644

ASSISTED SUICIDE BAN ACT
HOUSE/SENATE BILL No. ______ By Representatives/Senators ____________ Section 1. Title. This Act may be known and cited as the “Assisted Suicide Ban Act.” Section 2. Legislative Findings and Purposes. (a) The [Legislature] of the State of [Insert name of State] finds that: (1) “In almost every State—indeed, in almost every western democracy—it is a crime to assist a suicide. The States’ assisted-suicide bans are not innovations. Rather they are longstanding expressions of the States’ commitment to the protection and preservation of all human life.” Washington v. Glucksberg, 521 U.S. 702, 710 (1997). “Indeed, opposition to and condemnation of suicide—and, therefore, of assisting suicide—are consistent and enduring themes of our philosophical, legal and cultural heritages.” This universal tradition has long rejected a right to assisted suicide and the State of [Insert name of State] “continues to explicitly reject it today, even for terminally ill, mentally competent adults.” Washington v. Glucksberg, 521 U.S. 702, 711 and 723 (1997). The State of [Insert name of State] “has an unqualified interest in the preservation of human life…[and] in preventing suicide.” Washington v. Glucksberg, 521 U.S. 702, 729-30 (1997). The State of [Insert name of State] “has an interest in protecting vulnerable groups—including the poor, the elderly, and disabled persons—from abuse, neglect, [coercion] and mistakes.” A ban on assisted suicide reflects and reinforces our well-supported policy “that the lives of the terminally ill, disabled, and elderly people must be no less valued than the lives for the young and healthy, and that a seriously disabled [terminally-ill or elderly] person’s suicidal impulses should be interpreted and treated the same way as anyone else’s.” Washington v. Glucksberg, 521 U.S. 702, 731-32 (1997). The State of [Insert name of State] has an interest in protecting the integrity

(2)

(3)

(4)

(5)

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645 and ethics of the medical profession and affirms its responsibility to its patients as healers and those principles articulated in the Hippocratic Oath to: a. b. (6) Keep the sick from harm and injustice. Refrain from giving anybody a deadly drug if asked for it, nor make a suggestion to this effect.

More specifically, the State of [Insert name of State] recognizes the close link between physician-assisted suicide and euthanasia where a right to die easily becomes a “duty to die.” A prohibition of assisted suicide is the only reasonable means to protect from foreseeable abuses. Washington v. Glucksberg, 521 U.S. 702, 734-35 (1997); Vacco v. Quill, 521 U.S. 793, 808-09 (1997). The State of [Insert name of State] recognizes the distinction between a patient refusing life-sustaining medical treatment (not to include the withdrawal of artificial nutrition and hydration), where he dies from the underlying fatal disease or pathology; and a patient ingesting or administering a lethal medication prescribed by a physician, where the medication is the cause of death. Vacco v. Quill, 521 U.S. 793, 801 (1997). The State of [Insert name of State] recognizes the importance of palliative care and pain management and emphasizes the distinction in the “legal principles of causation and intent” between pain management intended to alleviate pain and assisted suicide intended to cause death. Vacco v. Quill, 521 U.S. 793, 801-03 (1997).

(7)

(8)

(b)

Based on the findings in Subsection (a) of this Act, it is the purpose of this Act to: (1) (2) Provide protection for our most vulnerable citizens by explicitly prohibiting assisted suicide within the State of [Insert name of State]’s criminal code. Reinforce and reflect the intended purpose of our medical professions to preserve life and act as healers.

Section 3. Definitions. As used in this Act only: (a) “Deliberately” means to consider carefully, done on purpose; or intentional.

