Legislature(2017 - 2018)CAPITOL 106
01/30/2018 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB54 | |
| HB162 | |
| HB268 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 54 | TELECONFERENCED | |
| += | HB 162 | TELECONFERENCED | |
| *+ | HB 268 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 54-TERMINALLY ILL: ENDING LIFE OPTION
3:06:37 PM
CHAIR SPOHNHOLZ announced that the first order of business would
be SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 54, "An Act providing
an end-of-life option for terminally ill individuals; and
providing for an effective date."
3:07:00 PM
REPRESENTATIVE HARRIET DRUMMOND, Alaska State Legislature,
paraphrased from the Sponsor Statement [Included in members'
packets, which read in part:
This bill allows patients to have important end-of-
life discussions with the doctors they already know
and trust. Without this discussion, well-meaning
doctors are faced with prescribing painful procedures
even when the patient does not want them and there is
little or no hope for success. People in these
conditions have already lost their health and often
much, much more. This bill at least lets them control
the last and most important decision they have left.
House Bill 54 allows terminally ill patients to ease
their suffering and hasten an inevitable and certain
death. This bill preserves dignity and a person's
right to live, and die, on their own terms according
to they own desires and beliefs.
REPRESENTATIVE DRUMMOND offered an update of the bill since the
last hearing during the spring of 2017. She relayed that a
survey had been conducted of more than 600 Alaskans which showed
that more than 70 percent of voting Alaskans supported an end of
life option, "such that this bill allows." She declared that
community support was also rising, directing attention to a
Kodiak Island Borough assembly resolution in support of the
proposed bill. She encouraged support of the proposed bill.
3:08:52 PM
REPRESENTATIVE SULLIVAN-LEONARD asked for more information about
the survey.
REPRESENTATIVE DRUMMOND explained that this survey by a private
group was offered regularly on a quarterly basis and questions
could be added. In response, she said that the cost, paid by
her office account, was between $1600 - $1800.
CHAIR SPOHNHOLZ pointed out that Representative Saddler,
although present, was a committee alternate, and would not be
needed to participate as a committee member.
3:10:02 PM
CHAIR SPOHNHOLZ moved to adopt Amendment 1, labeled 30-
LS0254\O.1, Laffen/Bannister, 1/29/18, which read:
Page 2, line 21, following "request":
Insert "and a written request"
Page 2, following line 28:
Insert a new subsection to read:
"(c) Notwithstanding (a) of this section, if a
qualified individual is not physically able to sign a
written request, the qualified individual may direct
another individual to sign for the qualified
individual."
Page 2, line 31, following "request":
Insert "and the written request"
Page 3, following line 4:
Insert new sections to read:
"Sec. 13.55.050. Written request requirements.
(a) A written request for medication under this
chapter must be in substantially the form described in
AS 13.55.060, signed and dated by the qualified
individual, and witnessed by at least two other
individuals. The attending physician may not witness
the request. The witnesses shall, in the presence of
the qualified individual, attest that, to the best of
their knowledge and belief, the qualified individual
is capable, acting voluntarily, and not under undue
influence to sign the request.
(b) Only one witness may be
(1) a relative of the qualified individual
by blood, marriage, or adoption;
(2) an individual who, at the time the
qualified individual signs the request, would be
entitled to a portion of the estate of the qualified
individual at death under a will or by operation of
law; or
(3) an owner, operator, or employee of a
health care facility where the qualified individual is
receiving medical treatment or is a resident.
(c) If the qualified individual is an inpatient
in a long-term care facility when the qualified
individual signs the request, one of the witnesses
shall be an individual designated by the facility who
has the qualifications established by the department
by regulation. In this subsection, "long-term care
facility" includes an assisted living home as defined
in AS 47.32.900 and a nursing facility as defined in
AS 47.32.900.
Sec. 13.55.060. Form for written request. A
request for a medication under this chapter must be in
substantially the following form:
REQUEST FOR MEDICATION TO END MY LIFE
I, _________________, am an adult of sound mind.
I am suffering from _______________, which my
attending physician has determined is a terminal
disease and which has been medically confirmed by a
consulting physician.
I have been fully informed of my diagnosis,
prognosis, the nature of the medication to be
prescribed and potential associated risks, the
expected result, and the feasible alternatives,
including comfort care, hospice care, and pain
control.
I request that my attending physician prescribe
medication that will end my life in a humane and
dignified manner.
