Legislature(1993 - 1994)
03/28/1994 01:00 PM JUD
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
HB 356 LIVING WILLS AND MEDICAL CARE REP. CYNTHIA TOOHEY explained HB 356 to be, "An Act relating to the living wills and `Do Not Resuscitate' orders; and providing for an effective date." HB 356 compliments current statutes on the right of the terminally ill by adding specific recognition of "Do Not Resuscitate" (DNR) orders to the existing legislation on the rights of the terminally ill. To make a declaration relating to the use of life sustaining procedures. A new section allows attending physicians to issue DNR orders, requires the Department of Health and Social Services, with the approval of the State Medical Board, to issue regulations adopting a standardized protocol governing the withholding of CPR by physicians and other health care providers and establishes the requirements under which health care providers other than the physicians may comply with a DNR order. Section 18.12.037 requires the Department of Health and Social Services to develop the standardized design for DNR identification card, forms, necklaces and bracelets, to indicate that the possessor has executed a living will or that a DNR order has been issued by a physician. Other provisions of the bill amend existing statutory provisions by including DNR's along with living wills in areas such as immunity for health care providers, acting under the provisions of the living will and DNR orders, and penalties, etc. Do not resuscitate orders are issued only in the case of a terminally ill person. Under existing practices, emergency response providers, (EMT's and paramedics) are required to institute CPR on site even if the sick person has a living will. A properly executed DNR order and procedure protocol recognized by all concerned parties would help to avoid futile and unwanted interventions. Similarly, within health care institutions, DNR orders are necessary in the absence of the living will, when attempts at resuscitation serve only to prolong the process of dying. She urged favorable consideration of this legislation." Number 557 REP. PHILLIPS asked Rep. Toohey if a person has to have a living will in order to get the DNR bracelet or necklace, or whatever, or can they could get one without having a living will. Number 561 REP. TOOHEY said the only thing they must have in order to get one is the physician who originally signed the DNR. Number 566 REP. PHILLIPS said that on behalf of this bill, she had been requested by the senior centers in her district to put some legislation similar to this forward, and there has been support from her district for this legislation. Number 573 MR. JOHNSON said this DNR, as Rep. Toohey stated, does for people who are in the final stages of death, to put them through the agony and discomfort of resuscitation, this would allow them and their physician to agree, and it would allow us at the state level to have a standardized system and protocol across the state. There are some good systems already in place in Anchorage and Juneau, and a few other places that he thinks work quite well, which will be used as models if this bill passes. The main advantage is that it would be standardized across the state and the identifications and everything would be standardized, so everybody understands how the system works, and when the EMT's get there, they know what they are looking for. Sometimes, if it is a person who collapses on the street, the EMT's are not right now able to recognize the DNR patients, so this would help resolve some of those issues. Number 590 REP. PHILLIPS clarified that there has to be an actual physical piece of evidence that the EMT actually sees and reads in order to not do the resuscitation. CHAIRMAN PORTER said you could also get a verbal order from a doctor in the hospital. Number 608 MR. JOHNSON said that sometimes they will have a person's home identified, or maybe a name at the nursing home, so the dispatch will already know the person has a DNR. That works fairly well. Number 613 REP. PHILLIPS made a motion to move HB 356 with individual recommendations and fiscal notes attached. CHAIRMAN PORTER, hearing no objection, declared HB 356 moved from committee.