HB 371 - RIGHTS OF TERMINALLY ILL PERSONS Number 196 JAMES O. BURRIS testified via teleconference from Sitka that he wanted to lend his complete support to the provisions of this legislation. He felt this was a bill that should be passed so people who are terminally ill can die with the degree of dignity they are entitled to. Terminally ill people should not be subjected to weeks and months of medication and pain. Number 274 TERI LUNDY testified via teleconference from Sitka. She began her testimony by asking what the DNR identification is and if it was going to become a mandatory form that needed to be filled out and signed when being registered into a pioneer's home or a hospital before major surgery? She asked if the living will is a mandatory document at this time? What is the medication or medications that will be used by the physician for the physician assisted suicide? She referred to Section 2, AS 18.20.005 (a) "The legislature finds that the people of the state have a fundamental right to make their own end-of-life decisions. The right should include...." She asked if the other choices were suicide by hanging, suicide using a firearm, suicide by cutting one's wrists. She said the proper term for "dignified" is euthanasia. Regarding Section 3 (a) (1) - (4), she expressed concern that there is an option for the requester not to notify the next of kin of their decision or they may not have any next of kin to notify. She questioned who these people are that are given the authority to witness and sign the Request for Medication, but are not required to give their residence address. She referenced page 3, line 18, and asked why an individual had to be over 18 years of age to complete the Request for Medication. Additionally, line 29 pushes responsibility on the physician to write the prescription thereby becoming the messenger of death. She asked what the meaning was regarding the language on page 4, line 13. She inquired as to the types of identification that would be required for the witnesses. In conclusion, Ms. Lundy said she was not pleased with the drafting of HB 371 or its presentation to the public. Number 580 CLOTHILDE BAHOVEC testified from Sitka via teleconference that the time for people to die with dignity has long past; it should have been law years ago. She discussed the high cost of medical care and didn't feel that a terminally ill person should be forced to have medication and life-support equipment to keep them alive. She believes the decision to end your life should be a private matter between the physician and the patient. She concluded that inasmuch as this is a voluntary decision, she doesn't understand why people should be upset about it. Number 654 BRUCE GORDON testified from Fairbanks urging the committee's support of HB 371. His wife died about 1 l/2 years ago after suffering over 15 years from Parkinson's disease, which is always progressive and at present there is no cure. The symptoms include deterioration of muscle control spreading over the entire body. Her X-rays and biopsy of lung tissue resulted in a diagnosis of lymphoma and in 1991 she experienced a cardiac arrest while in the hospital. When her Parkinson's disease suddenly accelerated in September 1994, she knew the final stage was near. She had signed a living will, durable power of attorney and a Do Not Resuscitate order in 1992, all of which were witnessed by disinterested parties. She hoped for another heart attack that would be the final release to her constant pain. Failing that, she was determined to end her own life while she was still able to do so without any assistance from him so as not to put him at risk for criminal prosecution. She finally found a nonviolent means and died peacefully in her bed, as she had wanted. He commented that he and his wife had been members of groups for several years that supported the right to die with dignity and the freedom to choose the time and the circumstance. House Bill 371 provides this freedom with the necessary and appropriate safeguards. He urged the committee to pass HB 371. Number 773 CHUCK BOOTH testified from Seward in opposition to the legislation. Number 786 BEVERLY DUNHAM testified from Seward that at the age of 12, she watched her father die of cancer. She saw this magnificent 225 pound man turn into nothing but a vegetable who was in great pain and would have done anything to have been alleviated of that pain. She commented that she has asthma and has seriously considered not taking her doctors advice about getting a pneumonia shot because thankfully her father died from pneumonia a few days earlier than he would have otherwise. She has always known that if the time came when one of her loved ones asked for her help in ending their life she would do it regardless if she had to go to prison. She commented that churches and many people don't want laws except when it comes to issues like the right to die or having the choice of what happens to your own body. Her 82-year-old brother has multiple sclerosis and they are both aware of what