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646 (b) “Healthcare provider” means any individual who may be asked to participate in any way in a healthcare service, including, but not limited to, the following: a physician, physician’s assistant, nurse, nurses’ aide, medical assistant, hospital employee, clinic employee, nursing home employee, pharmacist, pharmacy employee, researcher, medical or nursing school faculty, student or employee, counselor, social worker, or any professional, paraprofessional, or any other person who furnishes, or assists in the furnishing of, healthcare services. (c) “Person” means any natural person; and when appropriate, an “organization” to include: (1) (2) (3) A public or private corporation, company, association, firm, partnership, or joint-stock company; Government or a governmental instrumentality; or A foundation, institution, society, union, club, or church.

(d) “Physician” means a person licensed to practice medicine in the State of [Insert name of State]. This term includes medical doctors and doctors of osteopathy. (e) “Suicide” means the act or instance of taking one’s own life voluntarily and intentionally.

(f) “Aid in dying” means the act or instance of a person providing the means or manner for another is able to commit suicide. Section 4. Criminal Penalties. (a) Any person who deliberately advises, assists, or encourages another to commit suicide, is guilty of [Insert appropriate degree of felony]. (b) Any physician or healthcare provider that: (1) (2) Prescribes any drug, compound, or substance to a patient with the intended purpose to assist in ending the patient’s life; or Assists or performs any medical procedure for the intended purpose to assist in ending the patient’s life

is guilty of [Insert appropriate degree of felony]. Section 5. Civil Penalties and Fines. (a) Any person, physician, or healthcare provider who intentionally or knowingly violates

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647 this Act shall be liable for damages. (b) If any person assists a suicide, any surviving family member, other beneficiary, executor, or administrator of the decedent’s estate may bring an appropriate action under [Insert reference(s) to state’s wrongful death statute(s)]. (c) Any physician or other healthcare provider who assists a suicide in violation of this Act shall be considered to have engaged in unprofessional conduct for which his or her [certificate or] license to provide healthcare services in the State of [Insert name of State] shall be suspended or revoked by the State of [Insert name of State Medical Board or other appropriate entity]. Section 6. Construction. Nothing in this Act shall be construed to prohibit a physician or healthcare provider from: (1) (2) Participating in the execution of a person sentenced by a court to death by lethal injection; Following a patient’s clear, expressed, and documented wishes to withhold or withdraw life-sustaining treatment [not necessarily inclusive of withdrawing artificial nutrition and hydration]. Prescribing and administering palliative care or pain medication treatment options intended to relieve pain while the patient’s illness or condition follows its natural course.

(3)

Section 7. Right of Intervention. The [Legislature], by joint resolution, may appoint one or more of its members, who sponsored or cosponsored this Act in his or her official capacity, to intervene as a matter of right in any case in which the constitutionality of this Act or any portion thereof is challenged. Section 8. Severability. If any provision, word, phrase, or clause of this Act or the application thereof to any person or circumstance is held invalid, such invalidity shall not affect the provisions, words, phrases, clauses, or applications of this Act which can be given effect without the invalid provision, word, phrase, clause, or application and to this end, the provisions, words, phrases, and clauses of this Act are declared severable.

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648 Section 9. Effective Date. This Act takes effect on [Insert date].

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649

JOINT RESOLUTION OPPOSING PHYSICIAN-ASSISTED SUICIDE
JOINT RESOLUTION No. _________ By Representatives/Senators ______________ WHEREAS, [Insert name of State] has an “unqualified interest in the preservation of human life” and this “State’s prohibition on assisted suicide, like all homicide laws, both reflects and advances its commitment to this1;” WHEREAS, neither this State’s constitution nor the U.S. Constitution contains a right to assisted suicide and, thus, no individual has the right to authorize another to kill him or her in violation of federal and state criminal laws2; WHEREAS, suicide is not a typical reaction to an acute problem or life circumstance, and many individuals who contemplate suicide, including the terminally ill, suffer from treatable mental disorders, most commonly clinical depression, which frequently goes undiagnosed and untreated by physicians3; WHEREAS, in Oregon, 46 percent of patients seeking assisted-suicide changed their minds when their physicians intervened and appropriately addressed suicidal ideations by treating their pain, depression, and/or other medical problems4; WHEREAS, palliative care continues to improve and is nearly always successful in relieving pain and allowing a person to die naturally, comfortably and in a dignified manner without a change in the law5; WHEREAS, the experiences in Oregon and the Netherlands explicitly demonstrate that palliative care options deteriorate with the legalization of physician-assisted suicide6; WHEREAS, [Insert name of State] rejects abuses of palliative care through “futility care” protocols and the use of “terminal sedation” as seen in the Liverpool Care Pathway7; WHEREAS, a physician’s recommendation for assisted suicide relies on the physician’s judgment—to include prejudices and negative perceptions—that a patient’s life is not worth living, ultimately contributing to the use of “futility care” protocols and euthanasia8; WHEREAS, [Insert name of State] rejects the “sliding-scale approach” which claims certain “qualities of life” are not worthy of equal legal protections9;

