Legislature(1995 - 1996)

02/20/1996 03:04 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
          HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES                          
                       STANDING COMMITTEE                                      
                       February 20, 1996                                       
                           3:04 p.m.                                           
 MEMBERS PRESENT                                                               
 Representative Cynthia Toohey, Co-Chair                                       
 Representative Con Bunde, Co-Chair                                            
 Representative Gary Davis                                                     
 Representative Norman Rokeberg                                                
 Representative Caren Robinson                                                 
 Representative Tom Brice                                                      
 MEMBERS ABSENT                                                                
 Representative Al Vezey                                                       
 COMMITTEE CALENDAR                                                            
 HOUSE BILL NO. 371                                                            
 "An Act relating to the rights of terminally ill persons."                    
      - PASSED CSHB 371(HES) OUT OF COMMITTEE                                  
 * HOUSE CONCURRENT RESOLUTION NO. 27                                          
 Relating to prevention of teenage pregnancy by implementation of              
 the Sugar Baby project.                                                       
      - PASSED OUT OF COMMITTEE                                                
 (* First public hearing)                                                      
 PREVIOUS ACTION                                                               
 BILL:  HB 371                                                               
 SHORT TITLE: RIGHTS OF TERMINALLY ILL PERSONS                                 
 SPONSOR(S): REPRESENTATIVE(S) BROWN,TOOHEY,Finkelstein,Davies                 
 JRN-DATE     JRN-PG               ACTION                                      
 12/29/95      2363    (H)   PREFILE RELEASED                                  
 01/08/96      2363    (H)   READ THE FIRST TIME - REFERRAL(S)                 
 01/08/96      2363    (H)   HES, STATE AFFAIRS, JUDICIARY                     
 02/06/96              (H)   HES AT  3:00 PM CAPITOL 106                       
 02/06/96              (H)   MINUTE(HES)                                       
 02/13/96              (H)   HES AT  3:00 PM CAPITOL 106                       
 02/13/96              (H)   MINUTE(HES)                                       
 02/20/96              (H)   HES AT  3:00 PM CAPITOL 106                       
 BILL:  HCR 27                                                               
 SHORT TITLE: TEEN PREGNANCY EDUCATION                                         
 SPONSOR(S): REPRESENTATIVE(S) BUNDE                                           
 JRN-DATE     JRN-PG               ACTION                                      
 02/12/96      2721    (H)   READ THE FIRST TIME - REFERRAL(S)                 
 02/12/96      2721    (H)   HEALTH, EDUCATION AND SOCIAL SERVICES             
 02/20/96              (H)   HES AT  3:00 PM CAPITOL 106                       
 WITNESS REGISTER                                                              
 JOHN P. MONAGLE, President                                                    
 Alaskans for Life                                                             
 P.O. Box 210527                                                               
 Auke Bay, Alaska  99821                                                       
 Telephone:  (907) 789-5910                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 DICK REGAN, Member                                                            
 Hemlock Society                                                               
 825 Goldbelt                                                                  
 Juneau, Alaska  99801                                                         
 Telephone:  (907) 586-6237                                                    
 POSITION STATEMENT:  Testified in support of HB 371                           
 RITCHIE SONNER, Executive Director                                            
 Hospice and Home Care                                                         
 3200 Hospital Drive                                                           
 Juneau, Alaska  99801                                                         
 Telephone:  (907) 463-3113                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 SHIRLEEN RANNALS                                                              
 1751 Westview Circle                                                          
 Anchorage, Alaska  99504                                                      
 Telephone:  (907) 333-9425                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 THERESE SYREN                                                                 
 7027 Lake Otis Parkway                                                        
 Anchorage, Alaska  99507                                                      
 Telephone:  (907) 349-5966                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 KENNETH HITCH, Representative                                                 
 Council 11558, Knights of Columbus                                            
 1706 Dimond Drive                                                             
 Anchorage, Alaska  99507                                                      
 Telephone:  (907) 563-6779                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 NANCY COLE                                                                    
 8231 Wilcox                                                                   
 Anchorage, Alaska  99502                                                      
 Telephone:  (907) 248-0122                                                    
 POSITION STATEMENT:  Testified in support of HB 371                           
 MARGUERITE McINTOSH, Family Doctor                                            
 35670 Spur Highway                                                            
 Soldotna, Alaska  99669                                                       
 Telephone:  (907) 262-6105                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 KAREN STROH, Representing                                                     
 Frontier Training Center                                                      
 P.O. Box 2110                                                                 
 Soldotna, Alaska  99669                                                       
 Telephone:  (907) 262-6331                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 AMY BOLLENBACH                                                                
 P.O. Box 3429                                                                 
 Homer, Alaska  99603                                                          
 Telephone:  (907) 235-6954                                                    
 POSITION STATEMENT:  Testified in support of HB 371                           
 JULIE ABBOTT-JONES, Medical Social Worker                                     
 Box 6286                                                                      
 Sitka, Alaska  99835                                                          
 Telephone:  Not Available                                                     
 POSITION STATEMENT:  Testified on HB 371                                      
 JEANNE EVERHART                                                               
 P.O. Box 81269                                                                
 Fairbanks, Alaska  99708                                                      
 Telephone:  (907) 479-2049                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 JIM EDE, Member                                                               
 Hemlock Society                                                               
 P.O. Box 870365                                                               
 Wasilla, Alaska  99687                                                        
 Telephone:  (907) 376-4631                                                    
 POSITION STATEMENT:  Testified in support of HB 371                           
 KIM BRYAN                                                                     
 817 West 6th Avenue, Number 207                                               
 Anchorage, Alaska  99501                                                      
 Telephone:  (907) 258-5199                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 PHIL REEMTSMA, Pastor                                                         
 Calvary Baptist Church                                                        
 208 Lawton Drive                                                              
 Kenai, Alaska  99611                                                          
 Telephone:  (907) 283-4781                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 BOB BIRD, President                                                           
 Alaska Right to Life                                                          
 P.O. Box 3400, Suite 4                                                        
