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THE OREGON DEATH WITH DIGNITY ACT

OREGON REVISED STATUTES

(General Provisions)

(Section 1)

Note: The division headings, subdivision headings and leadlines for 127.800 to

127.890, 127.895 and 127.897 were enacted as part of Ballot Measure 16 (1994) and

were not provided by Legislative Counsel.

127.800 §1.01. Definitions. The following words and phrases, whenever used in

ORS 127.800 to 127.897, have the following meanings:

(1) "Adult" means an individual who is 18 years of age or older.

(2) "Attending physician" means the physician who has primary responsibility for the

care of the patient and treatment of the patient’s terminal disease.

(3) "Capable" means that in the opinion of a court or in the opinion of the patient’s

attending physician or consulting physician, psychiatrist or psychologist, a patient has

the ability to make and communicate health care decisions to health care providers,

including communication through persons familiar with the patient’s manner of

communicating if those persons are available.

(4) "Consulting physician" means a physician who is qualified by specialty or experience

to make a professional diagnosis and prognosis regarding the patient’s disease.

(5) "Counseling" means one or more consultations as necessary between a state

licensed psychiatrist or psychologist and a patient for the purpose of determining that

the patient is capable and not suffering from a psychiatric or psychological disorder or

depression causing impaired judgment.

(6) "Health care provider" means a person licensed, certified or otherwise authorized or

permitted by the law of this state to administer health care or dispense medication in

the ordinary course of business or practice of a profession, and includes a health care

facility.

(7) "Informed decision" means a decision by a qualified patient, to request and obtain a

prescription to end his or her life in a humane and dignified manner, that is based on an

appreciation of the relevant facts and after being fully informed by the attending

physician of:

(a) His or her medical diagnosis;

(b) His or her prognosis;

(d) The probable result of taking the medication to be prescribed; and

(e) The feasible alternatives, including, but not limited to, comfort care, hospice care

and pain control.

(8) "Medically confirmed" means the medical opinion of the attending physician has

been confirmed by a consulting physician who has examined the patient and the

patient’s relevant medical records.

(9) "Patient" means a person who is under the care of a physician.

(10) "Physician" means a doctor of medicine or osteopathy licensed to practice

medicine by the Board of Medical Examiners for the State of Oregon.

(11) "Qualified patient" means a capable adult who is a resident of Oregon and has

satisfied the requirements of ORS 127.800 to 127.897 in order to obtain a prescription

for medication to end his or her life in a humane and dignified manner.

(12) "Terminal disease" means an incurable and irreversible disease that has been

medically confirmed and will, within reasonable medical judgment, produce death within

six months. [1995 c.3 §1.01; 1999 c.423 §1]

(Written Request for Medication to End One’s Life in a Humane and Dignified Manner)

(Section 2)

127.805 §2.01. Who may initiate a written request for medication. (1) An adult

who is capable, is a resident of Oregon, and has been determined by the attending

physician and consulting physician to be suffering from a terminal disease, and who has

voluntarily expressed his or her wish to die, may make a written request for medication

for the purpose of ending his or her life in a humane and dignified manner in

accordance with ORS 127.800 to 127.897.

(2) No person shall qualify under the provisions of ORS 127.800 to 127.897 solely

because of age or disability. [1995 c.3 §2.01; 1999 c.423 §2]

127.810 §2.02. Form of the written request. (1) A valid request for medication

under ORS 127.800 to 127.897 shall be in substantially the form described in ORS

127.897, signed and dated by the patient and witnessed by at least two individuals

who, in the presence of the patient, attest that to the best of their knowledge and belief

the patient is capable, acting voluntarily, and is not being coerced to sign the request.

(2) One of the witnesses shall be a person who is not:

(a) A relative of the patient by blood, marriage or adoption;

(b) A person who at the time the request is signed would be entitled to any portion of

the estate of the qualified patient upon death under any will or by operation of law; or

is receiving medical treatment or is a resident.

(3) The patient’s attending physician at the time the request is signed shall not be a

witness.

