03/07/2011 01:30 PM Senate HEALTH & SOCIAL SERVICES

         SB  14-PROTECT HEALTH CARE PROVIDER CONSCIENCE                                                                     
                                                                                                                                
1:33:15 PM                                                                                                                    
CHAIR DAVIS announced the first order of business would be SB
.                                                                                                                             
                                                                                                                                
SENATOR  FRED  DYSON,  sponsor  of  SB 14,  said  this  bill  was                                                               
prompted by  a conversation  with a pharmacist  who was  tired of                                                               
dispensing large amounts  of Oxycontin to people  on Medicaid. It                                                               
is sold on the streets, and  people have figured out how to smoke                                                               
it  and  shoot it.  Senator  Dyson  then  read from  the  sponsor                                                               
statement, as follows:                                                                                                          
                                                                                                                                
     A health care professional's  view of health, sickness,                                                                    
     patient care  and purpose of medicine  comprise a well-                                                                    
     formed  professional  conscience.  This  conscience  is                                                                    
     changed with  new information  and technology.  A broad                                                                    
     application  of a  right of  conscience applies  to the                                                                    
     issues of  end of life care,  consumer genetic testing,                                                                    
     the  practice  of  pain management,  psychotropic  drug                                                                    
     use, sterilizations,  race-specific medications, infant                                                                    
     circumcision,   physician  and   nurse  complicity   in                                                                    
     capital   punishment,   physician   assisted   suicide,                                                                    
     abortion, etc.                                                                                                             
                                                                                                                                
     This  bill   recognizes  the  societal   benefits  that                                                                    
     divergent   organizational    identities   bring;   the                                                                    
     relational   dimension   of   professional   conscience                                                                    
     between   health  care   institutions  and   providers,                                                                    
     between providers  and patients, and  between providers                                                                    
     and  communities;  and   helps  ensure  the  conditions                                                                    
     necessary  for  the   conversations  of  conscience  to                                                                    
     continue concerning the health care profession.                                                                            
                                                                                                                                
     Most states have laws  protecting the conscience rights                                                                    
     of  health care  providers. Alaska  law currently  does                                                                    
     not  provide   for  a  general  health   care  provider                                                                    
     protection of conscience.                                                                                                  
                                                                                                                                
     SB 14 provides  a guarantee for the  exercise of health                                                                    
     care   provider    conscience   in    an   increasingly                                                                    
     pluralistic  environment.  All  health  care  providers                                                                    
     must be treated equally, and  must have recourse to the                                                                    
     exception made for conscience.                                                                                             
                                                                                                                                
1:37:08 PM                                                                                                                    
CHARLES COBB,  Staff to  Senator Dyson,  summarized the  bill, as                                                               
follows:                                                                                                                        
                                                                                                                                
   · Provides within Alaska Statutes, Title 18, a protection and                                                                
     reasonable  accommodation  for   a  health  care  provider's                                                               
     expression  of  conscience  pertaining  to  provision  of  a                                                               
     health care service;                                                                                                       
   · Establishes written notice as the method of communicating                                                                  
     an  expression of  conscience, and  that  the employer  will                                                               
     reasonably  accommodate  and  not discriminate  against  the                                                               
     employee providing notice; and                                                                                             
   · Provides that the notice does not have to include the                                                                      
     reason  for  the  objection,  but must  be  related  to  the                                                               
     provider's conscience and  not to a protected  status of the                                                               
     patient; and                                                                                                               
   · Provides that an employer is not required to accommodate                                                                   
     the employee if the  employer demonstrates the accommodation                                                               
     poses undue hardship  or the objecting employee  is the only                                                               
     health  care   provider  available  in   a  life-threatening                                                               
     circumstance,  and that  the health  care  provider may  not                                                               
     refuse to  provide treatment or  care in  a life-threatening                                                               
     circumstance  until an  alternate  health  care provider  is                                                               
     available; and                                                                                                             
   · Provides civil and criminal immunity to health care                                                                        
     providers  who express  conscience in  compliance with  this                                                               
     section; and                                                                                                               
   · Provides that this section will be construed in a manner                                                                   
     consistent with Title  VII of the Civil Rights  Act of 1964;                                                               
     and                                                                                                                        
   · Defines terms.                                                                                                             
                                                                                                                                
1:39:22 PM                                                                                                                    
SENATOR  MEYER said  he  was concerned  about  rural areas  where                                                               
there is only one health care provider.                                                                                         
                                                                                                                                
SENATOR DYSON  responded if it  was a life  threatening situation                                                               
they must provide the care.                                                                                                     
                                                                                                                                
MR. COBB  said the bill  recognizes relationships.  For instance,                                                               
if one provider provides 99.9  percent of all requested services,                                                               
we don't  want that  provider to  be shut  down. It  is important                                                               
that  those things  are discussed  with  patients. Conscience  is                                                               
different in each community.                                                                                                    
                                                                                                                                
SENATOR  DYSON stated  that most  doctors think  the bill  is not                                                               
necessary.  One  doctor   did  not  want  to   use  a  particular                                                               
medication  because patients  were  dying when  he  used it.  His                                                               
professional judgment was to use what was best for his patients.                                                                
                                                                                                                                
1:43:39 PM                                                                                                                    
SENATOR DYSON noted  the bill was endorsed by  the state pharmacy                                                               
board, as well as several doctors.                                                                                              
                                                                                                                                
CHAIR DAVIS said she has  gathered research information about the                                                               
bill,  which  she  will  distribute  to  committee  members.  She                                                               
announced that SB 14 would be held in committee.