the future holds for him. She is hopeful that he will be able to die when he gets to that stage. She referenced the Oregon law and said even though it's in court now, it has finally made the medical community realize that it has a responsibility to help people die less painfully. There is an effort among the doctors now to begin medications that really might have some effect. They are trying to counsel patients who are dying and their families. She concluded that she favors HB 371. Number 938 APRIL WOLFE testified from Bethel that she is not supportive of this legislation. She commented that it has taken a friend of hers five years to be properly diagnosed with metal toxicity which is a condition that doesn't just go away, but doctors were able to find a process called chelation that's beginning to draw the poisons out of her body. During this five year period, Ms. Wolfe said she watched her friend's stress and emotional levels go up and down. There were days when her friend was ready to give up and Ms. Wolfe's concern is that with this legislation a person might decide to give it up if the timing is just right. In her friend's case there has been a major break-through in treatment. She believes this bill would destroy hope in terms of medical break throughs. Number 1051 ELAINE ROSE testified from Sitka via teleconference that she is against this bill. She thinks that suicide is suicide, and it doesn't make it right just because the doctors say it's okay. She added neither the legislature nor the federal government has a right to decide on this issue; it's an individual decision. Number 1080 MARY SOLTIS testified from Sitka that pain is controllable with modern medicine. A person who seeks to kill him or herself to avoid pain does not need legalized assisted suicide, but needs a doctor who is better trained in alleviating pain. She asked who would ensure the lethal dose of medication didn't get into the wrong hands. She noted that euthanasia in the Netherlands has been legal for 15 years and voluntary assisted suicide for those with a terminal illness has now spread to include nonvoluntary euthanasia for children born with disabilities. Half of the killings in the Netherlands are now nonvoluntary and the problems for which death is now a legal solution include mental illness, permanent disability and simple old age. Number 1161 HELEN CRAIG testified from Sitka that she supports HB 371 for several reasons. First, she has seen loved ones suffer for many years. She does believe that every possible option should be pursued first, but the terminally ill who are suffering from great pain that is not able to be controlled, should be allowed to go to the Lord. She noted that one of her children was born early and born a vegetable. She and her husband were faced with the difficult decision of allowing their child to suffer, be a vegetable and to have no joy in her life, or letting that child to go to the Lord. She does not believe this is a decision that should be made by everyone, but the person afflicted or the parents of a child whose life will have no meaning or joy should have the right to make this decision. Number 1265 RON SHEEHAN testified via teleconference that he is basically against HB 371 on the assumption that the sanctity of life is being put into some variables. He said this is a bill that, through the euthanasia, could get into patricide. He referred to a survey done in Washington State in 1994 which indicated that physicians who were originally for euthanasia, mainly the ontologists and hematologists who deal with the subject every day, were opposed to it after some long thought. The psychologists and the physicians who are the farthest removed from the problem were for it. He commented that our doctors are almost phobic in their lack of willingness to prescribe adequate amounts of pain medication for the terminally ill. Until they get over that phobia and start administering sufficient pain medication, this is not an appropriate measure. He is concerned over whether this issue is being driven by the insurance companies and their willingness to sacrifice human life to stem the tide of cost (indisc.) life-saving measures of people who are going through their last six months of life, which is when the largest amounts of money are spent in health care. Number 1357 VESTA LEIGH testified from Kenai that she has looked for something like this since she was 30 years of age. She watched her mother die a very slow death and the doctors would administer sufficient medication to ease her pain. She asked why the individuals opposed to this legislation aren't beating the drum to do away with alcohol and tobacco, which kills millions of people every year. She personally believes this bill doesn't go far enough, but it is a good start. Number 1420 LORI BROWN testified via teleconference that she is a pharmacist and understood that HB 371 stated the physician would write a prescription and the pharmacist would fill it. Currently, it is not mandatory for a physician to include a diagnosis, prognosis