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where treatment is withdrawn and the patient dies from the underlying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.