Senate of the Republic PROJECT of STATUTORY LAW No ______ by Which the Practices of The

Senate of the Republic PROJECT OF STATUTORY LAW No ______“By which the practices of the Euthanasia and the attendance to the suicide in Colombia are regulated, the service of palliative cares and dictates to other dispositions”

CHAPTER I GENERAL DISPOSITIONS

ARTICLE 1. OBJECT. This law has the intention to regulate integral rigorously and the form in which the requests of the patients will be taken care of on the completion of their life in worthy and human conditions; the necessary procedures for such aim and the practice of the Euthanasia and the attendance to the suicide, by the respective treating doctors; as well as, to establish the mechanisms that allow to control and to evaluate the correct accomplishment of euthanasia and the attended suicide, taking care of when having of the State to protect the life. Also it is object of the present law to determine the system on watch of palliative cares offered by Integral the Social Security system in Health.

In order to fulfil this intention, the following definitions will consider:

Euthanasia: it is the intentional completion of the life by another person, this is, third described, the treating doctor, of a worthy form and human, from the free request, informed and reiterated into the patient, who is suffering intense pains, continued sufferings or a condition of great dependency and handicap that the person considers infuriates because of terminal disease or burdens corporal injury.
Attended suicide: it consists of helping or attending another person intentionally, the patient, to commit suicide, or in providing to him with necessary means for the accomplishment of he himself, from its free request, informed and reiterated, when it is suffering intense pains, continued sufferings or a condition of great dependency and handicap that the person considers infuriates because of terminal disease or burdens corporal injury.
Palliative cares: they are the active and total cares of the diseases that do not have answer to the curative treatment, being the primary target to obtain to the best quality of possible life for the patients in final stage and its families.
Treating doctor: one talks about the professional of the medicine who has had the responsibility of the care of the patient, victim of a terminal disease or burdens corporal injury and who in addition, according to the Euthanasia medical registry and to the act of death, has finished, by express request of the patient, with its life of a worthy and human form or it has provided to him of means necessary to obtain he himself result.
Doctor of Reference: she is the therapeutic professional of the medicine that has been consulted by the treating doctor, in second instance, with the intention of obtaining a medical confirmation of the diagnosis, options and the respective prognosis of the patient that has asked for the completion of its life of a worthy and human form, by virtue of its specialized level of knowledge and experience in the matter.
Medical confirmation: it means that the medical opinion of the treating doctor has been confirmed, in second instance, by an independent doctor, who as well, has examined to the patient and his respective clinical history.
Council: one talks about one, or to the consultations that are necessary between psychiatrist and/or a psychologist, or an equipment of support conformed by professionals of both disciplines, and the patient whom the completion of its life of worthy and human form has asked for repeatedly to its treating doctor; in order to determine the real situation of the patient, the maturity of its judgment and its unequivocal will to die; as well as to confirm that it does not suffer of any psychiatric disorder, psychological or of a momentary depression that can be disturbing its judgment.
Informed decision: it means the decision taken by the patient, to ask for or to obtain an order or medical prescription, of its treating doctor, to finish with its life of a worthy and human form, which implies that the person has serious and trustworthy information about its disease and of the therapeutic options: as well as of the different existing palliative medicine alternatives, including treatments for the control of the pain and its prognosis; and in addition, that counts on the capacity sufficient to make the decision.
Terminal disease: it means incurable and irreversible disease or serious injury that registered and has been confirmed by the treating doctor, who esteem will take place the death of the patient in a lapse not more than six (6) months, without this one last lapse constitutes an invariable constant, since it can vary according to the particular circumstances of each case.
Able adult: it means a person with 18 years of greater age or, and than in opinion of a court, the treating doctor or of the specialist, psychiatrist and/or a psychologist or a support battalion, it has the ability to understand, to take and to communicate, by itself or through its relatives, the decisions respect to its state of health and its life before the competent authorities.
Specialist doctor. She is the professional of the medicine that shows an academic specialty in the field of knowledge that studies the disease by which the patient is treated.

