Dispense With Death

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Please confirm your email address by clicking the link in the email received from us. Please wait until the countdown has finished before clicking the resend button. Just fill in your email and we will help you reset your password. A poorly policed accreditation system has made us lose sight of the essence of tea culture. The move affected a number of professionals in the tea industry, including tea growers and tea masters, both of which are no longer accredited jobs.

The news has certainly made waves in the Chinese media, with online platforms Sohu, Baidu, and iQIYI all running stories on the decision. Two millennia ago, during the Eastern Han Dynasty, it was written that the doctor Shen Nong had discovered the properties of various teas. The Chinese have all sorts of local customs for drinking tea. In some regions, tea leaves are grilled before hot water is added to them; other people elect to steep or boil the leaves.

The appearance of professional tea masters in the s marked the modernization and commercialization of Chinese tea culture. Tea masters are required to demonstrate an exceptional knowledge of the historical background of all kinds of tea leaves. They assiduously study brewing methods and carefully select the equipment most suited to bring out the flavor of each strain of tea.

Dressed in plain garments, the master lights incense, washes their hands, purifies the environment around them, and finally brews the tea for their guests, explaining certain rituals throughout. The backlog this produced led the Ministry of Commerce to encourage the domestic popularization of tea culture and the health benefits to be gained from drinking tea. Whether tea masters hold a paper certificate declaring professional competence is less important than cultivating their personal artistry.

By the turn of the century, tea ceremonies were a common sight even in provinces not traditionally known for producing the beverage. Tea had been restored as a significant part of Chinese life. Seven years later, the government published a set of work standards and gave agencies in the ministries of agriculture and human resources the right to issue certificates. Although the standards decreed that tea specialists had to pass an exam before obtaining a certificate, the rule was never stringently enforced.

The difficulty in enforcing standards seems a good enough reason to abolish the tea master certificate. In addition to their knowledge of tea, masters engage in various forms of ceremonial performance that remain difficult to objectively evaluate. Patient-directed care at the end of life.

This bill enacts the Maine Death with Dignity Act authorizing a person who is 18 years of age or older, who meets certain qualifications and who has been determined by the person's attending physician to be suffering from a terminal disease, as defined in the Act, to make a request for medication prescribed for the purpose of ending the person's life. The bill establishes the procedures for making these requests, including 2 waiting periods and one written and 2 oral requests and requires a 2nd opinion by a consulting physician. The bill requires specified information to be documented in the person's medical record, including all oral and written requests for a medication to hasten death.

The bill requires the attending and consulting physicians to assess the patient for depression or other mental health condition that impairs judgment. If the attending or consulting physician, in the physician's professional opinion, believes such a condition exists, the patient must be evaluated and treated by a state-licensed psychiatrist, psychologist, clinical social worker or clinical professional counselor. Medication to end a patient's life in a humane and dignified manner may not be prescribed until the person performing the counseling determines that the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.

The bill prohibits a provision in a contract, will or other agreement from being conditioned upon, or affected by, a person's making or rescinding a request for medication under the Act. The bill prohibits the sale, procurement or issuance of any life, health or accident insurance or annuity policy or the rate charged for any life, health or accident insurance or annuity policy from being conditioned upon or affected by the making or rescinding of such a request.

The bill authorizes a health care provider to prohibit its employees, independent contractors or other persons or entities, including other health care providers, from participating in activities under the Act while on premises owned by or under the management or direct control of that prohibiting health care provider or while acting within the course and scope of any employment by, or contract with, the prohibiting health care provider.

The bill makes it a Class A crime to knowingly alter or forge a request for medication to end a person's life without that person's authorization or to conceal or destroy a withdrawal or rescission of a request for medication, if it is done with the intent or effect of causing the person's death. The bill makes it a Class A crime to knowingly coerce or exert undue influence on a person to request medication for the purpose of ending that person's life or to destroy a withdrawal or rescission of a request.

The bill provides that the Act does not authorize ending a patient's life by lethal injection, mercy killing or active euthanasia and provides that action taken in accordance with the Act does not constitute, among other things, suicide or homicide.

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The bill requires health care providers to submit specified information to the Department of Health and Human Services upon their writing a prescription for or dispensing medication under the Act and after the death of the qualified patient. The bill requires the department to generate and make available to the public an annual statistical report of information collected regarding compliance with the Act.

The bill requires a copy of the report to be submitted to the joint standing committee of the Legislature having jurisdiction over health matters annually by March 1st. Short title. This chapter may be known and cited as "the Maine Death with Dignity Act. As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings.

Right to information. A patient has a right to information regarding all treatment options reasonably available for the care of the patient, including, but not limited to, information in response to specific questions about the foreseeable risks and benefits of medication, without a physician's withholding requested information regardless of the purpose of the questions or the nature of the information.

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Written request for medication. An adult who is competent, is a resident of this State, has been determined by an attending physician and a consulting physician to be suffering from a terminal disease and has voluntarily expressed the wish to die may make a written request for medication that the adult may self-administer in accordance with this Act.

An adult does not qualify under this Act solely because of age or disability. Form of written request. A valid request for medication under this Act must be substantially in the form described in subsection 24, signed and dated by the patient and witnessed by at least 2 individuals who, in the presence of the patient, attest that to the best of their knowledge and belief the patient is competent, is acting voluntarily and is not being coerced to sign the request.