 Anchorage, Alaska  99510                                                      
 Telephone:  (907) 776-5898                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 LYLE JONES                                                                    
 P.O. Box 1946                                                                 
 Valdez, Alaska  99686                                                         
 Telephone:  (907) 835-4542                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 GLENN LITTLE                                                                  
 P.O. Box 934                                                                  
 Valdez, Alaska  99686                                                         
 Telephone:  (907) 835-4898                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 PAUL BALL, Pastor                                                             
 Immanuel Baptist Church                                                       
 P.O. Box 1049                                                                 
 Kenai, Alaska  99611                                                          
 Telephone:  (907) 283-7873                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 GEORGE MARTIN                                                                 
 P.O. Box 2920                                                                 
 Soldotna, Alaska  99669                                                       
 Telephone:  (907) 262-1381                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 LONI THIRLWELL                                                                
 P.O. Box 8182                                                                 
 Nikiski, Alaska  99635                                                        
 Telephone:  (907) 776-5716                                                    
 POSITION STATEMENT:  Testified on HB 371                                      
 KEITH CARNES, Pastor                                                          
 Church of the Nazarene                                                        
 P.O. Box 3351                                                                 
 Valdez, Alaska  99686                                                         
 Telephone:  (907) 835-2440                                                    
 POSITION STATEMENT:  Testified in opposition to HB 371                        
 REPRESENTATIVE KAY BROWN                                                      
 Alaska State Legislature                                                      
 State Capitol, Room 517                                                       
 Juneau, Alaska  99801-1182                                                    
 Telephone:  (907) 465-4998                                                    
 POSITION STATEMENT:  Sponsor of HB 371                                        
 ACTION NARRATIVE                                                              
 TAPE 96-13, SIDE A                                                            
 Number 001                                                                    
 The House Health, Education and Social Services Standing Committee            
 was called to order by Co-Chair Toohey at 3:04 p.m.  Members                  
 present at the call to order were Representatives Toohey, Bunde,              
 Rokeberg and Robinson.   Members absent were Representatives Davis,           
 Brice and Vezey.  A quorum was present to conduct business.                   
 HB 371 - RIGHTS OF TERMINALLY ILL PERSONS                                   
 Number 138                                                                    
 JOHN P. MONAGLE, President, Alaskans for Life, testified in                   
 opposition to HB 371.  He agreed with the woman who testified at              
 the last meeting that the bill doesn't go far enough; maybe it                
 should be a felony to die.  He said that may sound ludicrous, but             
 to him that's no more ludicrous than saying this is not assisted              
 suicide legislation.  Basically, people can commit suicide now, so            
 why does the state need to become involved?  It's tragic that the             
 people who testified had to watch their loved ones die; we need to            
 have concern for our fellow man.  Certainly the way to handle that            
 is for our loved ones to be with us to ease the pain of their                 
 dying.  To bring the state into the position of overseeing and then           
 placing the responsibility of the killing on caretakers and doctors           
 is a cop-out.                                                                 
 Number 346                                                                    
 DICK REGAN, Member, Hemlock Society, testified that as a longtime             
 member of the Hemlock Society he has supported bills on the right             
 to die issue which have been introduced in other state                        
 legislatures, but this bill is better drafted and better thought-             
 out than any other that he has seen.  Death lies ahead for all of             
 us; even for little children.  He has always thought we should be             
 working on ways to make it as easy as possible for ourselves and              
 each other.  With present drugs and technology, the life span can             
 be artificially extended, often causing lives to end with                     
 protracted painful dying, costly to the patient and to society.               
 This legislation would permit a terminally ill person to shorten              
 the period of suffering for himself or herself, which would be done           
 by the patient; the physician would not do the killing, as Mr.                
 Monagle suggested.  The doctor, if his conscience permits him to do           
 so, simply would prescribe a medication.  Mr. Regan said for about            
 the last year he has had an inoperable cancer; he may or may not              
 wish to make use of the provisions of this bill if it's enacted.              
 However, he feels that everyone should have the choice HB 371                 
 affords.  He said we, humankind, are in this life together and need           
 to look out for each other.  One way to do that is to work against            
 laws and attitudes that condemn a person to needless suffering at             
 the end of life.                                                              
 MR. REGAN read an excerpt from a letter sent to Representatives               
 Toohey and Brown from Dr. Ken Moss of Juneau:  "The question of               
 whether this bill should be passed is a moral, an ethical and                 
 religious one, as well as legal.  I have not yet discussed it with            
 my clergyman, but will do so  As far as my own moral principles are           
 concerned, it comes down to two of the very strongest ones:  one,             
 that Christ taught that we should honor one commandment above all             
 others, that is, to love one another; and the other is to do unto             
 others as we would have them do unto us.  Medical science has                 
 changed.  Technology has increased to the point where life, death             
 and dying have become prolonged and different than in previous                
 times.  The option to death with dignity, versus death without                
 dignity and without relief, should be examined and offered."                  
 Number 590                                                                    
 RITCHIE SONNER, Executive Director, Hospice and Home Care of                  
 Juneau, testified she was representing the other hospices from                
 around the state of Alaska.  She commended Representative Brown and           
 the co-sponsors for drawing attention to the needs of the                     
 terminally ill.  She feels however, that it's the right problem,              
 but the wrong solution.  The hospice philosophy addresses death               
 with dignity.  There is a lot of pain, discomfort and suffering               
 associated with some deaths and the hospice philosophy tries to               
 address those needs, the needs of the family and the quality of               
 life in the final days of the terminally ill.  Unfortunately, the             
 medical community is not altogether familiar with some of the                 
 hospice philosophies and they are not adequately educated about               
 some of the alternatives to the suffering that happens with the               
 terminally ill.  She said she could share some very scary stories             
 about people who have been in pain, people who have asked to die,             
 but the pain was able to be reversed and hospice was able to                  
 provide a high quality of life in the final days, weeks or months             
 of their lives.  This legislation makes her a little nervous about            
 a person who is in pain and requests death, but then the pain is              
 able to be controlled.  She added that if the patient was in that             
 painful stage and requesting death, they may not know there is                
 light at the end of the tunnel. In conclusion, she said the hospice           
 community in Alaska rejects the practice of voluntary euthanasia              
 and assisted suicide with the terminally ill and opposes HB 371.              
 REPRESENTATIVE GARY DAVIS arrived at 3:14 p.m.                                