(4) If the patient is a patient in a long term care facility at the time the written request

is made, one of the witnesses shall be an individual designated by the facility and

having the qualifications specified by the Department of Human Services by rule. [1995

c.3 §2.02]

(Safeguards)

(Section 3)

127.815 §3.01. Attending physician responsibilities. (1) The attending physician

shall:

(a) Make the initial determination of whether a patient has a terminal disease, is

capable, and has made the request voluntarily;

(b) Request that the patient demonstrate Oregon residency pursuant to ORS 127.860;

(A) His or her medical diagnosis;

(B) His or her prognosis;

(D) The probable result of taking the medication to be prescribed; and

(E) The feasible alternatives, including, but not limited to, comfort care, hospice care

and pain control;

(d) Refer the patient to a consulting physician for medical confirmation of the diagnosis,

and for a determination that the patient is capable and acting voluntarily;

(e) Refer the patient for counseling if appropriate pursuant to ORS 127.825;

(f) Recommend that the patient notify next of kin;

(g) Counsel the patient about the importance of having another person present when

the patient takes the medication prescribed pursuant to ORS 127.800 to 127.897 and of

not taking the medication in a public place;

(h) Inform the patient that he or she has an opportunity to rescind the request at any

time and in any manner, and offer the patient an opportunity to rescind at the end of

the 15 day waiting period pursuant to ORS 127.840;

(i) Verify, immediately prior to writing the prescription for medication under ORS

127.800 to 127.897, that the patient is making an informed decision;

(j) Fulfill the medical record documentation requirements of ORS 127.855;

(k) Ensure that all appropriate steps are carried out in accordance with ORS 127.800 to

127.897 prior to writing a prescription for medication to enable a qualified patient to

end his or her life in a humane and dignified manner; and

(L)(A) Dispense medications directly, including ancillary medications intended to

facilitate the desired effect to minimize the patient’s discomfort, provided the attending

physician is registered as a dispensing physician with the Board of Medical Examiners,

has a current Drug Enforcement Administration certificate and complies with any

applicable administrative rule; or

(B) With the patient’s written consent:

(i) Contact a pharmacist and inform the pharmacist of the prescription; and

(ii) Deliver the written prescription personally or by mail to the pharmacist, who will

dispense the medications to either the patient, the attending physician or an expressly

identified agent of the patient.

(2) Notwithstanding any other provision of law, the attending physician may sign the

patient’s death certificate. [1995 c.3 §3.01; 1999 c.423 §3]

127.820 §3.02. Consulting physician confirmation. Before a patient is qualified

under ORS 127.800 to 127.897, a consulting physician shall examine the patient and his

or her relevant medical records and confirm, in writing, the attending physician’s

diagnosis that the patient is suffering from a terminal disease, and verify that the

patient is capable, is acting voluntarily and has made an informed decision. [1995 c.3

§3.02]

127.825 §3.03. Counseling referral. If in the opinion of the attending physician or

the consulting physician a patient may be suffering from a psychiatric or psychological

disorder or depression causing impaired judgment, either physician shall refer the

patient for counseling. No medication to end a patient’s life in a humane and dignified

manner shall be prescribed until the person performing the counseling determines that

the patient is not suffering from a psychiatric or psychological disorder or depression

causing impaired judgment. [1995 c.3 §3.03; 1999 c.423 §4]

127.830 §3.04. Informed decision. No person shall receive a prescription for

medication to end his or her life in a humane and dignified manner unless he or she has

made an informed decision as defined in ORS 127.800 (7). Immediately prior to writing

a prescription for medication under ORS 127.800 to 127.897, the attending physician

shall verify that the patient is making an informed decision. [1995 c.3 §3.04]

127.835 §3.05. Family notification. The attending physician shall recommend that

the patient notify the next of kin of his or her request for medication pursuant to ORS

127.800 to 127.897. A patient who declines or is unable to notify next of kin shall not

have his or her request denied for that reason. [1995 c.3 §3.05; 1999 c.423 §6]

127.840 §3.06. Written and oral requests. In order to receive a prescription for

medication to end his or her life in a humane and dignified manner, a qualified patient

shall have made an oral request and a written request, and reiterate the oral request to

his or her attending physician no less than fifteen (15) days after making the initial oral

request. At the time the qualified patient makes his or her second oral request, the

attending physician shall offer the patient an opportunity to rescind the request. [1995

c.3 §3.06]

127.845 §3.07. Right to rescind request. A patient may rescind his or her request

at any time and in any manner without regard to his or her mental state. No

prescription for medication under ORS 127.800 to 127.897 may be written without the

attending physician offering the qualified patient an opportunity to rescind the request.