CHAPTER II CONDITIONS AND PROCEDURE OF CARE DUE

ARTICLE 2. CONDITIONS. In the strict terms of this law, the only person who can practice the euthanasia procedure or attend the suicide to a patient, is a professional of the medicine, who stops the effects of this regulation is, the treating doctor. Of this form, it will not be object of penal sanction the treating doctor who respect the conditions strictly and the procedure of care due that this law provides, and additionally, it verifies the fulfilment of each one of the following requirements:

That the patient is Colombian or foreign resident by a at least a term of (1) a year, adult of legal age, legally able and in the heat of use of their mental faculties at the time of soliciting, orally or in writing, to the treating doctor the completion of their life of a worthy and human form or the attendance to the suicide; in agreement with the had thing in the matter of capacity by the article 1503 and following the Civil Code. In the cases in that the adult patient of legal age, one is unconscious and it cannot express its will in writing, nor by any other means, will be due to come solely from the form indicated in article 5, relative to the written request completed by the relatives and/or the treating doctor, of the present law.
That the request or request for the completion of the life of the patient free and is informed, showed unequivocally in writing, when is possible, voluntary and reiterated, who does not allow to lodge the smaller doubt on if the origin of the same one is the product of an illegal outer pressure or the result of a momentary depression. When it is not possible to obtain the authorization of the terminal patient will be come in writing according to the arranged thing in article 5 of the present Law.
That the patient, in effect, suffers of a terminal disease or burdens corporal, registered injury in his clinical history by two specialist doctors, who produce intense pains to him, continued sufferings or a condition of great dependency and handicap that the person considers infuriates, which cannot be alleviated by present medical science with hope of cures or improvement.

PARAGRAPH. No treating doctor could be forced to practice the euthanasia procedure or to provide the necessary aid for such aim, if this one therefore decides it. In case that the treating doctor refuses itself to practice the euthanasia procedure or to provide the necessary aid for the completion with the life of the patient, this one last or their relatives, if he himself is unconscious, at any time, will be able to ask for the aid of another doctor, who assumes the case like treating doctor in the terms of the present law.

This same disposition will be applied, when like the treating doctor, they conclude that another therapeutic alternative possible does not exist to alleviate the laborious situation of first.

ARTICLE 3. PROCEDURE OF DUE CARE To guarantee the fulfilment of the procedure of due care, before carrying outprocedure euthanasia or the assistance to the suicide, the treating doctor will in every case have

To inform in detail the patient about his medical condition, his diagnosis, prognosis and the different therapeutic options and of medicine palliative existing (the hospitable treatments, medicines and control of the pain); of his potential benefits, risks and consequences as regards the effects on his expectation of life.
To verify with all the scientific means to his scope, the intense pains or

continuous sufferings that the patient suffers, and the reiterated, free nature andvolunteer of his request. Of such a way, which jointly so much the patientas the medical dealer, conclude that another therapeutic alternative does not existpossible to relieve the painful situation of the first one

To engage in a dialog repeatedly with the patient, about the request to finish with its life of a worthy and human form or of the provision of the attendance to the suicide, as well as of the different existing therapeutic options. These sessions must be made within a period ofnot less than 48 hours not more than 15 days and, in the same ones, it will participate to an equipment of support conformed by specialists in psychiatry and denominated psychology Council that will help to confirm the maturity of the judgment of the patient and its unequivocal will to die. Parallel, the treating doctor must also examine the progress in the medical condition of the patient during this period of sessions.

To send to the patient with its respective clinical history, for one second valuation of the diagnosis, the therapeutic options and the prognosis emitted by the treating doctor, to the doctor of reference, by virtue of his level of knowledge and experience in the matter, that will have to return to integrally examine the patient. The results of this valuation will denominate medical confirmation, and will include a complete report of the condition of the patient, as well as a reiteration, if it is the case, of the intense pains, continued sufferings or a condition of great dependency and handicap that the person considers infuriates that it causes the terminal disease to him or it burdens corporal injury to the patient, and that cannot be alleviated or be cured with the conventional treatments that medical science offers. Also, a copy of this report to the patient will have to be given and to the treating doctor.

PARAGRAPH. The doctor of reference in charge to make the medical confirmation must as much be independent of the treating doctor as of the patient, this is, must be specialist doctor in the disease that undergoes the patient and to be tie to a specialized unit of another Clinic or HospiceCentre, according to corresponds. In the cases of the hospitals that for level reasons or adjustment, do not have specialists, it will be demanded that the confirmation is provided by the director of unit or the clinic or hospitable centre, or by a doctor of second opinion delegated by this one.