or history on prescriptions. She feels this information would be vital for pharmacists to conscientiously fill the prescription or to choose not to. Some pharmacists may be completely against aiding to end a patient's life and that option should be available to them. She expressed concern that it is not included in this legislation. She added that without knowing why the prescription was written and what it is being used for, the pharmacists may put themselves in a professional or morally compromising situation, because they are the ones who would ultimately be dispensing the medication. She asked the committee to consider that issue. Number 1470 SUE KELLY testified via teleconference that she is in favor of this legislation. Number 1485 ELEANOR VIERECK testified via teleconference from Fairbanks. She indicated she is speaking for herself, but is also the Fairbanks representative for the Hemlock Society, which is an organization that has the right to die as its mission. She supports HB 371. She remarked that she is also a member of the Christian Ecumenical Peace with Justice Committee in Fairbanks and wanted to speak about non-harming. Non-harming is one of the major ethical tenets of all world religions. She referred to the oath taken by doctors: They do not vow in the hippocratic to refrain from assisting a person who wishes to commit suicide. They do, however, vow non-harming. She referred to a poll conducted by Mark Clements, Inc., of 352 doctors who subscribe to Scientific American Medicine and said the results indicate that 95 percent of these doctors believe a doctor should be able to help a terminally ill patient die by withholding life-support. Only 73 percent of those doctors feel that a doctor should be allowed to help the terminally ill person die with dignity. She pointed out this legislation does not force any doctor who does not comply with this philosophy to do so. Eighty percent of the doctors said there is no conflict about a patient's right to die and the oath taken when they became a doctor. It is her feeling that it is a compassionate, caring and ethical choice to assist a terminally ill person who wants to avoid the legalized torture of a prolonged terminal illness. Number 1595 FATHER MICHAEL KANIECKI testified from Fairbanks that he is totally opposed to HB 371. He feels it is bad public policy and bad morals. He said it seeks to establish a new fundamental right equal to those of the U.S. Constitution; the right of people to make their own end-of-life decisions. He feels that what is being proposed through soft sounding language is that suicide is as basic a right as life, liberty and the pursuit of happiness. He thinks much of this comes from the distorted view we have of freedom; the root of the contradiction between the solemn affirmation of human rights and their tragic denial in practice lies in a notion of freedom which exalts the isolated individual in an absolute way. While it is true that the taking of life in its final stages is sometimes marked by a mistaken sense of altruism and human compassion, it cannot be denied that such a culture of death, taken as a whole, betrays a completely individualistic concept of freedom, which ultimately becomes the freedom of the strong against the weak who have no choice but to submit. The freedom of choice as popularly understood today to be freedom from all restriction, has led to the breakdown of family and eroded our bonds of fidelity with each other. We have an obligation to sustain and support members of our family for better or worse, in sickness and in health. Freedom seems to be the battle cry of the proponents for euthanasia or assisted suicide. He knows that all human life is valuable. Medicine should have as its prime goal the easing of pain, not the termination. Father Kaniecki said we're trying to play God. God gives life and only God can take it away. Number 1672 FATHER KANIECKI remarked that in Holland, where euthanasia with safeguards is the accepted practice, some 95 percent of persons in nursing homes expressed a concern for their future. They think they are going to be forced into signing something that will terminate their life. In conclusion, Father Kaniecki said at a time when individual rights are universally acknowledged and upheld, the most fundamental human right, the right to life, is being trampled in the name of personal freedom. Freedom, as granted by God, is not individualistic or absolute. Rather, freedom finds its true expression within the context of the faithfulness of each person to family and community. Authentic freedom recognizes the value of all human life and rejects the current bias in favor of death that runs through society. We affirm that life is a gift from God to be treasured, supported and dealt with compassionately from its very conception until its last breath. Number 1715 JOHN COGHILL, JR., testified from Fairbanks that in listening to the previous testimony, he appreciates the concern for people in our society that are in pain and dying, but he thinks we