Michigan: Full Text of Proposal B

“Merian’s Friends” (a group named after Jack Kevorkian’s 19th victim) obtained enough signatures to place “Proposal B,” a measure that would legalize assisted suicide, on Michigan’s November 3 ballot. The text of that proposal, which was part of the petition, covered 12 legal-sized pages with very small print. If printed out from this web site, in 12 point type, the text is 37 pages long. Spelling, grammatical and formatting errors which were in the original petition have been maintained in the text on this web site.

Text which is deleted from existing law is italicized and placed in brackets [ ]. New text is printed in CAPITAL letters.


Full Text of Proposal B – Michigan’s assisted suicide ballot initiative


INITIATIVE OF LEGISLATION

AN ACT to amend 1978 PA 368, entitled “Public health code,” by amending sections 2844, 5658, 5660, 7401, 16221, 16226, 17033, 17533, 17766, and 20165 (MCL 333.2844, 333.5658, 333.5660, 333.7401, 333.16221, 333.16226, 333.17033, 333.17533, 333.17766, and 333.20165), sections 5658 and 5660 as added and sections 16221 and 16226 as amended by 1996 PA 594, section 7401 as amended by 1996 PA 249, sections 17033 and 17533 as amended by 1994 PA 234, section 17766 as amended by 1990 PA 30, and section 20165 as amended by 1990 PA 179, and by adding part 56b entitled “Terminally Ill Patient’s Right to End Unbearable Pain and Suffering Act”; to amend 1953 PA 181 (MCL 52.201-216), commonly referred to as the “Medical examiners act,” by amending sections 2 and 3 (MCL 52.202 and 52.203), to amend 1976 PA 267, entitled “Open meetings act,” by amending section 3(MCL 15.263), as amended by 1988 PA 278, and to repeal acts and parts of acts.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

Sec. 2844. (1) [When] IF death occurs more than 10 days after the deceased was last seen by a physician, if the cause of death appears to be other than the illness or condition for which deceased was being treated, or if the attending physician cannot accurately determine the cause of death, the case shall be referred to the county medical examiner for investigation to determine and certify the cause of death. If the county medical examiner determines that the case does not fall within his or her jurisdiction, the county medical examiner shall refer the case back to the deceased’s physician within 24 hours for completion of the medical certification. IN ACCORDANCE WITH SECTION 5686(1), IF AN INDIVIDUAL HAS DIED AS A RESULT OF THE PROCEDURES AUTHORIZED UNDER PART 56B, THEN FOR PURPOSES OF THIS SUBSECTION, THE CAUSE OF DEATH IS THE TERMINAL ILLNESS FOR WHICH THE DECEASED WAS BEING TREATED.

(2) [When] IF an investigation is required under ACT [No. 181 of the Public Acts of 1953, as amended, being Sections 52.201 to 52.216 of the Michigan Compiled Laws] 1953 PA 181, MCL 52.201 TO 52.216, the county medical examiner shall determine the cause of death and shall complete and sign the medical certification within 48 hours after taking charge of the case.
(3) If the cause of death cannot be determined within 48 hours after death, the medical certification may be completed as provided by the department. The attending physician or county medical examiner shall give the funeral director in custody of the body notice of the reason for the delay, and final disposition shall not be made until authorized by the attending physician or medical examiner.Sec. 5658. A physician who, as part of a medical treatment plan for a terminally ill patient, prescribes for the terminally ill patient a controlled substance that is included in schedules 2 to 5 under part 72 and that is a narcotic [drug is immune from]administrative and civil liability based on prescribing the controlled substance if the prescription is given in good faith and with the intention to treat a patient with a terminal illness or alleviate the patient’s pain, or both, OR TO COMPLY WITH A REQUEST MADE IN COMPLIANCE WITH PART 56B and all of the following are met: 

(a) The prescription is for a legitimate legal and professionally recognized therapeutic purpose OR IS WRITTEN PURSUANT TO A REQUEST MADE IN COMPLIANCE WITH PART 56B.
(b) Prescribing the controlled substance is within the scope of practice of the physician.
(c) The physician holds a valid license under article 7 to prescribe controlled substances.Sec. 5660. This part does not do the following: 

(a) Impair or supersede a legal right a parent, patient, advocate, legal guardian, or other individual may have to consent to or refuse medical treatment on behalf of another.(b) [create] CREATE a presumption about a terminally ill patient’s desire to receive or refuse medical treatment, regardless of the ability of the patient to participate in medical treatment decisions. 

(c) Limit the ability of a court making a determination about a terminally ill patient’s medical treatment decisions to take into consideration all of the following state interests:

 

(i) The preservation of life.
(ii) The prevention of suicide. THIS SUBPARAGRAPH DOES NOT INCLUDE THE DEATH OF AN INDIVIDUAL WHO ENDED HIS OR HER LIFE BY USING THE PROCEDURES AUTHORIZED BY PART 56B.
(iii) The protection of innocent third parties.
(iv) The preservation of the integrity of the medical profession. 

(d) Condone, authorize, or approve suicide, assisted suicide, mercy killing, or euthanasia. THIS SUBDIVISION DOES NOT AFFECT THE OPERATION OF PART 56B. 

PART 56B

TERMINALLY ILL PATIENT’S RIGHT TO END UNBEARABLE PAIN OR SUFFERINGSEC. 5671. THIS PART SHALL BE KNOWN AND MAY BE CITED AS THE “TERMINALLY ILL PATIENT’S RIGHT TO END UNBEARABLE PAIN OR SUFFERING ACT”.

SEC. 5672. IT IS THE INTENT OF THE PEOPLE IN ENACTING THIS PART TO DO ALL OF THE FOLLOWING:

 

(A) GIVE A TERMINALLY ILL ADULT WHO IS COMPETENT, FULLY INFORMED, AND A RESIDENT OF THIS STATE, OR A CLOSE RELATIVE OF A RESIDENT OF THIS STATE, THE RIGHT TO END UNBEARABLE PAIN OR SUFFERING THROUGH THE SELF-ADMINISTRATION OF MEDICATION TO HASTEN DEATH;(B) ASSURE THE PATIENT’S RIGHT TO REVOKE HIS OR HER REQUEST FOR MEDICATION AT ANY TIME AND NUMEROUS OTHER PATIENT SAFEGUARDS; 

 

(C) MAINTAIN CONFIDENTIALITY OF PATIENT RECORDS AT ALL TIMES; 

(D) PROTECT OTHER LEGAL RIGHTS OF A PATIENT WHO COMPLIES WITH THIS ACT;(E) PROVIDE OVERSIGHT OF PHYSICIAN’S WHO PRESCRIBE MEDICATION PURSUANT TO THIS ACT; AND 

 

(F) PUNISH A PHYSICIAN OR OTHER INDIVIDUAL WHO VIOLATES THIS ACT.SEC. 5673. AS USED IN THIS PART: 

 

(A) “ADULT” MEANS AN INDIVIDUAL WHO IS 18 YEARS OF AGE OR OLDER. 

(B) “ATTENDING PHYSICIAN” MEANS A PHYSICIAN WHO HAS PRIMARY RESPONSIBILITY FOR THE CARE OF THE PATIENT.(C) “COMPETENT” MEANS THE ABILITY TO MAKE PERSONAL MEDICAL DECISIONS BASED UPON AN UNDERSTANDING OF THE RELEVANT ASPECTS OF A PATIENT’S CURRENT MEDICAL CIRCUMSTANCES, AND UNDERSTANDING OF THE BENEFITS, RISKS, AND LIKELY CONSEQUENCES OF THE TREATMENT ALTERNATIVES DESCRIBED IN THIS PART, AND THE ABILITY TO ARRIVE AT AN INDEPENDENT AND SUSTAINED DECISION BASED UPON THE PATIENT’S RATIONAL CHOICE. 

(D) “CONSULTING PHYSICIAN” MEANS A PHYSICIAN WHO SPECIALIZES IN THE DISEASE THAT HAS CAUSED A PATIENT TO BECOME TERMINAL, IS ACTIVELY PRACTICING THAT SPECIALTY, AND IS CERTIFIED BY AN NATIONAL PROFESSIONAL ORGANIZATION FOR THAT SPECIALTY AND APPROVED BY THAT PHYSICIAN’S LICENSING BOARD.

 

(E) “DEPARTMENT” MEANS THE DEPARTMENT OF COMMUNITY HEALTH. 

(F) “HEALTH CARE PROVIDER” MEANS A PERSON LICENSED, REGISTERED, OR OTHERWISE AUTHORIZED OR PERMITTED BY THE LAW OF THIS STATE TO PROVIDE HEALTH CARE IN THE ORDINARY COURSE OF BUSINESS OR PRACTICE OF A HEALTH PROFESSION. HEALTH CARE PROVIDER INCLUDES A HEALTH FACILITY. 

(G) “HEALTH FACILITY” MEANS A HEALTH FACILITY OR AGENCY LICENSED UNDER ARTICLE 17.(H) “INFORMED DECISION” MEANS A DECISION BY A PATIENT TO REQUEST A PRESCRIPTION UNDER THIS ACT FOR MEDICATION TO END HIS OR HER UNBEARABLE PAIN OR SUFFERING BY ENDING HIS OR HER LIFE IN A HUMANE AND DIGNIFIED MANNER THAT IS MADE AFTER BEING FULLY INFORMED BY THE PATIENT’S ATTENDING PHYSICIAN OR A CONSULTING PHYSICIAN UNDER THIS PART OF ALL OF THE FOLLOWING: 

(i) THE PATIENT’S MEDICAL DIAGNOSIS.
(ii) THE PATIENT’S PROGNOSIS.
(iii) THE POTENTIAL RISKS ASSOCIATED WITH TAKING THE MEDICATION TO BE PRESCRIBED.
(iv) THE PROBABLE RESULT OF TAKING THE MEDICATION TO BE PRESCRIBED.
(v) THE ALTERNATIVES TO TAKING THE MEDICATION PRESCRIBED, INCLUDING, BUT NOT LIMITED TO, COMFORT CARE, HOSPICE CARE, AND PAIN CONTROL.
(vi) THAT THE PATIENT MAY RESCIND THE DECISION AT ANY TIME BY EITHER WRITTEN OR ORAL COMMUNICATION OR IN ANY MANNER THAT COMMUNICATES THE SAME INTENT.

 

(I) “MEDICATION” MEANS 1 OR MORE PRESCRIPTION DRUGS THAT CAN BE TAKEN ORALLY OR BY NASOGASTRIC OR GASTROSTOMY TUBE. 

(J) “PATIENT” MEANS AN INDIVIDUAL WHO IS AN ADULT RESIDENT AND WHO IS UNDER THE CARE OF AN ATTENDING PHYSICIAN AND IS BEING TREATED BY THAT PHYSICIAN OR BY A CONSULTING PHYSICIAN FOR A TERMINAL ILLNESS.(K) “PATIENT’S MEDICAL RECORD” MEANS BOTH OF THE FOLLOWING: 

 

(i) FOR A PATIENT WHO IS AN INPATIENT OR AN OUTPATIENT IN A HEALTH FACILITY, THE PERMANENT RECORD OF THE MEDICAL CARE AND TREATMENT RECEIVED BY THE PATIENT IN OR FROM THAT HEALTH FACILITY, WHICH RECORD IS REQUIRED TO BE COMPILED AND MAINTAINED BY THE HEALTH FACILITY UNDER SECTION 20175 AND BY PROFESSIONAL STANDARDS OF PRACTICE.
(ii) FOR A PATIENT WHO IS NOT AN INPATIENT OR OUTPATIENT IN A HEALTH FACILITY, BUT IS RECEIVING MEDICAL CARE AND TREATMENT FROM A LICENSED HEALTH PROFESSIONAL, THE PERMANENT RECORD OF THE MEDICAL CARE AND TREATMENT RECEIVED BY THE PATIENT FROM THE LICENSED HEALTH PROFESSIONAL, WHICH RECORD IS REQUIRED TO BE COMPILED AND MAINTAINED BY THE LICENSED HEALTH PROFESSIONAL BY LAW AND BY PROFESSIONAL STANDARDS OF PRACTICE. 

(L) “PHARMACIST” MEANS AN INDIVIDUAL LICENSED UNDER ARTICLE 15 TO ENGAGE IN THE PRACTICE OF PHARMACY. 