[1995 c.3 §3.07]

127.850 §3.08. Waiting periods. No less than fifteen (15) days shall elapse

between the patient’s initial oral request and the writing of a prescription under ORS

127.800 to 127.897. No less than 48 hours shall elapse between the patient’s written

request and the writing of a prescription under ORS 127.800 to 127.897. [1995 c.3

§3.08]

127.855 §3.09. Medical record documentation requirements. The following

shall be documented or filed in the patient’s medical record:

(1) All oral requests by a patient for medication to end his or her life in a humane and

dignified manner;

(2) All written requests by a patient for medication to end his or her life in a humane

and dignified manner;

(3) The attending physician’s diagnosis and prognosis, determination that the patient is

capable, acting voluntarily and has made an informed decision;

(4) The consulting physician’s diagnosis and prognosis, and verification that the patient

is capable, acting voluntarily and has made an informed decision;

(5) A report of the outcome and determinations made during counseling, if performed;

(6) The attending physician’s offer to the patient to rescind his or her request at the

time of the patient’s second oral request pursuant to ORS 127.840; and

(7) A note by the attending physician indicating that all requirements under ORS

127.800 to 127.897 have been met and indicating the steps taken to carry out the

request, including a notation of the medication prescribed. [1995 c.3 §3.09]

127.860 §3.10. Residency requirement. Only requests made by Oregon residents

under ORS 127.800 to 127.897 shall be granted. Factors demonstrating Oregon

residency include but are not limited to:

(1) Possession of an Oregon driver license;

(2) Registration to vote in Oregon;

(3) Evidence that the person owns or leases property in Oregon; or

(4) Filing of an Oregon tax return for the most recent tax year. [1995 c.3 §3.10; 1999

c.423 §8]

127.865 §3.11. Reporting requirements. (1)(a) The Department of Human

Services shall annually review a sample of records maintained pursuant to ORS 127.800

to 127.897.

(b) The department shall require any health care provider upon dispensing medication

pursuant to ORS 127.800 to 127.897 to file a copy of the dispensing record with the

department.

(2) The department shall make rules to facilitate the collection of information regarding

compliance with ORS 127.800 to 127.897. Except as otherwise required by law, the

information collected shall not be a public record and may not be made available for

inspection by the public.

(3) The department shall generate and make available to the public an annual statistical

report of information collected under subsection (2) of this section. [1995 c.3 §3.11;

1999 c.423 §9; 2001 c.104 §40]

127.870 §3.12. Effect on construction of wills, contracts and statutes. (1) No

provision in a contract, will or other agreement, whether written or oral, to the extent

the provision would affect whether a person may make or rescind a request for

medication to end his or her life in a humane and dignified manner, shall be valid.

(2) No obligation owing under any currently existing contract shall be conditioned or

affected by the making or rescinding of a request, by a person, for medication to end

his or her life in a humane and dignified manner. [1995 c.3 §3.12]

127.875 §3.13. Insurance or annuity policies. The sale, procurement, or issuance

of any life, health, or accident insurance or annuity policy or the rate charged for any

policy shall not be conditioned upon or affected by the making or rescinding of a

request, by a person, for medication to end his or her life in a humane and dignified

manner. Neither shall a qualified patient’s act of ingesting medication to end his or her

life in a humane and dignified manner have an effect upon a life, health, or accident

insurance or annuity policy. [1995 c.3 §3.13]

127.880 §3.14. Construction of Act. Nothing in ORS 127.800 to 127.897 shall be

construed to authorize a physician or any other person to end a patient’s life by lethal

injection, mercy killing or active euthanasia. Actions taken in accordance with ORS

127.800 to 127.897 shall not, for any purpose, constitute suicide, assisted suicide,

mercy killing or homicide, under the law. [1995 c.3 §3.14]

(Immunities and Liabilities)

(Section 4)

127.885 §4.01. Immunities; basis for prohibiting health care provider from

participation; notification; permissible sanctions. Except as provided in ORS

127.890:

(1) No person shall be subject to civil or criminal liability or professional disciplinary

action for participating in good faith compliance with ORS 127.800 to 127.897. This

includes being present when a qualified patient takes the prescribed medication to end

his or her life in a humane and dignified manner.

(2) No professional organization or association, or health care provider, may subject a

person to censure, discipline, suspension, loss of license, loss of privileges, loss of

membership or other penalty for participating or refusing to participate in good faith

compliance with ORS 127.800 to 127.897.

