(a)
Before prescribing an aid-in-dying drug, the attending physician shall do all of the following:
(1)
Make the initial determination of all of the following:
(A)
(i)Whether the requesting adult has the capacity to make medical decisions.
(ii)
If there are indications of a mental disorder, the physician shall refer the individual for a mental health specialist assessment.
(iii)If a mental health specialist assessment referral is made, no aid-in-dying drugs shall be prescribed until the mental health specialist determines that the individual has the capacity to make medical decisions and is not suffering from impaired judgment due to a mental disorder.
(B)
Whether the requesting adult has a terminal disease.
(C)
Whether the requesting adult has voluntarily made the request for an aid-in-dying drug pursuant to Sections 443.2 and 443.3.
(D)
Whether the requesting adult is a qualified individual pursuant to subdivision (o) of Section 443.1.
(2)
Confirm that the individual is making an informed decision by discussing with him or her all of the following:
(A)
His or her medical diagnosis and prognosis.
(B)
The potential risks associated with ingesting the requested aid-in-dying drug.
(C)
The probable result of ingesting the aid-in-dying drug.
(D)
The possibility that he or she may choose to obtain the aid-in-dying drug but not take it.
(E)
The feasible alternatives or additional treatment options, including, but not limited to, comfort care, hospice care, palliative care, and pain control.
(3)
Refer the
individual to a consulting physician for medical confirmation of the diagnosis and prognosis, and for a determination that the individual has the capacity to make medical decisions and has complied with the provisions of this part.
(4)Confirm that the qualified individual’s request does not arise from coercion or undue influence by another person by discussing with the qualified individual, outside of the presence of any other persons, except for an interpreter as required pursuant to this part, whether or not the qualified individual is feeling coerced or unduly influenced by another person.
(5)
Counsel the qualified individual about the importance of all of the following:
(A)
Having another person present when he or she ingests the aid-in-dying drug prescribed pursuant to this part.
(B)
Not ingesting the aid-in-dying drug in a public place.
(C)
Notifying the next of kin of his or her request for an aid-in-dying drug. A qualified individual who declines or is unable to notify next of kin shall not have his or her request denied for that reason.
(D)
Participating in a hospice program.
(E)
Maintaining the aid-in-dying drug in a safe and secure location until the time that the qualified individual will ingest it.
(6)
Inform the individual that he or she may withdraw or rescind the request for an aid-in-dying drug at any time and in any manner.
(7)
Offer the individual an opportunity to withdraw or rescind the
request for an aid-in-dying drug before prescribing the aid-in-dying drug.
(8)
Verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision.
(9)Confirm that all requirements are met and all appropriate steps are carried out in accordance with this part before writing a prescription for an aid-in-dying drug.
(10)
Fulfill the record documentation required under Sections 443.8 and 443.19.
(11)
Complete the attending physician checklist and compliance form, as described in Section 443.22, include it and the consulting physician compliance form in the individual’s medical record, and submit both forms to the State Department of Public Health.
(12)
Give the qualified individual the final attestation form, with the instruction that the form be filled out and executed by the qualified individual within 48 hours prior to the qualified individual choosing to self-administer the aid-in-dying drug.
(b)
If the conditions set forth in subdivision (a) are satisfied, the attending physician may deliver the aid-in-dying drug in any of the following ways:
(1)
Dispensing the aid-in-dying drug directly, including ancillary medication intended to minimize the qualified individual’s discomfort, if the attending physician meets all of the following criteria:
(A)
Is authorized to dispense medicine under California law.
(B)
Has a current United
States Drug Enforcement Administration (USDEA) certificate.
(C)
Complies with any applicable administrative rule or regulation.
(2)
With the qualified individual’s written consent, contacting a pharmacist, informing the pharmacist of the prescriptions, and delivering the written prescriptions personally, by mail, or electronically to the pharmacist, who may dispense the drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual and with the designation delivered to the pharmacist in writing or verbally.
(c)
Delivery of the dispensed drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual may be made by personal delivery, or, with a signature required on delivery, by United Parcel Service,
United States Postal Service, Federal Express, or by messenger service.