INITIAL ONE OF THE FOLLOWING:
_____ I have informed my family of my decision
and taken their opinions into consideration.
_____ I have decided not to inform my family of
my decision.
_____ I have no family to inform of my decision.
I understand that I have the right to rescind
this request at any time.
I understand the full import of this request, and
I expect to die when I take the medication to be
prescribed. I further understand that, although most
deaths occur within three hours, my death may take
longer, and my attending physician has counseled me
about this possibility.
I make this request voluntarily and without
reservation, and I accept full moral responsibility
for my actions.
Signed: _____________________
Dated: ______________________
DECLARATION OF WITNESSES
We declare that the person signing this request
(1) is personally known to us or has
provided proof of identity;
(2) in our presence signed or directed
another person to sign this request;
(3) is not an individual for whom either of
us is the attending physician; and
(4) to the best of our knowledge and belief,
(A) has the ability to make and communicate
health care decisions to health care providers; and
(B) is acting voluntarily and not under
undue influence.
_______________________ Witness 1 Date: _____
_______________________ Witness 2 Date: _____
NOTE: One witness may not be a relative (by
blood, marriage, or adoption) of the individual
signing this request, may not be entitled to a portion
of the individual's estate on death, and may not own,
operate, or be employed at a health care facility
where the person is an individual or resident. If the
individual is an inpatient at a health care facility,
one of the witnesses shall be an individual designated
by the facility."
Page 3, line 5:
Delete "Sec. 13.55.050"
Insert "Sec. 13.55.070"
Page 3, line 22:
Delete "AS 13.55.070"
Insert "AS 13.55.090"
Page 4, line 2:
Delete "AS 13.55.110"
Insert "AS 13.55.130"
Page 4, line 20:
Delete "Sec. 13.55.060"
Insert "Sec. 13.55.080"
Page 4, line 26:
Delete "Sec. 13.55.070"
Insert "Sec. 13.55.090"
Page 5, line 2:
Delete "Sec. 13.55.080"
Insert "Sec. 13.55.100"
Page 5, line 7:
Delete "Sec. 13.55.090"
Insert "Sec. 13.55.110"
Page 5, line 10:
Delete "Sec. 13.55.100"
Insert "Sec. 13.55.120"
Page 5, line 13, following "prescription":
Insert "and more than 48 hours have elapsed
between the qualified individual's written request and
the writing of the prescription"
Page 5, line 14:
Delete "Sec. 13.55.110"
Insert "Sec. 13.55.130"
Page 5, following line 18:
Insert a new paragraph to read:
"(2) all written requests by a qualified
individual for medication under this chapter;"
Renumber the following paragraphs accordingly.
Page 6, line 2:
Delete "Sec. 13.55.120"
Insert "Sec. 13.55.140"
Page 6, line 6:
Delete "Sec. 13.55.130"
Insert "Sec. 13.55.150"
Page 6, line 19:
Delete "Sec. 13.55.140"
Insert "Sec. 13.55.160"
Page 6, line 28:
Delete "Sec. 13.55.150"
Insert "Sec. 13.55.170"
Page 7, line 5:
Delete "Sec. 13.55.160"
Insert "Sec. 13.55.180"
Page 7, line 9:
Delete "Sec. 13.55.170"
Insert "Sec. 13.55.190"
Delete "AS 13.55.130"
Insert "AS 13.55.150"
Delete "13.55.140"
Insert "13.55.160"
Page 7, line 10:
Delete "AS 13.55.150"
Insert "AS 13.55.170"
Page 7, line 11:
Delete "AS 13.55.160"
Insert "AS 13.55.180"
Page 7, line 27:
Delete "Sec. 13.55.180"
Insert "Sec. 13.55.200"
Page 8, line 12:
Delete "Sec. 13.55.190"
Insert "Sec. 13.55.210"
Page 8, line 14:
Delete "Sec. 13.55.200"
Insert "Sec. 13.55.220"
Page 8, line 18:
Delete "Sec. 13.55.210"
Insert "Sec. 13.55.230"
Page 9, line 2:
Delete "Sec. 13.55.220"
Insert "Sec. 13.55.240"
Page 9, line 12:
Delete "Sec. 13.55.230"
Insert "Sec. 13.55.250"
Page 9, line 20:
Delete "Sec. 13.55.240"
Insert "Sec. 13.55.260"
Page 9, line 26:
Delete "Sec. 13.55.250"
Insert "Sec. 13.55.270"
Page 10, line 1:
Delete "AS 13.55.220"
Insert "AS 13.55.240"
Page 11, line 11:
Delete "AS 13.55.150"
Insert "AS 13.55.170"
Page 11, line 13:
Delete "AS 13.55.150"
Insert "AS 13.55.170"
3:10:28 PM
REPRESENTATIVE TARR objected for discussion.