are going about it the wrong way. The U.S. Constitution and the State Constitution show gratitude to God for the life He has given us. He thinks we're trying to wipe out the tragedy by really pandering to the final excesses of our society, starting with alcohol, tobacco and any other excess that we do as a society that brings us to the place of pain and suffering. And then finally to make it okay, by a stroke of a legislative-policy-making-pen, for people to watch other people take their life in suicide. Our society, just by virtue of the fact that this is bait, is in trouble. Mr. Coghill suggested the committee kill the bill and watch those people who want to take care of their loved ones. No one likes suffering, but it is part of life. Watching people die is one of the most painful experiences of life, but it is also one of the instruments that God has given us to allow the extremes of love this side of eternity. He said we are robbing ourselves of that by allowing the government to okay suicide. He encouraged committee members to not bring the quick fix relief many people are looking for, but allow us to take care of our living and dying with dignity. Number 1826 DEBORAH VAN VELDHUIZEN testified from Fairbanks that she is a citizen and supports this legislation. She said if we do not respect the integrity and dignity of a person in the matter of death, then she questions if people really believe in the integrity and dignity in life; it is just a continuance. She urged the committee to support HB 371. Number 1850 SANDI DOYLE testified via teleconference from Fairbanks that she opposes HB 371 as an act against all human life and the right to life. She said this bill is nothing more than assisted suicide by doctors who take an oath to preserve life. All life is a gift from God. This bill, if passed, would and could lead to the killing of the mentally ill and the physically handicapped. Number 1901 DR. FREDERICK HILLMAN testified from Anchorage that he is a retired physician who practiced in Anchorage from 1958 to 1990. He said in founding this Nation, the founding fathers from the various sects made it clear that the new constitutional nation would be not only nonsectarian, but indeed secular. It debated the matter and in the end, they wrote the Constitution to include neither the word God nor the word Christ. In no sense, can this country be called a Christian one. The ensuing two centuries of religious liberty that we have enjoyed have shown the wisdom of the founding fathers' decision. Now we find that some church leaders are using the religious argument to prevent passage of a law that has nothing to do with religion. House Bill 371 is a bill that does not infringe on the religious rights of anyone. On the other hand, spokespersons for some churches would like to impose their own narrow religious views on everybody. Their religious arguments concerning purely a non-religious bill directly contravenes the First Amendment of the Bill of Rights and they mock our 200 year history separation of church and state. House Bill 371 is entirely voluntary and permissive. It allows an individual to escape needless suffering if the person chooses; it does not require action by anyone. It is not about killing, but it is about a person's own personal decision of whether to continue to endure one's own needless suffering. It contains safeguards to prevent such a decision being made in haste, without thought, under pressure or for financial reasons. It concerns a decision that Dr. Hillman may well want to make for himself some day. As a long time church member, he does not attempt to force his religious views on other people and he deeply resents the attempts from other sects to stand in the way of a law that may benefit him. He suggested that the committee strike from the record any testimony against HB 371 that is based on religious argument. Number 2010 PEGGY BURGIN testified from Anchorage that she is a senior citizen and has lived in Alaska for almost 50 years. She has three very personal reasons why she supports this legislation. First, her mother had a stroke which was totally debilitating. She had been an energetic, active person in the community, but when she realized that her quality life was gone she wanted to die. She did not want to be a burden on her family. She ended up in a nursing home for almost three years and finally willed herself to die. Secondly, her husband contracted lung cancer several years ago. He went through an operation, chemotherapy and radiation hoping it would give him some quality of life and a few more years. But the cancer spread and within 2 l/2 years he was dead, but he died in great pain. She has heard there is medication to relieve pain, but he did not receive that help. The last time she saw him in the hospital, they were using a vein in his foot because all his other veins had been used. It was very difficult to watch him die with all the pain and suffering. Her last reason is that she and her sister watched the suffering of their family and made a pact