(Maine Public photo by Steve Mistler, read story here)

Last week, Governor Janet Mills signed the ‘Death with Dignity’ bill into law, allowing adult terminally ill Maine residents who meet certain qualifications, and who have been determined by the person’s attending physician to be suffering from a terminal disease, to make a request for medication that will hasten their death. In enacting the law, Maine joins California, Colorado, Hawaii, Oregon, Vermont, Washington, New Jersey and the District of Columbia in legalizing what is commonly known as “medically-assisted suicide” or “death with dignity.”

It’s a topic Mainers have been hearing about, and we’ve compiled a comprehensive overview of the Death with Dignity Act.

Under the Act, the patient’s attending physician plays a central role. The physician is responsible for:

• Determining whether the patient indeed has a terminal disease
• Determining whether the patient is competent and made the medication request voluntarily
• Ensuring that the patient is making an informed decision by informing the patient of:
  • The details of his or her medical diagnosis
  • The patient’s prognosis
  • Risks associated with taking the medication to be prescribed
  • The probable result of taking the medication
  • Any feasible alternatives to taking the medication such as palliative and comfort care, hospice care, pain control, and disease-directed treatment

The physician must counsel the patient about notifying next of kin, having others in the room when the patient takes the medication, and recommend against taking the medication in a public place. It’s also required that the physician refer the patient to a consulting physician for a second opinion.

If either physician believes the patient is suffering from a mental health disorder that impairs his or her judgment, the physician must refer the patient for counseling. The physician may not prescribe the medication until the licensed professional counselor has determined the patient is not suffering from impaired judgment.

Importantly, the Act provides for two different waiting periods. First, a patient must make an oral request for the prescription and then wait at least 15 days before making both an oral and written request for the prescription medication. After the patient has made the written request and the attending physician has informed the patient of his or her right to rescind the request, another 48 hours must pass before the physician may write the prescription. At the end of this waiting period, the physician must verify that the patient is making an informed decision, complete certain medical record documentation requirements, and ensure that all appropriate legal steps have been taken before writing the prescription. The patient can change his or her mind and rescind the medication request at any time.

The patient’s written request for medication must be in a specified format in order to be valid, and must be signed and dated by the patient and witnessed by two disinterested individuals who attest that the patient is competent, acting voluntarily, and is not being coerced to sign the medication request. Any provision in a person’s Last Will and Testament or other written or oral contract or agreement that would affect the person’s ability to make or rescind the medication request is not valid.

Health care providers may prohibit employees, independent contractors, or other providers from participating in activities under the Act while on premises owned by or under the management or direct control of the health care provider, or while acting within the course and scope of any employment by, or contract with, the health care provider.

The Act does not authorize ending a patient’s life by lethal injection, mercy killing, or active euthanasia.  However, importantly, action taken in accordance with the Act does not constitute suicide or homicide. But certain violations of the Act carry stiff penalties: incarceration up to 30 years and fines up to $50,000.

The actual language of the Act can be viewed here in its entirety.