The language of a written request for medication under this Act must be the language in which any conversations or consultations or interpreted conversations or consultations between a patient and the patient's attending physician or consulting physician are held. Notwithstanding paragraph A, the language of a written request for medication under this Act may be English when the conversations or consultations or interpreted conversations or consultations between a patient and the patient's attending physician or consulting physician were conducted in a language other than English if the form described in subsection 24 contains the attachment described in subsection At least one of the 2 or more witnesses required under this subsection and any interpreter required under this subsection must be a person who is not: 1 A relative of the patient by blood, marriage or adoption;.

The patient's attending physician at the time the written request is signed may not be a witness. If the patient is a patient in a long-term care facility at the time the patient makes the written request, one of the witnesses must be an individual designated by the facility who has the qualifications specified by the department by rule.

Attending physician responsibilities. The attending physician shall: A. Make the initial determination of whether a patient has a terminal disease, is competent and has made the written request under subsection 4 voluntarily;.


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Request that the patient demonstrate state residency as required by subsection 15;. To ensure that the patient is making an informed decision, inform the patient of: 1 The patient's medical diagnosis;. Refer the patient to a consulting physician for medical confirmation of the diagnosis and for a determination that the patient is competent and acting voluntarily;.

Confirm that the patient's request does not arise from coercion or undue influence by another individual by discussing with the patient, outside the presence of any other individual, except for an interpreter, whether the patient is feeling coerced or unduly influenced;. Refer the patient for counseling, if appropriate, as described in subsection 8;.

Recommend that the patient notify the patient's next of kin;. Counsel the patient about the importance of having another person present when the patient takes the medication prescribed under this Act, and counsel the patient about not taking the medication prescribed under this Act in a public place;. Inform the patient that the patient has an opportunity to rescind the request at any time and in any manner and offer the patient an opportunity to rescind the request at the end of the day waiting period pursuant to subsection 11;.

Verify, immediately before writing the prescription for medication under this Act, that the patient is making an informed decision;. Fulfill the medical record documentation requirements of subsection 14;. Ensure that all appropriate steps are carried out in accordance with this Act before writing a prescription for medication to enable a qualified patient to end the qualified patient's life in a humane and dignified manner; and. Dispense medications directly, including ancillary medications intended to minimize the patient's discomfort, if the attending physician is authorized under state law or rule to dispense medications and has a current drug enforcement administration certificate or with the patient's written consent: 1 Contact a pharmacist and inform the pharmacist of the prescription; and.

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Consulting physician confirmation. Before a patient is determined to be a qualified patient under this Act, a consulting physician shall examine the patient and the patient's relevant medical records and confirm, in writing, the attending physician's diagnosis that the patient is suffering from a terminal disease and verify that the patient is competent, is acting voluntarily and has made an informed decision. Consulting referral. If, in the opinion of the attending physician or the consulting physician, a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment, the physician shall refer the patient for counseling.

Informed decision. A qualified patient may not receive a prescription for medication under this Act unless the qualified patient has made an informed decision. Immediately before writing a prescription for medication under this Act, the attending physician shall verify that the qualified patient is making an informed decision. Notification of next of kin. A patient who declines or is unable to notify the patient's next of kin may not have the patient's request for medication denied for that reason. Written and oral requests. To receive a prescription for medication that the qualified patient may self-administer under this Act, a qualified patient must make an oral request and a written request and reiterate the oral request to the qualified patient's attending physician at least 15 days after making the initial oral request.

At the time the qualified patient makes the qualified patient's 2nd oral request, the attending physician shall offer the qualified patient an opportunity to rescind the request. Right to rescind request. A patient may rescind the patient's request at any time and in any manner without regard to the patient's mental state. A prescription for medication may not be written under this Act without the attending physician's offering the qualified patient an opportunity to rescind the request. Waiting periods.

At least 15 days must elapse between the patient's initial oral request and the date the patient signs the written request under subsection At least 48 hours must elapse between the date the patient signs the written request and the writing of a prescription under this Act. Medical record documentation requirements. The following must be documented or filed in a patient's medical record: A.

All oral requests by the patient for medication to end that patient's life in a humane and dignified manner;. All written requests by the patient for medication to end that patient's life in a humane and dignified manner;. The attending physician's diagnosis and prognosis and the attending physician's determination that the patient is competent, is acting voluntarily and has made an informed decision;.

The consulting physician's diagnosis and prognosis and the consulting physician's verification that the patient is competent, is acting voluntarily and has made an informed decision;.

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A report of the outcome and determinations made during counseling, if counseling is provided as described in subsection 8;. The attending physician's offer to the patient to rescind the patient's request at the time of the patient's 2nd oral request under subsection 11; and. A note by the attending physician indicating that all requirements under this Act have been met, including the requirements of subsection 6, and indicating the steps taken to carry out the patient's request, including a notation of the medication prescribed.

Residency requirement. For purposes of this Act, only requests made by residents of this State may be granted. The residence of a person is that place where the person has established a fixed and principal home to which the person, whenever temporarily absent, intends to return. The following factors may be offered in determining a person's residence under this Act and need not all be present in order to determine a person's residence: A.

Registration to vote in this State;. Evidence that the person owns or leases property in this State;. The location of any dwelling currently occupied by the person;. The place where any motor vehicle owned by the person is registered;. The residence address, not a post office box, shown on a current income tax return;. The residence address, not a post office box, at which the person's mail is received;. The residence address, not a post office box, shown on any current resident hunting or fishing licenses held by the person;.

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