HB 25-HEALTH CARE SERVICES DIRECTIVES  REPRESENTATIVE BRUCE WEYHRAUCH, District 4, gave the following introduction of HB 25. HB 25 was prefiled in 2002 and it had roughly six hearings in House Health and Social Services and then four hearings in House Judiciary. And then over here, Chair Dyson of the Senate Health and Social Services Committee held I think, roughly, eight hearings and it's gone through substantial revision in the Senate and I owe a great deal of respect and appreciation to Senator Dyson for what that committee did on this bill in conjunction with our office. This bill is a significant piece of legislation in that it brings together programs that deal with organ donation, the living will program, the comfort one, do-not resuscitate provisions of statute, the durable powers of attorney and advanced directives for health care decisions. Death is a critical part of life and we all die. This bill is intended to provide in one place the information available to people who are dying and whose families are dying and who want to plan for their deaths when that time comes. It's intended to help clarify existing law and to help bring other good portions of laws throughout the United States into one law here in Alaska and it's garnered a great deal of attention from a multitude of parties that are interested in clarifying the statutes on these issues and allowing the public who needs to deal with this in hospitals, hospices - medical providers, a clear standard to deal with end-of-life health care decisions. The bill gathered my interest because of my father who recently passed away and he had a durable power of attorney and advanced health care directives but he didn't advise my mother of it. Therefore, he languished in a state where he did not want to be for three years before he actually passed away and when my mother was advised of the situation she was upset because he was living the life that he never would have wanted. If his advanced health care directives had been simply acted upon, he would have been treated a lot differently in terms of his medical health care decisions. And so this is something that all people can use and, Mr. Chairman, it is a meaty bill. I want the committee comfortable with it as the other committees have been as they passed it out and so what I was planning to do was step back and let a lot of other people testify who've had input on this. SENATOR OGAN asked how a medical provider in Alaska would know if a visiting patient here had a do-not-resuscitate order in another state. REPRESENTATIVE WEYHRAUCH deferred to Dr. Wallington for an answer. SENATOR OGAN said he also would like an explanation of the do- not-resuscitate protocol on page 10 of the bill. DR. MARIE WALLINGTON, medical ethicist for the Providence health system in Alaska, told members she has worked extensively with Representative Weyhrauch and the Senate HESS Committee on this legislation. She told members that regarding a visitor with a do-not-resuscitate order in another state, in general, a person with a do-not-resuscitate order has some kind of definition. If the medical staff can verify that a person has such an order, they are relieved from providing resuscitation. An Alaskan who does not have a do-not-resuscitate order identification on him will be resuscitated. 9:15 a.m. MR. PAUL MALLEY, President of Aging with Dignity, a non-profit organization in Florida, gave the following testimony. He said he is familiar with what is happening with the Five Wishes document on a national level and how it is promoting good quality care at the end of life. He provided the following highlights of what is happening nationally. His agency had three goals when it developed the Five Wishes document. First, it wanted to make a document that was easy to understand and use. Second, it wanted the document to address more than medical issues because when people are asked what is most important to them at the end of life, they most often want to be at home, with their family, without pain, etcetera, along with their preferences for life support treatment. He noted that the popularity of the Five Wishes document has grown rapidly, and about 6,000 organizations are distributing it, including hospitals and employers. However, a few roadblocks remain on the national level. In 15 states, including Alaska, mandatory forms are required and those forms do not provide much "wiggle room" for people to put their wishes in their own words, which can deter people from using those documents. His understanding of HB 25 is that it makes the process much more streamlined and effective by putting all of the requirements for durable powers of attorney for health care, living wills, organ donation and others under one umbrella. It also makes it easier for Alaskans to put their wishes in their own words, whether in a Five Wishes document or another document. SENATOR OGAN commented that had he had a living will when he had his full cardiac arrest, he probably would not be alive right now because his prognosis was very poor. He said although he had a fantastic experience with Alaska's medical community, he finds physicians to be pessimistic in general. DR. WALLINGTON responded that the fact that a person has signed an advanced directive does not mean the person has agreed to not be resuscitated. The physician must be sure of that person's medical situation and if the physician knows the person cannot be kept alive, he might consider writing a "Do-Not-Resuscitate" order but that would not have been the case when Senator Ogan had his cardiac arrest. She said the medical community hopes people will spend a lot of time determining how their advance directives will read so that they are telling the medical staff how to decide. Had Senator Ogan had an advance directive that said he wanted every effort to be made to keep him alive, that would have given clear direction to his medical staff. She pointed out the old form was terrible in that it gave no direction in unclear situations. CHAIR SEEKINS noted the committee had other commitments at this time and stated his intent to bring HB 25 before the committee on Thursday. He then adjourned the meeting.