To send to the patient to Council, which constitutes the third valuation within the procedure of which had care, in which an equipment of support specialized in psychiatry and psychology of the respective Clinic or HospiceCentre in which is the patient, will confirm in last instance, who the patient has had the elements necessary to make an informed decision, respect to the completion of its life. Also, in case of any doubt on the medical condition of the patient, the treating doctor will have to send it to one third medical revision made by specialist in the matter, in such terms indicated for the previous valuations and later it will come to again send it to Council. Once fulfilled this I complete proceeding, and after analysing the respective information, the treating doctor will have to indicate to him to the patient about the possibility of stopping of his request. In any case, a period of minimum time of 15 days will be due to hope before practicing to the patient the euthanasia procedure or the attendance to the suicide, according to is the case.
To verify that the request of completion of the life in a worthy and human form or the attendance to the suicide, has been made fulfilling strictly the demanded formalities in article 4 of the present law.
To sign the euthanasia medical title deed and the act of death of the patient. For all the legal effects, the treating doctor, in the death act must indicate that the death of the patient took place by natural causes, in agreement with the article indicated thing 12 of Chapter V of this law.

ARTICLE 4. REQUIREMENTS AND CONTENT OF THE REQUEST. All request of completion of the life in a worthy and human form or of attendance to the suicide, will have to be made in writing, whenever it is possible, personally by the patient. The request will have to be hastened and signed by the patient and at least two witnesses who in the presence of he himself, testify of good faith that the patient this acting voluntarily, is totally able and she is not being forced by other people to sign the request of completion of the life. Signed will have to be documented before Notary who will give faith of the authenticity of the company/signature of the witnesses.

At least one of the witnesses could not be:

(i). Relative of the patient, in none of the established degrees of kinship in article 35 and following of the Civil Code: consanguinity, marriage and adoption;

(ii). Person (s) with material interest in the death of the patient, by virtue of civil and commercial contracts or obligations;

(iii). The treating doctor.

If the patient is in such physical training conditions that she is to him impossible to by itself hasten and to sign the request of completion of the life, another one the patient will be able to revoke the request to finish with its life of a worthy and human form or attendance to the suicide, at any time, even until in the last moment, in which case such document will not have validity and will be removed of history clinical and given back to the patient.

ARTICLE 5. REQUEST BY PREVIOUS INSTRUCTION. The request by previous instruction consists of the designation on the part of the patient of one or more people, previously, in prevailed and strict order of preference, so that they inform to the treating doctor about his will to die, in case that the circumstances that concur treats this law and is incapable to show their will or is unconscious. The request by previous instruction, can at any time be elaborated, must be written and be signed before public notary in the presence of two (2) witnesses, following the same conditions of article 4 of the present law. Of this form, the single request will be valid if it is elaborated or confirmed by the patient, at least 5 years before the loss of the capacity to express, completely its will. The request by previous instruction could at any time be modified or be revoked.

CHAPTER III MEDICAL REGISTRY EUTHANASIA

ARTICLE 6. OBLIGATIONS AND CONTENT. All treating doctor who, in the terms of the present law, has practiced a procedure euthanasia or attended the suicide of the patient in order to finish his life of a worthy and human form, will be forced to complete a euthanasia medical registry that will have to be sent within following the ten (10) working days to the decease of the patient, to the Ministry of Social Protection. Without damage of the indicated thing previously, to the euthanasia medical registry, the following documentation will have to be added:

The registry of all requests, oral and written, done to the treating doctor by the patient for the completion of its life of a worthy and human form.
A first report, elaborated by the treating doctor whom it includes: medical diagnosis and its prognosis, as well as a general concept on the capacity, autonomy and maturity of the judgment of the patient to take an informed decision, respect to the completion of its life.
A second informs, elaborated by the specialist doctor, or in his defect of second opinion, that it includes: the confirmation of the medical diagnosis and its prognosis, as well as a new valuation on the capacity, autonomy and maturity of the judgment of the patient to take an informed decision, respect to the completion of its life.
Copy of the complete report emitted by the specialized Council the treating doctor.
In the case anticipated in article 3 numeral 5 interjection 2, the treating doctor will have to send copy of the third report of last confirmation, elaborated by a third specialist doctor and his corresponding psychological valuation by the Council.

CHAPTER IV EVALUATION AND LATER CONTROL OF PROCEDURES EUTHANASIAS AND ATTENDED SUICIDE AND THE BENEFIT OF THE SERVICE OF PALLIATIVE MEDICAL CARES

ARTICLE 7. MANDATE. The Ministry of Social Protection will generate mechanisms internal that allow him to monitor the fulfilment of the normative dispositions that conform this law, the defence of the rights of the patients; as well as to establish the mechanisms that allow to control and to evaluate later, the correct observance of the procedure of care due in