 Number 747                                                                    
 SHIRLEEN RANNALS testified from Anchorage via teleconference.  She            
 spoke of the attitude regarding the prevailing tendency to value              
 life only if it brings pleasure and well-being.  Suffering is                 
 viewed as an unbearable setback, something that a person must be              
 freed from at all costs.  That's because of a right (indisc.) life            
 would be no longer meaningful because it is filled with pain.  This           
 is a distortion of what God meant for his people.  She reminded               
 committee members of the commandment "Thou Shalt Not Kill."  She is           
 strongly opposed to the passage of HB 371.                                    
 Number 843                                                                    
 THERESE SYREN testified from Anchorage that she had two issues she            
 wanted to address.  The first issue was related to the argument               
 that everyone should be allowed to make their own choice.  She said           
 Frederick Douglas made that same argument about slavery.  He said             
 the new territories coming into America should be allowed to choose           
 for themselves whether to have slavery or not.  She quoted Abraham            
 Lincoln's answer that no one "has a right to choose one's wrong."             
 Based on the Declaration of Independence, a suicide is greatly                
 opposed to our human nature regardless of our particular religion.            
 She commented that hospice played a big role in the final days of             
 her brother's death, as opposed to her father who died ten years              
 earlier without the help of hospice.                                          
 Number 948                                                                    
 KENNETH HITCH, Representative, Council 11558, Knights of Columbus,            
 testified from Anchorage in strong opposition to HB 371.  He said             
 the rights this bill purports to protect contradict every human's             
 basic right to life.  The right of life ensured to each of us by              
 the constitution is being negated.  Enshrining in law the alleged             
 right to make one's own end of life decisions would provide the               
 framework for the death of other than terminally ill persons, such            
 as the mentally ill or physically handicapped.  Rather, our efforts           
 should be devoted to comfort and easing the pain of terminally ill            
 persons so they have the opportunity to understand dying and make             
 peace with the Creator.  State government should not establish a              
 new fundamental right equal to those in the U.S. Constitution - to            
 have the right to commit a suicide.  The precise role of the state            
 is rather to protect the rights and dignity of those individuals              
 unable to speak for themselves, as is often the case of the                   
 terminally ill.  All human life must be valued, especially in its             
 final and most vulnerable moments.  The medical profession would be           
 in a compromising position if required to obey the provisions of              
 this legislation.  Their ethical code requires them to do no harm             
 to their patients.  House Bill 371 would allow a bias in favor of             
 death to pervade our society even more than it does now.  The risks           
 to already vulnerable members of our society would be                         
 extraordinary, especially considering the growing cost-                       
 consciousness prevalent in the health care industry.  It was for              
 these reasons the American Bar Association rejected euthanasia in             
 1992.  He asked committee members not to put the state of Alaska in           
 the forefront of anti-life legislation; the fate of so many                   
 otherwise innocent lives within their control.                                
 Number 1075                                                                   
 NANCY COLE testified via teleconference from Anchorage.  She said             
 her testimony was quite different than the previous speaker.  Her             
 daughter was that very moment at the bedside of her grandfather-in-           
 law while he is dying of cancer.  He is in pain and unable to care            
 for himself; in fact, his daughter and son are caring for him as if           
 he were a baby and has expressed his shame and embarrassment to all           
 family members.  Even though he has made his peace with God and is            
 ready to die, he has to wait until his body stops functioning.  She           
 spoke of the pain for the family members waiting for the last                 
 breath; hoping on one hand it won't come, but on the other hand,              
 hoping it will come so the pain will end.  She commented she has              
 worked for doctors, a pharmacy, and has been a real estate broker.            
 Risk management is very important and without legal permission to             
 prescribe medication to ease someone out of pain, doctors and                 
 pharmacists have no choice but to protect themselves, their                   
 businesses and their families from lawsuits.  Malpractice insurance           
 costs and terms prevent many doctors and pharmacists from doing               
 what they feel would be the humane thing to do.  Any law can be               
 misused and this one is no different.  But the ultimate good must             
 be considered, not the ultimate bad fears.  She concluded that if             
 she could say goodbye to her family on her own terms, leave this              
 earth and her body on her own terms, know that she has finished her           
 own business and not caused extended pain to her loved ones as they           
 watch her slowly become incapacitated and wait for the terrible               
 sounds of her last breath, that would be her choice.  Dignity is              
 all that she asks for and permission legally, so those she trusts             
 do not have to go to prison for helping her and don't suffer from             
 watching her die with pain.  She asked committee members to pass HB           
 MARGUERITE McINTOSH, family doctor, testified via teleconference              
 that she is opposed to HB 371.  She read comments from a letter               
 written by Dr. Stephen Hileman, "This letter is to emphasize my               
 personal and professional opposition to the proposals of HB 371.              
 I believe that neither society nor any individual has the right to            
 take human life at any point from its conception to its natural               
 end.  Life is a gift from God and it is not ours to bestow or                 
 withdraw.  As a physician I took an oath to preserve life.  I have            
 sworn not to wilfully destroy it.  How then can I participate in              
 the execution of another human being.  To refer that patient to               
 another physician willing to accomplish that end would be no less             
 an act of complicity on my part.  I would relinquish my license to            
 practice medicine rather than to be an accomplice of the state in             
 the taking of human life.  Events in our century have shown clearly           
 how rapidly medical ethics can deteriorate in a society that                  
 countenance is killing.  The Nazi era with its physician assisted             
 and endorsed progression from sterilization of the imperfect to               
 euthanasia for the suffering, to the comprehensive institution of             
 programs to eliminate lives not worth living must serve to remind             
 us that evil is a continuum, not a point on a curve, and that the             
 best of intentions if based on a flawed premise lead to the most              
 horrorific of consequences."  She applauded the efforts of all the            
 hospice workers in the state and around the world who have really             
 started to educate doctors and other health care professionals on             
 helping people to die with dignity and without pain.  With the                
 technology available today, no one should die a horrible, painful             
 death.  The medical profession has not done that well in the past,            
 but can do better.  It is up to the relatives of dying patients to            
 take a proactive stance and request better pain control for their             
 loved ones.                                                                   
 Number 1367                                                                   
 KAREN STROH, Representative, Frontier Training Center, testified              
 via teleconference.  She said the Frontier Training Center provides           
 a variety of services to disabled individuals in the community.               
