Legislature(2015 - 2016)CAPITOL 106

04/09/2015 03:00 PM HEALTH & SOCIAL SERVICES

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03:04:05 PM Start
03:04:33 PM HB99
04:57:55 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 99 VOLUNTARY TERMINATION OF LIFE TELECONFERENCED
Heard & Held
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         April 9, 2015                                                                                          
                           3:04 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Paul Seaton, Chair                                                                                               
Representative Liz Vazquez, Vice Chair                                                                                          
Representative Neal Foster                                                                                                      
Representative Louise Stutes                                                                                                    
Representative David Talerico                                                                                                   
Representative Geran Tarr                                                                                                       
Representative Adam Wool                                                                                                        
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
OTHER LEGISLATORS PRESENT                                                                                                     
                                                                                                                                
Representative Dan Ortiz                                                                                                        
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
HOUSE BILL NO. 99                                                                                                               
"An Act relating to the voluntary termination of life by                                                                        
terminally ill individuals; and providing for an effective                                                                      
date."                                                                                                                          
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 99                                                                                                                   
                                                                                                                                
SHORT TITLE: VOLUNTARY TERMINATION OF LIFE                                                                                      
SPONSOR(s): REPRESENTATIVE(s) DRUMMOND                                                                                          
                                                                                                                                
02/09/15       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/09/15       (H)       HSS, JUD                                                                                               
04/09/15       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
REPRESENTATIVE HARRIET DRUMMOND                                                                                                 
Alaska State Legislature                                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Presented HB 99 as prime sponsor of the                                                                  
bill.                                                                                                                           
                                                                                                                                
KRISTEN KRANENDONK, Staff                                                                                                       
Representative Harriet Drummond                                                                                                 
Alaska State Legislature                                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Explained HB 99 for the prime sponsor of                                                                 
the bill, Representative Drummond.                                                                                              
                                                                                                                                
TERRY BANNISTER, Attorney                                                                                                       
Legislative Legal Counsel                                                                                                       
Legislative Legal and Research Services                                                                                         
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions during discussion of                                                                  
HB 99.                                                                                                                          
                                                                                                                                
PETER REAGAN, M.D., National Medical Director                                                                                   
End-of-Life Consultation                                                                                                        
Compassion & Choices                                                                                                            
Denver, Colorado                                                                                                                
POSITION STATEMENT:  Testified in support of HB 99.                                                                           
                                                                                                                                
KAREN DECHMAN BOND, President                                                                                                   
Midtown Community Council                                                                                                       
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 99.                                                                           
                                                                                                                                
PETER BANGS                                                                                                                     
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 99.                                                                           
                                                                                                                                
KELLY BEHEN                                                                                                                     
Homer, Alaska                                                                                                                   
POSITION STATEMENT:  Testified in support of HB 99.                                                                           
                                                                                                                                
SUSAN ARTHUR                                                                                                                    
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 99.                                                                           
                                                                                                                                
RALPH FENNER                                                                                                                    
Sitka, Alaska                                                                                                                   
POSITION STATEMENT:  Testified in support of HB 99.                                                                           
                                                                                                                                
NANCY CLONAN                                                                                                                    
Sterling, Alaska                                                                                                                
POSITION STATEMENT:  Testified in support of HB 99.                                                                           
                                                                                                                                
J. R. MEYERS                                                                                                                    
Alaska Constitution Party                                                                                                       
Soldotna, Alaska                                                                                                                
POSITION STATEMENT:  Testified in opposition to HB 99.                                                                        
                                                                                                                                
LANCE ROBERTS                                                                                                                   
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 99.                                                                        
                                                                                                                                
JIM BECK                                                                                                                        
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:  Testified in opposition to HB 99.                                                                        
                                                                                                                                
RICHARD ASHER, M.D.                                                                                                             
Dillingham, Alaska                                                                                                              
POSITION STATEMENT:  Testified in opposition to HB 99.                                                                        
                                                                                                                                
GEORGE STEWART                                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 99.                                                                        
                                                                                                                                
PATRICIA COLL FREEMAN                                                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 99.                                                                        
                                                                                                                                
JANET MCCOY                                                                                                                     
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 99.                                                                        
                                                                                                                                
MARY LANZA, M.D.                                                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 99.                                                                        
                                                                                                                                
CYNTHIA KIMBLEY                                                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 99.                                                                           
                                                                                                                                
CHRISTOPHER KURKA, Executive Director                                                                                           
Alaska Right to Life                                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 99.                                                                        
                                                                                                                                
RON JOHNSON                                                                                                                     
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 99.                                                                           
                                                                                                                                
MONTE JORDAN                                                                                                                    
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 99.                                                                           
                                                                                                                                
MARGARET DORE, President                                                                                                        
Choice is an Illusion                                                                                                           
Seattle, Washington                                                                                                             
POSITION STATEMENT:  Testified during discussion of HB 99.                                                                    
                                                                                                                                
ANDREW LESSIG                                                                                                                   
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 99.                                                                           
                                                                                                                                
MARLENE EDENSHAW                                                                                                                
Hydaburg, Alaska                                                                                                                
POSITION STATEMENT:  Testified in support of HB 99.                                                                           
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:04:05 PM                                                                                                                    
                                                                                                                                
CHAIR PAUL  SEATON called  the House  Health and  Social Services                                                             
Standing   Committee    meeting   to    order   at    3:04   p.m.                                                               
Representatives Seaton,  Talerico, Vazquez,  Tarr, and  Wool were                                                               
present at the call to  order.  Representatives Stutes and Foster                                                               
arrived as the  meeting was in progress.  Also  in attendance was                                                               
Representative Ortiz.                                                                                                           
                                                                                                                                
              HB 99-VOLUNTARY TERMINATION OF LIFE                                                                           
                                                                                                                                
3:04:33 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON announced  that the only order of  business would be                                                               
HOUSE BILL NO. 99, "An  Act relating to the voluntary termination                                                               
of  life by  terminally  ill individuals;  and  providing for  an                                                               
effective date."                                                                                                                
                                                                                                                                
3:05:14 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HARRIET   DRUMMOND,  Alaska   State  Legislature,                                                               
paraphrased  from  the  sponsor statement  [original  punctuation                                                               
provided], which read:                                                                                                          
                                                                                                                                
      House Bill 99 allows terminally ill patients to ease                                                                      
      their suffering and hasten an inevitable and certain                                                                      
     death.  This  bill  preserves dignity  and  a  person's                                                                    
     right to  live, and die,  on their own  terms according                                                                    
     to they own desires and beliefs.                                                                                           
                                                                                                                                
     Oregon enacted  the first "death  with dignity"  law in                                                                  
     1994  through a  citizens  approved ballot  initiative.                                                                  
     The Supreme  Court upheld the  law in  2006. Washington                                                                  
     followed  with another  ballot  vote  in 2008.  Vermont                                                                  
     passed the  first death  with dignity  law passed  by a                                                                  
     state legislature.  Similar legislation has  now sprung                                                                  
     up in twenty-five other states.                                                                                            
                                                                                                                                
     Death  is a  natural part  of life.  Providing dignity,                                                                  
     control  and peace  of mind  during  a patient's  final                                                                  
     days with family  and loved ones places  a much greater                                                                  
     focus on a person's life  than on the often painful and                                                                  
     agonizing  process  of  dying. This  bill  specifically                                                                  
     requires  the request  process to  stop immediately  if                                                                  
     there  is any  evidence of  coercion. The  laws further                                                                  
     require  the  two  physicians who  work  regularly  and                                                                  
     closely  with terminally  ill patients  to be  involved                                                                  
     throughout  the request  process.  These two  qualified                                                                  
     and independent diagnoses ensure against coercion.                                                                         
                                                                                                                              
     This  bill allows  patients to  have important  end-of-                                                                  
     life  discussions with  the doctors  they already  know                                                                  
     and  trust.   Without  this   discussion,  well-meaning                                                                  
     doctors are  faced with prescribing  painful procedures                                                                  
     even when the  patient does not want them  and there is                                                                  
     little  or  no  hope   for  success.  People  in  these                                                                  
     conditions  have already  lost their  health and  often                                                                  
     much, much more.  This bill at least  lets them control                                                                  
     the last and most important decision they have left.                                                                       
                                                                                                                                