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650 WHEREAS, the legalization of assisted suicide sends a message that it is a socially-acceptable response to aging, terminal illness, disabilities, and depression and subsequently imposes a “duty to die”; WHEREAS, the medical profession as a whole opposes physician-assisted suicide because it is contrary to the medical profession’s role as healer and undermines the physician-patient relationship10; WHEREAS, assisted suicide is significantly less expensive than other care options and Oregon’s experience demonstrates that cost constraints can create financial incentives to limit care and offer assisted suicide11; WHEREAS, as evidenced in Oregon, the private nature of end-of-life decisions makes it virtually impossible to police a physician’s behavior to prevent abuses, making any number of safeguards insufficient12; and WHEREAS, a prohibition on assisted suicide, specifically physician-assisted suicide, is the only way to protect vulnerable citizens from coerced suicide and euthanasia13. NOW THEREFORE, BE IT RESOLVED BY THE [LEGISLATURE] OF THE STATE OF [Insert name of State]: Section 1. That the [Legislature] strongly opposes and condemns physician-assisted suicide because it has an “unqualified interest in the preservation of human life” and “its assistedsuicide ban insists that all persons’ lives, from beginning to end, regardless of physical or mental condition, are under the full protection of the law14.” Section 2. That the [Legislature] strongly opposes and condemns physician-assisted suicide because anything less than a prohibition leads to foreseeable abuses and eventually to euthanasia by devaluing human life, particularly the lives of the terminally ill, elderly, disabled, and depressed, whose lives are of no less value or quality than any other citizen of this State. Section 3. That the [Legislature] strongly opposes and condemns physician-assisted suicide even for terminally ill, mentally competent adults because assisted suicide eviscerates efforts to prevent the self-destructive act of suicide and hinders progress in effective physician interventions including diagnosing and treating depression, managing pain, and providing hospice care.