 She was asked to testify as a representative of the training center           
 because they received several calls from consumers and family                 
 members of their consumers who are deeply distressed by this                  
 legislation and are adamantly opposed to HB 371.  These individuals           
 live daily with pain, with disabilities and with what many people             
 would consider life without dignity.  They wanted her to express to           
 the committee that every moment of life has dignity and to allow a            
 bill like this to pass in our state would be allowing murder and              
 would be robbing people of dignity.                                           
 Number 1436                                                                   
 AMY BOLLENBACH testified she has been a resident of Homer for three           
 years and a resident of Alaska for 35 years.  She thanked                     
 Representatives Brown and Toohey for introducing HB 371.  She,                
 herself, would like the right to request medication to shorten her            
 life if she was terminally ill and in pain.  She commented that               
 most families have probably had an experience that prompts them to            
 think about this issue.  Her experience was with her father who at            
 the age of 95 suffered a stroke.  He was an intelligent man who was           
 thinking and reading before the stroke and still was after the                
 stroke.  He was paralyzed on one side and in most cases, the staff            
 of the nursing home couldn't understand him, but his three children           
 could.  Unfortunately, he wouldn't let her teach him how to use the           
 buzzer to call the nurse because he had never been seriously ill in           
 his life and hadn't suffered the indignities of hospitals, for the            
 most part.  The family would find him lying in feces sometimes when           
 they went to visit because he couldn't call for help.  He prayed              
 constantly for Jesus to take him to Heaven.  She had discussions              
 with the social worker and the director of the institution about              
 whether it was possible to give him medication that would help him            
 die if he wanted it.  They advised her it was not legal in the                
 state and religious institutions wouldn't condone it.  The family             
 suffered watching him suffer.  This was a man of dignity who at the           
 age of 92 had spent 4 hours getting a trunk down from a closet so             
 he could get his World War I uniform to march in the Desert Storm             
 parade.  She thought it was horrible for him to have to suffer and            
 die not being able to control any of his functions.  She concluded            
 that her father may not have asked for medication if this bill had            
 been a law, but she would and certainly others would.                         
 Number 1576                                                                   
 JULIE ABBOTT-JONES, Medical Social Worker, testified from Sitka via           
 teleconference.  She thanked the sponsors of this legislation for             
 presenting it and opening the issue up for public discussion.  She            
 is looking forward to following it through the legislative process.           
 Number 1616                                                                   
 JEANNE EVERHART testified from Fairbanks that she opposes this                
 legislation.  She said people enter this world through pain and               
 have many painful life experiences.  Pain is many times a part of             
 death.  Just a year ago, her father died of terminal cancer in a              
 hospital, was given medication for the pain and died with dignity.            
 She commented that pain, emotional and physical, should not be an             
 excuse for any form of assisted suicide.  Life should be                      
 encouraged, not death.  She read an excerpt from a book entitled              
 Two Old Women.  She concluded that we as a society should not               
 justify whose quality of life will benefit society and who should             
 die.  She questioned how long it will be before society is so                 
 desensitized to the sacredness of human life, like millions of                
 aborted babies, the old or the disabled will be declared terminally           
 ill and they will be submitted to some medical procedure prescribed           
 by a doctor while society turns its head.  She sees no dignity in             
 taking one's own life.                                                        
 Number 1742                                                                   
 JIM EDE, Member, Hemlock Society, testified via teleconference that           
 he is in favor of HB 371.  He said most of the people who testified           
 in support of the bill had basically expressed his views.  He                 
 encouraged people to read the legislation before testifying.                  
 Number 1779                                                                   
 KIM BRYAN testified from Anchorage via teleconference.  She wanted            
 to comment on assisted suicide because she is concerned what the              
 final outcome will be if this becomes law.  She compared it to                
 abortion and how when it was legalized, it was only under certain             
 circumstances, but now it is widespread.  She questioned how the              
 human race could be improved if its weaker members are eliminated.            
 She believes that society is persuading the elderly and handicapped           
 that they are of no value.  For the past five years she has been a            
 volunteer at the Anchorage Pioneer Home where she has met some                
 beautiful people who are terminally ill.  She was very offended               
 when she saw a sign in the elevator about assisted suicide, and               
 wondered why the residents of the Pioneers' Home had to be                    
 subjected to something that could make them think they are a burden           
 to society.                                                                   
 Number 1870                                                                   
 PHIL REEMTSMA, Pastor, Calvary Baptist Church, testified via                  
 teleconference that he is strongly opposed to HB 371 and is                   
 speaking on behalf of a number of other individuals who weren't               
 able to testify.  He believes we do not have the right to make that           
 decision.  He commented that he has been with a number of people              
 when they died, and it is not dignified to speed that death up.               
 There is no dignity in taking life when we don't have the right to            
 do so.   He believes this is a door that shouldn't be opened.  God            
 is the author of life and He is the one who determines when life              
 should cease.                                                                 
 Number 1914                                                                   
 BOB BIRD, President, Alaska Right to Life; candidate for the U.S.             
 Senate in 1990; and Government and History Teacher at Nikiski High            
 School, testified via teleconference.  He referenced a Time/Life             
 Book which talked about all the things the Nazis did during World            
 War II and to the film I Accuse which is the story of a physician           
 whose wife persuades him to poison her.  He referred to the                   
 Hippocratic oath taken by physicians that they will give no deadly            
 medicine to anyone if asked, nor suggest any such counsel.  As he             
 was reviewing the bill, he thought about the physicians who refused           
 to take part in an assisted suicide, but are required to make a               
 referral.  That creates a situation of forcing doctors to violate             
 their oaths and their religious beliefs, not to mention over 2,000            
 years of jurisprudence which has decided that the pagan ethics of             
 ancient times where a doctor had a dual function, which was to cure           
 and to kill, was really not a good way for our culture and society            
 to survive.                                                                   
 Number 2051                                                                   
 LYLE JONES testified from Valdez that the original sin of man is              
 what leads us to the point of even discussing a bill like HB 371.             