3:07:28 PM                                                                                                                    
                                                                                                                                
KRISTEN  KRANENDONK,  Staff,   Representative  Harriet  Drummond,                                                               
Alaska   State  Legislature,   briefly  reviewed   the  sectional                                                               
analysis  of  the  proposed  bill,  which  read:    [Included  in                                                               
members' packets]                                                                                                               
                                                                                                                                
     Section  1:  Page  1: Lines  4-7  Amends  AS  11.41.115                                                                    
     (defenses to  murder) to  allow an  affirmative defense                                                                    
     for acting under 13.55.                                                                                                    
                                                                                                                                
     Section 2: Page 1: Lines  8-10 Adds a new subsection to                                                                    
     AS   11.41.120    (manslaughter)   to    establish   an                                                                    
     affirmative defense  to a prosecution  for manslaughter                                                                    
     for performing any action allowed in AS 13.55.                                                                             
                                                                                                                                
     Section 3: Pages  1-14: Lines 11-24 Adds  a new chapter                                                                    
     AS  13.55,   which  provides   the  process   in  which                                                                    
     terminally  ill individuals  may request  medication to                                                                    
     terminate their life.                                                                                                      
                                                                                                                                
     Sec.   13.55.010:  Describes   which  individuals   may                                                                    
     terminate their  life under the new  chapter. Lists the                                                                    
     criteria  for being  a  qualified individual.  Includes                                                                    
     state residency, being an  adult, being capable, having                                                                    
     a  terminal disease,  and having  voluntarily expressed                                                                    
     the wish to  die. States that age or  disability is not                                                                    
     sufficient by itself to qualify.                                                                                           
                                                                                                                                
     Sec.  13.55.020:  Authorizes a  qualified  individual's                                                                    
     attending   physician   to    dispense   or   write   a                                                                    
     prescription  for  the   necessary  medication  if  the                                                                    
     physician  complies  with  the  chapter.  Authorizes  a                                                                    
     pharmacist  to dispense  the  prescribed medication  to                                                                    
     the qualified  individual, the attending  physician, or                                                                    
     an agent of the qualified individual.                                                                                      
                                                                                                                                
     Sec.  13.55.030:  Requires  a qualified  individual  to                                                                    
     make an  oral request  and a  written request  to their                                                                    
     attending   physician   to    receive   the   necessary                                                                    
     medication.  Requires   the  qualified   individual  to                                                                    
     repeat  the  oral request  15  days  after the  initial                                                                    
     request.  Provides  alternative   request  methods  for                                                                    
     qualified individuals who are not  able to speak or not                                                                    
     able to sign the request.                                                                                                  
                                                                                                                                
CHAIR SEATON asked for clarification that Section 13.55.020 was                                                                 
permissive, and not a requirement, for a physician.                                                                             
                                                                                                                                
MS. KRANENDONK  expressed her  agreement and  noted that  a later                                                               
section clearly stated that medical  professionals were not under                                                               
any obligation to  provide these prescriptions.  She  moved on to                                                               
explain the next sections of the proposed bill:                                                                                 
                                                                                                                                
     Sec.  13.55.040:  Directs  the attending  physician  to                                                                    
     offer  the  qualified  individual  the  opportunity  to                                                                    
     rescind  the  initial  oral  request  and  the  written                                                                    
     request when the qualified  individual makes the second                                                                    
     oral request. Allows a  qualified individual to rescind                                                                    
     a  request   at  any   time.  Prohibits   an  attending                                                                    
     physician  from  dispensing or  prescribing  medication                                                                    
     unless  the physician  offers the  qualified individual                                                                    
     an opportunity to rescind the request.                                                                                     
                                                                                                                                
     Sec.  13.55.050:  Sets  up  the  requirements  for  the                                                                    
     written  request.  Prohibits  the  attending  physician                                                                    
     from being a witness.  Requires the witnesses to attest                                                                    
     that  the  qualified   individual  is  capable,  acting                                                                    
     voluntarily,  and not  under undue  influence to  sign.                                                                    
     Sets limits on who may be witness.                                                                                         
                                                                                                                                
     Sec.  13.55.060:  Lays  out  a  form  for  the  written                                                                    
     request to be signed by the qualified individual.                                                                          
                                                                                                                                
     Sec. 13.55.070:  Lays out the  duties of  the attending                                                                    
     physician. Includes determining  whether the individual                                                                    
     has a  terminal disease, is  capable, and has  made the                                                                    
     medication    request   voluntarily.    Also   includes                                                                    
     providing certain listed  information to the individual                                                                    
     about the  medical diagnosis  and prognosis,  the risks                                                                    
     and  probable  result  of taking  the  medication,  and                                                                    
     feasible alternatives. Requires  the physician to refer                                                                    
     the  individual to  a consulting  physician to  confirm                                                                    
     the diagnosis  and to determine that  the individual is                                                                    
     capable and acting  voluntarily. Requires the physician                                                                    
     to refer  the individual for counseling  if appropriate                                                                    
     under  Sec.  13.55.090.  Lists   other  duties  of  the                                                                    
     attending physician. Allows  the attending physician to                                                                    
     sign the death certificate.                                                                                                
                                                                                                                                
     Sec. 13.55.080: Before an  individual can qualify under                                                                    
     the  chapter, it  requires  a  consulting physician  to                                                                    
     examine  the  individual   and  confirm  the  attending                                                                    
     physician's  diagnosis of  a terminal  disease, and  to                                                                    
     verify   that  the   individual   is  capable,   acting                                                                    
     voluntarily, and has made an informed decision.                                                                            
                                                                                                                                
     Sec.  13.55.090: Requires  the attending  or consulting                                                                    
     physician to  refer the  individual for  counseling and                                                                    
     prohibits   the  dispensing   or  prescribing   of  the                                                                    
     necessary medicine until  the counselor determines that                                                                    
     the  individual   is  not  suffering   from  depression                                                                    
     causing impaired judgment.                                                                                                 
                                                                                                                                
     Sec. 13.55.100: Prohibits  the attending physician from                                                                    
     dispensing   or  prescribing   medication  unless   the                                                                    
     qualified individual has made an informed decision.                                                                        
                                                                                                                                
     Sec. 13.55.110: Prohibits  the attending physician from                                                                    
     denying the  medication request because  the individual                                                                    
     declines or cannot notify next of kin.                                                                                     
                                                                                                                                
     Sec.  13.55.120:   Requires  certain   waiting  periods                                                                    
     before medication can be dispensed or prescribed.                                                                          
                                                                                                                                
     Sec.  13.55.130: Requires  that the  medical record  of                                                                    
     the qualified  individual contains the items  listed in                                                                    
     the   section  before   the  individual   receives  the                                                                    
     medication.                                                                                                                
                                                                                                                                
     Sec. 13.55.140:  Invalidates will or  contractual terms                                                                    
     that  require,  prohibit,   impose  conditions  on,  or                                                                    
     otherwise addresses  whether an individual may  make or                                                                    
     rescind a request under this chapter.                                                                                      
                                                                                                                                
     Sec. 13.55.150:  Provides a  person with  immunity from                                                                    
     civil   and   criminal    liability   or   professional                                                                    
     disciplinary  action for  participating  in good  faith                                                                    
     compliance with  the chapter. States that  a medication                                                                    
     request  by an  individual  or  an attending  physician                                                                    
     providing  medication  in  good faith  compliance  with                                                                    
     this chapter  may not  provide the  sole basis  for the                                                                    
     appointment of a guardian or conservator.                                                                                  
                                                                                                                                
     Sec. 13.55.160: States that a  health care provider has                                                                    
     no duty to participate.                                                                                                    
                                                                                                                                
3:13:47 PM                                                                                                                    
                                                                                                                                
MS. KRANENDONK continued with her explanations:                                                                                 
                                                                                                                                
     Sec.  13.55.170:  Under  certain  conditions  allows  a                                                                    
     health care  provider to  prohibit another  health care                                                                    
     provider from participating in this chapter.                                                                               
                                                                                                                                
     Sec.  13.55.180: Establishes  the  crime  of abuse  for                                                                    
     certain activities. Makes the crime a class A felony.                                                                      
                                                                                                                                
     Sec. 13.55.190: States that the  chapter does not limit                                                                    
     liability for  civil damages resulting from  a person's                                                                    
     negligent conduct or intentional misconduct.                                                                               
                                                                                                                                