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651 Section 4. That the [Legislature] strongly opposes and condemns physician-assisted suicide because assisted suicide undermines the integrity and ethics of the medical profession, subverts a physician’s role as healer, and compromises the physician-patient relationship. For these reasons and others, the medical community also summarily rejects it. Section 5. That the Secretary of State of [Insert name of State] transmit a copy of this resolution to the Governor, the State Department of Health and Human Services, and the [Insert name of State] Medical Association.
Endnotes 1 Washington v. Glucksberg, 521 U.S. 702, 728 (1997). 2 See id. at 735 (upholding Washington’s ban on assisted suicide and finding there is no constitutional right to assisted suicide under the Due Process Clause of the Fourteenth Amendment); Vacco v. Quill, 521 U.S. 793, 808-09 (1997) (upholding New York’s statute prohibiting assisted suicide as consistent with the U.S. Constitution and in that it did not violate the Equal Protection Clause of the Fourteenth Amendment); Sampson v. State, 31 P.3d 88, 95 (Alaska 2000) (finding Alaska’s manslaughter statute prohibiting assisted suicide constitutional in that it does not infringe upon their constitutional rights to privacy, liberty, and equal protection); Donaldson v. Lungren, 2 Cal. App. 4th 1614, 4 Cal. Rptr. 2d 59, 63-5 (Cal. Ct. App. 1992) (finding no constitutional right to assisted suicide under the California Constitution); and Krischer v. McIver, 697 So. 2d 97, 104 (Fla. 1997) (upholding the constitutionality of Florida’s statute prohibiting assisted suicide. 3 New York State Task Force on Life and the Law, WHEN DEATH IS SOUGHT: ASSISTED SUICIDE AND EUTHANASIA IN THE MEDICAL CONTEXT 77-82 (May 1994) available at http://www.health.state.ny.us/nysdoh/provider/death.htm (last visited August 12, 2010). 4 Linda Ganzini et al., Physicians’ Experiences with the Oregon Death with Dignity Act, 342 NEW ENG. J. MED. 557, 557 (2000). 5 Herbert Hendin & Kathleen Foley, Physician-Assisted Suicide in Oregon: A Medical Perspective, 106 MICH. L. REV. 1613, 163435 (2008). 6 Id. at 1615-20 (noting only 13% of patients received palliative care consultations after the Oregon law went into effect). 7 See id. at 1634-35; Kate Devlin, Sentenced to death on the NHS, TELEGRAPH, September 2, 2009 at http://www.telegraph.co.uk/ health/healthnews/6127514/Sentenced-to-death-on-the-NHS.html (last visited August 12, 2010). 8 See Washington v. Glucksberg, 521 U.S. 702, 732 (1997). 9 Glucksberg, 521 U.S. at 729.. 10 Id. at 731; see also, American College of Physicians, Ethics Manual, available at http://www.acponline.org/running_practice/ethics/manual/ethicman5th.htm#patients (last visited August 12, 2010) (“The College does not support legalization of physician-assisted suicide. After much consideration, the College concluded that making physician-assisted suicide legal raised serious ethical, clinical, and social concerns and that the practice might undermine patient trust and distract from reform in end of life care.”); Royal College of Physicians cannot support legal change on assisted dying – survey results, May 9, 2006, available at http://www.rcplondon.ac.uk/ news/news.asp?PR_id=310 (last visited August 12, 2010). 11 Susan Donaldson James, Death Drugs Cause Uproar in Oregon, Terminally Ill Denied Drugs for Life, But Can Opt for Suicide, ABC News, Aug 6, 2008 at http://abcnews.go.com/Health/story?id=5517492&page=1 (last visited August 12, 2010). 12 Hendin & Foley, supra note v at 1637-38. 13 Glucksberg, 521 U.S. at 733-34. 14 Id. at 728-29.

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652

PAIN MEDICINE EDUCATION ACT
HOUSE/SENATE BILL No. _________ By Representatives/Senators ______________ Section 1. Title. This Act may be known and cited as the “Pain Medicine Education Act.” Section 2. Legislative Findings and Purposes. (a) The Legislature of the State of [Insert name of State] finds that: (1) (2) One goal of medicine is to relieve suffering. Inadequate pain relief is a serious public health problem in the United States, especially for those with chronic pain, the terminally ill, or those who are otherwise in the last stages of life. Approximately 80 [or other number based on studies or other evidence] percent of chronic-pain patients in this State do not receive adequate treatment for their pain symptoms. Clinical experience demonstrates that adequate pain management leads to enhanced functioning and increased quality of life, while uncontrolled pain contributes to disability and despair. Every person dies, suffers, and experiences pain at some point in his or her life. Diagnosis and treatment of pain is integral to the practice of medicine and appropriate management for each patient is the responsibility of the treating physician. Inappropriate pain treatment may result from healthcare providers’ lack of knowledge about pain management. All healthcare providers should become knowledgeable about assessing patients’ pain and effective methods of pain treatment, as well as statutory requirements for prescribing controlled substances. Many healthcare providers are ill-informed about current and effective management techniques for patients’ pain symptoms because this topic is not adequately addressed in the normal course of healthcare provider schools’ curricula.

