Legislature(2003 - 2004)
04/26/2004 08:06 AM Senate JUD
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* first hearing in first committee of referral
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= bill was previously heard/scheduled
HB 25-HEALTH CARE SERVICES DIRECTIVES
REPRESENTATIVE BRUCE WEYHRAUCH, District 4, gave the following
introduction of HB 25.
HB 25 was prefiled in 2002 and it had roughly six
hearings in House Health and Social Services and then
four hearings in House Judiciary. And then over here,
Chair Dyson of the Senate Health and Social Services
Committee held I think, roughly, eight hearings and
it's gone through substantial revision in the Senate
and I owe a great deal of respect and appreciation to
Senator Dyson for what that committee did on this bill
in conjunction with our office.
This bill is a significant piece of legislation in
that it brings together programs that deal with organ
donation, the living will program, the comfort one,
do-not resuscitate provisions of statute, the durable
powers of attorney and advanced directives for health
care decisions. Death is a critical part of life and
we all die. This bill is intended to provide in one
place the information available to people who are
dying and whose families are dying and who want to
plan for their deaths when that time comes.
It's intended to help clarify existing law and to help
bring other good portions of laws throughout the
United States into one law here in Alaska and it's
garnered a great deal of attention from a multitude of
parties that are interested in clarifying the statutes
on these issues and allowing the public who needs to
deal with this in hospitals, hospices - medical
providers, a clear standard to deal with end-of-life
health care decisions.
The bill gathered my interest because of my father who
recently passed away and he had a durable power of
attorney and advanced health care directives but he
didn't advise my mother of it. Therefore, he
languished in a state where he did not want to be for
three years before he actually passed away and when my
mother was advised of the situation she was upset
because he was living the life that he never would
have wanted. If his advanced health care directives
had been simply acted upon, he would have been treated
a lot differently in terms of his medical health care
decisions.
And so this is something that all people can use and,
Mr. Chairman, it is a meaty bill. I want the committee
comfortable with it as the other committees have been
as they passed it out and so what I was planning to do
was step back and let a lot of other people testify
who've had input on this.
SENATOR OGAN asked how a medical provider in Alaska would know
if a visiting patient here had a do-not-resuscitate order in
another state.
REPRESENTATIVE WEYHRAUCH deferred to Dr. Wallington for an
answer.
SENATOR OGAN said he also would like an explanation of the do-
not-resuscitate protocol on page 10 of the bill.
DR. MARIE WALLINGTON, medical ethicist for the Providence health
system in Alaska, told members she has worked extensively with
Representative Weyhrauch and the Senate HESS Committee on this
legislation. She told members that regarding a visitor with a
do-not-resuscitate order in another state, in general, a person
with a do-not-resuscitate order has some kind of definition. If
the medical staff can verify that a person has such an order,
they are relieved from providing resuscitation. An Alaskan who
does not have a do-not-resuscitate order identification on him
will be resuscitated.
9:15 a.m.
MR. PAUL MALLEY, President of Aging with Dignity, a non-profit
organization in Florida, gave the following testimony. He said
he is familiar with what is happening with the Five Wishes
document on a national level and how it is promoting good
quality care at the end of life. He provided the following
highlights of what is happening nationally.
His agency had three goals when it developed the Five Wishes
document. First, it wanted to make a document that was easy to
understand and use. Second, it wanted the document to address
more than medical issues because when people are asked what is
most important to them at the end of life, they most often want
to be at home, with their family, without pain, etcetera, along
with their preferences for life support treatment.
He noted that the popularity of the Five Wishes document has
grown rapidly, and about 6,000 organizations are distributing
it, including hospitals and employers. However, a few
roadblocks remain on the national level. In 15 states, including
Alaska, mandatory forms are required and those forms do not
provide much "wiggle room" for people to put their wishes in
their own words, which can deter people from using those
documents. His understanding of HB 25 is that it makes the
process much more streamlined and effective by putting all of
the requirements for durable powers of attorney for health care,
living wills, organ donation and others under one umbrella. It
also makes it easier for Alaskans to put their wishes in their
own words, whether in a Five Wishes document or another
document.
SENATOR OGAN commented that had he had a living will when he had
his full cardiac arrest, he probably would not be alive right
now because his prognosis was very poor. He said although he had
a fantastic experience with Alaska's medical community, he finds
physicians to be pessimistic in general.
DR. WALLINGTON responded that the fact that a person has signed
an advanced directive does not mean the person has agreed to not
be resuscitated. The physician must be sure of that person's
medical situation and if the physician knows the person cannot
be kept alive, he might consider writing a "Do-Not-Resuscitate"
order but that would not have been the case when Senator Ogan
had his cardiac arrest. She said the medical community hopes
people will spend a lot of time determining how their advance
directives will read so that they are telling the medical staff
how to decide. Had Senator Ogan had an advance directive that
said he wanted every effort to be made to keep him alive, that
would have given clear direction to his medical staff. She
pointed out the old form was terrible in that it gave no
direction in unclear situations.
CHAIR SEEKINS noted the committee had other commitments at this
time and stated his intent to bring HB 25 before the committee
on Thursday. He then adjourned the meeting.
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