STAND. COM. REP. NO. 286

                                 Honolulu, Hawaii
                                                   , 1999

                                 RE: H.B. No. 171
                                     H.D. 1
                                     




Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twentieth State Legislature
Regular Session of 1999
State of Hawaii

Sir:

     Your Committee on Health, to which was referred H.B. No. 171
entitled: 

     "A BILL FOR AN ACT RELATING TO HEALTH CARE DECISIONS,"

begs leave to report as follows:

     The purpose of this bill is to support the execution of
advance directives by:

     (1)  Charging the Department of Health (DOH) to design a set
          of policies to improve compliance with current law;

     (2)  Clarifying that the patient's wishes have priority at
          all times; and

     (3)  Establishing a task force to undertake a comprehensive
          review of the entire Hawaii Revised Statutes.

     The Hawaii Nurses' Association and one individual submitted
testimony in support of this measure.  DOH, the Executive Office
on Aging, and Hawaii Right to Life submitted testimony in support
of the intent of this measure.  Pro-Family Hawaii submitted
testimony in opposition to this measure.  The Hawaii Medical
Association and one individual submitted comments.

     This measure is based upon the Governor's Blue Ribbon Panel
on Living and Dying with Dignity's unanimous recommendation that,
among other things, the contents of the Hawaii Revised Statutes

 
 
                                 STAND. COM. REP. NO. 286
                                 Page 2

 
dealing with advance directives for health care, including living
wills, be made more specific, their use more widespread, and
their provisions more binding.

     Your Committee finds that sections of this measure, as
written, are either premature or duplicative of other efforts.
Therefore, your Committee has amended this measure by:

     (1)  Deleting the provision that clarifies that patient's
          wishes have priority at all times;

     (2)  Deleting the provision charging DOH to design a set of
          policies to improve compliance with current advance
          directives laws;

     (3)  Inserting language substantively based on the Uniform
          Health Care Decisions Act, which would permit a
          competent individual to control decisions relating to a
          patient's own medical care; and

     (4)  Making technical, nonsubstantive amendments for
          purposes of clarity and style.

     Your Committee further finds that there are inconsistencies
in the Hawaii Revised Statutes regarding decision-making during
end-of-life care, and therefore, respectfully requests that the
Committee on Judiciary and Hawaiian Affairs address whether the
Uniform Health Care Decisions Act resolves this issue.

     As affirmed by the record of votes of the members of your
Committee on Health that is attached to this report, your
Committee is in accord with the intent and purpose of H.B. No.
171, as amended herein, and recommends that it pass Second
Reading in the form attached hereto as H.B. No. 171, H.D. 1, and
be referred to the Committee on Judiciary and Hawaiian Affairs.

                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committee on Health,



                                   ______________________________
                                   ALEXANDER C. SANTIAGO, Chair