 There has always been an innate desire in man to be equal with God            
 and desire is one of the reasons that led to death being prescribed           
 by God in the first place.  Since God is the one that prescribed              
 death, man has no business trying to play God and determine when              
 and how a person should die.  He believes with regard to dying with           
 dignity, it is our society that decided that people suffering in              
 certain ways have no dignity.  He is a pastor who has sat with                
 individuals who suffered terribly and had lost control of their               
 body functions, yet died with great dignity because they had a                
 faith in their Creator and knew what their end was going to be.               
 One of his fears with this bill is that many will be sent into an             
 eternity of much greater suffering than what they are experiencing            
 on earth; that suffering will be eternal.                                     
 Number 2114                                                                   
 GLENN LITTLE testified via teleconference from Valdez and stated              
 from the day we are born, we all become terminally ill.  Life is              
 nothing but a process of dying.  He is thankful for life.  God gave           
 him life and in God's time, He will take his life.  For the                   
 legislature or anyone else to do otherwise is to place themselves             
 in the position and exercising the authority of God.  He emphasized           
 we are One Nation Under God, not equal to God.  Death with dignity            
 is important, but dying demonstrates to our friends and family the            
 final process of life.  He commented that his father taught him to            
 live life and as he died, his father taught him how to die, too.              
 He doesn't believe this important process should be removed from              
 life.  It is the final process and a very important aspect of life.           
 We were born not of our choice, and he doesn't feel we should have            
 a choice about our death.  Those choices belong to someone greater            
 than us.  He voiced his opposition to HB 371.                                 
 Number 2184                                                                   
 PAUL BALL, Pastor, Immanuel Baptist Church, Kenai, testified his              
 strong opposition to HB 371.  He said he has always thought that              
 you don't take something that cannot be restored with the same or             
 better value than what it was.  Look at where society has come                
 from.  Since we've started murdering the young, our society has               
 deteriorated.  Now we are at the other end where we want to take              
 the lives of people who we feel have no quality of life.  He                  
 questioned where it would stop.                                               
 Number 2250                                                                   
 GEORGE MARTIN testified from Kenai in opposition to HB 371.  He was           
 speaking as a person who in a few years will be on the tail-end of            
 his life span.  He doesn't want to be in a position where his                 
 children, or he perceives that his children, are looking at him in            
 such a way that implies he's a burden.  He does not want to feel              
 the pressures that he has a duty to take his life.  He wants the              
 freedom to say, "Let God's will be done."  When his time is here,             
 then it will be time.                                                         
 Number 2290                                                                   
 LONI THIRLWELL testified via teleconference that she has been a               
 nurse in a hospital medical unit for 24 years and was going to play           
 devil's advocate.  She stated it was not her place to say if                  
 someone should live or die, but she doesn't believe in prosecuting            
 someone who acts with an unselfish conscience.  While she does not            
 support this bill, she does support the decriminalization of those            
 who act after long thought and prayer.  She concluded there are               
 worse things than death.  Death is not a bad thing, but killing is.           
 Number 2329                                                                   
 KEITH CARNES, Pastor, Church of the Nazarene in Valdez, testified             
 in opposition to HB 371.  He said the medical profession has the              
 primary responsibility to heal and preserve life.  To terminate               
 life is simply to give us hope and he does not believe there is any           
 dignity in ending one's life without any hope.  Ending one's life,            
 even with legal provision, is not and really cannot, add anything             
 to the dying process.  Medical science is continually searching for           
 new treatments and cures for terminal illnesses.  Perhaps the value           
 of life should be emphasized; living life to its natural end with             
 heads held high rather than losing hope.  There are contributions             
 to be made even by individuals who suffer from a terminal illness.            
 Life is much more than a gift, it is a privilege; and a privilege             
 for which we are accountable.                                                 
 TAPE 96-13, SIDE B                                                            
 Number 005                                                                    
 CO-CHAIR TOOHEY announced that would conclude the teleconference              
 testimony.  She asked the sponsor, Representative Kay Brown, to               
 come forward.                                                                 
 REPRESENTATIVE KAY BROWN, Sponsor of HB 371, expressed her                    
 appreciation for the committee's thoughtful consideration and                 
 patience in listening to Alaskans express their views on this                 
 difficult issue.  She acknowledged there are many points of view              
 and because there has been considerable testimony from the                    
 religious community, she wanted to share an additional point of               
 view in the form of a resolution approved by the Episcopal Diocese            
 of Newark.  After a year long study by a task force, two-thirds of            
 the delegates at the annual diocesan convention adopted a position            
 supporting assisted suicide under some situations.  She noted she             
 would make the entire report available for the record, but wanted             
 to bring this up just to point out that there are different points            
 of view even within the religious community.  Some of the points              
 mentioned were:  Christian theology demands respect for human life            
 and recognizes that human life is sacred; modern science has                  
 created a situation where biological existence may be extended far            
 beyond the point where reasonable quality of life exists; there are           
 circumstances where involuntarily prolonged biological existence is           
 a less ethical alternative than consciously chosen and mercifully             
 termination of earthly life; in such exceptional cases, assisting             
 a suffering person in accomplishing voluntary death can be morally            
 justified as part of the healing process because it enables a                 
 person to die well.  Representative Brown said she appreciated the            
 different points of view and emphasized this legislation does allow           
 people to act within their own moral convictions.  She thinks much            
 testimony heard against HB 371 is not part of the bill, but are               
 fears about what the bill might lead to.  She stated it is                    
 certainly not her intention to weaken the provisions of the bill.             
 She views it as the choice of the individual consistent with our              
 constitution.  She urged the committee's action in moving the bill            
 and added she had no objection to the amendment proposed by                   
 Representative Davis.                                                         
 REPRESENTATIVE GARY DAVIS said his amendment relates to the                   
 pharmacist who gets a prescription from a doctor who is prescribing           
 a terminally effected medication.  The amendment adds the provision           
 that the prescription specify what it is for; that is to provide a            
 strong enough medication for death.  Representative Davis explained           
 that line 5 of the amendment indicates "If a prescription for                 
 medication governed by this chapter is ordered telephonically, the            
 person communicating the prescription shall orally include a notice           
 that the prescription is being ordered at the request of a patient            
 under this chapter."  That language wasn't specifically ordered by            
 him but he assumed it was included because existing statute allows            
 for the availability of ordering a prescription telephonically.  He           
 didn't necessarily agree with that, but if there is a provision in            
 existing statute, then it should probably be included.                        