(3) No request by a patient for or provision by an attending physician of medication in

good faith compliance with the provisions of ORS 127.800 to 127.897 shall constitute

neglect for any purpose of law or provide the sole basis for the appointment of a

guardian or conservator.

(4) No health care provider shall be under any duty, whether by contract, by statute or

by any other legal requirement to participate in the provision to a qualified patient of

medication to end his or her life in a humane and dignified manner. If a health care

provider is unable or unwilling to carry out a patient’s request under ORS 127.800 to

127.897, and the patient transfers his or her care to a new health care provider, the

prior health care provider shall transfer, upon request, a copy of the patient’s relevant

medical records to the new health care provider.

(5)(a) Notwithstanding any other provision of law, a health care provider may prohibit

another health care provider from participating in ORS 127.800 to 127.897 on the

premises of the prohibiting provider if the prohibiting provider has notified the health

care provider of the prohibiting provider’s policy regarding participating in ORS 127.800

to 127.897. Nothing in this paragraph prevents a health care provider from providing

health care services to a patient that do not constitute participation in ORS 127.800 to

127.897.

(b) Notwithstanding the provisions of subsections (1) to (4) of this section, a health

care provider may subject another health care provider to the sanctions stated in this

paragraph if the sanctioning health care provider has notified the sanctioned provider

prior to participation in ORS 127.800 to 127.897 that it prohibits participation in ORS

127.800 to 127.897:

(A) Loss of privileges, loss of membership or other sanction provided pursuant to the

medical staff bylaws, policies and procedures of the sanctioning health care provider if

the sanctioned provider is a member of the sanctioning provider’s medical staff and

participates in ORS 127.800 to 127.897 while on the health care facility premises, as

defined in ORS 442.015, of the sanctioning health care provider, but not including the

private medical office of a physician or other provider;

(B) Termination of lease or other property contract or other nonmonetary remedies

provided by lease contract, not including loss or restriction of medical staff privileges or

exclusion from a provider panel, if the sanctioned provider participates in ORS 127.800

to 127.897 while on the premises of the sanctioning health care provider or on property

that is owned by or under the direct control of the sanctioning health care provider; or

sanctioned provider participates in ORS 127.800 to 127.897 while acting in the course

and scope of the sanctioned provider’s capacity as an employee or independent

contractor of the sanctioning health care provider. Nothing in this subparagraph shall be

construed to prevent:

(i) A health care provider from participating in ORS 127.800 to 127.897 while acting

outside the course and scope of the provider’s capacity as an employee or independent

contractor; or

(ii) A patient from contracting with his or her attending physician and consulting

physician to act outside the course and scope of the provider’s capacity as an employee

or independent contractor of the sanctioning health care provider.

subsection must follow all due process and other procedures the sanctioning health care

provider may have that are related to the imposition of sanctions on another health

care provider.

(d) For purposes of this subsection:

(A) "Notify" means a separate statement in writing to the health care provider

specifically informing the health care provider prior to the provider’s participation in

ORS 127.800 to 127.897 of the sanctioning health care provider’s policy about

participation in activities covered by ORS 127.800 to 127.897.

(B) "Participate in ORS 127.800 to 127.897" means to perform the duties of an

attending physician pursuant to ORS 127.815, the consulting physician function

pursuant to ORS 127.820 or the counseling function pursuant to ORS 127.825.

"Participate in ORS 127.800 to 127.897" does not include:

(i) Making an initial determination that a patient has a terminal disease and informing

the patient of the medical prognosis;

(ii) Providing information about the Oregon Death with Dignity Act to a patient upon the

request of the patient;

(iii) Providing a patient, upon the request of the patient, with a referral to another

physician; or

(iv) A patient conracting with his or her attending physician or consulting physician to

act outside of the course and scope of the provider’s capacity as an employee or

independent contractor of the sanctioning health care provider.

(6) Suspension or termination of staff membership or privileges under subsection (5) of

this section is not reportable under ORS 441.820. Action taken pursuant to ORS

127.810, 127.815, 127.820 or 127.825 shall not be the sole basis for a report of

unprofessional or dishonorable conduct under ORS 677.415 (2) or (3).