     Sec. 13.55.200: Allows a governmental  entity to file a                                                                    
     claim  against   an  individual's  estate   to  recover                                                                    
     expenses  incurred by  the  entity  resulting from  the                                                                    
     individual's termination of life under this chapter.                                                                       
                                                                                                                                
3:15:24 PM                                                                                                                    
                                                                                                                                
MS. KRANENDONK moved on with her explanation of the next                                                                        
sections:                                                                                                                       
                                                                                                                                
     Sec. 13.55.210:  Directs the  Department of  Health and                                                                    
     Social  Services  to review  a  sample  of the  records                                                                    
     maintained  under the  chapter every  year. Requires  a                                                                    
     health  care provider  to file  a record  of dispensing                                                                    
     medication  under  this  chapter with  the  department.                                                                    
     Directs   the  department   to  adopt   regulations  to                                                                    
     facilitate   the   collection  of   information   about                                                                    
     compliance  with  the  chapter. Makes  the  information                                                                    
     confidential  but requires  the  department to  provide                                                                    
     the  public  an  annual statistical  report  about  the                                                                    
     information collected.                                                                                                     
                                                                                                                                
     Sec.  13.55.220: Prohibits  construing  the chapter  to                                                                    
     authorize   or   require   health  care   contrary   to                                                                    
     applicable  generally accepted  health care  standards.                                                                    
     Prohibits  construing the  chapter  as authorizing  the                                                                    
     ending  of life  by certain  methods, including  lethal                                                                    
     injection. Establishes  that an action allowed  by this                                                                    
     chapter is  an affirmative  defense to  certain crimes,                                                                    
     including murder, manslaughter, and euthanasia.                                                                            
                                                                                                                                
     Sec.  13.55.230: Prohibits  a person  from conditioning                                                                    
     the  sale, procurement,  issuance,  rate, delivery,  or                                                                    
     another  aspect   of  a   life,  health,   or  accident                                                                    
     insurance  or   annuity  policy,   on  the   making  or                                                                    
     rescission  of  a  request  for  medication  under  the                                                                    
     chapter.                                                                                                                   
                                                                                                                                
3:16:31 PM                                                                                                                    
                                                                                                                                
MS. KRANENDONK explained the following sections:                                                                                
                                                                                                                                
     Sec. 13.55.240:  States that  a request  for medication                                                                    
     under  this  chapter  is not  an  advance  health  care                                                                    
     directive  under AS  13.52 and  that  AS 13.52  (Health                                                                    
     Care  Decision  Act)  does not  apply  to  an  activity                                                                    
     allowed by the chapter.                                                                                                    
                                                                                                                                
     Sec.  13.55.900:  Defines the  terms  used  in the  new                                                                    
     chapter.                                                                                                                   
                                                                                                                                
3:16:56 PM                                                                                                                    
                                                                                                                                
MS.  KRANENDONK  explained  the  remainder  of  the  bill,  which                                                               
included:                                                                                                                       
                                                                                                                                
     Section  4: Page  14: Lines  25-29  Indicates that  the                                                                    
     chapter applies to contracts,  wills, and life, health,                                                                    
     or accident insurance or  annuity policies delivered or                                                                    
     issued for delivery on or after the effective date.                                                                        
                                                                                                                                
     Section  5:   Pages  14-15:   Lines  30-3   Allows  the                                                                    
     Department  of  Health  and Social  Services  to  adopt                                                                    
     regulations for the new chapter.                                                                                           
                                                                                                                                
     Section  6:  Page  15:  Line  4  Makes  the  regulation                                                                    
     authority  given  under  Bill  Section  5  take  effect                                                                    
     immediately.                                                                                                               
                                                                                                                                
     Section 7: Page  15: Line 5 Makes the  Act (except Bill                                                                    
     Section 5) effective January 1. 2016.                                                                                      
                                                                                                                                
3:17:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE STUTES  asked how  many states had  already passed                                                               
this or similar legislation.                                                                                                    
                                                                                                                                
REPRESENTATIVE  DRUMMOND  replied  that   there  were  about  six                                                               
states.                                                                                                                         
                                                                                                                                
MS.  KRANENDONK relayed  that currently  Oregon, Washington,  and                                                               
Vermont  had  legislation in  place,  and  that Montana  and  New                                                               
Mexico had  provisions in law  to allow certain types,  which she                                                               
defined as "modified legislation to  this."  She reported that it                                                               
was moving in various parts in 25 other states.                                                                                 
                                                                                                                                
REPRESENTATIVE STUTES  clarified that  there were  currently only                                                               
five states with actual "laws on the books that relate to this."                                                                
                                                                                                                                
REPRESENTATIVE  WOOL   asked  how  many  people   had  used  this                                                               
legislation.                                                                                                                    
                                                                                                                                
MS. KRANENDONK  replied that,  although there  was not  data from                                                               
all five  states, there was 20  years of data from  Oregon, which                                                               
indicated  that 1,173  residents  had  requested the  medication,                                                               
with 752 individuals  having used the prescriptions  to end their                                                               
lives.     She   clarified  that   this  did   not  include   the                                                               
prescriptions through 2014.                                                                                                     
                                                                                                                                
REPRESENTATIVE  WOOL relayed  that  this was  fewer  than 40  per                                                               
year.   He asked  whether 18  years was  the age  limitation, and                                                               
pointed out that, although this was  the age for a legal adult, a                                                               
person could not buy cigarettes  or alcohol, but could order this                                                               
prescription.  He asked whether this was a contradiction.                                                                       
                                                                                                                                
REPRESENTATIVE  DRUMMOND replied  that the  age of  18 allowed  a                                                               
person to  vote or  to serve  in the military.   She  shared that                                                               
there had been a lot of  comments about this application to other                                                               
illnesses, and she  acknowledged that there was still  work to be                                                               
done on the proposed bill.                                                                                                      
                                                                                                                                
REPRESENTATIVE WOOL asked for  clarification that individuals had                                                               
to be deemed terminally ill by two physicians.                                                                                  
                                                                                                                                
REPRESENTATIVE DRUMMOND expressed her  agreement, noting that the                                                               
time frame  definition was for death  within 6 months as  well as                                                               
medicine was able  to predict.  She opined that  about 70 percent                                                               
of the  people requesting these prescriptions  have various types                                                               
of  cancer, and  have  "been through  every  conceivable kind  of                                                               
treatment, and it's failed, and  they know they're going to die."                                                               
She  pointed out  that often  the  pain was  unbearable, and  she                                                               
offered her  belief that many  people did  not want to  end their                                                               
lives  in the  fog of  deep pain  medication.   She shared  that,                                                               
although she had  not been through this personally,  she had read                                                               
that having the  control to use this  prescription allowed people                                                               
to focus on a  new joy in living, with less  concern for pain and                                                               
other issues.                                                                                                                   
                                                                                                                                
REPRESENTATIVE FOSTER asked whether it  was possible for a person                                                               
to shop around until they found two doctors who agreed to this.                                                                 
                                                                                                                                
MS. KRANENDONK  explained that  the primary  physician determined                                                               
whether  the medication  could be  prescribed,  whereas a  second                                                               
doctor only had  to confirm the diagnosis for  a terminal disease                                                               
with less  than six months  to live.   As the bill  was currently                                                               
written, if  a second  doctor did not  agree with  the diagnosis,                                                               
the process would be ended.                                                                                                     
                                                                                                                                
3:24:47 PM                                                                                                                    
                                                                                                                                
TERRY   BANNISTER,    Attorney,   Legislative    Legal   Counsel,                                                               
Legislative Legal Services, offered  her belief that the proposed                                                               
bill could  be clarified, as it  did not state what  would happen                                                               
should  doctors  disagree.   She  suggested  that this  could  be                                                               
addressed in another bill version.                                                                                              
                                                                                                                                
REPRESENTATIVE TALERICO  directed attention to page  11, line 11,                                                               
and referenced the  criminal penalties for the crime  of abuse of                                                               
the  life  termination process.    He  stated that  AS  11.41.100                                                               
defined murder in  the first degree, which included  the crime of                                                               
murder with the intent to cause  the death of a person, or compel                                                               
or  induce  any  person  to  commit  suicide  through  duress  or                                                               
deception.   He asked whether  the proposed bill was  in conflict                                                               
with the statute.                                                                                                               
                                                                                                                                