 Number 176                                                                    
 REPRESENTATIVE DAVIS moved to pass Amendment 1.                               
 REPRESENTATIVE ROKEBERG objected for discussion purposes.  He                 
 expressed concern with the concept of being able to order this type           
 of medication over the telephone.  He felt that a medication for              
 poisonous material should be picked up in person.  He suggested the           
 language could be changed to read, "A prescription for medication             
 governed by this chapter may not be ordered telephonically."                  
 CO-CHAIR TOOHEY commented she was offended by the word "poison" and           
 added the medication would be a sleeping pill or a medication that            
 would terminate life.                                                         
 REPRESENTATIVE DAVIS said he did not have a problem with                      
 Representative Rokeberg's suggestion other than he assumed it was             
 used elsewhere in statute and perhaps even in the bill, so it may             
 not be consistent.                                                            
 CO-CHAIR TOOHEY asked for clarification purposes if Representative            
 Davis was withdrawing the language on line 5, "If a prescription              
 for medication governed by this chapter...."                                  
 REPRESENTATIVE DAVIS said he didn't specifically have the language            
 for Representative Rokeberg's amendment to the amendment.                     
 REPRESENTATIVE ROKEBERG asked Representative Brown to comment.                
 Number 277                                                                    
 CO-CHAIR BUNDE pointed out this is 1996 and prescriptions are                 
 delivered by facsimile machines which is probably the reason for              
 the telephonic reference.  He didn't think it was referring to the            
 use of a telephone to order a life terminating medication.  He                
 added that all medications are potentially fatal; if a doctor                 
 transmits a prescription to a pharmacy via facsimile, people are              
 depending on the pharmacist to prescribe the right medication and             
 the proper dosage.   Given that consideration, he didn't know if              
 their concerns about the telephonic issue were merited.                       
 Number 339                                                                    
 REPRESENTATIVE BROWN suggested inserting "be in writing and must"             
 on line 3 following the word "must" and deleting the entire last              
 sentence of the amendment.  She believed that would still allow for           
 the facsimile transmission of a written prescription, but it would            
 address the issue of having the prescription in writing and allow             
 for communication from the Bush areas, for example.                           
 REPRESENTATIVE ROKEBERG stated that really was his point.  He was             
 of the belief that something of this nature should be a written               
 order and eliminate the potential for any misunderstanding between            
 the doctor and the pharmacist.                                                
 CO-CHAIR TOOHEY verified that line 3 of the amendment would read "A           
 prescription must be in writing for medication under this chapter             
 and must include a notation on the prescription that it is issued             
 at the request of the patient under this chapter."  The entire last           
 sentence would be deleted.                                                    
 Number 382                                                                    
 CO-CHAIR BUNDE pointed out deletion of the last sentence eliminates           
 modern technology as it relates to transmission of information.               
 Number 395                                                                    
 REPRESENTATIVE BROWN believed that the requirement for it to be in            
 writing would not preclude facsimile transmissions.  She suggested            
 inserting "be in writing and must" after the word must on line 3 of           
 the amendment.  The amendment would then read, "(i) A prescription            
 written for medication under this chapter must be in writing and              
 must include a notation on the prescription that it is issued at              
 the request of the patient under this chapter."                               
 REPRESENTATIVE ROKEBERG concurred with that language and withdrew             
 his objection.                                                                
 Number 415                                                                    
 CO-CHAIR BUNDE voiced his objection for discussion purposes.                  
 REPRESENTATIVE DAVIS commented he had no objection to the amendment           
 to the amendment.                                                             
 CO-CHAIR BUNDE said procedurally he did not object to the amendment           
 to the amendment, but wanted to discuss it.  He shared the concerns           
 about the pharmacist, but wondered about the invasion of privacy of           
 the individual who had AIDS for example, and the prescription                 
 stated that the medication was for someone with AIDS.  If the                 
 pharmacist has any strong feelings about AIDS, he may choose to               
 fill or not to fill the prescription.  He believes that pharmacists           
 should have a choice in the matter, but if they saw a legal dose of           
 medication being prescribed, they'd probably have a pretty good               
 idea of what was going on and since this legislation is being                 
 discussed as "death with dignity", should it be the topic of                  
 conversation at the local grocery store.                                      
 CO-CHAIR TOOHEY understood his concern, but she didn't believe the            
 connotation of AIDS as the reason for the request for medication              
 had any relevance to this legislation.  She explained this specific           
 amendment just gives the pharmacist the choice to fill the                    
 prescription or not to fill it.  The prescription doesn't need to             
 say why it is being done, except it is being done under this                  
 CO-CHAIR BUNDE interjected that certainly says why it is being                
 done; it's an assisted suicide.  His concern is that it may be an             
 invasion of privacy for the individual for whom the medication is             
 being prescribed and doesn't want their illness advertised to the             
 world.  Pharmacists undoubtedly have a professional knowledge of              
 the various medications and their general use so it doesn't have to           
 be spelled out specifically.                                                  
 REPRESENTATIVE BROWN understood that state law does not require               
 pharmacists to fill a prescription.  She thought the amendment is             
 consistent with the philosophy in the bill; that is people should             
 not have to participate and she hoped the privacy of the                      
 individuals involved would be respected.                                      
 CO-CHAIR BUNDE said he shared that feeling and didn't want anyone             
 participating in any way if they chose not to if this bill becomes            
 law.  On the other hand, what are the rights of an individual who             
 does choose to participate, as opposed to the rights of the                   
 CO-CHAIR TOOHEY noted the pharmaceutical industry should be invited           
 to testify at the next hearing.                                               
 REPRESENTATIVE DAVIS said this amendment, like this bill, addresses           
 something that requires statute.  Prescribing medicine to assist an           
 illness does not need legislation.  He, too, didn't want a                    
 prescription to indicate exactly what the medication was for.                 
 However, this case deals with something that requires legislation.            