(3)

(4)

(5) (6)

(7)

Defending Life 2011

653 (8) (9) With proper management techniques, chronic pain may be reduced in the overwhelming majority of suffering patients. Controlled substances, including opioid analgesics, may be essential in the courses of treatment for all types of pain and are, therefore, necessary to the public health. Healthcare professionals’ education has not provided appropriate training in the use of opioid medications for chronic pain. Patient pain should be assessed and treated promptly, and the quantity and frequency of doses should be adjusted to the intensity, duration of the pain, and treatment outcomes. Tolerance and physical dependence are normal consequences of sustained use of opioid analgesics and are not the same as addiction. The [Legislature] recognizes that some types of pain cannot be completely relieved.

(10) (11)

(12) (13) (b)

The [Legislature’s] purpose in promulgating this Act is to further the important and compelling societal interests of: (1) Expanding the opportunities for medical students, residents, and other healthcare providers to gain experience in treating severe pain symptoms in suffering patients. Ensuring the best possible medical care for all patients suffering from intractable and chronic pain. Improving the quality of life for all chronic pain sufferers, especially those in the last stages of life, by ensuring that patients undergo a peaceful, natural, and, as much as possible, pain-free end-of-life experience. Reducing patient requests for physician-assisted suicide (PAS) by addressing patient issues that may lead to depression and despair, the root causes and most-cited motivations for PAS. Broadening patient autonomy by presenting the greatest number of possible options for treatment through consultation with adequately knowledgeable physicians.

(2) (3)

(4)

(5)

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654 Section 3. Definitions. As used in this Act only: (a) “Addiction” means a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include the following: impaired control over drug use, craving, compulsive use, and continued use despite harm. Physical dependence and tolerance are normal physiological consequences of extended opioid therapy for pain and are not the same as addiction. (b) “Classroom instruction” means education conducted with a licensed instructor present, either by lecture or discussion, as an integrated part of a healthcare provider school course curriculum. (c) “Clinical instruction” means education conducted through interaction with patients suffering from severe chronic or acute pain in hospital-based sites, nonhospital-based ambulatory care settings, and palliative care sites and hospices, and under the supervision of a licensed healthcare provider. This can include standardized patient experiences. (d) “Double Effect” is a doctrine justifying palliative sedation and requiring three standards for ethical medical treatment: (1) the treatment itself is not morally wrong; (2) the intended benefit to the patient is not achieved by the secondary and unintended effects of the treatment; and (3) proportionality exists between the intended effects and the unintended secondary effects. (e) “Healthcare provider” includes the following professionals: (1) (2) (3) (4) “Nurses” means licensees of the [Insert name of the State Board of Nursing], including advanced practice nurses. “Pharmacists” means licensees of the [Insert the name of the State Board of Pharmacy]. “Physicians” means licensees of the [Insert name of the State Board(s) licensing M.D.s and D.O.s]. “Physician’s assistants” means licensees or registrants of the [Insert the name of the State Board regulating physician assistants, which may include the Board of Medicine].

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655 (5) “Nurse-practitioners” means licensees of the [Insert name of State Board(s) licensing nurse-practitioners].

(f) “Intractable pain” means a state of pain, even if temporary, in which reasonable efforts to remove or remedy the cause of the pain have failed or have proven inadequate. (g) “Opioid” means a strong pain medication derived from opium, or synthesized to behave like opium derivatives. Examples of opioids include but are not limited to morphine, codeine, oxycodone, methadone, and fentanyl. (h) “Pain” is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. (1) “Acute pain” is the normal, predicted physiological response to a noxious chemical, thermal, or mechanical stimulus and typically is associated with invasive procedures, trauma, and disease. It is generally time-limited. “Chronic pain” is a state in which pain persists beyond the usual course of an acute disease or healing of an injury, or that may or may not be associated with an acute or chronic pathologic process that causes continuous or intermittent pain over months or years.