CHAIR   SEATON   asked   whether  Representative   Talerico   was                                                               
referencing  page  11,  line  20, of  the  proposed  bill,  which                                                               
defined  abuse of  life  termination as  a class  A  felony.   He                                                               
questioned whether this created any conflict.                                                                                   
                                                                                                                                
MS. BANNISTER,  in response, acknowledged that,  although she was                                                               
not  an expert  on  criminal matters,  Sections 1  and  2 of  the                                                               
proposed  bill addressed  actual  homicides when  death had  been                                                               
achieved, whereas  this penalty  addressed "someone  who attempts                                                               
to  affect the  person's choice  of dying,"  and did  not require                                                               
that the  person had died.   She noted that any  penalty could be                                                               
selected.                                                                                                                       
                                                                                                                                
REPRESENTATIVE  TALERICO asked  that  this be  flagged for  later                                                               
consideration.                                                                                                                  
                                                                                                                                
3:28:21 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON shared that he  had received many e-mails requesting                                                               
that proposed  HB 99 not  be scheduled.   He offered  an anecdote                                                               
about his  family, and how  these issues  had affected them.   He                                                               
offered  his belief  that this  proposed bill  considered whether                                                               
people had the  right to make these decisions  for themselves, or                                                               
whether the  state should  make these decisions.   He  stated his                                                               
belief that  people should be  in control  of their lives  and be                                                               
able to  make decisions for  themselves.  He suggested  that this                                                               
proposed  decision  for  whether  people  make  their  own  final                                                               
decisions  should be  discussed.    He declared  that  it was  an                                                               
interesting  dilemma, and  he invited  thoughtful testimony  from                                                               
the committee and the public.                                                                                                   
                                                                                                                                
3:33:54 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  STUTES  offered  a   personal  anecdote  about  a                                                               
terminally ill person who was not prepared to die.                                                                              
                                                                                                                                
CHAIR SEATON said  that they wanted to ensure  that this decision                                                               
was made  by the  individual, and  not by  others.   He clarified                                                               
that he was not the sponsor of HB 99.                                                                                           
                                                                                                                                
[Chair Seaton opened public testimony]                                                                                          
                                                                                                                                
3:35:48 PM                                                                                                                    
                                                                                                                                
PETER  REAGAN,  M.D.,   National  Medical  Director,  End-of-Life                                                               
Consultation, Compassion  & Choices, shared  that he had  spent a                                                               
lot  of time  in Alaska,  and  that he  had retired  as a  family                                                               
practice  doctor  in  Oregon,   with  extensive  experience  with                                                               
terminally ill  patients and the  Oregon Death with  Dignity law.                                                               
He noted  that, in  1998, he had  written the  first prescription                                                               
under  this law.    He offered  his belief  that  the history  in                                                               
Oregon,   Vermont,  and   Washington  had   shown  that   patient                                                               
safeguards had  worked as  intended, and there  had not  been any                                                               
substantiated case  of abuse  or coercion during  this time.   He                                                               
addressed  the  slippery  slope  argument of  the  right  to  die                                                               
becoming a  duty to die or  another social harm, and  stated that                                                               
this had not happened.  He  declared that doctors wanted the best                                                               
outcomes for  their patients, and  there was not  any conflicting                                                               
motivation  in  these  situations.    He  declared  that  doctors                                                               
advocated  for what  their patients  wanted.   He reported  that,                                                               
after  more than  1,500  prescriptions, there  had  not been  any                                                               
instances for when the law  had been inappropriately applied, and                                                               
there  had  not been  any  circumstances  which had  necessitated                                                               
comment or discipline.   He emphasized that Oregon  had a culture                                                               
of care  focused on  autonomy, self-determination,  and increased                                                               
communication between  doctors and  the individuals  they served,                                                               
as  well  as  between  dying  patients  and  their  families  and                                                               
friends.   He said that  the law  provided a useful  framework to                                                               
aid with  this decision making.   He  stated that proposed  HB 99                                                               
contained the  core patient safeguards  of the Oregon  Death with                                                               
Dignity  law,  which would  provide  Alaskans  with true  patient                                                               
autonomy, as  well as  the opportunity for  more open  and honest                                                               
communication between dying  Alaskans and their care  givers.  He                                                               
clarified that  this proposed  bill was  all about  patient self-                                                               
determination, pointing out  that it was not legal  in Oregon for                                                               
anyone except the  person who was dying to  request or administer                                                               
the  medication.   That  meant  that  the  control was  with  the                                                               
patient from beginning to end.   As these deaths were legal, they                                                               
were witnessed and  experienced by loved ones  and caregivers and                                                               
were not  clandestine or mysterious.   He reported that  only two                                                               
per  thousand patients  have used  the law  since its  beginning,                                                               
about 900 people, with most of  these being people with end stage                                                               
cancer  or end  stage ALS.   He  shared that  he had  been deeply                                                               
moved  by the  gratitude  and relief  expressed  by patients  and                                                               
family  members when  they were  allowed to  have this  choice of                                                               
death with dignity.   He explained about  doctor shopping, noting                                                               
that if one  doctor did not agree that a  patient qualified, then                                                               
that ended the process, unless  another doctor more familiar with                                                               
the case  discussed it with the  first doctor.  He  declared that                                                               
all the  doctors were  working to  obey both  the spirit  and the                                                               
wording of  the law.   He addressed the  age of 18,  pointing out                                                               
that this  was the  age of  consent for  medical procedures.   He                                                               
reported that only  a very small number of people  under 21 years                                                               
of age were  using this law, noting that he  had only written one                                                               
prescription for anyone under 30 years of age.                                                                                  
                                                                                                                                
CHAIR SEATON  asked whether he  had reviewed proposed HB  99, and                                                               
if there  were any other parts  of the proposed bill  that needed                                                               
clarification.                                                                                                                  
                                                                                                                                
DR.  REAGAN  replied  that  the proposed  Alaska  bill  was  very                                                               
similar to  the Oregon law.   He  explained that the  Oregon bill                                                               
clarified  that if  there were  any concern  for a  mental health                                                               
issue  clouding  the patient's  judgement,  then  the person  was                                                               
required to have  a psychiatric or psychological  evaluation.  He                                                               
acknowledged that someone could  be unhappy with their situation,                                                               
but, as long  as they were "thinking straight" and  were clear in                                                               
their understanding of  the request, the proposed  Alaska law had                                                               
the same protections as the Oregon law.                                                                                         
                                                                                                                                
3:43:46 PM                                                                                                                    
                                                                                                                                
KAREN  DECHMAN   BOND,  President,  Midtown   Community  Council,                                                               
reported  that  the community  council  had  passed a  resolution                                                               
unanimously supporting  proposed HB 99.   She offered  a personal                                                               
anecdote, and  shared that she  had not understood  that terminal                                                               
illness meant  pain day after day.   She offered a  plea that the                                                               
committee  make  this  available  to Alaskans,  as  it  was  very                                                               
Alaskan for people to have power over the way they can die.                                                                     
                                                                                                                                
3:47:56 PM                                                                                                                    
                                                                                                                                
PETER BANGS, paraphrased from a prepared statement, which read:                                                                 
                                                                                                                                