(M) “PHYSICIAN” MEANS AN ALLOPATHIC OR OSTEOPATHIC PHYSICIAN LICENSED TO ENGAGE IN THE PRACTICE OF MEDICINE OR THE PRACTICE OF OSTEOPATHIC MEDICINE AND SURGERY UNDER ARTICLE 15. 

(N) “PRESCRIPTION DRUG” MEANS THAT TERM AS DEFINED IN SECTION 17708, AND INCLUDES, BUT IS NOT LIMITED TO, A CONTROLLED SUBSTANCE AS DEFINED IN SECTION 7104. 

(0) “PSYCHIATRIST” MEANS A PHYSICIAN WHO SPECIALIZES IN PSYCHIATRY. 

(P) “REQUEST” MEANS A REQUEST FOR MEDICATION UNDER THIS PART FOR SELF-ADMINISTRATION THE PRIMARY PURPOSE OF WHICH IS TO HASTEN OR CAUSE THE DEATH OF THE REQUESTER AND THAT MEETS THE REQUIREMENTS OF SECTION 5675. 

(Q) “RESIDENT” MEANS AN INDIVIDUAL WHO RESIDES IN THIS STATE AT THE TIME OF MAKING A REQUEST UNDER THIS PART AND WHO HAS RESIDED IN THIS STATE FOR NOT LESS THAN THE 6 MONTHS IMMEDIATELY PRECEDING THE DATE OF MAKING THE REQUEST. FOR PURPOSES OF THIS PART ONLY, RESIDENT INCLUDES A PARENT OF A RESIDENT, ADULT SIBLING OF A RESIDENT, ADULT CHILD OF A RESIDENT, OR A SPOUSE OF 1 OF THOSE INDIVIDUALS WHO DOES NOT RESIDE IN THIS STATE, IF THE RELATIONSHIP TO THE RESIDENT IS ATTESTED TO BY AFFIDAVIT OF THE RESIDENT PRESENTED TO AN ATTENDING PHYSICIAN. FOR PURPOSES OF THIS PART ONLY, THE PARENT, ADULT SIBLING, ADULT CHILD, OR SPOUSE OF 1 OF THOSE INDIVIDUALS IS CONSIDERED A RESIDENT OF THE COUNTY OF RESIDENCE OF THE RESIDENT PRESENTING THE AFFIDAVIT.(R) “SELF-ADMINISTRATION” MEANS THE INSERTION OR INGESTION OF MEDICATION REQUESTED UNDER THIS PART, INCLUDING ACCOMPANYING FLUIDS, THAT IS PERFORMED ENTIRELY UNDER A PATIENT’S OWN EFFORT. 

 

(S) “SIGNIFICANT OTHER” MEANS AN INDIVIDUAL WHO HAS HAD A MONOGAMOUS-TYPE RELATIONSHIP WITH A PATIENT FOR NOT LESS THAN 1 YEAR. 

(T) “SUFFERING” MEANS THE PHYSICAL OR MENTAL TORMENT CAUSED BY A TERMINAL ILLNESS AND THAT RESULTS FROM THE PROGRESSIVE AND SERIOUS LOSS OF THE ABILITY TO PERFORM MAJOR LIFE FUNCTIONS. 

(U) “TERMINAL ILLNESS” MEANS AN INCURABLE AND IRREVERSIBLE DISEASE THAT IS MEDICALLY CONFIRMED AND THAT WILL, WITHIN REASONABLE MEDICAL JUDGMENT, RESULT IN THE DEATH OF THE PATIENT WITHIN 6 MONTHS OR LESS. 

(V) “TERMINAL PERIOD” MEANS THE LAST 6 MONTHS OF LIFE FOR A PATIENT WITH A TERMINAL ILLNESS, WITHIN REASONABLE MEDICAL JUDGMENT.(W) “VOLUNTARY” MEANS THAT A DECISION IS MADE BY A PATIENT’S INDEPENDENT JUDGMENT WITHOUT EVIDENCE OF OUTSIDE COERCION, INSOFAR AS CAN BE REASONABLY DETERMINED BY THE PATIENT’S ATTENDING PHYSICIAN OR BY A CONSULTING PHYSICIAN OR BY A PSYCHIATRIST. 

SEC. 5674. (1) A PATIENT WHO MEETS ALL OF THE FOLLOWING REQUIREMENTS MAY MAKE A REQUEST UNDER THIS PART DURING THE TERMINAL PERIOD FOR MEDICATION FOR SELF-ADMINISTRATION, THE PRIMARY PURPOSE OF WHICH IS TO END THE PATIENT’S UNBEARABLE PAIN OR SUFFERING BY ENDING HIS OR HER LIFE IN A HUMANE AND DIGNIFIED MANNER:

 

(A) IS COMPETENT AND HAS MADE AN INFORMED DECISION.(B) IS DETERMINED BY THE PATIENT’S ATTENDING PHYSICIAN AND BY A CONSULTING PHYSICIAN TO BE SUFFERING FROM A TERMINAL ILLNESS. 

 

(C) HAS VOLUNTARILY EXPRESSED HIS OR HER WISH TO DIE BY MEANS OF MAKING A REQUEST UNDER THIS PART PURSUANT TO AN INFORMED DECISION. 

(2) AN INDIVIDUAL IS NOT QUALIFIED TO MAKE A REQUEST SOLELY BECAUSE OF AGE OR DISABILITY, OR A COMBINATION OF AGE AND DISABILITY, OTHER THAN A DISABILITY CAUSED BY A TERMINAL ILLNESS.SEC. 5675. (1) A REQUEST MAY BE IN WRITING OR, IF THE PATIENT IS UNABLE TO WRITE, MAY BE MADE ORALLY AND SHALL CONTAIN ALL OF THE FOLLOWING INFORMATION: 

(A) THE PATIENT’S FULL NAME AND HIS OR HER ADDRESS AT THE TIME THE REQUEST IS MADE. IF THE PATIENT IS AN INPATIENT OR A RESIDENT IN A HEALTH FACILITY, THE REQUEST SHALL CONTAIN THE PATIENT’S LAST KNOWN RESIDENTIAL ADDRESS.

 

(B) A STATEMENT THAT THE PATIENT BELIEVES HIMSELF OR HERSELF TO BE COMPETENT. 

(C) A STATEMENT THAT THE REQUEST IS BEING MADE VOLUNTARILY AND WITHOUT COERCION. 

(D) A DESCRIPTION OF THE TERMINAL ILLNESS FROM WHICH THE PATIENT IS SUFFERING. 

(E) A STATEMENT THAT THE PATIENT HAS BEEN INFORMED BY HIS OR HER ATTENDING PHYSICIAN THAT THE TERMINAL ILLNESS WILL LIKELY PRODUCE DEATH WITHIN 6 MONTHS OR LESS. 

(F) A STATEMENT THAT THE PATIENT HAS BEEN INFORMED BY HIS OR HER ATTENDING PHYSICIAN OR CONSULTING PHYSICIAN REGARDING COMFORT CARE, HOSPICE CARE, AND PAIN CONTROL. 

(G) A STATEMENT THAT THE PATIENT UNDERSTANDS THAT HE OR SHE MAY RESCIND THE REQUEST AT ANY TIME AND BY ANY METHOD OF COMMUNICATION. 

(2) THE PATIENT SHALL SIGN AND DATE A REQUEST MADE UNDER SUBSECTION (1) THAT IS IN WRITING. 

(3) A REQUEST MADE UNDER SUBSECTION (1) THAT IS IN WRITING SHALL BE WITNESSED BY AT LEAST 2 INDIVIDUALS WHO ATTEST THAT TO THE BEST OF THEIR KNOWLEDGE AND BELIEF THE PATIENT IS RATIONAL AND IS ACTING VOLUNTARILY. AT LEAST 1 OF THE WITNESSES REQUIRED UNDER THIS SUBSECTION SHALL NOT BE 1 OR MORE OF THE FOLLOWING: 

(A) A RELATIVE OF THE QUALIFIED PATIENT BY BLOOD, MARRIAGE, OR ADOPTION.(B) KNOWINGLY ENTITLED AT THE TIME THE REQUEST IS SIGNED TO HAVE CONTROL OVER A PORTION OF THE ESTATE OF THE PATIENT UPON THE PATIENT’S DEATH UNDER A WILL OR TRUST, OR BY OPERATION OF LAW. 

 

(C) AN OWNER, OPERATOR, OR EMPLOYEE OF A HEALTH FACILITY WHERE THE PATIENT IS RECEIVING MEDICAL TREATMENT OR IS A RESIDENT.(4) THE PATIENT’S ATTENDING PHYSICIAN AT THE TIME THE REQUEST IS SIGNED SHALL NOT BE A WITNESS UNDER SUBSECTION (3). 

 

(5) IF A PATIENT IS A PATIENT IN A HEALTH FACILITY AT THE TIME A REQUEST IS MADE, 1 OF THE WITNESSES REQUIRED UNDER SUBSECTION (3) SHALL BE AN INDIVIDUAL DESIGNATED BY THE HEALTH FACILITY, BUT WHO IS NOT EMPLOYED BY OR UNDER CONTRACT TO THE HEALTH FACILITY. 

(6) IF THE PATIENT HAS MADE AN ORAL REQUEST, THE REQUEST SHALL BE RECORDED BY VIDEO MEANS.SEC. 5676. (1) WHETHER OR NOT A PATIENT HAS MADE A REQUEST, THE ATTENDING PHYSICIAN OR, IF THE ATTENDING PHYSICIAN HAS NOT DONE SO, THE CONSULTING PHYSICIAN SHALL DO ALL OF THE FOLLOWING AS SOON AS POSSIBLE AFTER DETERMINING THAT THE PATIENT HAS A TERMINAL ILLNESS: 

 

(A) UPON REQUEST OF THE PATIENT, PROVIDE THE PATIENT WITH A TRUE COPY OF THIS PART AND WITH A COPY OF THE BOOKLET PRODUCED BY THE DEPARTMENT UNDER SECTION 5682. 

(B) INFORM THE PATIENT REGARDING COMFORT CARE, HOSPICE CARE, AND PAIN MANAGEMENT. 

(C) ASK THE PATIENT WHETHER HE OR SHE HAS QUESTIONS REGARDING PAYMENT FOR THE TREATMENT THE ATTENDING PHYSICIAN OR THE CONSULTING PHYSICIAN HAS PROVIDED OR WILL PROVIDE FOR THE TERMINAL ILLNESS OR PAYMENT FOR COMFORT CARE, HOSPICE CARE, OR PAIN CONTROL. IF THE PATIENT HAS SUCH QUESTIONS, THE ATTENDING PHYSICIAN OR THE CONSULTING PHYSICIAN SHALL REFER THE PATIENT TO A PROFESSIONAL WHO CAN IDENTIFY POSSIBLE FINANCIAL ASSISTANCE FOR THE PATIENT.(2) IN ADDITION TO COMPLYING WITH SECTIONS 5654 AND 5655, A PATIENT’S ATTENDING PHYSICIAN SHALL DO ALL OF THE FOLLOWING IN RELATION TO A REQUEST BEFORE WRITING A PRESCRIPTION UNDER THE REQUEST AND PURSUANT TO THIS PART: 

 

(A) CONFIRM THE INITIAL DETERMINATION THAT THE PATIENT HAS A TERMINAL ILLNESS, IS COMPETENT, AND IS MAKING THE REQUEST VOLUNTARILY AND PURSUANT TO AN INFORMED DECISION. 

(B) INFORM THE PATIENT OF ALL OF THE FOLLOWING:(i) THAT THE ATTENDING PHYSICIAN HAS CONFIRMED THAT THE PATIENT HAS A TERMINAL ILLNESS.
(ii) THE PATIENT’S PROGNOSIS.
(iii) THE POTENTIAL RISKS ASSOCIATED WITH TAKING THE MEDICATION TO BE PRESCRIBED UNDER THE REQUEST.
(iv) THE PROBABLE RESULT OF TAKING THE MEDICATION TO BE PRESCRIBED UNDER THE REQUEST.
(v) THE ALTERNATIVES TO MAKING A REQUEST, INCLUDING, BUT NOT LIMITED TO, COMFORT CARE, HOSPICE CARE, PAIN CONTROL, SEDATION COMA, REFUSAL OF HYDRATION AND NUTRITION, AND WITHDRAWAL OF LIFE-SUSTAINING TREATMENT, AS APPROPRIATE. 

