The New Illinois End of Life Options for Terminally Ill Patients Act – Considerations for Health Care Entities

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 medications is not considered suicide or homicide.   

Deb’s Law authorizes the “Attending Physician,” defined as the physician with primary responsibility for the care of a patient and the treatment of the patient’s terminal illness, to receive patient requests for AID medication; to determine whether the patient is a Qualified Patient under the new law and thus may receive a prescription for AID medication; and, to issue a prescription for the medication pursuant to the provisions of the new law.  

After making a determination that the patient is a Qualified Patient, the Attending Physician must 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.  

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.  

Deb’s Law will impact patients and their families, physicians and other health professionals and “Health Care Entities” (“HCEs”) in different ways.  This discussion focuses on HCEs.  

Under Deb’s Law, a Health Care Entity is defined 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.  “HCE” does not include a physician.

HCEs may, but are not obligated to, participate in AID care as described in Deb’s Law. Depending upon its decision to participate, or to decline to participate, an HCE will need to take certain steps to prepare for implementation of the new law.  It is important to note that the new law imposes obligations on HCEs regardless of their decision whether to participate in AID care. 

Should an HCE decide that it will not participate in AID care, and thus decide to prohibit its health care professionals, staff, employees or independent contractors from providing AID care while they are performing duties for or in the facilities of the HCE, the HCE must notify these individuals of its decision.  In addition to any initial notification it may provide, the entity must provide advance written notice of its decision at the time of hiring, contracting with or privileging its health care professionals and staff, and on a yearly basis thereafter.  

An HCE that declines to participate in AID care may not prohibit its health care professionals from providing AID care when they are working in an independent capacity and off the premises of the HCE, provided that the health care professionals providing AID care must explicitly inform their patients that they are acting in a capacity that is independent of, and not as a representative of, the HCE. In addition, an HCE may not restrict its health care professionals from providing information to patients about AID care or from providing information about relevant community resources and how to access those resources to obtain the care the patient chooses. If a patient decides to seek care from another Health Care Entity, the HCE must coordinate a timely transfer of care including a transmittal of the patient’s medical records without undue delay.

The HCE declining to permit AID care as part of its operations must be prepared to respond to patient requests for these services in a manner that is consistent with the new law.  The new law requires HCEs and health professionals who are unable or unwilling to carry out an individual’s request for AID care to inform the individual of this inability or unwillingness and to refer the individual either to a health care professional who is able and willing to evaluate and qualify the individual or to another individual or entity to assist the requesting individual in seeking AID care. 

The new law prohibits HCEs from engaging in false, misleading or deceptive practices relating to an HCE’s policy around end-of-life services and includes specific proscribed actions.  

The Illinois Healthcare Right of Conscience Act is incorporated into the new law and will require that HCEs permitting the delivery of AID care as part of their operations be responsive to the rights of its health professionals and staff to decline to participate in AID care, and to ensure that patients requesting AID care are transferred to other providers who are willing and able to provide it when this occurs. 

Regardless of whether an HCE decides to permit the delivery of AID care as part of its operations or declines to permit AID care, the HCE will want to ensure that its health professionals and staff are aware of its policy and have appropriate guidance and forms in compliance with the new law. 

The full scope of the responsibilities and requirements set forth in Deb’s Law are too detailed to include in this short discussion.  It will be necessary for the HCE to review the provisions of Deb’s Law carefully including documentation and referral requirements and other responsibilities of the HCE, Attending Physician, Consulting Physician and LMHP. Among the details warranting careful review 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 details of how a Qualified Patient who wishes to request AID medication must do so.

The new law provides a form for the patient request, contains reporting requirements and provides for the Illinois Department of Public Health, within 45 days of the effective date, to publish an Attending Physician Checklist Form and an Attending Physician Follow-Up Form to facilitate collection of reportable information.

In addition to the law, the HCE should carefully review any regulations, checklists and forms that may be issued by the Illinois Department of Public Health or the Illinois Department of Veterans Affairs pursuant to the new law, and incorporate these into any policies and practices as applicable and appropriate.  A review by counsel is also advisable. 

The summary contained in the above article is not intended to constitute legal advice and is not a complete description of the obligations of HCEs or health professionals 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.