     My  name is  Peter  Bangs  and I  would  like to  first                                                                    
     disclose that  I am a  state employee, but I  am taking                                                                    
     leave today  to share  my personal opinions  in support                                                                    
     of House Bill 99. I  would like to briefly describe two                                                                    
     contrasting  experiences  that  have helped  shaped  my                                                                    
     beliefs  on this  issue. Several  years ago,  my wife's                                                                    
     grandmother,   Helen,  was   severely  injured   in  an                                                                    
     accident.  Her doctors  told us  in no  uncertain terms                                                                    
     that  she was  dying  from her  injuries,  but that  it                                                                    
     could take  a few  weeks. Unfortunately, they  were not                                                                    
     able to keep  her comfortable. Helen had  always been a                                                                    
     remarkably strong  and tough woman,  but she was  in so                                                                    
     much pain and suffering that  she kept telling her care                                                                    
     givers that  it was  time and that  she begged  them to                                                                    
     let her go.  In an effort to speed up  the process, she                                                                    
     refused  to eat,  drink, or  take  her medications.  In                                                                    
     contrast, my  wife and I  recently lost two dogs  - one                                                                    
     to cancer  and another  to liver  disease. For  each of                                                                    
     them, we made  the decision to put them  to sleep after                                                                    
     exhausting  treatment options  and  when  they were  no                                                                    
     longer comfortable.  As much  as we  hated to  let them                                                                    
     go, I  am grateful  that we  had the  option to  end to                                                                    
     their needless  suffering. When it  comes to  people, I                                                                    
     don't understand  why we can't  provide our  loved ones                                                                    
     with  the   same  freedom  to  die   with  dignity  and                                                                    
     compassion as we do for  our companion animals. This is                                                                    
     an  issue  about  allowing people  to  make  their  own                                                                    
     decisions according  to their own desires  and beliefs.                                                                    
     To put this issue  in perspective, consider that Alaska                                                                    
     allows  19  year old  kids  to  decide whether  to  use                                                                    
     tobacco, even though tobacco  products cause cancer and                                                                    
     premature deaths  for hundreds  of thousands  of people                                                                    
     in  the US  each year.  One  of the  main reasons  that                                                                    
     tobacco  - and  now  marijuana -  is  legal is  because                                                                    
     Alaskans value  the right to make  their own decisions,                                                                    
     even if you  or I don't agree with  their choices. That                                                                    
     is  exactly  what  HB  99 is  all  about  -  empowering                                                                    
     terminally ill  people with the  right to die  on their                                                                    
     own terms according to their  own desires and beliefs -                                                                    
     not yours or mine. Thank you.                                                                                              
                                                                                                                                
3:50:42 PM                                                                                                                    
                                                                                                                                
KELLY   BEHEN  emphasized   that  this   was  a   very  important                                                               
conversation to have,  declaring that every person  had the right                                                               
to  die  with  dignity  and   as  painlessly  as  possible,  when                                                               
suffering a  terminal illness.   She offered a  personal anecdote                                                               
about the  death of her  fiancé.   She expressed her  desire that                                                               
people have  control over "the  last and most  important decision                                                               
they do have in their life."                                                                                                    
                                                                                                                                
3:52:53 PM                                                                                                                    
                                                                                                                                
SUSAN ARTHUR  declared that this  had been very important  to her                                                               
for many  years, and she offered  an anecdote about the  death of                                                               
her mother.   She stated that her mother's death  had been denied                                                               
"by others  who were not  related, not emotionally  involved, nor                                                               
had  ever  felt  such  total  anguish  and  helplessness."    She                                                               
declared  that   there  was  not  any   moral  justification  for                                                               
prolonging misery on a fellow human  being.  She pointed out that                                                               
"this humane bill has many built  in safety measures so it cannot                                                               
be misused."   She said  that it would  be a comfort  to Alaskans                                                               
who existed in pain and suffering  to at least know they have the                                                               
choice to end it.                                                                                                               
                                                                                                                                
3:54:41 PM                                                                                                                    
                                                                                                                                
RALPH  FENNER asked  that the  proposed bill  be passed,  stating                                                               
that choice  was the key.   He offered an anecdote  of his wife's                                                               
suffering  and slow  death from  colon cancer.   Even  though her                                                               
family and her doctor wanted to  help her with her suffering, the                                                               
law would not allow it.  He  emphasized that "we need to open our                                                               
eyes  in  this  state  and  do  all we  can  to  prevent  such  a                                                               
horrendous occurrence."                                                                                                         
                                                                                                                                
3:57:04 PM                                                                                                                    
                                                                                                                                
NANCY CLONAN read excerpts from  a suicide note from her husband,                                                               
declaring that,  if the proposed  bill were passed, no  one would                                                               
ever have to go through this again.  She read:                                                                                  
                                                                                                                                
     If you are reading this, I am  dead.  I did not come by                                                                    
     this  decision  lightly.   I  didn't  plan  on  getting                                                                    
     melanoma or brain cancer.   These are horrendous things                                                                    
     I have  no control over, but  how I choose to  live and                                                                    
     die  I do  have control  over.   Euthanasia, in  Greek,                                                                    
     meaning  good  death  ... I  believe  in  this  because                                                                    
     society  does not.   I  could not  discuss this  you. I                                                                    
     wanted to protect you from all  aspects of my death.  I                                                                    
     do not  believe that  for me there  is dignity  in long                                                                    
     suffering and  debilitating death.   To know  you would                                                                    
     see the suffering,  pain and anguish I  would have gone                                                                    
     through were  not the memories  I want for you  to have                                                                    
     of me,  nor do  I want to  suffer from  them physically                                                                    
     with no possibility of recovery.   My death is not fear                                                                    
     based, it is my choice.   I think society is archaic to                                                                    
     put its values  on something so personal.   Let society                                                                    
     live like this and I  believe the majority would choose                                                                    
     to let people decide for  themselves.  I get enraged to                                                                    
     hear other  people tell me what  I should do, ask  if I                                                                    
     am doing  enough, or  worse, tell me  that is  not what                                                                    
     they would  do.   For a country  that prides  itself on                                                                    
     individuality it is amazingly  overbearing in its views                                                                    
     of death  and dying.   I believe  in life  with dignity                                                                    
     and  dying and  the  dying, me  and  millions like  me,                                                                    
     should have  dignity in  the way we  see fit,  not what                                                                    
     politicians and family members who  are not in the fray                                                                    
     wants, but what those suffering  want, and what I want.                                                                    
     This  is   not  a   suicide.     It  is   no  momentary                                                                    
     hopelessness with terminal illness.   Cancer killed me,                                                                    
     I did not  kill me.  I helped myself  live with dignity                                                                    
     and a  purpose I have not  felt in a long  while, and I                                                                    
     have helped myself  die with a measure  of control I've                                                                    
     not  had in  four years  in an  unending battle  with a                                                                    
     disease that is robbing me of the things that I love.                                                                      
                                                                                                                                
MS. CLONAN continued to read:                                                                                                   
                                                                                                                                
     I want what I have worked  so hard to build with you to                                                                    
     be what I leave  with you.  Me at my best.   I love you                                                                    
     very  much and  would never  want to  leave you  with a                                                                    
     legacy of  shame.  This is  a choice for me  in my last                                                                    
     days to  go on my terms.   People can hold  my hand and                                                                    
     feel bad,  but they cannot  know what it feels  like to                                                                    
     have had cancer  inside eating away at  you, and you're                                                                    
     being able  to physically feel  it chew away  your body                                                                    
     and eating your  brain like a parasite  eating its host                                                                    
     alive.   I did  not expect others  to understand  but I                                                                    
     expected others at a minimum  to respect me as a human.                                                                    
     I deserve  that.   I am kind  and only  wanted kindness                                                                    
     back.                                                                                                                      
                                                                                                                                
MS.  CLONAN stated  that the  reality  of losing  her husband  30                                                               
years early to cancer was horrible,  and it had forced him to use                                                               
the last  of his own  strength to die  alone.  She  stressed that                                                               
the proposed  bill could  keep others  from dying  alone, protect                                                               
families from  this trauma,  and offer  an opportunity  to extend                                                               
quality time for  the terminally ill without the  threat of legal                                                               
consequences.                                                                                                                   
                                                                                                                                
4:00:36 PM                                                                                                                    
                                                                                                                                
J. R.  MEYERS, Alaska Constitution  Party, stated that  the party                                                               
supported the  right of  life, as  this was  a paramount  duty of                                                               
government  to support.   He  stated  that medical  professionals                                                               
were licensed  by the state,  and that the medical  community had                                                               
an  historical  position  for  not  "doing  active  harm."    The                                                               
proposed  bill would  make  medical  professionals the  potential                                                               
agents  for  termination  of  life,  which,  he  declared,  would                                                               
reverse centuries of precedent.   He offered the belief that this                                                               
would lead to  degradation in the value of life.   He stated that                                                               
this was different from "do  not resuscitate" and from "declining                                                               
extraordinary medical  interventions with informed consent."   He                                                               
noted that  this also  was different  from the  way we  treat our                                                               
pets, as many  laws made this differentiation  between humans and                                                               
animals.   He testified against  the proposed bill,  stating that                                                               
it was "an affront against human life."                                                                                         
                                                                                                                                