(C) REQUIRE THE PATIENT TO CONSULT WITH A PSYCHIATRIST. THE PSYCHIATRIST SHALL INTERVIEW THE PATIENT AND REVIEW THE PATIENT’S RELEVANT MEDICAL RECORDS. IF THE PSYCHIATRIST DETERMINES BOTH OF THE FOLLOWING, HE OR SHE SHALL DOCUMENT THAT DETERMINATION IN THE PATIENT’S MEDICAL RECORD AND SHALL ISSUE THE PATIENT A WRITTEN STATEMENT OF THE DETERMINATION, THAT THE PATIENT SHALL PRESENT TO HIS OR HER ATTENDING PHYSICIAN:

(i) THAT THE PATIENT HAS NO DIAGNOSABLE MENTAL DISORDER OR, IF THE PATIENT DOES HAVE A DIAGNOSABLE MENTAL DISORDER, THAT THE REQUEST FOR MEDICATION UNDER THIS PART IS NOT THE RESULT OF A DISTORTION OF THE PATIENT’S JUDGMENT DUE TO CLINICAL DEPRESSION OR ANOTHER MENTAL ILLNESS.
(ii) THAT THE REQUEST IS REASONED, IS FULLY INFORMED, AND IS VOLUNTARY, AS FAR AS CAN REASONABLY BE DETERMINED.

(D) REFER THE PATIENT TO THE PATIENT’S CONSULTING PHYSICIAN OR, IF NONE IS INVOLVED, TO ANOTHER CONSULTING PHYSICIAN WHO SPECIALIZES IN TREATING THE TERMINAL ILLNESS FROM WHICH THE PATIENT IS SUFFERING FOR MEDICAL CONFIRMATION OF THE DIAGNOSIS MADE UNDER SUBDIVISION (B)(i), AND FOR AN INDEPENDENT DETERMINATION THAT THE PATIENT IS COMPETENT AND IS MAKING THE REQUEST VOLUNTARILY AND PURSUANT TO AN INFORMED DECISION, AND IS INFORMED REGARDING SEDATION COMA, REFUSAL OF HYDRATION AND NUTRITION, AND WITHDRAWAL OF LIFE-SUSTAINING TREATMENT, AS APPROPRIATE. IF THE PATIENT’S TERMINAL ILLNESS IS CANCER, THE ATTENDING PHYSICIAN SHALL REFER THE PATIENT TO A CONSULTING PHYSICIAN WHO SPECIALIZES IN ONCOLOGY.

 

(E) INFORM THE PATIENT AT THE TIME THE REQUEST IS MADE THAT HE OR SHE HAS THE RIGHT TO RESCIND THE REQUEST AT ANY TIME AND BY ANY METHOD OF COMMUNICATION. 

(F) IMMEDIATELY BEFORE WRITING THE PRESCRIPTION FOR THE REQUESTED MEDICATION, VERIFY THAT THE PATIENT IS MAKING THE REQUEST VOLUNTARILY AND PURSUANT TO AN INFORMED DECISION. 

(G) FULFILL THE MEDICAL RECORD DOCUMENTATION REQUIREMENTS OF SECTION 5681. 

(H) ENSURE THAT ALL REQUIRED STEPS ARE CARRIED OUT IN ACCORDANCE WITH THIS PART BEFORE WRITING A PRESCRIPTION FOR MEDICATION UNDER THIS PART. 

(3) A PHYSICIAN SHALL NOT ESTABLISH A CLINIC THAT EXCLUSIVELY PROVIDES THE PROCEDURES AUTHORIZED UNDER THIS PART. 

(4) AN ATTENDING PHYSICIAN SHALL CONFORM HIS OR HER CONDUCT TO THE APPLICABLE STANDARD OF PRACTICE AT ALL TIMES WHILE PROVIDING THE SERVICES, MAKING THE DETERMINATIONS, AND FOLLOWING THE PROCEDURES AUTHORIZED UNDER THIS PART. 

(5) A LICENSED PHYSICIAN SPECIALIZING IN PSYCHIATRY WHO INTERVIEWS A PATIENT UNDER SUBSECTION (2)(C) SHALL CONFORM HIS OR HER CONDUCT TO THE APPLICABLE STANDARD OF PRACTICE IN MAKING THE DETERMINATIONS REQUIRED UNDER SUBSECTION (2)(C).SEC. 5677. (1) AFTER A PATIENT HAS BEEN REFERRED TO A CsONSULTING PHYSICIAN UNDER SECTION 5676(2)(D), THE CONSULTING PHYSICIAN SHALL EXAMINE THE PATIENT AND THE PATIENT’S RELEVANT MEDICAL RECORDS. IF THE CONSULTING PHYSICIAN CONCURS WITH THE ATTENDING PHYSICIAN, HE OR SHE SHALL CONFIRM, IN WRITING IN THE PATIENT’S MEDICAL RECORD, THE ATTENDING PHYSICIAN’S DIAGNOSIS THAT THE PATIENT IS SUFFERING FROM A TERMINAL ILLNESS, AND SHALL VERIFY THAT THE PATIENT IS COMPETENT AND IS MAKING THE REQUEST VOLUNTARILY AND PURSUANT TO AN INFORMED DECISION. THE CONSULTING PHYSICIAN SHALL CONFORM HIS OR HER CONDUCT TO THE APPLICABLE STANDARD OF PRACTICE IN MAKING THE DETERMINATIONS REQUIRED UNDER THIS SECTION. 

 

(2) IF THE CONSULTING PHYSICIAN WRITES THE PRESCRIPTION FOR THE REQUESTED MEDICATION, HE OR SHE SHALL ASSURE THAT THE REQUIREMENTS OF SECTIONS 5676, 5679, AND 5681 ARE MET.SEC. 5678. IF AN ATTENDING PHYSICIAN OR A CONSULTING PHYSICIAN IS UNWILLING TO PERFORM 1 OR MORE OF THE DUTIES PRESCRIBED UNDER THIS PART, INCLUDING, BUT NOT LIMITED TO, GIVING A PATIENT A TRUE COPY OF THIS PART OR A COPY OF THE BOOKLET PRODUCED BY THE DEPARTMENT UNDER SECTION 5682, PRESCRIBING MEDICATION PURSUANT TO A REQUEST, OR PERFORMING A REQUIRED EXAMINATION, THE ATTENDING PHYSICIAN OR CONSULTING PHYSICIAN SHALL IMMEDIATELY INFORM THE PATIENT OF THAT FACT AND SHALL TRANSMIT A COPY OF THE PATIENT’S RELEVANT MEDICAL RECORDS TO A PHYSICIAN OF THE PATIENT’S CHOICE WITHIN 72 HOURS. THE PHYSICIAN CHOSEN BY THE PATIENT BECOMES THE PATIENT’S ATTENDING PHYSICIAN OR CONSULTING PHYSICIAN, AS APPROPRIATE. 

SEC. 5679. (1) A PATIENT WHO HAS MADE A REQUEST TO AN ATTENDING PHYSICIAN SHALL REITERATE THE REQUEST AFTER ALL OF THE REQUIREMENTS OF SECTIONS 5674 TO 5677 HAVE BEEN MET. WHEN THE PATIENT MAKES THE SECOND REQUEST UNDER THIS SUBSECTION, THE ATTENDING PHYSICIAN SHALL AT THAT TIME OFFER THE PATIENT AN OPPORTUNITY TO RESCIND THE REQUEST. IF THE PATIENT DOES NOT RESCIND THE REQUEST, THE ATTENDING PHYSICIAN SHALL ENTER THE SECOND REQUEST IN THE PATIENT’S MEDICAL RECORD.

(2) IF NOT LESS THAN 7 DAYS HAVE PASSED SINCE THE PATIENT’S INITIAL REQUEST, THE ATTENDING PHYSICIAN OR THE CONSULTING PHYSICIAN SHALL PRESCRIBE IN WRITING THE MEDICATION TO THE PATIENT AND THE PATIENT MAY OBTAIN THE MEDICATION FOR SELF-ADMINISTRATION THE PRIMARY PURPOSE OF WHICH IS TO END THE PATIENT’S UNBEARABLE PAIN OR SUFFERING BY ENDING THE PATIENT’S LIFE. THE PRESCRIPTION SHALL MEET ALL OF THE FOLLOWING REQUIREMENTS:

(A) BE PROVIDED ON THE SAME OFFICIAL PRESCRIPTION FORM THAT IS REQUIRED FOR THE PRESCRIPTION OF CONTROLLED SUBSTANCES INCLUDED IN SCHEDULE 2 UNDER ARTICLE 7. THE ATTENDING PHYSICIAN SHALL GIVE THE PATIENT THE OFFICIAL PRESCRIPTION FORM AND SHALL ENTER THE NAME OF THE MEDICATION, DOSAGE, AND QUANTITY PRESCRIBED AND THE INSTRUCTIONS FOR USE IN THE PATIENT’S MEDICAL RECORD IN THE MANNER REQUIRED BY SECTION 7334. THE ATTENDING PHYSICIAN SHALL RETAIN THAT PART OF THE MEDICAL RECORD FOR NOT LESS THAT 5 YEARS.

 

(B) BE FOR ONLY A SINGLE DOSE OF THE QUANTITY OF THE MEDICATION ESTIMATED TO CAUSE DEATH. 

(C) CONTAIN DIRECTIONS THAT SPECIFY ONLY THE DOSE THAT WILL HASTEN OR CAUSE DEATH. 

(D) BE LABELED WITH A STATEMENT THAT THE PRESCRIPTION WAS ISSUED PURSUANT TO THIS PART. 

(E) BE LABELED WITH A PROMINENT CAUTIONARY STATEMENT THAT ADMINISTRATION OF THE PRESCRIBED DOSE IS LIKELY TO CAUSE DEATH. 

(F) BE DISPENSED ONLY TO THE PATIENT OR TO AN AGENT OF THE PATIENT WITH APPROPRIATE IDENTIFICATION. 

(3) A PHARMACIST WHO FILLS THE PRESCRIPTION SHALL CONFIRM THE DOSE WITH THE PRESCRIBING PHYSICIAN BEFORE DISPENSING THE MEDICATION TO THE PATIENT. THE PHARMACIST SHALL SIGN THE OFFICIAL PRESCRIPTION FORM AND FORWARD IT OR TRANSMIT THE INFORMATION ON THE OFFICIAL PRESCRIPTION FORM TO THE DEPARTMENT, AND SHALL RETAIN THE OFFICIAL PRESCRIPTION FORM OR A COPY OF THE FORM IN COMPLIANCE WITH SECTION 7334. 

(4) NOTWITHSTANDING SECTION 7334(10) AND (11), THE FORM OR THE INFORMATION TRANSMITTED TO THE DEPARTMENT UNDER SUBSECTION (3) IS NOT A PUBLIC RECORD, IS NOT AVAILABLE FOR INSPECTION BY THE PUBLIC, AND IS NOT SUBJECT TO DISCLOSURE UNDER THE FREEDOM OF INFORMATION ACT, 1976 PA 442, MCL 15.231 TO 15.246.SEC.5680. A PATIENT MAY RESCIND A REQUEST AT ANY TIME AND IN ANY MANNER BY WHICH HE OR SHE CAN COMMUNICATE AN INTENT TO RESCIND THE REQUEST, WITHOUT REGARD TO HIS OR HER MENTAL OR EMOTIONAL STATE. 

SEC. 5681. (1)THE ATTENDING PHYSICIAN SHALL DOCUMENT IN WRITING AND FILE ALL OF THE FOLLOWING IN A PATIENT’S MEDICAL RECORD:

 

(A) EACH ORAL REQUEST MADE BY THE PATIENT. 

(B) EACH WRITTEN REQUEST MADE BY THE PATIENT.(C) THE ATTENDING PHYSICIAN’S DIAGNOSIS THAT THE PATIENT HAS A TERMINAL ILLNESS, THE PROGNOSIS, AND THE DETERMINATION THAT THE PATIENT IS COMPETENT AND IS MAKING THE REQUEST VOLUNTARILY AND PURSUANT TO AN INFORMED DECISION. 