(2)

(i)

“Palliative care” means (1) the active, total care of patients whose disease or medical condition is not responsive to curative treatment or whose prognosis is limited due to progressive, far-advanced disease; and the evaluation, diagnosis, treatment, and management of primary and secondary pain, whether acute, chronic, persistent, intractable, or associated with the end of life, the purpose of which is to diagnose and alleviate pain and other distressing signs and symptoms and to enhance the quality of life.

(2)

(j) “Palliative sedation” means the administration of sedatives to terminally ill, conscious patients whose pain cannot be otherwise relieved to alleviate suffering, but with the effect of inducing unconsciousness. The intent of administering the drug is to relieve pain, not to produce unconsciousness. (k) “Physical dependence” means a state of adaptation that is manifested by drug class-specific signs and symptoms that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist. Physical

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656 dependence by itself does not equate with addiction. (l) “Tolerance” means a physiologic state resulting from regular use of a drug in which an increased dosage is needed to produce a specific effect, or a reduced effect is observed with a constant dose over time. Tolerance may or may nor be evident during opioid treatment and does not equate with addiction. Section 4. Requirements for Healthcare Provider Education. (a) Objectives. The instruction required by this Act is designed to meet the following objectives: (1) (2) (3) That students will become more comfortable addressing the needs of patients experiencing chronic or severe pain. That students will be trained in the most current methods regarding the use of controlled substances, especially opioid analgesics. That students will realize the importance of developing a pain treatment plan for each patient in chronic or severe pain and learn methods and techniques necessary for developing such a plan. That students will learn objective methods for evaluating pain symptoms in patients. That students will understand the differences between addiction to opioid analgesics and tolerance and dependence on opioid analgesics. That students will understand the principle of double effect, especially with regard to palliative sedation. That students will understand the extreme unlikelihood of opioid administration hastening death when properly monitored. That students will understand relevant laws applicable to prescription of controlled substances. That students will become aware of differences in diverse cultural approaches to pain management and end-of-life care and become comfortable working with patients who may express preferences different than those of the student’s own intuitions.

(4) (5) (6) (7) (8) (9)

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657 (b) Curriculum. The curriculum in each school educating healthcare providers and receiving public funds shall include at least eight (8) hours of classroom instruction and at least four (4) hours of clinical instruction on pain management. The curriculum shall be designed to accomplish all objectives listed in Sections 4(a)(1)-(9) of this Act. In developing a curriculum for pain management education, it is recommended that faculty educators are trained in or consult the “Education for Physicians on End-of-Life Care (EPEC) Curriculum” created by the Institute for Ethics at the American Medical Association. (c) Procedures for evaluating and monitoring pain. Students shall be instructed in the following seven-step method for pain treatment: be (1) Evaluation of the patient. A medical history and physical examination must obtained, evaluated, and documented in the medical record. The medical record should document the nature and intensity of the pain, current and past treatments for pain, underlying and co-existing diseases or conditions, the effect of pain on physical and psychological function, and history of substance abuse. The medical record should also document the presence of one or more recognized medical indications for the use of a controlled substance. (2) Treatment plan. A written treatment plan should state objectives that will be used to determine treatment access, such as pain relief and improved physical and psychosocial function, and should indicate if any further diagnostic evalua tions or other treatments are planned. After treatment begins, the physician should adjust drug therapy to the individual medical needs of each patient. Other treatment modalities or a rehabilitation program may be necessary de pending on the etiology of the pain and the extent to which the pain is associ ated with physical and psychosocial impairment. Informed consent and agreement for treatment. The physician should discuss the risks and benefits of the use of controlled substances with the patient, persons designated by the patient, or the patient’s surrogate or guardian if the patient is without medical decision-making capacity. The patient should receive prescriptions from one physician and one pharmacy whenever possible. If the patient is at high risk for medication abuse or has a history of substance abuse, the physician should consider the use of a written agreement between physician and patient outlining patient responsibilities, including: a. b. Urine/serum medication levels screening when requested; Number and frequency of all prescription refills; and

(3)

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658

c. (4)

Reasons for which drug therapy may be discontinued (e.g., violation of agreement).