 CO-CHAIR TOOHEY said there is a motion on the table to move                   
 Amendment 1, with a friendly amendment.  She asked the wishes of              
 the committee.                                                                
 CO-CHAIR BUNDE maintained his objection and asked for a roll call             
 vote.  Voting in favor of the motion were Representatives Davis,              
 Rokeberg, Brice, Robinson and Toohey.  Representative Bunde voted             
 against the motion.                                                           
 Number 658                                                                    
 REPRESENTATIVE ROBINSON asked Representative Brown to briefly                 
 summarize the safeguards in the bill and to discuss how she                   
 foresees the process on page 5, lines 14-23, being carried out.               
 She noted the concerns of the Hospice Association and said she                
 wanted to ensure that all attempts were made to include the                   
 appropriate people were informed and had the opportunity to speak             
 with the individual.                                                          
 REPRESENTATIVE BROWN advised the committee that the safeguards were           
 summarized in writing on the back of the sponsor statement.  The              
 option provided by the legislation would apply only to people who             
 are terminally ill in the opinion of a physician.  She added a                
 definition of terminal condition already exists in AS 18.12.111;              
 it's a progressive, incurable or irreversible condition that                  
 without the administration of life sustaining procedures will in              
 the opinion of two physicians, when available, who have personally            
 examined the patient, one of whom must be the attending physician,            
 result in death in a relatively short time.  She explained the                
 patient must knowingly make a written request for life-ending                 
 medication.  A second consulting physician must then confirm both             
 the diagnosis and the patient's mental competence.  The language              
 referenced on page 5, subsection (e), spells out in detail what the           
 attending physician shall inform the requester of:  the diagnosis,            
 the prognosis, the potential risks, probable results, and of                  
 irreversible consequences of taking the medication, and feasible              
 alternatives including but not limited to comfort care, hospice               
 care and pain control.  She pointed out certainly it is the intent            
 that the patient would have full knowledge and information                    
 available to him/her at the time, by discussing this as a private             
 matter between that person and their doctor.  After the second                
 consulting physician has confirmed it, then the written request has           
 to be witnessed by individuals who have nothing to gain from the              
 patient's death and are not connected with the health care                    
 providers.  A second request has to be made, at least 10 days                 
 subsequent to the first one.  The administration of the medication            
 is solely in the hands of the patient and that patient could change           
 his/her mind at any time.  She added that physicians in hospitals             
 have the absolute and unquestioned right to decline involvement;              
 however, they must refer the patient to physicians in institutions            
 who are willing to proceed.                                                   
 Number 824                                                                    
 REPRESENTATIVE ROBINSON asked if Representative Brown had done any            
 further thinking regarding the physicians who may not be willing.             
 She asked if there would be a list of doctors who might be willing            
 to assist in this.  Also, what would happen if there were no                  
 willing doctors in the state.                                                 
 REPRESENTATIVE BROWN replied that based on conversations she's had            
 with different people, there will be doctors willing to proceed and           
 the medical community itself will work out a method for                       
 implementing the referral process.  She referenced previous                   
 testimony regarding a survey which indicated that more than 70                
 percent of the doctors favored the option like the one presented in           
 this legislation.  She acknowledged that a significant amount of              
 opinion exists on both sides and there are probably many doctors              
 who will not wish to participate, but she believes there will be a            
 number of doctors and institutions that are willing to assist                 
 people in the manner anticipated HB 371.                                      
 CO-CHAIR BUNDE said a doctor who doesn't want to participate but              
 refers the patient to another doctor, makes the referring doctor an           
 unwilling participate.  He asked Representative Brown if she                  
 envisioned the Hemlock Society or some other organization                     
 maintaining a list of doctors who are willing participants in order           
 to eliminate even the referral participation for the unwilling                
 REPRESENTATIVE BROWN responded that was a consideration.  She                 
 hadn't thought of having an outside group maintaining a list, but             
 was willing to entertain that possibility.  She thought the removal           
 of the required referral would lessen the concerns of the people              
 opposed to the legislation.                                                   
 CO-CHAIR BUNDE encouraged further work in that area.                          
 CO-CHAIR TOOHEY advised that HB 371 has further referrals to the              
 State Affairs and Judiciary Committees which should allow                     
 sufficient time for these issues to be addressed.                             
 REPRESENTATIVE ROKEBERG said he was of the understanding that no              
 other state in the Union had a similar statutory provision right              
 REPRESENTATIVE BROWN interjected the state of Oregon did have a law           
 adopted by initiative that is now under appeal in the courts.  It's           
 not exactly like HB 371, but has some similarities.                           
 REPRESENTATIVE ROKEBERG asked if Representative Brown had                     
 considered the impact of any migration of people coming to Alaska             
 to have access to this law if it were to pass.                                
 REPRESENTATIVE BROWN responded she had not given that any                     
 Number 1006                                                                   
 CO-CHAIR BUNDE made a motion to pass CSHB 371(HES) out of committee           
 with individual recommendations.                                              
 REPRESENTATIVES ROKEBERG AND DAVIS objected.                                  
 Number 1027                                                                   
 REPRESENTATIVE DAVIS said there had been some extremely valuable              
 testimony and discussion raised regarding HB 371, and if the bill             
 passes out of the HESS Committee, he was sure there would be                  
 additional beneficial testimony and discussion.  Based on the                 
 testimony he had heard, he could not support it.  He thought some             
 of they key testimony was that of Dr. Wilson relating to the                  
 physical state of the terminally ill and the effects of the                   
 medication they take.  He pointed out that people in this physical            
 state, especially to the degree where they may request the                    
 medication to end their life, have probably been on medication for            
 some period of time.  This raised a question in his mind regarding            
 the requirement for an individual to be mentally competent.  He               
 addressed the issue of the future of medicine as it relates to pain           
 medication and commented we need to have faith in the medical                 
 profession, the research field, that more emphasis will be placed             
 on how to treat terminally ill patients so they can be free of                
 pain.  A personal note for him is the definition of dignity.  It's            
 been said this legislation is death with dignity, but dignity has             
 a different meaning to different people.  He asked who are we to              
 say this is dignified, as opposed to anyone else saying this is               
 dignified.   He felt those were key areas of testimony that were              
 presented.  He reiterated that based on those testimonies and his             
 interpretation and understanding of the testimony, he could not               
 support this legislation.                                                     
 REPRESENTATIVE ROBINSON addressed Representative Davis' comment               
 relating to the mental competency of an individual who has been on            
 medication for a long time and said she thought he should rethink             
 that issue.  She is of the opinion there are a lot of terminally              
 ill people who have been on medication for a very long time and               
 are, without a doubt, extremely competent to make their own                   
 decisions.  She noted that is a difficult issue, but she will get             
 another opportunity to look at the bill in the next committee of              
 referral.  She believes it is important that members of all                   
 committees of referral get an opportunity to address the issues.              