(D) THE CONSULTING PHYSICIAN’S CONFIRMATION OF THE ATTENDING PHYSICIAN’S DIAGNOSIS AND PROGNOSIS, AND THE CONSULTING PHYSICIAN’S INDEPENDENT VERIFICATION THAT THE PATIENT IS COMPETENT AND IS MAKING THE REQUEST VOLUNTARILY AND PURSUANT TO AN INFORMED DECISION AND THAT THE PATIENT IS INFORMED REGARDING SEDATION COMA, REFUSAL OF HYDRATION AND NUTRITION, AND WITHDRAWAL OF LIFE-SUSTAINING TREATMENT, AS APPROPRIATE.

 

(E) THE WRITTEN STATEMENT FROM THE PSYCHIATRIST CONSULTED BY THE PATIENT AS REQUIRED UNDER SECTION 5676(2)(C).(F) THE ATTENDING PHYSICIAN’S OFFER TO THE PATIENT OF AN OPPORTUNITY TO RESCIND THE REQUEST MADE UNDER SECTION 5679. 

 

(G) A NOTE BY THE ATTENDING PHYSICIAN INDICATING THAT ALL REQUIREMENTS OF THIS PART HAVE BEEN MET AND THE STEPS TAKEN TO CARRY OUT THE REQUEST, INCLUDING, BUT NOT LIMITED, TO A NOTATION OF THE MEDICATION PRESCRIBED.(2) THE ATTENDING PHYSICIAN SHALL RETAIN THAT PART OF A PATIENT’S MEDICAL RECORD REQUIRED TO BE KEPT UNDER SUBSECTION (1) FOR NOT LESS THAN 3 YEARS. 

SEC. 5682. (1) WITHIN 60 DAYS AFTER THE EFFECTIVE DATE OF THIS PART, THE DEPARTMENT, IN CONSULTATION WITH THE OVERSIGHT COMMITTEE APPOINTED IN SECTION 5685, SHALL DEVELOP AND PUBLISH A BOOKLET THAT CONTAINS ALL OF THE FOLLOWING INFORMATION:

 

(A) THE PROCEDURE FOR MAKING A REQUEST AND OBTAINING MEDICATION UNDER THIS PART. 

(B) THE AVAILABILITY OF MEDICATION UNDER THIS PART. 

(C) ALTERNATIVES TO MAKING A REQUEST UNDER THIS PART, INCLUDING, BUT NOT LIMITED TO, COMFORT CARE, HOSPICE CARE, AND PAIN CONTROL. 

(2) THE DEPARTMENT SHALL MAKE COPIES OF THE BOOKLET PUBLISHED UNDER SUBSECTION (1) AVAILABLE UPON REQUEST AND WITHOUT CHARGE TO PHYSICIANS WHO ARE SUBJECT TO THIS PART.SEC. 5683. (1) A DETERMINATION MADE BY AN ATTENDING PHYSICIAN AND VERIFIED BY A CONSULTING PHYSICIAN UNDER THIS PART IN COMBINATION WITH A WRITTEN STATEMENT FROM A PSYCHIATRIST UNDER SECTION 5676(2)(C) CREATES A REBUTTABLE PRESUMPTION THAT THE DETERMINATION IS CORRECT FOR PURPOSES OF A LEGAL PROCEEDING INVOLVING THE PROCEDURES SET FORTH IN THIS PART. 

 

(2) ONLY A SPOUSE OF A PATIENT, A PARENT OF A PATIENT, AN ADULT SIBLING OF A PATIENT, AN ADULT CHILD OF A PATIENT, OR SIGNIFICANT OTHER OF A PATIENT MAY BRING AN ACTION TO CHALLENGE A DETERMINATION MADE IN ACCORDANCE WITH SECTION 5676 OR 5677. IF THE PATIENT IS STILL ALIVE, THE ACTION SHALL BE BROUGHT IN THE CIRCUIT COURT FOR THE COUNTY IN WHICH THE PATIENT RESIDES OR IS FOUND AND ASSIGNED TO THE CHIEF JUDGE OF THAT CIRCUIT. 

(3) AS SOON AS PRACTICABLE AFTER AN ACTION DESCRIBED IN SUBSECTION (2) IS FILED, THE CIRCUIT COURT IN WHICH THE ACTION IS FILED SHALL ISSUE A TEMPORARY RESTRAINING ORDER PROHIBITING THE PRESCRIPTION OR DISPENSING, OR BOTH, OF THE REQUESTED MEDICATION OR REQUIRING THE CONFISCATION OF THE REQUESTED MEDICINE. THE ORDER ISSUED UNDER THIS SUBSECTION DOES NOT AFFECT OBTAINING THE DETERMINATIONS MADE BY AN ATTENDING PHYSICIAN, A CONSULTING PHYSICIAN, OR A PSYCHIATRIST UNDER THIS PART. 

(4) THE COURT IN WHICH AN ACTION DESCRIBED IN SUBSECTION (2) IS FILED SHALL HOLD AN EXPEDITED HEARING WITHIN 5 DAYS AFTER THE ACTION IS FILED. THE COURT SHALL CONCLUDE THE HEARING WITHIN 2 DAYS AFTER THE HEARING IS COMMENCED AND SHALL RENDER A DECISION IN THE ACTION WITHIN 5 DAYS AFTER THE HEARING IS CONCLUDED. 

(5) IF THE CIRCUIT COURT DOES NOT COMPLY WITH THE TIME SCHEDULE PRESCRIBED IN SUBSECTION (4), EITHER PARTY TO THE ACTION MAY SEEK AN EMERGENCY HEARING FOR A SUPERINTENDING CONTROL ORDER FROM THE COURT OF APPEALS TO COMPEL COMPLIANCE BY THE CIRCUIT COURT.SEC. 5685. (1)THE GOVERNOR SHALL APPOINT AN OVERSIGHT COMMITTEE OF 14 PHYSICIANS AND 3 MEMBERS OF THE GENERAL PUBLIC TO REVIEW THE OPERATION OF THIS PART NOT LATER THAN 90 DAYS AFTER THE EFFECTIVE DATE OF THIS PART AS FOLLOWS: 

 

(A) EIGHT MEMBERS, 2 FROM EACH STATE MEDICAL AND OSTEOPATHIC SCHOOL, SHALL BE APPOINTED FROM NOMINEES SUBMITTED BY THE HIGHEST EXECUTIVE OFFICER OF EACH SCHOOL WHO IS NOT OPPOSED TO COMPLYING WITH THIS PART. 

(B) SIX MEMBERS, 3 FROM THE MICHIGAN STATE MEDICAL SOCIETY AND 3 FROM THE MICHIGAN OSTEOPATHIC ASSOCIATION SOCIETY, SHALL BE APPOINTED FROM NOMINEES SUBMITTED BY THE HIGHEST EXECUTIVE OFFICER OF EACH ORGANIZATION WHO IS NOT OPPOSED TO COMPLYING WITH THIS PART. 

(C) THREE MEMBERS SHALL BE APPOINTED FROM THE GENERAL PUBLIC. THE MEMBERS APPOINTED UNDER THIS SUBDIVISION SHALL NOT BE OPPOSED TO COMPLYING WITH THIS PART. 

(2) EACH NOMINEE UNDER SUBSECTION (1)(A) AND (B) SHALL HAVE PRACTICED HIS OR HER SPECIALTY FOR NOT LESS THAN 10 YEARS. AT LEAST 1 NOMINEE FROM EACH MEDICAL SCHOOL AND PROFESSIONAL ORGANIZATION SHALL BE A SPECIALIST IN ONCOLOGY. A NOMINEE SHALL NOT BE OPPOSED TO COMPLYING WITH THIS PART. 

(3) THE GOVERNOR SHALL STAGGER INITIAL APPOINTMENTS FOR TERMS OF UP TO 4 YEARS SO THAT SUBSEQUENT APPOINTMENTS OF 4 YEARS ASSURE CONTINUITY OF EXPERIENCE ON THE OVERSIGHT COMMITTEE. 

(4) THE DIRECTOR OF THE DEPARTMENT SHALL SERVE AS EXECUTIVE SECRETARY TO THE OVERSIGHT COMMITTEE, SHALL PROVIDE ALL NECESSARY ADMINISTRATIVE SUPPORT TO MEMBERS OF THE OVERSIGHT COMMITTEE, AND SHALL OBTAIN PATIENT MEDICAL RECORDS AS DESCRIBED IN THIS SECTION. 

(5) NINE MEMBERS CONSTITUTE A QUORUM FOR THE PURPOSE OF CONDUCTING BUSINESS. AS SOON AS 9 MEMBERS ARE APPOINTED, THE OVERSIGHT COMMITTEE IS OPERATIVE. 

(6) MEMBERS OF THE OVERSIGHT COMMITTEE SHALL BE COMPENSATED FOR EXPENSES INCURRED IN THE PERFORMANCE OF OFFICIAL DUTIES.(7) THE OVERSIGHT COMMITTEE SHALL MEET AT LEAST TWICE YEARLY AND, DURING THE COURSE OF THE YEAR, SHALL REVIEW THE PATIENTS’ MEDICAL RECORDS OF A RANDOM SAMPLE OF NOT LESS THAN 25% OF ALL DEATHS OCCURRING AS A RESULT OF THE OPERATION OF THIS PART DURING THE PRECEDING YEAR AND SHALL DETERMINE COMPLIANCE BY THE ATTENDING PHYSICIAN, CONSULTING PHYSICIAN, AND PSYCHIATRIST WITH THE REQUIREMENTS OF THIS PART AND WITH THE APPLICABLE STANDARDS OF PRACTICE. THE RANDOM SAMPLE SHALL BE BASED UPON THE PRESCRIPTION COPIES OR INFORMATION SENT TO THE DEPARTMENT UNDER SECTION 5679. AT LEAST 2 MEMBERS OF THE OVERSIGHT COMMITTEE SHALL REVIEW EACH CASE AND PRESENT THEIR FINDINGS TO THE ENTIRE OVERSIGHT COMMITTEE FOR THE OVERSIGHT COMMITTEE’S CONSIDERATION AND DECISION. 

 

(8) IF 25% OF OVERSIGHT COMMITTEE MEMBERS VOTING ON A PARTICULAR CASE DETERMINE THAT A PHYSICIAN HAS NOT COMPLIED WITH THE REQUIREMENTS OF THIS PART OR HAS NEGLIGENTLY FAILED TO COMPLY WITH THE APPLICABLE STANDARDS OF PRACTICE IN PROVIDING THE PROCEDURES AUTHORIZED BY THIS PART, OR BOTH, THE OVERSIGHT COMMITTEE SHALL REVIEW ADDITIONAL MEDICAL RECORDS FROM THE PHYSICIAN OF OTHER PATIENTS, IF ANY, WHOSE DEATHS WERE A RESULT OF THE OPERATION OF THIS PART. 

(9) ALL PROCEEDINGS, MINUTES, CONCLUSIONS, AND ACTIONS OF THE OVERSIGHT COMMITTEE AND PATIENT MEDICAL RECORDS AND OTHER MATERIALS REVIEWED BY THE OVERSIGHT COMMITTEE ARE CONFIDENTIAL, ARE NOT PUBLIC RECORDS, ARE NOT OPEN TO INSPECTION, AND ARE NOT SUBJECT TO THE OPEN MEETINGS ACT, 1976 PA 267, MCL 15.261 TO 15.275, OR THE FREEDOM OF INFORMATION ACT, 1976 PA 442, MCL 15.231 TO 15.246. THE OVERSIGHT COMMITTEE SHALL ISSUE AND MAKE AVAILABLE TO THE PUBLIC AN ANNUAL REPORT OF THE EFFECT AND OPERATION OF THIS PART CONTAINING A STATISTICAL SUMMARY, WITHOUT INDIVIDUAL IDENTIFIERS OF PATIENTS OR PHYSICIANS, AND SHALL MAKE AVAILABLE ANY SPECIAL STATISTICAL REPORTS SUBMITTED TO THE GOVERNOR OR LEGISLATURE ON THE OPERATION OF THIS PART, WITHOUT INDIVIDUAL IDENTIFIERS OF PATIENTS OR PHYSICIANS, THAT THE OVERSIGHT COMMITTEE MAY BE REQUIRED TO PREPARE BY THE GOVERNOR OR LEGISLATURE OR THAT ARE CONSIDERED NECESSARY BY THE OVERSIGHT COMMITTEE. 

