result in disciplinary action.
7    Section 75. Effect on construction of wills, contracts,
8and statutes.
9    (a) No provision in a contract, will, or other agreement,
10whether written or oral, that would determine whether a
11patient may make or rescind a request pursuant to this Act is
13    (b) No obligation owing under any contract that is in
14effect on the effective date of this Act shall be conditioned
15or affected by a patient's act of making or rescinding a
16request pursuant to this Act.
17    (c) It is unlawful for an insurer to deny or alter health
18care benefits otherwise available to a patient with a terminal
19disease based on the availability of aid-in-dying care or
20otherwise attempt to coerce a patient with a terminal disease
21to make a request for aid-in-dying medication.
22    Section 80. Insurance or annuity policies.
23    (a) The sale, procurement, or issuance of a life, health,
24or accident insurance policy, annuity policy, or the rate



SB3499- 27 -LRB103 38464 RPS 68600 b

1charged for a policy shall not be conditioned upon or affected
2by a patient's act of making or rescinding a request for
3medication pursuant to this Act.
4    (b) A qualified patient's act of self-administering
5medication pursuant to this Act does not invalidate any part
6of a life, health, or accident insurance, or annuity policy.
7    (c) An insurance plan, including medical assistance under
8Article V of the Illinois Public Aid Code, shall not deny or
9alter benefits to a patient with a terminal disease who is a
10covered beneficiary of a health insurance plan, based on the
11availability of aid-in-dying care, their request for
12medication pursuant to this Act, or the absence of a request
13for medication pursuant to this Act. Failure to meet this
14requirement shall constitute a violation of the Illinois
15Insurance Code.
16    Section 85. Death certificate.
17    (a) Unless otherwise prohibited by law, the attending
18physician may sign the death certificate of a qualified
19patient who obtained and self-administered a prescription for
20medication pursuant to this Act.
21    (b) When a death has occurred in accordance with this Act,
22the death shall be attributed to the underlying terminal
24        (1) Death following self-administering medication
25    under this Act does not alone constitute grounds for



SB3499- 28 -LRB103 38464 RPS 68600 b

1    postmortem inquiry.
2        (2) Death in accordance with this Act shall not be
3    designated a suicide or homicide.
4    (c) A qualified patient's act of self-administering
5medication prescribed pursuant to this Act shall not be
6indicated on the death certificate.
7    Section 90. Liabilities and penalties.
8    (a) Nothing in this Act limits civil or criminal liability
9arising from:
10        (1) Intentionally or knowingly altering or forging a
11    patient's request for medication pursuant to this Act or
12    concealing or destroying a rescission of a request for
13    medication pursuant to this Act.
14        (2) Intentionally or knowingly coercing or exerting
15    undue influence on a patient with a terminal disease to
16    request medication pursuant to this Act or to request or
17    use or not use medication pursuant to this Act.
18        (3) Intentional misconduct by a health care
19    professional or health care entity.
20    (b) The penalties specified in this Act do not preclude
21criminal penalties applicable under other laws for conduct
22inconsistent with this Act.
23    (c) As used in this Section, "intentionally" and
24"knowingly" have the meanings provided in Sections 4-4 and 4-5
25of the Criminal Code of 2012.



SB3499- 29 -LRB103 38464 RPS 68600 b

1    Section 95. Construction.
2    (a) Nothing in this Act authorizes a physician or any
3other person, including the qualified patient, to end the
4qualified patient's life by lethal injection, lethal infusion,
5mercy killing, homicide, murder, manslaughter, euthanasia, or
6any other criminal act.
7    (b) Actions taken in accordance with this Act do not, for
8any purposes, constitute suicide, assisted suicide,
9euthanasia, mercy killing, homicide, murder, manslaughter,
10elder abuse or neglect, or any other civil or criminal
11violation under the law.
12    Section 100. Severability. The provisions of this Act are
13severable under Section 1.31 of the Statute on Statutes.
14    Section 999. Effective date. This Act takes effect 6
15months after this Act becomes law.