CHAIR SPOHNHOLZ explained that proposed Amendment 1 would
include in statute a requirement that a terminally ill
individual's desire for life ending medication be written down
and witnessed by two individuals. Of those two, only one could
be related to an individual entitled to a portion of the estate
of the individual whose life would be ending or be employed by
the health care facility where the individual was living or
receiving treatment. She clarified that two interested parties
could not sign off on this. She shared that there was an
exemption to the written requirement if the individual did not
possess the capacity to physically sign the document. In that
case, the individual could direct another person to sign on
their behalf. She reported that pages 2 and 3 of proposed
Amendment 1 spelled out the form of the written request and the
witnessing aspect. She directed attention to page 5, lines 1 -
2, of proposed Amendment 1, where the written request waiting
period was outlined. On page 5, lines 10 - 11, the
documentation requirement was outlined.
3:11:38 PM
REPRESENTATIVE TARR removed her objection.
3:11:47 PM
REPRESENTATIVE SULLIVAN-LEONARD objected.
REPRESENTATIVE EASTMAN asked about a request for medication by
an individual as an option, as they may be unsure of their
decision. He asked if these witnesses would have to be present
during the administration of the medicine.
CHAIR SPOHNHOLZ said no.
3:12:35 PM
REPRESENTATIVE JOHNSTON directed attention to Page 2, line 7 and
asked if the "by regulation" referenced the facility and not the
person.
CHAIR SPOHNHOLZ replied, "correct."
REPRESENTATIVE EASTMAN acknowledged that the concerns for
coercion had been raised in the last year. He asked if there
were concerns for coercion regarding an individual, and whether
that would prohibit the written request from going through or
would it not have an effect.
CHAIR SPOHNHOLZ offered her belief that the written request was
to document and insure that coercion was not in place.
REPRESENTATIVE EASTMAN asked if a situation of coercion would
prohibit this as a second attempt.
CHAIR SPOHNHOLZ questioned whether the reference of second
attempt was toward an individual choosing to end their life.
She opined that the individual would still have the autonomy for
choice.
3:14:24 PM
REPRESENTATIVE SULLIVAN-LEONARD maintained her objection.
3:14:33 PM
A roll call vote was taken. Representatives Spohnholz,
Johnston, Edgmon, Kito, and Tarr voted in favor of proposed
Amendment 1. Representatives Sullivan-Leonard and Eastman voted
against it. Therefore, Amendment 1 was adopted by a vote of 5
yeas - 2 nays.
3:15:27 PM
REPRESENTATIVE EASTMAN asked what would appear on the death
certificate if someone went through this process.
REPRESENTATIVE DRUMMOND offered her understanding that the
diagnosis on the death certificate would be the terminal illness
which would have killed the person.
REPRESENTATIVE EASTMAN mused that, from a legal perspective, it
would appear that the person had not engaged entirely in this
process, and they had died of natural causes.
REPRESENTATIVE DRUMMOND replied, "I think so."
REPRESENTATIVE SADDLER (alternate) asked to clarify that,
although he was not allowed to vote on the proposed bill, he was
not allowed to debate the issue, as well.
CHAIR SPOHNHOLZ offered her belief that "an alternate is to make
sure that you caucus is properly represented and that you're
here for informational purposes."
3:17:59 PM
REPRESENTATIVE TARR moved to report SSHB 54, Version 30-
LS0254\O, as amended, out of committee with individual
recommendations and the accompanying fiscal notes.
3:18:13 PM
REPRESENTATIVE EASTMAN objected. He shared that his concerns
were "squarely on the side of what happens when what is supposed
to happen doesn't happen." He declared that a chief role of
government was to protect an individual's right to life and he
expressed his concern that within this intention of creating a
path for things to happen, there would be abuse. He stated his
concern that, if there was no requirement for any witnesses to
be present when the drugs were administered, it would be very
difficult for law enforcement to investigate if something
criminal and illegal did take place which resulted in the death.