(10) AN ATTENDING PHYSICIAN, CONSULTING PHYSICIAN, PSYCHIATRIST, PHARMACIST, OR HEALTH FACILITY THAT PARTICIPATES IN THE PROCEDURES AUTHORIZED UNDER THIS PART SHALL MAKE AVAILABLE UPON THE REQUEST OF THE DEPARTMENT PATIENT MEDICAL RECORDS AND ANY OTHER CLINICAL MATERIAL REQUIRED BY THE OVERSIGHT COMMITTEE UNDER THIS SECTION IN A TIMELY FASHION, NOT TO EXCEED 30 DAYS. THE FOLLOWING DO NOT APPLY TO A REQUEST FOR MEDICAL RECORDS, MENTAL HEALTH RECORDS, OR OTHER CLINICAL MATERIAL REQUESTED UNDER THIS SECTION OR TO THE DEPARTMENT ACTING WITHIN THE SCOPE OF ITS AUTHORIZATION: 

(A) THE PHYSICIAN-PATIENT PRIVILEGE CREATED IN SECTION 2157 OF THE REVISED JUDICATURE ACT OF 1961, 1961 PA 236, MCL 600.2157. 

(B) ANY OTHER HEALTH PROFESSIONAL-PATIENT PRIVILEGE CREATED OR RECOGNIZED BY LAW. 

(11) THE DEPARTMENT MAY COMPEL DELIVERY OF THE DOCUMENTS REQUESTED UNDER SUBSECTION (10) BY SUBPOENA, IF THE DOCUMENTS ARE NOT PROVIDED IN A TIMELY FASHION. 

(12) ALL PATIENT MEDICAL RECORDS AND OTHER CLINICAL MATERIAL SHALL BE TREATED AS CONFIDENTIAL BY THE OVERSIGHT COMMITTEE, SHALL BE KEPT BY THE DEPARTMENT IN A SECURE AREA, SHALL BE TRANSMITTED TO OVERSIGHT COMMITTEE MEMBERS FOR REVIEW IN A SECURE MANNER, AND SHALL BE RETURNED TO THE HEALTH PROFESSIONAL OR HEALTH FACILITY PROVIDING THE MEDICAL RECORDS AND OTHER CLINICAL MATERIAL AS SOON AS THE OVERSIGHT COMMITTEE HAS NO FURTHER NEED FOR IT. 

(13) IF, AS A RESULT OF REVIEWING THE PATIENT MEDICAL RECORDS AND OTHER CLINICAL MATERIAL OF A HEALTH PROFESSIONAL OR HEALTH FACILITY, THE OVERSIGHT COMMITTEE DETERMINES, BY PROCEDURES INCORPORATING APPROPRIATE PROTECTIONS TO BE AGREED UPON BY THE OVERSIGHT COMMITTEE, THAT A HEALTH PROFESSIONAL OR HEALTH FACILITY HAS WILLFULLY FAILED TO COMPLY WITH, OR RECKLESSLY DISREGARDED, THE REQUIREMENTS OF THIS PART, THEN THE OVERSIGHT COMMITTEE SHALL PREPARE A REPORT TO THAT EFFECT AND SUBMIT IT TO THE PROSECUTING ATTORNEY FOR THE COUNTY IN WHICH THE HEALTH PROFESSIONAL PRACTICES OR IN WHICH THE HEALTH FACILITY IS LOCATED.(14) IF, AFTER REVIEWING PATIENT MEDICAL RECORDS AND OTHER CLINICAL MATERIAL UNDER THIS SECTION, THE OVERSIGHT COMMITTEE DETERMINES BY PROCEDURES INCORPORATING APPROPRIATE PROTECTIONS TO BE AGREED UPON BY THE OVERSIGHT COMMITTEE THAT A PHYSICIAN MAY HAVE NEGLIGENTLY FAILED TO COMPLY WITH THE APPLICABLE STANDARDS OF PRACTICE IN PROVIDING THE PROCEDURES AUTHORIZED BY THIS PART, THE OVERSIGHT COMMITTEE SHALL NOTIFY THE PHYSICIAN IN WRITING OF THAT DETERMINATION AND SHALL PROVIDE THE PHYSICIAN WITH AN OPPORTUNITY FOR A HEARING. THE HEARING SHALL BE CONDUCTED AS A CONTESTED CASE HEARING UNDER THE ADMINISTRATIVE PROCEDURES ACT OF 1969. IF, AFTER NOTICE AND AN OPPORTUNITY FOR A HEARING UNDER THIS SUBSECTION, THE OVERSIGHT COMMITTEE FINDS BY A MAJORITY VOTE THAT THE PHYSICIAN NEGLIGENTLY FAILED TO COMPLY WITH 1 OR MORE APPLICABLE STANDARDS OF PRACTICE IN PROVIDING THE PROCEDURES AUTHORIZED UNDER THIS PART, THE OVERSIGHT COMMITTEE MAY ISSUE AN ORDER LIMITING OR TERMINATING THE PHYSICIAN’S ABILITY TO PRESCRIBE MEDICATION AS AUTHORIZED UNDER THIS PART. AN APPEAL FROM A FINAL ACTION OF THE OVERSIGHT COMMITTEE UNDER THIS SUBSECTION SHALL BE FILED WITH THE CIRCUIT COURT FOR THE COUNTY IN WHICH THE PHYSICIAN HAS HIS OR HER PRIMARY PLACE OF PRACTICE. 

 

(15) IN THE THIRD YEAR AFTER THE EFFECTIVE DATE OF THIS PART AND EVERY 5 YEARS AFTER THAT THIRD YEAR, THE OVERSIGHT COMMITTEE SHALL UNDERTAKE A SURVEY, IN COLLABORATION WITH QUALIFIED EPIDEMIOLOGISTS AT A STATE UNIVERSITY, OF THE EXTENT OF COMPLIANCE WITH THE REPORTING REQUIREMENTS UNDER THIS PART. THE DELIBERATIONS AND PROCEEDINGS OF THE OVERSIGHT COMMITTEE AND THE EPIDEMIOLOGISTS UNDER THIS SUBSECTION ARE NOT SUBJECT TO THE OPEN MEETINGS ACT, 1976 PA 267, MCL 15.261 TO 15.275. INFORMATION COLLECTED IN THE COURSE OF THE INVESTIGATION IS NOT A PUBLIC RECORD, SHALL NOT BE MADE AVAILABLE FOR INSPECTION BY THE PUBLIC, AND IS EXEMPT FROM DISCLOSURE UNDER THE FREEDOM OF INFORMATION ACT, 1976 PA 442, MCL 15.231 TO 15.246. THE OVERSIGHT COMMITTEE SHALL MAKE AVAILABLE TO THE PUBLIC A REPORT OF THIS INVESTIGATION CONTAINING A STATISTICAL SUMMARY, WITHOUT INDIVIDUAL IDENTIFIERS OF PATIENTS OR PHYSICIANS. 

(16) ALL INFORMATION ACQUIRED UNDER SUBSECTION (15) SHALL BE TREATED AS CONFIDENTIAL BY SURVEY PERSONNEL, SHALL BE KEPT BY THE DIRECTOR OF THE SURVEY IN A SECURE AREA, AND SHALL BE DESTROYED ONCE THE REPORT IS COMPLETE.(17) THE GOVERNOR’S FAILURE TO APPOINT OVERSIGHT COMMITTEE MEMBERS DOES NOT ALTER THE EFFECTIVE DATE OF THIS PART. 

SEC. 5686. (1) PURSUANT TO SECTION 2844, THE DEATH OF A PATIENT WHO ENDS HIS OR HER LIFE AFTER COMPLYING WITH THIS PART SHALL BE CLASSIFIED FOR LEGAL PURPOSES AS HAVING BEEN CAUSED BY THE PATIENT’S TERMINAL ILLNESS.

 

(2) A PATIENT WHO ENDS HIS OR HER LIFE IN COMPLIANCE WITH THIS PART SHALL NOT BE CONSIDERED A SUICIDE OR AN INTENTIONAL DEATH FOR THE PURPOSE OF VOIDING A POLICY OF INSURANCE ON THE LIFE OF THE PATIENT. 

(3) A PROVISION IN A CONTRACT, WILL, OR OTHER AGREEMENT, WHETHER WRITTEN OR ORAL, IS INVALID TO THE EXTENT THE PROVISION WOULD AFFECT WHETHER AN INDIVIDUAL MAY MAKE OR RESCIND A REQUEST UNDER THIS PART, OR USE MEDICATION PRESCRIBED UNDER THIS PART, TO END HIS OR HER LIFE. 

(4) THE MAKING OR RESCINDING OF A REQUEST UNDER THIS PART OR THE USE OF MEDICATION PRESCRIBED UNDER THIS PART SHALL NEITHER AFFECT NOR BE A CONDITION UPON AN OBLIGATION OWING UNDER A PRESENTLY EXISTING CONTRACT, OR THE SALE, PROCUREMENT, COVERAGE, BENEFITS, OR ISSUANCE OF A LIFE, HEALTH, ACCIDENT, OR ANNUITY POLICY, OR THE RATE CHARGED FOR SUCH A POLICY.SEC. 5687. (1) BEGINNING 2 YEARS AFTER THE EFFECTIVE DATE OF THIS PART, A PHYSICIAN WHO PROVIDES PATIENTS WITH THE PROCEDURES AUTHORIZED BY THIS PART WHO APPLIES FOR RENEWAL OF HIS OR HER LICENSE SHALL PRESENT SATISFACTORY EVIDENCE, AS PART OF THE 150 HOURS OF CONTINUING MEDICAL EDUCATION REQUIRED UNDER SECTIONS 17033 AND 17533, REGARDLESS OF ANY PREVIOUS TRAINING, THAT HE OR SHE HAS HAD NOT LESS THAN 20 HOURS OF CONTINUING MEDICAL EDUCATION IN THE THEORY AND PRACTICE OF COMFORT CARE, HOSPICE CARE, PAIN CONTROL, SEDATION COMA, REMOVAL OF NUTRITION AND HYDRATION, PSYCHIATRIC COUNSELING, AND THE PRESCRIPTION OF MEDICATIONS AUTHORIZED BY THIS PART. 

 

(2) AT A LICENSE RENEWAL SUBSEQUENT TO THE LICENSE RENEWAL DESCRIBED IN SUBSECTION (1), A PHYSICIAN SHALL PRESENT TO THE BOARD SATISFACTORY EVIDENCE, AS PART OF THE 150 HOURS OF CONTINUING MEDICAL EDUCATION REQUIRED UNDER SECTIONS 17033 AND 17533, OF 4 HOURS OF THE CONTINUING MEDICAL EDUCATION DESCRIBED IN SUBSECTION (1).SEC. 5688. (1) EXCEPT AS OTHERWISE PROVIDED IN THIS PART, A HEALTH CARE PROVIDER OR OTHER PERSON IS NOT SUBJECT TO CIVIL OR CRIMINAL LIABILITY OR ADMINISTRATIVE DISCIPLINARY ACTION FOR PARTICIPATING IN THE PROCEDURES AUTHORIZED BY THIS PART IN GOOD FAITH AND IN COMPLIANCE WITH THIS PART OR FOR NOT PARTICIPATING IN THOSE PROCEDURES. IN ADDITION, A HEALTH CARE PROVIDER WHO CLAIMS THE IMMUNITY PROVIDED BY THIS SUBSECTION MUST HAVE CONFORMED HIS OR HER OR THE HEALTH FACILITY’S CONDUCT UNDER THIS PART TO THE APPLICABLE STANDARD OF PRACTICE FOR THE CONDUCT, PROCEDURES, OR DETERMINATIONS UNDERTAKEN UNDER THIS PART. 

 

(2) THIS PART DOES NOT PROVIDE FOR OR OTHERWISE ALLOW A LOWER STANDARD OF PRACTICE OR CARE FOR PATIENTS WITH TERMINAL ILLNESS. 

(3) A PROFESSIONAL ORGANIZATION OR ASSOCIATION OR A HEALTH FACILITY OR OTHER HEALTH CARE PROVIDER SHALL NOT SUBJECT A PERSON TO CENSURE, DISCIPLINE, SUSPENSION, LOSS OF LICENSE, LOSS OF PRIVILEGES, LOSS OF MEMBERSHIP, OR OTHER PENALTY FOR PARTICIPATING OR REFUSING TO PARTICIPATE IN THE PROCEDURES AUTHORIZED BY THIS PART. 

(4) PROVISION BY AN ATTENDING PHYSICIAN OF MEDICATION IN COMPLIANCE WITH THIS PART DOES NOT CONSTITUTE NEGLIGENCE OR MALPRACTICE FOR ANY PURPOSE OF LAW. 