that if at anytime either one of them needed some help, they would try to help the other to alleviate the pain and allow that person to die with dignity. Her sister was diagnosed with cancer of the liver. She sent for Ms. Burgin immediately and reminded her of their agreement and said, "I want you to help me. I don't want to go on like this, I know my time is short, but I don't want to suffer." Ms. Burgin was not able to help her; it was heartbreaking to watch her suffer and to wonder why Ms. Burgin hadn't kept her promise. Number 2137 SHIRLEEN RANNALS testified via teleconference from Anchorage. She said there are two basic views; that God exists and that God doesn't exist. If God exists, then people have certain (indisc.) rights. Americans are very fortunate that our country was founded on the first view; that God exists. Because of this, America is not a secular nation, but an interface nation. This recognition of a Creator has and continues to have, a great impact on our country. We recognize there are limits of what we can do to ourselves or others. We are always in search of what is right in a particular situation. We attempt to know what the Creator wants. We believe there is an objective right or a wrong. Therefore, it is entirely appropriate within the framework of our form of government to consider the morality of the proposed bill. She remarked the question must always be asked of every piece of proposed legislation is it consistent with the recognition that we are the created, not the Creator. If we fail to do this, then we are acting against the nature of our foundation as a nation. We are being un-American. We failed to do this with the issue of slavery and we reaped the tragic results. We failed to do this with the issue of abortion, and we continue to reap the tragic results. We cannot afford to continue in this way. The self-destruction we have incurred is all around us. Our nation is literally falling down around us, but we can turn it around. We must turn again to the tradition of being "One Nation Under God." We must search for what is right and what the Creator wants in every situation. Ms. Rannals maintains that if we examine this bill, we will conclude that it is not what the Creator wants. Our Declaration of Independence states the Creator gives the right to life, the right to liberty and the right to the pursuit of happiness; not the right over life, not the right over liberty or the right over the pursuit of happiness. No one can take his or her own life or that of another. Only the Creator gives and takes away. Number 2243 ANITA SYREN testified via teleconference that she has lived in Alaska for 47 years, most of which have been in Anchorage. She is a widow and the mother of a deceased son. She asked the committee to vote for life and against the legalization of assisted suicide. Her husband died of cancer and her son from lymphoma ten years later. Both of them died at home. She is a nurse and could have administered an overdose under the circumstances, but none of them ever considered bringing about their deaths in this manner. She stated the family supported them through their suffering with the best of care until their natural death. That was truly death with dignity. Her son fought especially hard to beat his cancer. He had a wife and two small children and said over and over that he didn't want to give up. He was aware of the suffering that would come to him because he had witnessed his father's death. Her son courageously rejected two extreme courses of action. On one hand, he refused further treatment that was disproportionate to any expected results. He never considered the other extreme of suicide. Ms. Syren said this issue is unfairly characterized as compassion by those who are obviously misled, but are sincere. She finds this characterization reprehensible. TAPE 96-10, SIDE B Number 017 BERT SHAW testified from Anchorage that he is in favor HB 371. He believes the safeguards are sufficient to avoid abuse. He said when it is his time to go, he is hopeful this is law. His wife died three years ago after a very painful year of cancer. The medical costs were approximately $200,000. The last few weeks she could barely see, could only whisper, couldn't walk or eat and screamed out from the pain many times a day. The last week of her life she was in a coma most of the time. He feels this bill is reasonable and should become law. Number 043 WILLIE LOGAN testified via teleconference from Anchorage in favor of HB 371. Number 071 THERESE SYREN testified from Anchorage via teleconference. She stated that committee members are being urged to accept this bill by individuals who assert that objective moral norms are unattainable, while others of us are arguing that the state cannot choose between different moralities but to simply guarantee maximum freedom for individuals. This argument is in direct contradiction to the Declaration of Independence which states that we are endowed by the Creator of our rights. This is a basic tenet of natural law. The same law