The Illinois End-of-Life Options for Terminally Ill Patients Act – Physician Considerations 

The Illinois End-of-Life Options for Terminally Ill Patients Act, also known as “Deb’s Law,” goes into effect in Illinois on September 12, 2026.  Deb’s Law is intended to provide an option for patients experiencing terminal illness.  It allows an adult Illinois resident who has the mental capacity to make medical decisions and who has a terminal disease with a prognosis of six months or less to live (a “Qualified Patient”) to request that their Attending Physician provide a prescription for “Aid In Dying” (“AID”) medication that will end their life in a peaceful manner.  Deb’s Law is intended to allow patients to exert some level of control over the progression of their disease as they near the end of life or to ease unnecessary pain and suffering.  The patient must be able to make an informed decision, be free of coercion or undue influence and, if they choose to take the medication, must self-administer it.  Under Deb’s Law, the use of AID medication is not considered suicide or homicide.   

The physician most impacted by Deb’s Law is the Attending Physician of a Qualified Patient.  The term “Attending Physician” is defined under the new law as the physician with primary responsibility for the care of the patient and for the treatment of the patient’s terminal disease.  By way of example, for cancer patients this is usually the oncologist.  But terminal disease is not limited to cancer and a physician, regardless of specialty, who has primary responsibility for the care of a patient and the treatment of the patient’s terminal disease is that patient’s Attending Physician for purposes of the new law.  Deb’s Law authorizes Attending Physicians to receive patient requests for AID medication; to determine whether the patient is a Qualified Patient; and, to issue a prescription for the medication pursuant to the provisions of the new law.  

The new law provides that the Attending Physician shall refer the patient to a “Consulting Physician,” a physician who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding the patient’s disease.  The Consulting Physician must evaluate the patient to confirm in writing that the patient has requested a prescription for AID medication; has a terminal disease with a prognosis of six months or less to live; has mental capacity (or has been referred for evaluation of mental capacity by a “Licensed Mental Health Professional” (“LMHP”) as discussed below; and is acting voluntarily, free from coercion or undue influence. 

Although a primary care physician such as an internist or family medicine physician may have a longstanding relationship with a patient, this physician is not necessarily the patient’s Attending Physician for purposes of the new law if this physician does not have primary responsibility for the care of the patient and the treatment of the patient’s terminal disease.  However, the primary care physician may still be involved in responding to a patient request for AID medication and may be requested to perform the role of a Consulting Physician if the primary care physician meets the qualifications for this role.  

If either the Attending Physician or the Consulting Physician is concerned that the patient may not have the mental capacity to make an informed decision, they must consult a third type of provider, the LMHP, to make a written determination concerning the patient’s mental capacity.  An LMHP may be a psychiatrist, a clinical psychologist, a clinical social worker or an advanced practice nurse and must fulfill specific requirements detailed in the new law.  

What should physicians do to prepare for requests for AID medication and for the discussions that will inevitably occur once the new law goes into effect?

Providers who practice as part of a Health Care Entity must determine the policy of that entity regarding the new law.  Deb’s Law defines a “Health Care Entity” (“HCE”) as a hospital or hospital affiliate, nursing home, hospice or any other facility licensed under any of the following Acts: the Ambulatory Surgical Treatment Center Act; the Home Health, Home Services and Home Nursing Agency Licensing Act; the Hospice Program Licensing Act; the Hospital Licensing Act; the Nursing Home Care Act; or the University of Illinois Hospital Act.  The term Health Care Entity does not include a physician.  

Section 65 of Deb’s Law expressly provides that an HCE is under no duty to participate in the provision of AID care as described in that law, and expressly allows an HCE to prohibit health care professionals, staff, employees or independent contractors from providing AID care while performing duties for, or in the facilities of, the HCE.  Thus, if a physician provides care as part of an HCE that prohibits AID care, the physician may not provide this care unless the physician is acting independently and off the premises of the prohibiting HCE.  When providing AID care in this independent capacity, the physician must explicitly notify the patient that the physician is acting in a capacity that is independent of the HCE.

The full scope of the responsibilities and detailed requirements set forth in Deb’s Law are too numerous to include in this short discussion. Whether a physician is acting under the auspices of an HCE that allows for the provision of AID care or is acting independently, it will be necessary for physicians to review the provisions of Deb’s Law carefully, including documentation, referral and reporting requirements and other responsibilities of the Attending Physician and Consulting Physician.  The physician will need to become familiar with any regulations, checklists and forms that may be issued by the Illinois Department of Public Health or the Illinois Department of Veterans Affairs.  A review by counsel is also advisable. 

Among the provisions critical to physicians are the requirements for a Qualified Patient to make an informed decision; a list of the Attending Physician, Consulting Physician, LMHP and HCE responsibilities; and provisions that specify how a Qualified Patient must request AID medication.  The new law includes a form for the patient request and a list of reports the Attending Physician must make to the IDPH. 

Even if a physician chooses not to provide AID care, the physician may still receive requests from patients and must be prepared to respond in a manner that complies with the new law.  If a patient requests AID care, an Attending Physician who declines to provide this care must, at minimum, inform the patient of the physician’s inability or unwillingness to provide the requested care and must refer the patient either to a health care professional who is able and willing to evaluate and qualify the patient for the requested care or must refer the patient to another individual or entity to assist the patient in seeking AID care.    

Deb’s Law contains detailed requirements, protections and immunities pertaining to patients, physicians, health care professionals and health care entities.  As the effective date approaches all physicians, regardless of their individual perspectives on the law, will need to be ready for the discussions that will undoubtedly occur.  Physicians must be prepared to refer patients to other providers who can assist them if the physician cannot; and must take care to avoid any actions that may be construed as misleading, coercive or as exerting an undue influence over the patient’s decision.  Helping patients to navigate this new healthcare option will require understanding, compassion and diplomacy.  

The summary contained in the above article is not intended to constitute legal advice and is not a complete description of the obligations of physicians under Deb’s Law.  Please review the statutory text in its entirety, as well as any regulations that may be issued, and consult counsel as appropriate.