1.0 BACKGROUND
1.1 When writing
the Assisted Suicide Funding Restriction Act of 1997 (Public Law
105-12), Congress found the following:
1.1.1 The Federal Government provides
financial support for the provision and payment for health care
services, as well as for the advocacy activities to protect the
rights of individuals.
1.1.2 Assisted suicide, euthanasia,
and mercy killing have been criminal offenses throughout the United
States (U.S.) and, under current law, it would be unlawful to provide
services in support of such illegal activities.
1.1.3 Because
of the recent legal developments, it may become lawful in areas
of the U.S. to furnish services in support of such activities.
1.1.4 Congress
is not providing Federal financial assistance in support of assisted
suicide, euthanasia, and mercy killing and intends that Federal
funds not be used to promote such activities.
1.2 It is the
principal purpose of this Act to continue current Federal policy
by providing explicitly that Federal funds may not be used for items
and services (including assistance) the purpose of which is to cause
(or assist in causing) the suicide, euthanasia, or mercy killing
of any individual. See Policy below for specifics regarding this
subject.
3.0 POLICY
3.1 No TRICARE
funds may be used:
3.1.1 To provide any health care item or service
furnished for the purpose of causing, or for the purpose of assisting
in causing, the death on any individual, such as by assisted suicide,
euthanasia, or mercy killing;
3.1.2 To pay (directly, through
payment of Federal financial participation or other matching payment,
or otherwise) for such an item or service, including payment of
expenses relating to such an item or service; or
3.1.3 To pay
(in whole or in part) for health benefit coverage that includes
any coverage of such an item or service or of any expenses relating
to such an item or service.
3.2 Situations where treatment
is withdrawn and the patient dies from the underlying pathology are
not considered physician-assisted suicide. Also, there are times
when a physician withholds or withdraws treatment with the intention
of respecting the patient’s wishes and not to cause the person’s death.
This policy, therefore, does not affect:
3.2.1 The withholding or withdrawing
of medical treatment or medical care;
3.2.2 The withholding or withdrawing
of nutrition or hydration;
3.2.3 The use of an item, good,
benefit, or service furnished for the purpose of alleviating pain
or discomfort, even if such use may increase the risk of death,
so long as such item, good, benefit or service is not also furnished
for the purpose of causing, or the purpose of assisting in causing,
death, for any reason.
3.3 Limitation on Federal facilities
and employees with respect to health care items and services furnished
includes those provided:
3.3.1 By or in a health care facility
owned or operated by the Federal Government; or
3.3.2 By any
physician or other individual employed by the Federal Government
to provide health care services within the scope of the physician’s
or individual’s employment, no such item or service may be furnished
for the purpose of causing, or for the purpose of assisting in causing,
the death of any individual, such as by assisted suicide, euthanasia,
or mercy killing.
3.4 When the contractor becomes
aware that a provider has been prosecuted and convicted of a physician-assisted
suicide or when documentation is attached to the claim indicating
a physician-assisted suicide, the care is to be denied.