 Based on that perspective, she thought the bill should move on to             
 the next committee.                                                           
 REPRESENTATIVE ROKEBERG said he was particularly struck with the              
 testimony of the Alaska Nurses' Association, as well as the                   
 testimony regarding the high potential for abuse with this type of            
 legislation, particularly as it relates to the more vulnerable                
 population; the elderly, disabled and the poor.  He feels it may              
 create another alternative for the elderly, especially if an                  
 individual is depressed.  Without even speaking to the ethical,               
 moral or religious grounds, which he accepts as problems with the             
 bill, he will be voting against HB 371.  He complimented the                  
 sponsors for attempting to craft a workable piece of legislation.             
 Number 1367                                                                   
 CO-CHAIR TOOHEY thanked Representative Brown for allowing her to be           
 a co-sponsor of this bill.  She asked for a roll call vote on the             
 motion before the committee.  Voting in favor of the motion to pass           
 CSHB 371(HES) out of committee were Representatives Brice,                    
 Robinson, Toohey and Bunde.  Voting against the motion were                   
 Representative Davis and Rokeberg.  CO-CHAIR TOOHEY announced CSHB            
 371(HES) moved out of the HESS Committee with zero fiscal notes.              
 HCR 27 -  TEEN PREGNANCY EDUCATION                                          
 Number 1478                                                                   
 CO-CHAIR TOOHEY passed the gavel to Co-Chair Bunde for HCR 27.                
 CO-CHAIR BUNDE said this committee was probably more aware than any           
 other committee in the legislature of the problems facing Alaska              
 stemming from teen pregnancies.  Alaska has an incredibly high teen           
 pregnancy rate, higher than some Third World countries, and it is             
 an ongoing challenge to deal with the problems created by teen                
 pregnancy.  Pregnant teens are more likely to have children who               
 then become pregnant teens and pregnant teens are more apt to be on           
 welfare and have economically depressed circumstances.  One thing             
 that has worked quite well in encouraging young people to                     
 understand just what a major experience it is to have a child is a            
 project at Mears Junior High in Anchorage called "Sugar Baby."  The           
 project provides students the opportunity to experience some of the           
 difficult responsibilities involved in being a parent.  A "Sugar              
 Baby" is a 10 pound bag of sugar which the student must be                    
 responsible for the total care and protection for a week.  Students           
 may not lose, break or drop the baby, and they may not cause the              
 child to be taken away.  It is the students responsibility to make            
 sure the baby is protected from hazardous situations at all times,            
 and they must plan to include their baby in all activities, dates,            
 and shopping sprees.  The project prohibits hiring a baby-sitter.             
 Co-Chair Bunde said this resolution not only recognizes the work              
 done at Mears Junior High, but commends this project to high                  
 schools and junior high schools in the state and encourages them to           
 look at the project for their school.                                         
 REPRESENTATIVE ROBINSON said she was aware of other projects that             
 used eggs as the baby and wondered if the project should be                   
 expanded to include other programs, or did Co-Chair Bunde think the           
 Sugar Baby concept was the best.                                              
 CO-CHAIR BUNDE thought the Sugar Baby project worked well because             
 the weight and bulk are most closely associated with a child.                 
 REPRESENTATIVE ROBINSON asked if the project required young men and           
 women both to participate in the project.                                     
 CO-CHAIR BUNDE responded yes.                                                 
 REPRESENTATIVE ROBINSON asked if there was a particular grade level           
 CO-CHAIR BUNDE replied the project had been done in the junior high           
 school.  His personal opinion was that the project needed to be               
 conducted at the impressionable age, but not the terribly                     
 vulnerable age.                                                               
 REPRESENTATIVE ROBINSON asked if there were other aspects of                  
 parenting that were taught.                                                   
 CO-CHAIR BUNDE said the entire lesson teaching plan was available             
 in committee members' packets.  It is an entire research project              
 that deals with clothing, feeding, costs involved, etc.                       
 CO-CHAIR TOOHEY directed the attention of the committee to comments           
 made by the boys involved in the project.  She thought it was an              
 excellent tool in getting boys to recognize what it was like to be            
 a teen-age father.                                                            
 REPRESENTATIVE ROKEBERG pointed out that Mears Junior High School             
 was in his district and he is particularly proud they did such a              
 wonderful job implementing this program in spite of the fact they             
 have very few computers, no Close Up program and no travel budget             
 for their high school sport team.  Representative Rokeberg was very           
 supportive of the resolution.                                                 
 REPRESENTATIVE DAVIS referenced the responses from the children               
 regarding the project and said one student indicated she was                  
 definitely not having any children after having to tote the "Sugar            
 Baby" around for a week.  On the other hand, one student indicated            
 she was definitely waiting to have a child.                                   
 CO-CHAIR BUNDE referenced the report in the committee packets on              
 the percentage of students having sexual intercourse; 30 percent              
 are sexually active starting in the 7th grade.                                
 CO-CHAIR TOOHEY said that many of them were unplanned pregnancies             
 and every unplanned pregnancy is a potential AIDS victim.                     
 Unprotected sex is like playing Russian Roulette.                             
 Number 2035                                                                   
 REPRESENTATIVE ROKEBERG moved to pass HCR 27 out of committee with            
 accompanying fiscal note and individual recommendations.  Hearing             
 no objection, HCR 27 was moved out of committee.                              
 CO-CHAIR BUNDE announced that on Thursday the committee would be              
 hearing a bill on the WICHE/WAMI program and would begin hearings             
 on the Juvenile Code Revision.                                                
 CO-CHAIR BUNDE adjourned the House HESS Committee meeting at 4:38             

Document Name Date/Time Subjects