NCIOM Study/Medical Aid in Dying.

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 410

Short Title: NCIOM Study/Medical Aid in Dying. (Public)
Sponsors: Representatives Harrison, Lambeth, Howard, and Prather (Primary Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Rules, Calendar, and Operations of the House
March 18, 2025
*H410-v-1*
A BILL TO BE ENTITLED 1
AN ACT DIRECTING THE NORTH CAROLINA INST ITUTE OF MEDICINE TO STUDY 2
THE LEGALIZATION OF MEDICAL AID IN DYING IN NORTH CAROLINA; AND 3
APPROPRIATING FUNDS FOR THIS PURPOSE. 4
Whereas, medical aid in dying (MAID) is a recognized end -of-life (EOL) option for 5
terminally ill, mentally competent adults who have been diagnosed with a life expectancy of less 6
than 6 months to hasten the dying process; and 7
Whereas, since 1997, 10 states and the District of Columbia have legalized MAID to 8
enable eligible adults who have been examined by at least two physicians to receive an aid in 9
dying medication that these adults may choose to self -administer in the comfort of their own 10
homes among family members and friends; and 11
Whereas, many adults choose not to t ake the aid in dying medication even after 12
completing the rigorous application process, but are nevertheless comforted by a renewed sense 13
of autonomy and control in having the aid in dying medication on hand; and 14
Whereas, data from the 11 United States jur isdictions that have legalized MAID 15
indicates that over 90% of MAID applicants have medical insurance and are enrolled in hospice 16
but nevertheless prefer to abbreviate the dying process through MAID; and 17
Whereas, in the collective 50 years of data availabl e from the 11 United States 18
juridictions that have legalized MAID, there have been no recorded instances of misuse, abuse, 19
or coercion and the MAID laws have been operating as envisioned since the time of enactment; 20
and 21
Whereas, the percentage of eligible adults who have availed themselves of this 22
end-of-life option in each United States jurisdiction where MAID has been legalized has not 23
exceeded 0.75%; Now, therefore, 24
The General Assembly of North Carolina enacts: 25
SECTION 1.(a) The North Carolina Institute of Medicine shall study the advantages 26
and disadvantages of legalizing medical aid in dying (MAID) in North Carolina. The study shall 27
include an evaluation of at least all of the following: 28
(1) In the 11 United States jurisdictions that have legalized MAID (current MAID 29
states), the process by which a person applies and receives approval for 30
MAID, including applicant qualifications and safeguards. 31
(2) The factors that contribute most to a person's decision to seek MAID. 32
(3) The characteristics and demographic backgrounds of persons who seek 33
MAID. 34
General Assembly Of North Carolina Session 2025
Page 2 House Bill 410-First Edition
(4) The social and emotional impacts on a person's family members when MAID 1
is available to a person as an alternative to an extended dying process. 2
(5) Which medications have been or are currently being used for MAID, and 3
whether intravenous self -administration would be an improvement over 4
self-ingestion through the gastrointestinal tract. 5
(6) The best options for healthcare providers to opt out of participating in MAID. 6
(7) Available data from the current MAID states that are reporting on conclusions 7
arising from the legalization of MAID, particularly with respect to the 8
effectiveness of MAID laws in providing an end-of-life option. 9
(8) What end -of-life options are currently available in North Carolina and 10
recommendations about whether MAID is an advisable additional alternative. 11
(9) To what extent the absence of MAID in North Carolina and other states 12
increases the chance that a terminally ill person will choose to commit suicide 13
by violent or other means. 14
(10) Developments in MAID legislation since Oregon's 1997 Death with Dignity 15
Act and recommendations about what safeguards are essential to ensure that 16
only mentally competent, terminally ill persons are seeking MAID and that 17
they are seeking MAID without coercion or undue pressure; and, by contrast, 18
which current safeguards have become redundant and are no longer needed. 19
(11) Using data from current MAID states, the number of people who would likely 20
utilize MAID if it became legal in North Carolina. 21
(12) In current MAID states, whether there are indications that individuals have 22
been coerced into using MAID. 23
(13) In current MAID states, the implementation impact of MAID on healthcare 24
systems, institutions, and providers. 25
(14) In current MAID states, the impact of MAID on awareness or utilization of 26
hospice and palliative care as an alternative to MAID. 27
(15) The reasons why approximately one -third of the persons who apply for and 28
receive MAID drugs decide not to take them, including whet her there are 29
psychological benefits to having MAID as a legal option even if people 30
ultimately decide against using or even applying for MAID. 31
(16) The percentage of eligible terminally ill, mentally competent persons in each 32
United States jurisdiction where MAID is legal who do, in fact, avail 33
themselves of this law. 34
(17) Any other areas the Department deems relevant or helpful to determining 35
whether to legalize MAID in North Carolina. 36
SECTION 1.(b) The North Carolina Institute of Medicine (NCIOM) shal l, prior to 37
submitting the report required by subsection (c) of this section, conduct at least one public hearing 38
to ensure the general public has an opportunity to provide the NCIOM with comments regarding 39
the advantages and disadvantages of legalizing MA ID in North Carolina. The NCIOM shall 40
provide at least 15 days' advance notice of a public hearing conducted pursuant to this subsection. 41
All interested persons shall be heard at the public hearing. 42
SECTION 1.(c) By April 1, 2027, the North Carolina Insti tute of Medicine shall 43
report its findings and any recommendations with respect to legalizing MAID in North Carolina, 44
including any recommendations regarding proposed legislation, to the Joint Legislative 45
Oversight Committee on Health and Human Services and the Department of Health and Human 46
Services. 47
SECTION 2. Effective July 1, 2025, there is appropriated from the General Fund to 48
the Department of Health and Human Services the sum of one hundred fifty thousand dollars 49
($150,000) in nonrecurring funds for the 2025 -2026 fiscal year to be allocated to the North 50
Carolina Institute of Medicine to fund the study authorized by Section 1 of this act. 51
General Assembly Of North Carolina Session 2025
House Bill 410-First Edition Page 3
SECTION 3. Except as otherwise provided, this act is effective when it becomes 1
law. 2