Periodic Review. The physician should periodically review the course of pain treatment and any new information about the etiology of the pain or the patient’s state of health. Continuation or modification of controlled substances for pain management therapy depends on the physician’s evaluation of progress toward treatment objectives. Satisfactory response to treatment may be indicated by the patient’s decreased pain, increased level of function, or improved quality of life. Objective evidence of improved or diminished function should be moni tored and information from family members or other caregivers should be considered in determining the patient’s response to treatment. If the patient’s progress is unsatisfactory, the physician should assess the appropriateness of the continued use of the current treatment plan and consider the use of other therapeutic modalities. Consultation. The physician should be willing to refer the patient as necessary for additional evaluation and treatment in order to achieve treatment objectives. Special attention should be given to those patients with pain who are at risk for medication misuse, abuse, or diversion. The management of pain in patients with a history of substance abuse or with a comorbid psychiatric disorder may require extra care, monitoring, documentation, and consultation with or referral to an expert in the management of such patients. Medical records. The physician should keep accurate medical records to include: a. b. c. d. e. f. g. The medical history and physical examination; Diagnosis, therapeutic, and laboratory results; Evaluations and consultations; Treatment objectives; Discussion of risks and benefits; Informed consent; Treatments;

(5)

(6)

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659

h. i. j.

Medications (including date, type, dosage, and quantity prescribed); Instructions and agreements; and Periodic reviews.

Records should remain current and be maintained in an accessible manner and readily available for review. (7) Compliance with controlled substance laws and regulations. To prescribe, dispense, or administer controlled substances, the physician must be licensed in the State and comply with applicable federal and State regulations. Physicians are referred to the Physician’s Manual of the U.S. Drug Enforcement Administration [and any relevant documents issued by the State Medical Board] for specific rules governing controlled substances as well as applicable State regulations.

(d) Hours Requirements. The following requirements apply to the core curriculum of any healthcare provider education program and are in addition to any course content required in elective courses or courses required for discrete areas of medicine. A board issuing a license or certification to any healthcare provider under [Insert relevant citation(s)] shall require that each applicant for initial licensure complete at least: (1) (2) Eight (8) hours of classroom instruction, and Four (4) hours of clinical instruction. This Section shall not apply to those seeking licensure from the [Insert the name of the State Board of Pharmacy].

(e) Application. The licensure requirements of this document shall apply to any student beginning healthcare provider education anytime after [Insert date]. Section 5. Pain Management Regulations Encouraged. The [Legislature] strongly encourages [Insert name of State Medical Licensing Board] to adopt pain management regulations based on the Pain Management Model Policy of the Federation of State Medical Licensing Boards and the provisions of this Act. [Drafter’s Note: Include this Section when the State Medical Board has not already adopted pain management regulations or similar standards.]

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660 Section 6. Severability. Any provision of this Act held to be invalid or unenforceable by its terms, or as applied to any person or circumstance, shall be construed so as give it the maximum effect permitted by law, unless such holding shall be one of utter invalidity or unenforceability, in which event such provision shall be deemed severable herefrom and shall not affect the remainder hereof or the application of such provision to other persons not similarly situated or to other, dissimilar circumstances. Section 7. Right of Intervention. The [Legislature], by joint resolution, may appoint one or more of its members, who sponsored or cosponsored this Act in his or her official capacity, to intervene as a matter of right in any case in which the constitutionality of this Act or any portion thereof is challenged. Section 8. Effective Date. This Act takes effect [Insert date].

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