Legislature(1995 - 1996)
02/20/1996 03:04 PM House HES
| Audio | Topic |
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ 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
371.
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
chapter.
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
pharmacist.
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
doctor.
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
now.
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
consideration.
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
involved.
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.
ADJOURNMENT
CO-CHAIR BUNDE adjourned the House HESS Committee meeting at 4:38
p.m.
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