4:02:38 PM                                                                                                                    
                                                                                                                                
LANCE  ROBERTS  said that  he  was  representing himself  and  he                                                               
expressed his  concern for the  proposed bill.  He  reported that                                                               
he had  sent out  a local  message when he  first learned  of the                                                               
proposed  bill.   He shared  a response  to his  message, stating                                                               
that, decades ago, a person  had wanted to commit suicide because                                                               
he had been  determined to be terminally ill, but  his family had                                                               
talked him  out of it  and he had  lived an additional  20 years.                                                               
He declared  that it was  necessary to remember that  science and                                                               
doctors were not  perfect, and that people could get  better.  He                                                               
stated that  it was important  not to accept  infallibility, even                                                               
with  two doctors.    He also  pointed out  that  Alaska had  the                                                               
highest suicide  rate in  the nation,  and that  a lot  of people                                                               
were  actively  working to  stop  this.    He declared  that  the                                                               
proposed bill was  "telling people that suicide is  okay.  You're                                                               
telling  them it's  an acceptable  alternative at  some point  in                                                               
time."   He asked  that the  proposed bill not  be passed  out of                                                               
committee.                                                                                                                      
                                                                                                                                
4:05:33 PM                                                                                                                    
                                                                                                                                
JIM BECK stated his adamant opposition  to the proposed bill.  He                                                               
reported that the American Medical  Association and 24 states had                                                               
also rejected  this.  He  acknowledged that the  personal stories                                                               
were very  compelling, and  he did not  intend to  minimize those                                                               
experiences.    He  expressed  his hope  that  the  Alaska  State                                                               
Legislature would see  that its duty was much broader,  to all of                                                               
society, and that  this bill should be rejected.   He offered his                                                               
belief that "handing medical professionals  the right to end life                                                               
is a  recipe for disaster  and nothing  that our state  should be                                                               
involved   with."     He   offered   an   example  that   medical                                                               
professionals already  devalue or undervalue the  lives of people                                                               
with disabilities,  and suggested that this  same attitude toward                                                               
the quality of  life would be extended to  terminally ill people.                                                               
He  said  that   this  was  a  very  dangerous   mix  that  could                                                               
undoubtedly  result  in  an   incorrect  and  unfortunately  very                                                               
irreversible outcome.   He  asked if  doctors would  rally around                                                               
someone  who  expressed  the  desire  to die  and  use  the  best                                                               
practices and  palliative care to  ensure the last days  were the                                                               
best.  He  stated that the proposed bill could  end some people's                                                               
lives  without   their  consent   through  mistakes   and  abuse.                                                               
Assisted   suicide    proponents   confused    bureaucracy   with                                                               
safeguards.    He  stated  that doctor  shopping  was  common  in                                                               
Oregon, and that  Compassion & Choices would  offer referrals for                                                               
assistance.  He said that assisted  suicide was a deadly mix with                                                               
our  profit  driven  health  care  system, and,  as  it  was  the                                                               
cheapest treatment, it would save  money for insurance companies.                                                               
He suggested  that financial and  emotional pressures  could also                                                               
make people  choose death, and  he offered his  personal opinion,                                                               
as a  person with a disability,  that he keenly felt  the burden.                                                               
He  asked  how hard  people  would  work  to ensure  that  people                                                               
received best practice palliative care.   He declared that it was                                                               
ludicrous to  believe that there  had never been coercion  in the                                                               
Oregon experience.   He stated that the  Oregon experience lacked                                                               
data and  transparency.  He  declared that the proposed  bill was                                                               
unnecessary  as   everyone  already  had  the   right  to  refuse                                                               
treatment, and could receive palliative  care which included pain                                                               
relief  and sedation.   He  urged that  the committee  reject the                                                               
proposed bill.                                                                                                                  
                                                                                                                                
4:10:00 PM                                                                                                                    
                                                                                                                                
RICHARD ASHER,  M.D., reported  that he  was a  family physician,                                                               
and  that he  had  been  practicing in  Alaska  since  1982.   He                                                               
expressed his agreement  that taking care of patients  at the end                                                               
of life was  challenging, and that patients in  Rural Alaska were                                                               
in control of  life as much as their mental  ability allowed.  He                                                               
stated  that  physicians  worked  with  the  patients  and  their                                                               
families to provide  terminal care and to prepare for  death.  He                                                               
suggested  that  the  proposed  bill  would  change  the  doctor,                                                               
family, patient relationship as it  could cause dissension in the                                                               
family.   He stated that  the Hippocratic Oath was  not mentioned                                                               
in the proposed bill, or why  a healer should go in opposition to                                                               
this historical  pledge for not taking  life.  He stated  that it                                                               
took skill to  provide superb, end of life care.   He opined that                                                               
the proposed bill was dangerous as  it gives a physician too much                                                               
power.   He stated that  he did  not keep patients  alive against                                                               
their will, as  it was their right to refuse  treatment, and that                                                               
he worked  with hospice  and palliative  care physicians  to give                                                               
better  care   in  Rural  Alaska,   stating  that  it   was  more                                                               
compassionate to  give care,  than to assist  suicide.   He asked                                                               
how it  could be  determined whether someone  was coerced,  as it                                                               
was cloaked  in a shroud of  secrecy, which made it  difficult to                                                               
ascertain any abuses.   He pointed out that Alaska  already had a                                                               
huge suicide  rate, and  they had worked  hard telling  people to                                                               
live and have hope.  The  proposed bill sent the wrong message to                                                               
depressed  suicidal  youth  and  adults.     He  asked  that  the                                                               
committee not  pass the proposed  bill.   He stated that  it was,                                                               
instead, necessary  to become better at  palliative, hospice, and                                                               
compassionate care.                                                                                                             
                                                                                                                                
4:13:47 PM                                                                                                                    
                                                                                                                                
GEORGE STEWART  stated that  he was a  retired physician  and had                                                               
practiced intensive care medicine in  Anchorage for 34 years.  He                                                               
spoke in  opposition to proposed HB  99, stating that it  was not                                                               
about  giving  patients the  right  to  die,  but it  was  giving                                                               
physicians  the  right to  kill.    He  stated that  suicide  was                                                               
tragic, but  not illegal.  He  opined that the proposed  bill was                                                               
dangerous for  physicians, referencing the Hippocratic  Oath, and                                                               
stated that it  destroyed the trust, which was  the foundation in                                                               
a doctor-patient relationship.  He  declared that it takes really                                                               
great skill  to provide  superb end-of-life care.   He  said that                                                               
the proposed bill was dangerous  for families, as they don't have                                                               
to be  informed.  He offered  his belief that it  will open doors                                                               
for  elder  abuse  by  self-centered  care  providers  or  greedy                                                               
relatives.    He  said  the  right to  die  for  elders  will  be                                                               
dangerous  for patients  as it  will become  a duty  to die.   He                                                               
reported that drugs used for end  of life did not work 20 percent                                                               
of the  time.  He said  that often patients live  longer than the                                                               
guesstimate  of six  months.   He  said  that physician  assisted                                                               
suicide  was dangerous  for society,  as  statistics showed  that                                                               
doctors would  only get a second  opinion from a doctor  who they                                                               
knew  would  agree,  and that,  while  under  physician  assisted                                                               
suicide laws,  they were immune  from malpractice.  He  asked for                                                               
the origin of the proposed bill.                                                                                                
                                                                                                                                
4:17:54 PM                                                                                                                    
                                                                                                                                
PATRICIA  COLL  FREEMAN stated  her  opposition  to the  proposed                                                               
bill.   She said that  a measure of  quality in society  was with                                                               
the treatment of family members  who were dependent, defenseless,                                                               
and  disenfranchised, which  included people  who were  seriously                                                               
ill.   She reported that, in  2001, the Alaska Supreme  Court had                                                               
unanimously  ruled  that there  was  not  a state  constitutional                                                               
right   for  doctor   prescribed   suicide,   writing  that   the                                                               
"terminally  ill are  the class  of persons  who need  protection                                                               
from family,  social, and  economic pressures  and who  are often                                                               
particularly  vulnerable to  such  pressures  because of  chronic                                                               
pain, depression,  and the  effects of  medication."   She stated                                                               
that  these  serious ill  persons  deserved  real compassion  and                                                               
better access  to health care,  and not  death.  She  opined that                                                               
the  proposed bill  would limit  health care  choices.   She said                                                               
that in Oregon,  doctor prescribed suicide had  limited access to                                                               
health care, as  the state health plan would  not provide certain                                                               
pain  relieving   and  lifesaving  medications,   which  included                                                               
recommended  but  costly  cancer  treatments.    She  offered  an                                                               
anecdote of  an Oregon cancer  patient who was informed  that her                                                               
chemotherapy  treatment  would  not   be  covered  but  a  doctor                                                               
prescribed  suicide would  be  covered.   She  declared that  the                                                               
choice to  die would become the  duty to die, and  that advocates                                                               
for  those with  disabilities  opposed the  proposed  bill.   She                                                               
asked that the committee oppose the proposed bill.                                                                              
                                                                                                                                