absolutely prohibits the wilful taking of innocent human life, whether one's own or another. The abandonment of natural law, again the basis for our Declaration of Independence and our Constitution has already had a disastrous effect on our country. We've lost millions of lives through legalized abortion, hundreds of thousands of lives in the Civil War, not to mention the suffering of slaves. This all comes as a result of the rejection of the natural law. She watched her brother die of cancer three years ago and had once asked him how he coped with the gradual separation from his two small children and wife. He said, "You simply let go." He was referring to the gradual psychological readiness for death that cannot be artificially rushed by suicide. Number 129 PATRICIA SENNE, Executive Director, Alaska Nurses Association, testified from Anchorage. She stated the Alaska Nurses Association is opposed to HB 371. In discussions with Alaska's registered nurses about the issue of assisted suicide, the concern that is raised most frequently is that allowing assisted suicide will open pandora's box. While there may be individual patient cases that are compelling, there is a high potential for abuse with assisted suicide particularly with vulnerable populations such as the elderly, poor and disabled. Number 171 CORALYN OINES testified from Sitka. She is the daughter of a woman diagnosed with senility dementia and the niece of three Alzheimer victims. She acknowledged their lives have caused pressures and difficulties for everyone around them, but their value in the family interaction is precious. She would be distressed to live in a state that would shorten their lives and the obvious progression from willing to unwilling participation. She is strongly opposed to HB 371. Number 220 JOLEE CARNEY testified via teleconference from Anchorage that she is opposed to this bill that basically allows legal suicide. Her concern is that once it starts, we won't be able to stop it. CO-CHAIR TOOHEY closed testimony via teleconference. Number 245 JACK MCGEE testified that he is a practicing attorney and also teaches philosophy at the University of Alaska Southeast. He had a number of difficulties with the bill he wanted to point out for the committee. The first concern was with the burden it puts on physicians. If a physician wanted to execute a request for medication, this legislation requires two doctors to make a determination that the patient has made a competent decision and that the patient's decision was voluntary. How is the physician supposed to make that determination? Competency and voluntariness are legal concepts that involve complex facts. They are not the kind of things that are disclosed by a medical examination. What happens if the physician is wrong? Given the explosive growth of tort litigation, sooner or later a physician is going to be sued on the grounds that he or she made a negligent judgment. He questioned whether it is fair for a physician to have this awesome burden imposed on them by law. Mr. McGee asked the committee to consider this real life situation from a letter to an editor, published in the September 14, 1993, edition of the Santa Rosa Press Democrat from an 84-year-old woman who had been living with her daughter. He read, "Everything went fine for many years, but when I started to lose my hearing about three years ago, it irritated my daughter. She began to question me about my financial matters and apparently feels I won't have much of an estate for her. She became very rude to me. Then suddenly one evening, my daughter said very cautiously she thought it was okay for older people to commit suicide if they cannot take care of themselves." The woman went on the recount the number of ways in which her daughter reenforced this message. She concluded her letter with, "So, here I sit, day after day, knowing what I am expected to do when I need a little help." Mr. McGee said if an older person under circumstances like these, requests assisted suicide under this bill, could anyone really be comfortable in claiming that this request was voluntary. MR. MCGEE explained that his second major problem with the legislation lies in Section 2 which creates a fundamental right to suicide. He fears this language is going to be used as a vehicle to expand this right in a way beyond the scope of the bill to include all sorts of groups, with all sorts of individual problems. If this right is fundamental, the argument will be that individuals suffering from mental illness or depression, for example, ought to be able to claim this right. In light of the shocking rise of the rates of suicide among senior citizens and teen-agers, particularly now between the ages of 11 and 14, it is difficult for him to see how this fundamental right language serves the public interest. Mr. McGee stated this is a very profound bill and it should be given very careful thought. CO-CHAIR TOOHEY announced that House Bill 371 would be held over until next Tuesday. She turned the gavel over to Co-Chair Bunde for HB 465.