He declared that this was not a fulfillment of the role to
protect an individual's right to life, or to prosecute someone
who took a life criminally. He expressed his concern that the
age requirement for this process was very young.
3:20:46 PM
REPRESENTATIVE SULLIVAN-LEONARD echoed the comments of
Representative Eastman and stated that she did not support the
proposed bill. She stated that she believed in the sanctity of
life, from beginning to end. She shared a personal anecdote of
death within her family. She declared that this was a very
controversial bill.
3:21:44 PM
REPRESENTATIVE TARR referenced the sad stories shared earlier.
She declared that each individual had the right to make this
decision. She expressed her concern for the more vulnerable
populations, including seniors and those individuals with
disabilities. She directed attention to page 2, line 7, that an
individual did not qualify solely because of age or
disabilities. She noted that many elders did feel themselves a
burden on family, especially as their health deteriorated, they
had more significant needs, and they did not have the resources
or access to good health care. She offered her belief that, as
the language of the proposed bill was restrictive, the issues
had been addressed sufficiently. She stated her support of the
proposed bill. She acknowledged that the witness aspect was "an
interesting component" and she expressed her desire that the
bill sponsor further address this as the bill moved forward.
3:24:11 PM
CHAIR SPOHNHOLZ offered her belief that it was a fundamental
right for an individual to make the decisions for their own
body. She allowed that the proposed bill included numerous
safeguards, including the written requirement. She said that it
was important to document the process. She directed attention
to page 7, line 27, which established AS 13.55.180, a new
section establishing criminal penalties for anyone committing
the crime of abuse of life ending process of a person. She
pointed out that this was equivalent to murder and may be
punished similarly. She declared that this proposed bill was
not legalizing anything other than giving an individual the
right to make their own choices with their bodies. This did not
give anyone else the right to choose to end another's life.
3:26:32 PM
REPRESENTATIVE EASTMAN maintained his objection.
3:26:37 PM
A roll call vote was taken. Representatives Spohnholz,
Johnston, Edgmon, Kito, and Tarr voted in favor of SSHB 54.
Representatives Sullivan-Leonard and Eastman voted against it.
Therefore, CSSSHB 54, Version 30-LS0254\O, was reported out of
the House Health and Social Services Standing Committee by a
vote of 5 yeas - 2 nays.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SSHB268 Sectional Analysis ver O 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Sponsor Statement 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-AK DHSS Opioid Addiction and Treatment Factsheet 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-AK DHSS Opioid Infographic 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-AK DHSS Heroin Use Infographic 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-AK DHSS Pain Treatment Handout 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-AMA Study 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-Article ADN AK Gov. Opioid Declaration 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-Article ADN AK Heroin Problem 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-Article Huffington Post 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB 268 Fiscal Note DCCED-CBPL 01.29.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-STUFF Online Article on Alternative Pain Treatment in NZ 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-Report CDC Long Term Opioid Use 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-NJAFP Notice RE New Jersey Opioid Law 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-New Jersey Legislature Relevant Opioid Statutes Doc 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-CDC Patient Opioid Fact Sheet 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-Article VOX 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-Article The Star Press Opioids and Foster Care Indiana 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-Article NIDA 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-Article New Yorker 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB268 Supporting Document-CDC Checklist for Opioid Prescribers 1.24.18.pdf |
HHSS 1/30/2018 3:00:00 PM HHSS 2/22/2018 3:00:00 PM HHSS 2/27/2018 3:00:00 PM HHSS 3/6/2018 3:00:00 PM |
HB 268 |
| SSHB 54 Supporting Document--End of Life Survey 1.29.2018.pdf |
HHSS 1/30/2018 3:00:00 PM |
HB 54 |
| SSHB 54 Supporting Document--Girdwood Board Of Supervisors.pdf |
HHSS 1/30/2018 3:00:00 PM |
HB 54 |
| SSHB54 Supporting Document - Medical Aid in Dying Kodiak Times.pdf |
HHSS 1/30/2018 3:00:00 PM |
HB 54 |
| SSHB 54 Fiscal Note--DHSS-DPH 1.29.2018.pdf |
HHSS 1/30/2018 3:00:00 PM |
HB 54 |
| SSHB 54 Fiscal Note--DOL-CJL 1.29.2018.pdf |
HHSS 1/30/2018 3:00:00 PM |
HB 54 |