4:21:12 PM                                                                                                                    
                                                                                                                                
JANET MCCOY  stated that she was  opposed to HB 99.   She relayed                                                               
that there was no way to  protect the vulnerable and mentally ill                                                               
once  this passed.   She  reported that,  although supporters  of                                                               
doctor  prescribed  suicide  had  long  maintained  that  it  was                                                               
necessary for  those suffering from  intractable pain,  there was                                                               
no documented case  in Oregon for its use  because of untreatable                                                               
pain.   She referenced  a study of  reasons cited  for prescribed                                                               
suicide,  and noted  that  pain or  fear of  pain  was the  least                                                               
offered  reason.   She  stated  that  nearly all  terminally  ill                                                               
patients who  desired death were suffering  from treatable mental                                                               
disorders, yet only  6.7 percent were referred  for a psychiatric                                                               
evaluation.  She noted that  many non-terminally ill patients had                                                               
received the  prescription.   She said that  a network  of doctor                                                               
prescribed  "death  proponents"  ensured that  patients  received                                                               
legal  prescription even  when the  family doctor  knew that  the                                                               
desire  for death  was  transient and  could  be alleviated  with                                                               
proper care  and concern.  She  noted that there were  cases when                                                               
family pressure was placed on  patients.  She declared that human                                                               
worth did not diminish as we weaken  or age, or if we live with a                                                               
disability.  She asked that the committee oppose HB 99.                                                                         
                                                                                                                                
4:23:50 PM                                                                                                                    
                                                                                                                                
MARY LANZA,  M.D., stated that  she was  in opposition of  HB 99.                                                               
She  reported  that  she  had  been a  physician  for  27  years,                                                               
practicing  in  Alaska  for  21   years,  as  a  board  certified                                                               
anesthesiologist with  training in pain  management.   She stated                                                               
that her research  had found many falsehoods  propagated by those                                                               
seeking  physician assisted  suicide, stating  that pain  was not                                                               
the  driving cause,  but  was,  instead, psychological  distress,                                                               
including  depression,  hopelessness,  and  a  fear  of  loss  of                                                               
control.  She  stated that suicide was not rational.   She shared                                                               
a statement  that a person  wanting to commit suicide  would lead                                                               
the  medical   community  to  take  the   appropriate  steps  for                                                               
treatment.    She said  that  her  role  as  a physician  was  to                                                               
alleviate  suffering, but  that was  "distinct from  apportioning                                                               
death,  even  upon request."    Autonomy  alone  can never  be  a                                                               
substitute for  moral reason, and that  implication was dangerous                                                               
to society.   If  interest in legalizing  euthanasia was  tied to                                                               
any  trend in  history, it  was  to the  rise of  individualistic                                                               
strains of  thought that glorified  personal choice.   She stated                                                               
that no  one was obligated  to use extraordinary or  heroic means                                                               
to stay  alive, but  to use ordinary  and reasonable  measures to                                                               
treat disease  and sickness.   She said  that the  recent actions                                                               
were a perverse  incentive for insurance carriers  to promote the                                                               
option of physician  assisted suicide over lifesaving  care.  She                                                               
said that the  focus of concern should be  those individuals most                                                               
likely to be abused by  physician assisted suicide, including the                                                               
poor, the  poorly educated,  and the disabled,  as well  as those                                                               
who could not speak for  themselves.  She suggested a re-doubling                                                               
of  efforts in  the education  of patients,  family members,  and                                                               
loved ones, as well as  physicians, to promote better end-of-life                                                               
care.                                                                                                                           
                                                                                                                                
4:29:36 PM                                                                                                                    
                                                                                                                                
CYNTHIA  KIMBLEY shared  an anecdote  about her  father, and  his                                                               
recent loss  of independence due to  a terminal illness.   He was                                                               
suffering from  anxiety, as this was  not the quality of  life he                                                               
had always  experienced.  She  pointed out  that he had  a health                                                               
care  directive,  which was  allowed  by  law,  and that  he  had                                                               
several times expressed to family  members his desire for a death                                                               
with dignity law in Alaska.   She pointed out that the Oregon law                                                               
was clear that the ability to  choose was the patient's, and that                                                               
the  patient  must administer  the  medication  themselves.   She                                                               
asked who had the right to  decide for someone else that they had                                                               
to  remain  alive, solely  for  our  emotional well-being.    She                                                               
stated  her  support  for  her  father's  choice  of  death  with                                                               
dignity, pointing  out that  this was  only specific  to terminal                                                               
patients  and their  ability to  choose quality  and quantity  of                                                               
life.                                                                                                                           
                                                                                                                                
4:33:05 PM                                                                                                                    
                                                                                                                                
CHRISTOPHER  KURKA, Executive  Director,  Alaska  Right to  Life,                                                               
said that suicide did not  dignify, it was surrender and despair,                                                               
and it was not the answer for pain.   He said that this was a sad                                                               
state of affairs to come to  as a culture.  He directed attention                                                               
to euthanasia in Europe.  He  encouraged the committee to vote no                                                               
on HB 99.                                                                                                                       
                                                                                                                                
4:36:52 PM                                                                                                                    
                                                                                                                                
RON JOHNSON  stated that he  was in  favor of the  proposed bill,                                                               
pointing out that  it was important to have this  discussion.  He                                                               
noted  that a  similar law  in Oregon  had not  been abused.   He                                                               
pointed   out   that  85   percent   of   Canadian  health   care                                                               
professionals supported  similar legislation.  He  shared that he                                                               
is in  a wheelchair, and  he offered  his belief that  not having                                                               
proposed HB 99  was the discrimination against the  disabled.  He                                                               
stated that  he was moved  by the  testimony of those  with loved                                                               
ones who were suffering interminably  in the last stages of life,                                                               
and how they had desired a means  to help them.  He noted that he                                                               
had not  heard any personal  encounters from those  in opposition                                                               
to the proposed bill.                                                                                                           
                                                                                                                                
4:39:15 PM                                                                                                                    
                                                                                                                                
MONTE JORDAN  stated that she was  in support of proposed  HB 99.                                                               
She paraphrased from a letter  that she had submitted:  [Included                                                               
in members' packets]                                                                                                            
                                                                                                                                
     I am  writing in support of  HB 99 by Rep.  Drummond. I                                                                    
     believe it is referred to by  many as the "the right to                                                                    
     die bill" although I personally  consider it the "death                                                                    
     with  dignity" bill.  My fervent  belief is  that every                                                                    
     person has a  right to die with  dignity when suffering                                                                    
     a  terminal  illness  and   as  painlessly  as  his/her                                                                    
     medical   provider  and   family   can  arrange.   This                                                                    
     conviction  is the  result of  my experiences  with the                                                                    
     end  of life.  As a  hospice volunteer  I have  watched                                                                    
     people  progress towards  their death.  No doubt,  many                                                                    
     would  not want  to  end their  lives  sooner. All  are                                                                    
     given significant  doses of pain  relieving medication,                                                                    
     some  to the  degree that  they  are not  aware of  the                                                                    
     family or friends that may  be at their bedside. Others                                                                    
     may  welcome the  choice of  when  and how  the end  of                                                                    
     their  life   would  take  place.  The   choice  to  be                                                                    
     conscious of  their surrounding and the  ability to say                                                                    
     goodbye. My Father died a  painful cancer death in 1965                                                                    
     two  days  before his  52nd  birthday  and on  my  22nd                                                                    
     birthday. Of course, he was  deeply medicated that last                                                                    
     night  that  I  sat  in  his  hospital  room  therefore                                                                    
     oblivious to my presence.  Perhaps he would have chosen                                                                    
     a different  end, I don't  know but the  operative word                                                                    
     is "choice". We have many  protections for our right to                                                                    
     choose  how to  live  our  lives, to  be  free to  make                                                                    
     choices  yet such  freedoms are  denied when  dying. As                                                                    
     has  been  pointed out  by  many,  our pets  and  other                                                                    
     animals  are  allowed  more  privilege  than  us.  Four                                                                    
     months ago I  was able to ask the  kind veterinarian to                                                                    
     put my 16  year old cat down when his  kidneys gave out                                                                    
     rather than  try to keep  him alive for an  unknown but                                                                    
     likely short  period of time.  I wish for, ask  for the                                                                    
     same option  - to be "put  down" at my request  when my                                                                    
     body is  giving out.  Please bring this  bill up  for a                                                                    
     hearing so all views can  be discussed. You may wish to                                                                    
     review this site: deathwithdignity.org                                                                                     
                                                                                                                                
