Bill
SB 2051
Rhode Island would allow eligible terminally ill adults to self-administer prescribed medications to hasten death, under a tightly regulated, physician-supervised process with safe
Purpose
- Establishes a legalized framework for terminally ill patients to obtain medications to self-administer with the intent to hasten death, creating a specific statutory pathway for physician involvement, patient qualifications, and safeguards.
- Name: The Lila Manfield Sapinsley Compassionate Care Act.
Key Provisions and Changes
1) Definitions (Chapter 4.15, 23-4.15-2)
- Clarifies terms essential to the act, including:
- Bona fide physician-patient relationship
- Capable (patient able to make decisions)
- Terminal condition (incurable, irreversible disease with death expected within six months or less)
- Interested person (defined list: patient’s physician, certain relatives, or facility stakeholders)
- Palliative care, patient, physician, and related terms
- Sets framework for assessing capability, voluntariness, informed decision-making, residency, and other criteria.
2) Requirements for Prescription and Documentation; Immunity (23-4.15-3)
- Prescribing physician protections: no civil/criminal liability or professional discipline if requirements are met.
- Multi-step process for obtaining a lethal dose:
- First oral request in physician’s presence.
- At least 15 days later, a second oral request in presence.
- Opportunity to rescind offered at second request.
- Written request signed by the patient in the presence of two or more witnesses (at least one not an interested person; witnesses 18+; one not related by the defined relationship).
- Physician must determine: terminal condition, capability, informed decision, voluntary request, Rhode Island residency.
- Informed discussion in person about diagnosis, prognosis, end-of-life options (including hospice, palliative care), risks, and probable outcome.
- Referral to a second physician for medical confirmation (diagnosis, prognosis, capability, voluntariness, informed decision).
- Verification of no impaired judgment or referral for psychiatric/psychological/clinical social work evaluation.
- If applicable, consult with patient’s primary care physician with consent.
- Patient must be informed they may rescind at any time, including after the second oral request.
- Written prescription written at least 48 hours after the last of: written request, second oral request, or rescind offer.
- Prescription dispensing: physician may dispense if licensed in RI and DEA-certified; else may coordinate with pharmacist with patient’s written consent.
- Comprehensive medical record entries: detailed chronology of oral/written requests, diagnoses, prognoses, confirmations of capability and voluntariness, hospice status, evaluations, rescissions, and steps taken; include notes on the medication prescribed.
- After writing the prescription, the physician must file a report with the Department of Health confirming completion of all requirements.
3) No Duty to Aid (23-4.15-4)
- Acknowledges that a patient who self-administers a lethal dose is not subject to grave physical harm liability merely for being present or for not intervening.
4) Limitations on Actions (23-4.15-5)
- No duty to participate in providing lethal medication.
- Facilities/providers cannot discipline individuals acting in good faith under this act or who refuse to act under it.
- Exception: liability remains for negligent or intentional misconduct outside the act’s provisions.
5) Healthcare Facility Exception (23-4.15-6)
- Facilities can prohibit prescribing lethal doses to residents on premises, provided policy is in writing.
- Violating facility policy may subject the physician to sanctions allowable by law or contract.
6) Insurance Provisions (23-4.15-7)
- Life insurance benefits shall not be denied for actions taken under this act.
- Malpractice insurance policies and premiums shall not be conditioned on participation in this act.
7) No Effect on Palliative Sedation (23-4.15-8)
- Does not limit or affect palliative sedation within accepted medical standards.
8) Protection of Patient Choice at End-of-Life (23-4.15-9)
- Clarifies professional conduct standards for physicians who:
- Establish capability and absence of impaired judgment
- Inform about end-of-life options
- Prescribe potentially lethal medication
- Advise on risks
- Respect patient’s independent, voluntary decision to self-administer
9) Immunity for Physicians (23-4.15-10)
- Broad immunity for physicians acting in good faith under the act.
10) Safe Disposal of Unused Medications (23-4.15-11)
- The Department of Health must adopt rules for safe disposal of unused medications prescribed under this act.
11) Statutory Construction (23-4.15-12)
- Clarifies that this act does not authorize euthanasia, mercy killing, or homicide; does not conflict with federal laws (e.g., ACA provisions) as amended.
Effective Date
- Takes effect upon passage and applies to actions once enacted.
Impact and Considerations
Note: The bill is scheduled for a hearing/consideration in May 2026 and is currently in the Senate Judiciary committee stage.
Compiled from official sources — confirm details with the bill’s official record.
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