SB 38 ANATOMICAL GIFTS,LIVING WILLS & DNR ORDER  CHAIRMAN ROBIN TAYLOR called the Judiciary Committee meeting to order at 1:30 p.m. and announced SB 38 to be up for consideration. Present were Senators Taylor, Pearce and Parnell. MR. JOE AMBROSE, staff to Senator Taylor, said this legislation modifies existing statutes dealing with living wills and would add a provision by which those who execute a living will can choose to become organ or tissue donors. By adding this provision to statutory language of a living will, the loved ones and health professionals will be more fully informed as to the wishes of family members and their patients. MR. AMBROSE said there is a much greater demand than supply for tissue and organ donations. In addition to adding anatomical gifts to the language of a living will, SB 38 would also instruct the Division of Motor Vehicles to indicate on drivers' licenses not only the fact that the bearer has elected to become an organ donor, but also that the individual has a living will. Other than a nominal expense, this legislation should cost little to enforce, but may become invaluable if it increases Alaska's participation in organ and tissue donation. Since 1989, 19 Alaskans have received kidney transplants through University Hospital in Seattle; 12 Alaskans have received liver transplants; and one resident received both a kidney and a pancreas. To understand the need to make the organ donation as uncomplicated as possible, Mr. Ambrose pointed out that as of January 24 of this year, there were 20 Alaskans on the waiting list and the United Network for Organ Sharing in Virginia has 68 Alaskans on their waiting list. MR. AMBROSE said the bill currently melds two different titles; one addresses living wills and the other addresses organ donations. CHAIRMAN TAYLOR reiterated that notification is provided to EMTs and others through drivers' licenses. MR. AMBROSE added that the importance of notifying an EMT of the existence of a living will strengthens the declaration that the person is also an organ donor and it might alert them to other instructions from someone who was in an accident and incapacitated. CHAIRMAN TAYLOR asked him to explain the amendment. MR. AMBROSE directed committee members to page 4, line 25, where organ donation declaration to the living will language is added. The process of changing the language on line 30 went too far therefore on line 25 the word "declarant" was changed to "at the declarant's direction," to make it clearer. SENATOR PARNELL moved to adopt amendment #1, LSO183W.1. There were no objections therefore the motion carried. MS. FRAN MCNEILL, a family care coordinator with Life Alaska, said she was testifying for the director who had a medical emergency. Life Alaska supports SB 38 because it facilitates the communication of an individual's wishes regarding living wills, do-not- resuscitate orders, and anatomical gifts. It supports individual autonomy and self-determination and respects the individual's right to make this very personal decision. Furthermore, SB 38 ensures that people will have an opportunity to make these choices independent of crises and encourages them to discuss their decisions with family members. The family burden can be eased greatly by knowing what a loved one wants. Number 90 MR. FRANCES NOLAN , Battalion Chief, Emergency Medical Services Training, supported SB 38; however expressed concern with one area of the bill, AS 13.50.030(d) "person authorized to accept a gift may employ or authorize any surgeon or physician for the purpose of removing,...." This provision does not reflect the current standard either in Alaska or nationally. Organ harvest, particularly in non-living donors, is routinely performed by organ transplant technicians. He thought limiting the procurement process to surgeons and physicians would hamper the existing process. CHAIRMAN TAYLOR appreciated the comment, but noted that language is existing law. He offered to amend the language if that was the current status. MR. NOLAN said two issues exist; organ donation and tissue donation. A heart, for example, from a live body would be removed by a physician or surgeon. On the other hand, many other body parts, like bones and skin or corneas, are considered tissue donations and harvested by technicians. MS. MCNEILL added their director suggested amending the bill to refer to an "appropriate Alaska organ or tissue bank." An organ bank does employ a group of surgeons who usually come up to Alaska. In the case of tissue, that surgery is done by Life Alaska. This amendment would cover both situations. Number 150 SENATOR PARNELL moved to adopt a conceptual amendment (#2) on page 2, line 6 to insert after the word "any" the phrase "appropriate Alaska organ or tissue bank or." There were no objections and the amendment was adopted. MR. MARK JOHNSON, Chief, Community Health and Emergency Medical Services, supported the intent of SB 38. They had worked with Life Alaska in the past to improve and increase organ and tissue donations in the State. He noted his agency has been responsible for implementing the most recent amendments to the statute regarding do not resuscitate orders. He said no dollars were available for public education, but they are trying to increase funding. He would need to discuss the best way to implement the legislation with his staff. CHAIRMAN TAYLOR said one of his concerns was the disregarding of advance instructions, such as living wills and orders, that people have placed with their physicians and others regarding do-not- resuscitate. He hoped they might find a simple way through this vehicle so emergency personnel feel comfortable with the document they have in their hand when responding because serious decisions would be based on it. MR. JOHNSON agreed with him and displayed the logo used for do-not- resuscitate orders in Alaska. His agency has notified all doctors in the State of the logo. Previous legislation required a standard logo be used; that will help as people become more familiar with it. He said public education is an important part of implementation. CHAIRMAN TAYLOR said he thought it would be advantageous for all states to come up with one logo. MR. JOHNSON said that the previous legislation required his agency to survey other states which they have done and have found many logos are used. Another challenge is to help Alaskan doctors identify the logos. CHAIRMAN TAYLOR said police officers can read a license number to a dispatcher and within five seconds receive all the information pertinent to that automobile and driver's license. The technology is there; it just needs to be applied. SENATOR PARNELL moved to pass CSSSSB 38(JUD) from committee with individual recommendations. There were no objections and it was so ordered.