4:42:14 PM                                                                                                                    
                                                                                                                                
MARGARET DORE, President, Choice is an Illusion, paraphrased                                                                    
from a prepared statement which she had submitted to the                                                                        
committee:  [included in members' packets]                                                                                      
                                                                                                                                
     I  am  a  lawyer  in Washington  State  where  assisted                                                                    
     suicide  is legal.  Our  law  is similar  to  a law  in                                                                    
     Oregon. The proposed bill  to legalize assisted suicide                                                                    
     in  Alaska  is  similar  to both  laws.  Problems  with                                                                    
     legalization  include the  following:  1. the  proposed                                                                    
     bill  legalizes assisted  suicide  for  persons with  a                                                                    
     "terminal  disease," which  is defined  as having  less                                                                    
     than  six months  to live.  In Oregon,  which uses  the                                                                    
     same definition,  young adults with  chronic conditions                                                                    
     such as  diabetes are "eligible" for  assisted suicide.                                                                    
     Such  persons can  have years,  even decades,  to live.                                                                    
     Consider also, Jeanette Hall, who  was adamant that she                                                                    
     would  do assisted  suicide, but  was  convinced to  be                                                                    
     treated instead.  Today, nearly 15 years  later, she is                                                                    
     "thrilled  to be  alive." 2.  In  Oregon, that  state's                                                                    
     Medicaid   Plan  steers   people  to   suicide  through                                                                    
     coverage incentives.  3. Legalization  is a  recipe for                                                                    
     elder abuse.  Your bill, like Washington's  law, allows                                                                    
     one of two  witnesses on the lethal dose  request to be                                                                    
     an  heir who  will  benefit from  the patient's  death.                                                                    
     Once the lethal  dose is issued by  the pharmacy, there                                                                    
     is  no oversight.  Even if  the patient  struggled, who                                                                    
     would know? 4. In  Oregon, other conventional "violent"                                                                    
     suicides   have   increased  significantly   with   the                                                                    
     legalization of physician-assisted  suicide. In Oregon,                                                                    
     conventional suicides are a $41  million problem due to                                                                    
     hospitalization  costs, etc.  Legalization, regardless,                                                                    
     sends the  wrong message to  young people  that suicide                                                                    
     is an  acceptable solution  to life's  problems. Alaska                                                                    
     already  has  highest  suicide   rate  in  the  nation.                                                                    
     Washington's  mistake.  Tell  your legislators  to  say                                                                    
     "NO" to assisted suicide.                                                                                                  
                                                                                                                                
4:47:12 PM                                                                                                                    
                                                                                                                                
ANDREW  LESSIG stated  that he  was  in support  of the  proposed                                                               
bill.  He shared that he  had reviewed these laws while currently                                                               
attending law school.   He acknowledged that Alaska  did have the                                                               
highest  rate of  suicide in  the nation,  and if  viewed by  age                                                               
demographics, the highest rate of  suicide was by people over the                                                               
age  of  70,  who  understood   their  health  and  their  future                                                               
prospects and  took it upon themselves.   He stated that  a death                                                               
with dignity  law would help  to lower  this suicide rate,  as it                                                               
would allow  them to end their  lives on their terms,  and remove                                                               
the  stigma.   He  directed  attention to  the  suicide rates  in                                                               
Oregon and  Washington.  He  suggested that, should this  fail in                                                               
the legislature, it should be put  on the ballot.  He pointed out                                                               
that a  similar measure in  the State of Washington  had received                                                               
more than  58 percent support,  even more popular  than marijuana                                                               
on the same ballot, and that he supported the proposed bill.                                                                    
                                                                                                                                
4:49:54 PM                                                                                                                    
                                                                                                                                
MARLENE EDENSHAW  stated that she was  in full support of  HB 99.                                                               
She stated  that she  did not  want to be  medicated and  left to                                                               
die, that she wanted to be able to die when she wanted.                                                                         
                                                                                                                                
4:51:45 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE DRUMMOND  shared the  story that had  inspired her                                                               
to bring  this legislation  forward.  She  relayed that  a young,                                                               
newly married  woman from California had  been recently diagnosed                                                               
with brain cancer and had to  move to Oregon to take advantage of                                                               
the death  with dignity laws.   She  thought about the  help this                                                               
legislation would bring  to so many Alaskans  who would otherwise                                                               
have  to move  away  from their  friends in  Alaska  to have  any                                                               
control over the last days and  weeks of their lives.  She shared                                                               
that she had  learned a lot in  the brief time that  she had been                                                               
researching  this  issue, and  what  transpires  with death  with                                                               
dignity bills.                                                                                                                  
                                                                                                                                
CHAIR SEATON  noted that  some things needed  to be  clarified in                                                               
the proposed bill.                                                                                                              
                                                                                                                                
REPRESENTATIVE WOOL  asked, after listening to  the testimony, if                                                               
she shared  any of  the concerns with  the non-supporters  of the                                                               
bill,  for example,  what was  the  definition of  terminal.   He                                                               
asked if she  shared any concerns for misuses or  had she thought                                                               
about these concerns.                                                                                                           
                                                                                                                                
REPRESENTATIVE DRUMMOND  relayed that she would  research whether                                                               
the patient  was to take  the medication themselves, or  have the                                                               
doctor administer  it, and determine  if this needed to  be added                                                               
to the proposed  bill.  She offered her belief  that the majority                                                               
of the  bill was  modelled on  the Oregon law,  where it  did not                                                               
appear there  had been any coercion  or misuse.  She  stated that                                                               
she would work  on the issues, and look into  palliative care and                                                               
end of life care in Alaska.                                                                                                     
                                                                                                                                
4:55:28 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  VAZQUEZ  offered  her   belief  that  there  were                                                               
several  loopholes in  the proposed  bill, suggesting  that there                                                               
was not  any professional supervision after  the prescription was                                                               
written.   She opined  that there were  fewer safeguards  in this                                                               
situation than when signing off on a will.                                                                                      
                                                                                                                                
REPRESENTATIVE DRUMMOND said that she would look at these.                                                                      
                                                                                                                                
REPRESENTATIVE  TARR thanked  the  testifiers  for sharing  their                                                               
emotional stories.                                                                                                              
                                                                                                                                
[HB 99 was held over]                                                                                                           
                                                                                                                                
4:57:55 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 4:58 p.m.                                                                                                          

Document Name Date/Time Subjects
HB99 Version W.PDF HHSS 4/9/2015 3:00:00 PM
HHSS 4/14/2015 3:00:00 PM
HB 99
HB99 Sectional Analysis.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Sponsor Statement.pdf HHSS 4/9/2015 3:00:00 PM
HHSS 4/14/2015 3:00:00 PM
HB 99
HB99 Backup Skelton Op Ed.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Supporting Research 2007.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Supporting Research 2004.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Leg Research Report.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Fiscal Note - LAW-CRIM -04-03-15.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Support Letter - Compassion and Choices.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Letter of Support Jordan.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Letter of Support Kimbley.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Letter of Support Lauster.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Additional Letters of Support.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Letter of Opposition Grace.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Letter of Opposition Kelly.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Letter of Opposition Potter.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 letter of opposition_Trimble_3-13-2015.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Support - assorted emails.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Opposition - Assorted emails.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Fiscal Note - DHSS-BVS - 04-05-2015.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Opposition - assorted emails- April 8 and 9.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 opposition -written testimony- Albrecht and Dore.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Support - McKinstry -4-9-15.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Support- Written Testimony - Bangs -4-09-2015.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Opposition - Dore Memo - 04-09-2015.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Opposition - Gov Council on Disabilities.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Opposition - Emails recieved 4-9-2015.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Support - Written Testimony- Kimbley.pdf HHSS 4/9/2015 3:00:00 PM
HB 99
HB99 Opposition - Dore Memo - 04-09-2015.pdf HHSS 4/9/2015 3:00:00 PM
HB 99