Maine’s Death with Dignity Act: An Abbreviated Guide

On June 12, 2019 Governor Mills made Maine the 9^th state in the nation to adopt what is widely known as the "Death with Dignity Act".  Laws of this nature have been political and social lightning rods throughout the United States.  This article will take no stance on the moral issues that surround the debate, rather it will breakdown what the Death with Dignity Act requires of potential patients.

Note, this article does not break down all the specifics of each step, please click the link below to read the act in its entirety:

Click Here to Read the Full Law

The Maine law has established an extensive process that prospective "qualified terminally ill patients" must go through before a physician may prescribe any end of life medication.  Below is the overview of the step-by-step process required by the Act:

1. To obtain "qualified terminally ill status", a patient MUST be a Maine resident who is determined to be "competent" by BOTH an attending physician and a consulting physician;
2. The individual MUST have been informed of a terminal diagnosis with a life expectancy of less than 6 months;
3. Prior to a doctor writing a prescription for end of life medication, the individual MUST make 2 oral requests and 1 written request, to his/her attending physician and a 15-day waiting period must pass between the first and second oral request;
4. To be "competent" the individual must have the capacity to communicate his/her decision to a health care professional or health care facility. If the individual is deemed not competent, he/she may be referred to a qualified mental health professional who will issue a written report confirming or denying competency;
5. If the report deems the individual competent, the report must also state that the individual is acting voluntarily and has made an informed decision to administer end of life medication;
6. The individual MUST also be informed on his/her prognosis, the potential risks of taking the medication, and the probable result. In addition, the attending physician is required to inform the individual of feasible alternatives including additional treatment, hospice care, pain control, palliative care and/or comfort care;
7. The attending physician MUST refer the individual to a consulting physician who MUST examine all the medical records and confirm the diagnosis in writing and verify that the individual is competent, acting voluntarily, and making an informed decision;
8. The written request MUST be witnessed by 2 or more people. At LEAST 1 witness MUST meet the below criteria;
   1. May not be related by blood, marriage, or adoption;
   2. May not be an heir, or inherit from the patient’s estate in any capacity under any will or by operation of any law, at the time of signing;
   3. Must not be an owner, operator, or employee of a health care facility where the qualified patient is receiving medical treatment or is a resident.
9. The patient’s attending physician, at the time the written request is signed, MAY NOT be a witness.
10. If the patient is in, or receiving treatment at, a long-term care facility at the time of the written request, ONE of the witnesses MUST be an individual designated by the facility who has qualifications specified by the department by rule.
11. All witnesses, in writing, MUST affirm that the individual can make this decision and is acting voluntarily;
12. Finally, if after 48 hours of completing all the required steps, and such required steps are documented in the individual’s medical chart, and receiving the individual’s written request (after the previously required oral requests), the attending physician may write the end of life prescription. The attending physician is responsible for verifying the accuracy of documentation.

The "Death with Dignity" Act is built to have numerous safeguards in place.  It goes without saying a decision like this is incredibly emotional.  If you or a loved one has any questions about the new law, please reach out to an Elder Law Attorney.

At Ainsworth, Thelin & Raftice we have 30 years of elder law experience.  Bob Raftice and Eleanor Dominguez are available.  If you need help understanding the new law, or any of the associated steps, please call us today.