(5) A REQUEST BY A PATIENT IN COMPLIANCE WITH THIS PART DOES NOT PROVIDE THE SOLE BASIS FOR THE APPOINTMENT OF A GUARDIAN OR CONSERVATOR. 

(6) A HEALTH FACILITY MAY PROHIBIT THE PROCEDURES AUTHORIZED BY THIS PART AND IMPOSE 1 OR MORE OF THE SANCTIONS DESCRIBED IN SUBSECTION (3), IF ALL OF THE FOLLOWING REQUIREMENTS ARE MET: 

(A) THE HEALTH FACILITY HAS GIVEN REASONABLE NOTICE OF THE PROHIBITION TO ITS STAFF AND TO THE PUBLIC.(B) IF REQUESTED BY A PATIENT, THE HEALTH FACILITY PROVIDES A TRANSFER OF THE PATIENT WITHIN 48 HOURS TO ANOTHER HEALTH FACILITY OF THE PATIENT’S CHOICE THAT WILL ALLOW THE PROCEDURES AUTHORIZED BY THIS PART, ALONG WITH A COPY OF THE PATIENT’S RELEVANT MEDICAL RECORDS AT THE TIME OF TRANSFER. 

 

(C) THE PARTICIPATION OF HEALTH FACILITY STAFF IN THE PROCEDURES AUTHORIZED BY THIS PART OUTSIDE THE HEALTH FACILITY IS NOT CONSIDERED A VIOLATION OF THE PROHIBITION.SEC. 5689. (1) A NON-PHYSICIAN OR UNLICENSED PHYSICIAN WHO ADMINISTERS, CAUSES TO BE ADMINISTERED, DELIVERS, OR CAUSES TO BE DELIVERED MEDICATIONS, CHEMICALS, OR ANY OTHER INSTRUMENTALITY, OR THE APPARATUS FOR THEIR DELIVERY OR USE, TO AN INDIVIDUAL FOR USE IN A MANNER SUBSTANTIALLY LIKELY TO CAUSE OR HASTEN THAT INDIVIDUAL’S DEATH, IS GUILTY OF A FELONY PUNISHABLE BY IMPRISONMENT FOR A TERM OF YEARS UP TO LIFE, REGARDLESS OF WHETHER OR NOT THE PURPOSE IS TO RELIEVE PAIN OR SUFFERING. 

(2) ONCE MEDICATION HAS BEEN PRESCRIBED UNDER SECTION 5679, SUBSECTION (1) DOES NOT APPLY TO A NON-PHYSICIAN HEALTH CARE PROVIDER, TO AN EMPLOYEE OF A HEALTH FACILITY, OR TO A PATIENT’S FAMILY MEMBER OR FRIEND WHO, AT THE PATIENT’S REQUEST, FILLS OR DELIVERS TO THE PATIENT THE PRESCRIPTION OR WHO, AT THE PATIENT’S REQUEST, SUPPORTS, CRADLES, OR MAKES THE PATIENT COMFORTABLE WHILE THE PATIENT SELF-ADMINISTERS THE PRESCRIBED MEDICATION.

(3) A PERSON WHO, WITHOUT AUTHORIZATION OF THE PATIENT, WILLFULLY ALTERS OR FORGES A REQUEST FOR MEDICATION UNDER THIS PART OR CONCEALS OR DESTROYS A RESCISSION OF THAT REQUEST WITH THE INTENT OR EFFECT OF CAUSING THE PATIENT’S DEATH IS GUILTY OF A FELONY PUNISHABLE BY IMPRISONMENT FOR A TERM OF YEARS UP TO LIFE.

 

(4) A PERSON WHO COERCES OR EXERTS UNDUE INFLUENCE ON A PATIENT TO MAKE A REQUEST UNDER THIS PART, OR TO DESTROY A RESCISSION OF A REQUEST, IS GUILTY OF A FELONY PUNISHABLE FOR A TERM OF YEARS UP TO LIFE.(5) A PHYSICIAN WHO WILLFULLY, OR WITH RECKLESS DISREGARD, FAILS TO COMPLY WITH THE REQUIREMENTS OF THIS PART AND WHO, AT THE REQUEST OF A PERSON UNDER THE PHYSICIAN’S CARE, PROVIDES TO THAT PERSON MEDICATION OR OTHER INSTRUMENTALITY FOR SELF-ADMINISTRATION THAT IS INTENDED TO CAUSE OR HASTEN DEATH IS GUILTY OF A FELONY PUNISHABLE BY A FINE OF NOT MORE THAN $50,000.00 OR IMPRISONMENT FOR UP TO 5 YEARS, OR BOTH. 

 

(6) A PHYSICIAN WHO WILLFULLY FAILS TO COMPLY WITH SECTION 5678 OR 5681(2) IS GUILTY OF A MISDEMEANOR PUNISHABLE BY A FINE OF NOT MORE THAN $10,000.00 OR IMPRISONMENT FOR UP TO 90 DAYS, OR BOTH. 

(7) A PERSON WHO FILES A FALSE AFFIDAVIT OF RELATION TO A RESIDENT, AS DESCRIBED IN SECTION 5673(Q), IS GUILTY OF A MISDEMEANOR PUNISHABLE BY A FINE OF NOT MORE THAN $10,000.00 OR IMPRISONMENT FOR NOT MORE THAN 90 DAYS, OR BOTH. 

(8) A PHARMACIST WHO FAILS TO FORWARD PRESCRIPTION INFORMATION OR A COPY OF THE PRESCRIPTION PROVIDED TO A PATIENT AS REQUIRED BY SECTION 5679(3) IS GUILTY OF A MISDEMEANOR PUNISHABLE BY A FINE OF NOT MORE THAN $1,000.00. 

(9) THE PENALTIES IMPOSED BY THIS SECTION DO NOT PRECLUDE CRIMINAL PENALTIES APPLICABLE UNDER OTHER STATUTES, INCLUDING CRIMINAL ATTEMPTS PURSUANT TO SECTION 29 OF THE MICHIGAN PENAL CODE, 1931 PA 328, MCL 750.29. 

(10) THIS SECTION DOES NOT LIMIT LIABILITY FOR CIVIL DAMAGES RESULTING FROM OTHER NEGLIGENT OR WILLFUL CONDUCT.SEC. 5690. (1) THE DEPARTMENT MAY PROMULGATE RULES TO IMPLEMENT THIS PART. 

 

(2) IN THE CONDUCT OF THE REVIEW AND INVESTIGATIVE FUNCTIONS OF THE OVERSIGHT COMMITTEE ESTABLISHED UNDER SECTION 5685, THE DEPARTMENT MAY REQUIRE BY SUBPOENA THE ATTENDANCE AND TESTIMONY UNDER OATH OF WITNESSES AND THE PRODUCTION OF EVIDENCE, INCLUDING MEDICAL RECORDS AND OTHER CLINICAL MATERIAL. WITNESSES SHALL BE PAID THE SAME FEES AND MILEAGE THAT ARE PAID WITNESSES IN THE CIRCUIT COURTS. IN CASE OF A FAILURE OR A REFUSAL OF A PERSON TO OBEY A SUBPOENA ISSUED BY THE DEPARTMENT, THE CIRCUIT COURT FOR THE COUNTY OF INGHAM, UPON APPLICATION BY THE DIRECTOR OF THE DEPARTMENT, MAY ISSUE AN ORDER REQUIRING THE PERSON TO APPEAR AND PRODUCE EVIDENCE OR GIVE TESTIMONY AS MAY BE REQUIRED FOR THE OVERSIGHT COMMITTEE FUNCTION. FAILURE TO OBEY THE ORDER OF THE CIRCUIT COURT MAY BE PUNISHED AS CONTEMPT. 

(3) A PERSON WHO WILLFULLY FAILS TO COMPLY WITH A SUBPOENA ISSUED UNDER THIS SECTION IS SUBJECT TO A FINE OF NOT MORE THAN $2,000.00 FOR EACH VIOLATION OR DAY THAT A VIOLATION CONTINUES.SEC.5691. IF ANY PORTION OF THE AMENDATORY ACT THAT ADDED THIS PART OR THE APPLICATION OF THIS PART TO ANY PERSON OR CIRCUMSTANCE IS FOUND TO BE INVALID BY A COURT, THE INVALIDITY DOES NOT AFFECT THE REMAINING PORTIONS OR APPLICATIONS OF THIS PART THAT CAN BE GIVEN EFFECT WITHOUT THE INVALID PORTION OR APPLICATION, IF REMAINING PORTIONS OF THE AMENDATORY ACT THAT ADDED THIS PART ARE NOT DETERMINED BY THE COURT TO BE INOPERABLE, AND TO THIS END THE AMENDATORY ACT THAT ADDED THIS PART IS DECLARED TO BE SEVERABLE. 

Sec. 7401. (1) Except as authorized by this article, a person shall not manufacture, create, deliver, or possess with intent to manufacture, create, or deliver a controlled substance, a prescription form, an official prescription form, or a counterfeit prescription form. A practitioner licensed by the administrator under this article shall not dispense, prescribe, or administer a controlled substance for other than legitimate and professionally recognized therapeutic or scientific purposes or outside the scope of practice of the practitioner, licensee, or applicant. THE DISPENSING, PRESCRIPTION, OR ADMINISTRATION OF A CONTROLLED SUBSTANCE FOR USE IN THE PROCEDURES AUTHORIZED UNDER PART 56B IS NOT A VIOLATION OF THIS SUBSECTION.

 

(2) A person who violates this section as to: 

(a) A controlled substance classified in schedule 1 or 2 that is a narcotic drug or a drug described in section 7214(a)(iv) and:(i) Which is in an amount of 650 grams or more of any mixture containing that substance is guilty of a felony and shall be imprisoned for life except as otherwise provided in this subparagraph. A person convicted of violating this subparagraph may be punished as provided by law by imposing a sentence of imprisonment for any term of years but not less than 25 years if any of the following apply:
(A) The person is within the jurisdiction of the circuit court [or recorder’s court of the City of Detroit] under section 606 of the revised judicature act of 1961, [Act No. 236 of the Public Acts of 1961, being section 600.606 of the Michigan compiled laws]1961 PA 236, MCL 600.606, OR section 4 of chapter XIIA of [Act No. 288 of the Public Acts of 1939, being section 712A.4 of the Michigan Compiled Laws, or section 10A(1)(c) of Act No. 369 of the Public Acts of 1919, being section 725.10A of the Michigan Compiled Laws ]1939 PA 288, MCL 712A.4.
(B) The person is being sentenced under section 18(1)(n) of chapter XIIA of [Act No. 288 of the Public Acts of 1939, being section 712A.18 of the Michigan Compiled Laws ]1939 PA 288, MCL 712A.18.
(ii) Which is an amount of 225 grams or more, but less than 650 grams, of any mixture containing that substance is guilty of a felony and shall be imprisoned for not less than 20 years nor more than 30 years.
(iii) Which is in an amount of 50 grams or more, but less than 225 grams, of any mixture containing that substance is guilty of a felony and shall be imprisoned for not less than 10 years nor more than 20 years.
(iv) Which is in an amount less than 50 grams, of any mixture containing that substance is guilty of a felony and shall be imprisoned for not less than 1 year nor more than 20 years, and may be fined not more than $25,000.00, or placed on probation for life. 

 

(b) Any other controlled substance classified in schedule 1, 2, or 3, except marihuana, is guilty of a felony punishable by imprisonment for not more than 7 years or a fine of not more than $10,000.00, or both. 

(c) A substance classified in schedule 4, is guilty of a felony punishable by imprisonment for not more than 4 years or a fine of not more than $2,000.00, or both. 

(d) Marihuana or a mixture containing marihuana, is guilty of a felony punishable as follows: 

(i) If the amount is 45 kilograms or more, or 200 plants or more by imprisonment for not more than 15 years or a fine of not more than $10,000,000.00, or both.
(ii) If the amount is 5 kilograms or more but less than 45 kilograms, or 20 plants or more but fewer than 200 plants, by imprisonment for not more than 7 years or a fine of not more than $500,000.00, or both.
(iii) If the amount is less than 5 kilograms or fewer than 20 plants, by imprisonment for not more than 4 years or a fine of not more than $20,000.00, or both. 

