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3.2 Situations where treatment is withdrawn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.