(7) No provision of ORS 127.800 to 127.897 shall be construed to allow a lower

standard of care for patients in the community where the patient is treated or a similar

community. [1995 c.3 §4.01; 1999 c.423 §10]

Note: As originally enacted by the people, the leadline to section 4.01 read

"Immunities." The remainder of the leadline was added by editorial action.

127.890 §4.02. Liabilities. (1) A person who without authorization of the patient

willfully alters or forges a request for medication or conceals or destroys a rescission of

that request with the intent or effect of causing the patient’s death shall be guilty of a

Class A felony.

(2) A person who coerces or exerts undue influence on a patient to request medication

for the purpose of ending the patient’s life, or to destroy a rescission of such a request,

shall be guilty of a Class A felony.

(3) Nothing in ORS 127.800 to 127.897 limits further liability for civil damages resulting

from other negligent conduct or intentional misconduct by any person.

(4) The penalties in ORS 127.800 to 127.897 do not preclude criminal penalties

applicable under other law for conduct which is inconsistent with the provisions of ORS

127.800 to 127.897. [1995 c.3 §4.02]

127.892 Claims by governmental entity for costs incurred. Any governmental

entity that incurs costs resulting from a person terminating his or her life pursuant to

the provisions of ORS 127.800 to 127.897 in a public place shall have a claim against

the estate of the person to recover such costs and reasonable attorney fees related to

enforcing the claim. [1999 c.423 §5a]

(Severability)

(Section 5)

127.895 §5.01. Severability. Any section of ORS 127.800 to 127.897 being held

invalid as to any person or circumstance shall not affect the application of any other

section of ORS 127.800 to 127.897 which can be given full effect without the invalid

section or application. [1995 c.3 §5.01]

(Form of the Request)

(Section 6)

127.897 §6.01. Form of the request. A request for a medication as authorized by

ORS 127.800 to 127.897 shall be in substantially the following form:

_______________________________________________________________________

_______

REQUEST FOR MEDICATION

TO END MY LIFE IN A HUMANE

AND DIGNIFIED MANNER

I, ______________________, am an adult of sound mind.

I am suffering from _________, which my attending physician has determined is a

terminal disease and which has been medically confirmed by a consulting physician.

I have been fully informed of my diagnosis, prognosis, the nature of medication to be

prescribed and potential associated risks, the expected result, and the feasible

alternatives, including comfort care, hospice care and pain control.

I request that my attending physician prescribe medication that will end my life in a

humane and dignified manner.

INITIAL ONE:

______ I have informed my family of my decision and taken their opinions into

consideration.

_______ I have decided not to inform my family of my decision.

______ I have no family to inform of my decision.

I understand that I have the right to rescind this request at any time.

I understand the full import of this request and I expect to die when I take the

medication to be prescribed. I further understand that although most deaths occur

within three hours, my death may take longer and my physician has counseled me

about this possibility.

I make this request voluntarily and without reservation, and I accept full moral

responsibility for my actions.

Signed: _______________

Dated: _______________

DECLARATION OF WITNESSES

We declare that the person signing this request:

(a) Is personally known to us or has provided proof of identity;

(b) Signed this request in our presence;

(d) Is not a patient for whom either of us is attending physician.

______________Witness 1/Date

______________Witness 2/Date

NOTE: One witness shall not be a relative (by blood, marriage or adoption) of the

person signing this request, shall not be entitled to any portion of the person’s estate

upon death and shall not own, operate or be employed at a health care facility where

the person is a patient or resident. If the patient is an inpatient at a health care facility,

one of the witnesses shall be an individual designated by the facility.

_______________________________________________________________________

_______

[1995 c.3 §6.01; 1999 c.423 §11]

PENALTIES

127.990: [Formerly part of 97.990; repealed by 1993 c.767 §29]

127.995 Penalties. (1) It shall be a Class A felony for a person without authorization

of the principal to willfully alter, forge, conceal or destroy an instrument, the

reinstatement or revocation of an instrument or any other evidence or document

reflecting the principal’s desires and interests, with the intent and effect of causing a

withholding or withdrawal of life-sustaining procedures or of artificially administered

nutrition and hydration which hastens the death of the principal.

(2) Except as provided in subsection (1) of this section, it shall be a Class A

misdemeanor for a person without authorization of the principal to willfully alter, forge,

conceal or destroy an instrument, the reinstatement or revocation of an instrument, or

any other evidence or document reflecting the principal’s desires and interests with the

intent or effect of affecting a health care decision. [Formerly 127.585]