(e) A substance classified in schedule 5, is guilty of a felony punishable by imprisonment for not more than 2 years or a fine of not more than $2,000.00, or both. 

(f) An official prescription form or a counterfeit official prescription form, is guilty of a felony punishable by imprisonment for not more than 20 years or a fine of not more than $25,000.00, or both. 

(g) A prescription form or a counterfeit prescription form other than an official prescription form or a counterfeit official prescription form, is guilty of a felony punishable by imprisonment for not more than 7 years or a fine of not more than $5,000.00, or both. 

(3) A term of imprisonment imposed pursuant to subsection (2)(a) or section 7403(2)(a)(i), (ii), (iii), or (iv) shall be imposed to run consecutively with any term of imprisonment imposed for the commission of another felony. An individual subject to a mandatory term of imprisonment under subsection (2)(a) or section 7403(2)(a)(i), (ii), (iii), or (iv) shall not be eligible for probation, suspension of that sentence, or parole during that mandatory term, except and only to the extent that those provisions permit probation for life, and shall not receive a reduction in that mandatory term of imprisonment by disciplinary credits or any other type of sentence credit reduction. 

(4) The court may depart from the minimum term of imprisonment authorized under subsection (2)(a)(ii), (iii), or (iv) if the court finds on the record that there are substantial and compelling reasons to do so. In addition, if any of the following apply, the court may depart from the minimum term of imprisonment authorized under subsection (2)(a)(ii), (iii), or (iv) if the individual has not previously been convicted of a felony or an assaultive crime and has not been convicted of another felony or assaultive crime arising from the same transaction as the violation of this section:(a) The person is within the jurisdiction of the circuit court [or recorder’s court of the city of Detroit ]under section 606 of the revised judicature act of 1961, [Act No. 236 of the Public Acts of 1961, being section 600.606 of the Michigan Compiled Laws] 1961 PA 236, MCL 600.606, OR section 4 of chapter XIIA of [Act No 288 of the Public Acts of 1939, being section 712A.4 of the Michigan Compiled Laws, or section 10a(1)(c) of Act No 369 of the Public Acts of 1919, being section 725.10a of the Michigan Compiled Laws] 1939 PA 288, MCL 712A.4. 

 

(b) The person is being sentenced under section 18(1)(n) of chapter XIIA of [Act No. 288 of the Public Acts of 1939, being section 712A.18 of the Michigan Compiled Laws] 1939 PA 288 MCL 712A.18. 

(5) As used in this section: 

(a) “Assaultive crime” means a violation of chapter XI of the Michigan penal code, [Act No. 328 of the Public Acts of 1931, being section 750 81 to 570.90 of the Michigan Compiled Laws] 1931 PA 328, MCL 750.81 TO 750.90. 

(b) “Plant” means a marihuana plant that has produced cotyledons or a cutting of a marihuana plant that has produced cotyledons.Sec. 16221. The department may investigate activities related to the practice of a health profession by a licensee, a registrant, or an applicant for licensure or registration. The department may hold hearings, administer oaths, and order relevant testimony to be taken and shall report its findings to the appropriate disciplinary subcommittee. The disciplinary subcommittee shall proceed under section 16226 if it finds that 1 or more of the following grounds exist: 

 

(a) A violation of general duty, consisting of negligence or failure to exercise due care, including negligent delegation to or supervision of employees or other individuals, whether or not injury results, or any conduct, practice, or condition which impairs, or may impair, the ability to safely and skillfully practice the health profession. 

(b) Personal disqualifications, consisting of 1 or more of the following:(i) Incompetence.
(ii) Subject to sections 16165 to 16170a, substance abuse as defined in section 6107.
(iii) Mental or physical inability reasonably related to and adversely affecting the licensee’s ability to practice in a safe and competent manner.
(iv) Declaration of mental incompetence by a court of competent jurisdiction.
(v) Conviction of a misdemeanor punishable by imprisonment for a maximum term of 2 years; a misdemeanor involving the illegal delivery, possession, or use of a controlled substance; or a felony. A certified copy of the court record is conclusive evidence of the conviction.
(vi) Lack of good moral character.
(vii) Conviction of a criminal offense under sections 520a to 520l of the Michigan penal code, [Act No 328 of the Public Acts of 1931, being sections 750.520a to 750.520l, of the Michigan Compiled Laws] 1931 PA 328, MCL 750.520A TO 750.520l . A certified copy of the court record is conclusive evidence of the conviction.
(viii) Conviction of a violation of section 492a of the Michigan penal code, [Act No. 328 of the Public Acts of 1931, being section 750.492a of the Michigan Compiled Laws] 1931 PA 328, MCL 750.492A. A certified copy of the court record is conclusive evidence of the conviction.
(ix) Conviction of a misdemeanor or felony involving fraud in obtaining or attempting to obtain fees related to the practice 25 of a health profession. A certified copy of the court record is 26 conclusive evidence of the conviction.
(x) Final adverse administrative action by a licensure, registration, disciplinary, or certification board involving the holder of, or an applicant for, a license or registration regulated by another state or a territory of the United States. A certified copy of the record of the board is conclusive evidence of the final action.
(xi) Conviction of a misdemeanor that is reasonably related to or that adversely affects the licensee’s ability to practice in a safe and competent manner. A certified copy of the court record is conclusive evidence of the conviction. 

 

(c) Prohibited acts, consisting of 1 or more of the following: 

(i) Fraud or deceit in obtaining or renewing a license or registration.
(ii) Permitting the license or registration to be used by an unauthorized person.
(iii) Practice outside the scope of a license.
(iv) Obtaining, possessing, or attempting to obtain or possess a controlled substance as defined in section 7104 or a drug as defined in section 7105 without lawful authority; or selling, prescribing, giving away, or administering drugs for other than lawful diagnostic or therapeutic purposes. THE PROVISION OF DRUGS TO COMPLY WITH A REQUEST MADE IN COMPLIANCE WITH PART 56B IS NOT A PROHIBITED ACT. 

(d) Unethical business practices, consisting of 1 or more of the following: 

(i) False or misleading advertising.
(ii)Dividing fees for referral of patients or accepting kickbacks on medical or surgical services, appliances, or medications purchased by or in behalf of patients.
(iii) Fraud or deceit in obtaining or attempting to obtain third party reimbursement. 

(e) Unprofessional conduct, consisting of 1 or more of the following: 

(i) Misrepresentation to a consumer or patient or in obtaining or attempting to obtain third party reimbursement in the course of professional practice.
(ii) Betrayal of a professional confidence.
(iii) Promotion for personal gain of an unnecessary drug, device, treatment, procedure, or service.
(iv) Directing or requiring an individual to purchase or secure a drug, device, treatment, procedure, or service from another person, place, facility, or business in which the licensee has a financial interest. 

(f) Failure to report a change of name or mailing address within 30 days after the change occurs. 

(g) A violation, or aiding or abetting in a violation, of this article or of a rule promulgated under this article. 

(h) Failure to comply with a subpoena issued pursuant to this part, failure to respond to a complaint issued under this article or article 7, failure to appear at a compliance conference or an administrative hearing, or failure to report under section 16222 or 16223. 

(i) Failure to pay an installment of an assessment levied pursuant to section 2504 of the insurance code of 1956, Act [No 218 of the Public Acts of 1956, being section 500.2504 of the Michigan Compiled Laws 1956] PA 218, MCL 500.2504, within 60 days after notice by the appropriate board. 

(j) A violation of section 17013 or 17513. 

(k) Failure to meet 1 or more of the requirements for licensure or registration under section 16174. 

(l) A violation of section 17015 or 17515. 

(m) A violation of section 17016 or 17516. 

(n) A violation of section 5654 or 5655. 

(o)A VIOLATION OF SECTION 5676 OR 5679.Sec. 16226. (1) After finding the existence of 1 or more of the grounds for disciplinary subcommittee action listed in section 16221, a disciplinary subcommittee shall impose 1 or more of the following sanctions for each violation: 

 

Violations of Section 16221 Sanctions
Subdivision (a), (b)(ii),(b)(iv), or (b)(vii) Probation, limitation, denial, suspension, revocation, restitution, community service, fine.
Subdivision (b)(viii) Revocation or denial.
Subdivision (b)(i), (b)(iii), (b)(v), (b)(ix), (b)(x), or (b)(xi) Limitation, suspension, revocation, denial, probation, restitution, community service, fine.
Subdivision (c)(i) Denial, revocation, suspension, probation, limitation, community service, or fine.
Subdivision (c)(ii) Denial, suspension, revocation, restitution, community service, or fine.
Subdivision (c)(iii) Probation, denial, suspension, revocation, restitution, community service, or fine.
Subdivision (c)(iv) or (d)(iii) Fine, probation, denial, suspension, revocation, community service, or restitution.
Subdivision (d)(i) or (d)(ii) Reprimand, fine, probation, community service, denial, or restitution.
Subdivision (e)(i) Reprimand, fine, probation, limitation, suspension, community service, denial, or restitution.
Subdivision (e)(ii) or (h) Reprimand, probation, suspension, restitution, community service, denial, or fine.
Subdivision (e)(iii) or (e)(iv) Reprimand, fine, probation, suspension, revocation, limitation, community service, denial, or restitution.
Subdivision (f) Reprimand or fine.
Subdivision (g) Reprimand, probation, denial, suspension, revocation, limitation, restitution, community service, or fine.
Subdivision (i) Suspension or fine.
Subdivision (j) or (n) Reprimand or fine.
Subdivision (k) Reprimand, denial, or limitation.
Subdivision (l) OR (O) Denial, revocation, restitution, probation, suspension, limitation, reprimand, or fine.
Subdivision (m) Revocation or denial.

 

(2) Determination of sanctions for violations under this section shall be made by a disciplinary subcommittee. If, during judicial review, the court of appeals determines that a final decision or order of a disciplinary subcommittee prejudices substantial rights of the petitioner for 1 or more of the grounds listed in section 106 of the administrative procedures act of 1969, [being section 24.306 of Michigan Compiled Laws] 1969 PA 306, MCL 24.306, and holds that the final decision or order is unlawful and is to be set aside, the court shall state on the record the reasons for the holding and may remand the case to the disciplinary subcommittee for further consideration. 

(3) A disciplinary subcommittee may impose a fine of up to, but not exceeding, $250,000.00 for a violation of section 16221(a) or (b). 

(4) A disciplinary subcommittee may require a licensee or registrant or an applicant for licensure or registration who has violated this article or article 7 or a rule promulgated under this article or article 7 to satisfactorily complete an educational program, a training program, or a treatment program, a mental, physical, or professional competence examination, or a combination of those programs and examinations.Sec. 17033. (1) Notwithstanding the requirements of part 161 AND SUBJECT TO SUBSECTIONS (2) AND (3), the board may require a licensee seeking renewal of a license to furnish the board with satisfactory evidence that during the 3 years immediately preceding application for renewal the licensee has attended continuing education courses or programs approved by the board totaling not less than 150 hours in subjects related to the practice of medicine including, but not limited to, medical ethics and designed to further educate licensees. 

 

(2) As required under section 16204, the board shall promulgate rules requiring each applicant for license renewal to complete as part of the continuing education requirement of subsection (1) an appropriate number of hours or courses in pain and symptom management. 

(3) PURSUANT TO SECTION 5687 AND AS PART OF THE CONTINUING EDUCATION REQUIREMENT OF SUBSECTION (1), BEGINNING 2 YEARS AFTER THE EFFECTIVE DATE OF PART 56B, A PHYSICIAN WHO PROVIDES PATIENTS WITH THE PROCEDURES AUTHORIZED BY PART 56B AND WHO APPLIES FOR RENEWAL OF HIS OR HER LICENSE SHALL PRESENT SATISFACTORY EVIDENCE, REGARDLESS OF ANY PREVIOUS TRAINING, THAT HE OR SHE HAS HAD NOT LESS THAN 20 HOURS OF CONTINUING MEDICAL EDUCATION IN THE THEORY AND PRACTICE OF COMFORT CARE, HOSPICE CARE, PAIN CONTROL, SEDATION COMA, REMOVAL OF NUTRITION AND HYDRATION, PSYCHIATRIC COUNSELING, AND THE PRESCRIPTION OF MEDICATIONS AUTHORIZED BY PART 56B. AT SUBSEQUENT RENEWALS, 4 HOURS OF SUCH TRAINING MUST BE DOCUMENTED.Sec. 17533. (1) Notwithstanding the requirements of part 161AND SUBJECT TO SUBSECTIONS (2) AND (3), the board may require a licensee seeking renewal of a license to furnish the board with satisfactory evidence that during the 3 years immediately preceding an application for renewal the licensee has attended continuing education courses or programs approved by the board and totaling no less than 150 hours in subjects related to the practice of osteopathic medicine and surgery and designed to further educate licensees. 

