Summary of S.74 Amendments

Summary of S.74 Amendments to Act 39

Senate Bill 74 was signed into law on April 27, 2022. The bill made three important changes to Act 39. Link to Text of S.74. The Text of Act 39 has been updated to include the S.74 amendments.

1. Legal Immunity:

All Health Care Professionals: S.74 clarified that all health care professionals, including physicians, nurses, pharmacists and others licensed, certified or otherwise authorized by law to deliver health care services are free from liability for acting in good faith compliance with Act 39.

Indemnity Agreement Eliminated: This means that the pharmacist who fills Act 39 prescriptions no longer requires the indemnity agreement that has been part of his practice. Doctors who previously declined to prescribe because of that indemnity agreement should be aware that this impediment has been eliminated.

2. Video Telemedicine:

Act 39 Requests and Consultations: Video telemedicine is now permitted as an option for patient requests for medical aid in dying under Act 39. S.74 eliminated the requirement that patient requests be made in the “physical presence” of the doctor. This means that the two oral requests required by Act 39 and consultation with the second physician are permitted to be made by telemedicine. As with any other patient interaction, it is up to the doctor to determine whether an adequate assessment can be accomplished by video telemedicine. The findings that a doctor must make are listed on the Department of Health forms.

Guidance from ACAMAID: Further guidance is available in the telemedicine policy adopted by ACAMAID (American Clinicians Academy for Medical Aid in Dying) and is available here.

Physical Exam Requirement: S.74 did not eliminate the requirement for an in-person physical examination entirely. The amendment specifies that there needs to be an in-person physical examination of the patient’s condition noted in the medical records and that the prescribing physician is required to review the report on this examination. The in-person physical examination may be performed by either the prescribing or consulting physician or by a third doctor (not a PA or RN) such as the patient’s primary care physician or another physician specialist.

3. Final 48-Hour Delay Eliminated:

Senate Bill 74 eliminated the final 48-hour delay before a prescription could be written. Now, as soon as all the other requirements are met, a prescription may be written.

Patient Choices Vermont is happy to consult with you if you have any questions on these changes. Medical professionals can receive advice directly from our network of Vermont doctors and nurses. Please contact us on the PCV Helpline at 802-448-0542 or through our contact form.