 

(2) As required under section 16204, the board shall promulgate rules requiring each applicant for license renewal to complete as part of the continuing education requirement of subsection (1) an appropriate number of hours or courses in pain and symptom management. 

(3) PURSUANT TO SECTION 5687 AND AS PART OF THE CONTINUING EDUCATION REQUIREMENT OF SUBSECTION (1), BEGINNING 2 YEARS AFTER THE EFFECTIVE DATE OF PART 56B, A PHYSICIAN WHO PROVIDES PATIENTS WITH THE PROCEDURES AUTHORIZED BY PART 56B AND WHO APPLIES FOR RENEWAL OF HIS OR HER LICENSE SHALL PRESENT SATISFACTORY EVIDENCE, REGARDLESS OF ANY PREVIOUS TRAINING, THAT HE OR SHE HAS HAD NOT LESS THAN 20 HOURS OF CONTINUING MEDICAL EDUCATION IN THE THEORY AND PRACTICE OF COMFORT CARE, HOSPICE CARE, PAIN CONTROL, SEDATION COMA, REMOVAL OF NUTRITION AND HYDRATION, PSYCHIATRIC COUNSELING, AND PRESCRIPTION OF MEDICATIONS AUTHORIZED BY PART 56B. AT SUBSEQUENT RENEWALS, 4 HOURS OF SUCH TRAINING MUST BE DOCUMENTED.Sec. 17766. Except as provided in section 17766a, a person who does [any] 1 OR MORE of the following is guilty of a misdemeanor: 

 

(a) Obtains or attempts to obtain a prescription drug by giving a false name to a pharmacist or other authorized seller, prescriber, or dispenser. 

(b) Obtains or attempts to obtain a prescription drug by falsely representing that he or she is a lawful prescriber, dispenser, or licensee, or acting on behalf of a lawful prescriber, dispenser, or licensee. 

(c) Falsely makes, utters, publishes, passes, alters, or forges a prescription. 

(d) Knowingly possesses a false, forged, or altered prescription. 

(e) Knowingly attempts to obtain, obtains, or possesses a drug by means of a prescription for other than a legitimate therapeutic purpose, or as a result of a false, forged, or altered prescription. THE PRESCRIPTION, OBTAINING, ATTEMPTING TO OBTAIN, AND POSSESSION OF A DRUG FOR USE IN THE PROCEDURES AUTHORIZED UNDER PART 56B IS NOT A VIOLATION OF THIS SUBDIVISION. 

(f) Possesses or controls for the purpose of resale, or sells, offers to sell, dispenses, or gives away, a drug, pharmaceutical preparation, or chemical that has been dispensed on prescription and has left the control of a pharmacist, or that has been damaged by heat, smoke, fire, water, or other cause and is unfit for human or animal use. 

(g) Prepares or permits the preparation of a prescription drug, except as delegated by a pharmacist. 

(h) Sells a drug in bulk or in an open package at auction, unless the sale has been approved in accordance with rules of the board.Sec. 20165. (1) Except as otherwise provided in this section, after notice of intent to an applicant or licensee to deny, limit, suspend, or revoke a license or certification and an opportunity for a hearing, the department may deny, limit, suspend, or revoke the license or certification if any 1 OR MORE of the following exist: 

 

(a) Fraud or deceit in obtaining or attempting to obtain a license or certification or in operation of the licensed health facility or agency. 

(b) A violation of this article or the rules promulgated under this article. 

(c) False or misleading advertising. 

(d) Negligence or failure to exercise due care, including negligent supervision of employees and subordinates. 

(e) Permitting a license or certificate to be used by an unauthorized health facility or agency. 

(f) Evidence of abuse regarding patient health, welfare, or safety or a denial of rights. 

(g) Failure to comply with section 10102a(7). 

(h) Failure to comply with part 222 or a term, condition, or stipulation of a certificate of need issued under part 222, or both. 

(i) FAILURE TO COMPLY WITH SECTION 5688 OR ANOTHER APPLICABLE PROVISION OF PART 56B. 

(2) An application for a license or certification may be denied on a finding of any condition or practice which would constitute a violation of this article if the applicant were a licensee. 

(3) Denial, suspension, or revocation of an individual emergency medical services personnel license under part 209 is governed by section 20958.Enacting section 1. 

 

1992 PA 270, MCL 752.1021 to 752.1027, is repealed.”Medical examiner act” Sec. 2. 

 

(1)[County] EXCEPT AS OTHERWISE PROVIDED IN SUBSECTION (2), A COUNTY medical [examiners] EXAMINER or deputy county medical [examiners] EXAMINER shall [make investigations as to] INVESTIGATE the cause and manner of death in [all] EACH OF THE FOLLOWING cases: [of persons who have come to their death] 

(A) THE CASE OF A PERSON WHO HAD DIED by violence. [; or

(B) THE CASE OF A PERSON whose death was unexpected. [ ; or

(C) THE CASE OF A PERSON WHO HAS DIED without medical attendance during the 48 hours [prior to] IMMEDIATELY PRECEDING the hour of death, unless the attending physician, if any, is able to determine accurately the cause of death. [; or

(D) THE CASE OF A PERSON WHO HAS DIED as the result of an abortion, whether self-induced or otherwise. 

(2) A COUNTY MEDICAL EXAMINER OR DEPUTY COUNTY MEDICAL EXAMINER SHALL NOT INVESTIGATE THE DEATH OF A PERSON WHO HAS DIED AS A RESULT OF THE PROCEDURES AUTHORIZED UNDER PART 56B OF THE PUBLIC HEALTH CODE, 1978 PA 368, MCL 333.5671 TO 333.5691, UNLESS THE COUNTY MEDICAL EXAMINER OR DEPUTY COUNTY MEDICAL EXAMINER IS REQUIRED TO INVESTIGATE THE DEATH UNDER THE CIRCUMSTANCES DESCRIBED IN SUBSECTION (1)(A). 

(3) If [any] A prisoner in [any] A county or city jail dies while imprisoned, the county medical examiner, upon being notified of the death of the prisoner, shall [make an examination upon] EXAMINE the body of the deceased prisoner.Sec. 3. [Any physician and any] A PHYSICIAN, A person in charge of [any] A hospital or institution, or [any] A person who [shall have] HAS first knowledge of the death of [any] A person who [shall have] died suddenly, unexpectedly, accidentally, violently, [or] as the result of [any] suspicious circumstances, or without medical attendance during the 48 hours [prior to] IMMEDIATELY PRECEDING the hour of death, unless the attending physician, if any, is able to determine accurately the cause of death, or in any case of death due to what is commonly known as an abortion, whether self-induced or otherwise, shall notify the county medical examiner or his OR HER deputy immediately of the death. A PHYSICIAN OR OTHER INDIVIDUAL DESCRIBED IN THIS SUBSECTION IS NOT REQUIRED TO NOTIFY THE COUNTY MEDICAL EXAMINER OR DEPUTY COUNTY MEDICAL EXAMINER OF THE DEATH OF A PERSON WHO HAS DIED AS A RESULT OF THE PROCEDURES AUTHORIZED UNDER PART 56B OF THE PUBLIC HEALTH CODE, 1978 PA 368, MCL 333.5671 TO 333.5691, UNLESS THE DEATH ALSO OCCURRED AS A RESULT OF VIOLENCE. 

“Open meetings act” Sec. 3.

 

(1) All meetings of a public body shall be open to the public and shall be held in a place available to the general public. All persons shall be permitted to attend any meeting except as otherwise provided in this act. The right of a person to attend a meeting of a public body includes the right to tape record, to videotape, to broadcast life on radio, and to telecast live on television the proceedings of a public body at a8 public meeting. The exercise of this right [shall] IS [not] be dependent upon the prior approval of the public body. However, a public body may establish reasonable rules and regulations in order to minimize the possibility of disrupting the meeting. 

(2) All decisions of a public body shall be made at a meeting open to the public. 

(3) All deliberations of a public body constituting a quorum of its members shall take place at a meeting open to the public except as provided in this section and sections 7 and 8. 

(4) A person shall not be required as a condition of attendance at a meeting of a public body to register or otherwise provide his or her name or other information or otherwise to fulfill a condition precedent to attendance. 

(5) A person shall be permitted to address a meeting of a public body under rules established and recorded by the public body. The legislature or a house of the legislature may provide by rule that the right to address may be limited to prescribed times at hearings and committee meetings only. 

(6) A person shall not be excluded from a meeting otherwise open to the public except for a breach of the peace actually committed at the meeting. 

(7) This act does not apply to the following public bodies only when deliberating the merits of a case: 

(a) The worker’s compensation appeal board created under the worker’s disability compensation act of 1969, [Act No 317 of the Public Acts of 1969, as amended, being sections 418.101 to 418.941 of the Michigan Compiled Laws] 1969 PA 317, MCL 418.101 TO 418.941. 

(b) The employment security board of review created under the Michigan employment security act, [Act No 1 of the Public Acts of the Extra Session of 1936, being sections 421.1 to 421.73 of the Michigan Compiled Laws]1936 (EX SESS) PA 1, MCL 421.1 TO 421.75. 

(c) The state tenure commission created under [Act No 4 of the Public Acts of the Extra Session of 1937, as amended, being 5 cautions 38.71 to 38.191 of the Michigan Compiled Laws] 1937 (EX SESS) PA 4, MCL 38.71 TO 38.191, when acting as a board of review from the decision of a controlling board. 

(d) An arbitrator or arbitration panel appointed by the employment relations commission under the authority given the 10 commission by [Act No. 176 of the Public Acts of 1939, as amended, being sections 423.1 to 423.30 of the Michigan Compiled Laws] 1939 PA 176, MCL 423.1 TO 423.30. 

(e) An arbitration panel selected under chapter 50A of the revised judicature act of 1961, [Act No. 236 of the Public Acts of 1961, being sections 600.5040 to 600.5065 of the Michigan Compiled Laws] 1961 PA 236, MCL 600.5040 TO 600.5065. 

(f) The Michigan public service commission created under [Act No. 3 of the Public Acts of 1939, being Portions 460 1 to 460.8 of the Michigan Compiled Laws] 1939 PA 236, MCL 460.1 TO 460.8. 

(8) This act does not apply to an association of insurers created under the insurance code of 1956, [Act No. 218 of the public Acts of 1956, being sections 500.100 to 500.8302 of the Michigan Compiled Laws] 1956 PA 218, MCL 500.100 TO 500.8302, or other association or facility formed under [Act No. 218 of the Public Acts of 1956] THE INSURANCE CODE OF 1956, 1956 PA 218, MCL 500.100 TO 500.8302, as a nonprofit organization of insurer members. 

(9) This act does not apply to a committee of a public body which adopts a nonpolicymaking resolution of tribute or memorial which resolution is not adopted at a meeting. 

(10) This act does not apply to a meeting which is a social or chance gathering or conference not designed to avoid this act. 

(11) This act shall not apply to the Michigan veterans’ trust fund board of trustees or a county or district committee created under [Act No 9 of the Public Acts of the first extra session of 1946, being sections 35 601 to 35.610 of the Michigan Compiled Laws]1946 (1ST EX SESS) PA 9, MCL 35.601 TO 35.610, when the board of trustees or county or district committee is deliberating the merits of an emergent need. A decision of the board of trustees or county or district committee made under this subsection shall be reconsidered by the board or committee at its next regular or special meeting consistent with the requirements of this act. “Emergent need” means a situation which the board of trustees, by rules promulgated under the administrative procedures act of 1969, Act No 306 of the Public Acts of 1969, as amended, being sections 24.201 to 24.328 of the Michigan Compiled Laws 1969 PA 306, MCL 24.201 TO 24.328, determines requires immediate action. 

(12) THIS ACT DOES NOT APPLY TO A PROCEEDING OR TO THE DELIBERATIONS OF THE OVERSIGHT COMMITTEE CREATED UNDER SECTION 5685 OF THE PUBLIC HEALTH CODE, 1978 PA 368, MCL 333.5685.