STAND. COM. REP. NO. 1102

                                   Honolulu, Hawaii
                                                     , 1999

                                   RE:  H.B. No. 171
                                        H.D. 2
                                        S.D. 1




Honorable Norman Mizuguchi
President of the Senate
Twentieth State Legislature
Regular Session of 1999
State of Hawaii

Sir:

     Your Committee on Health and Human Services, to which was
referred H.B. No. 171, H.D. 2, entitled: 

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

begs leave to report as follows:

     The purpose of this measure is to enact the Uniform Health-
Care Decisions Act.

     Your Committee received testimony in support of this measure
from the Executive Office on Aging, Hospice Hawaii, Commission on
Persons with Disabilities, Hawaii Nurses' Association, Healthcare
Association of Hawaii, Hawaii Medical Association, Hawaii
Catholic Conference, Protection and Advocacy Agency of Hawaii,
Right to Life, Kamuela Chapter, Policy Advisory Board for Elder
Affairs, and three private individuals.  Testimony in opposition
was received from Pro-Family Hawaii, Hawaii Right to Life, Hawaii
Christian Coalition, Christian Voice of Hawaii, Archbishop Fulton
Sheen Foundation, and three private individuals.

     This measure is intended to replace chapter 327D, Hawaii
Revised Statutes, relating to medical treatment decisions which
was first enacted in 1986 and has not been revised since 1992.
In the intervening years, medical science has advanced
tremendously and medical ethics has developed correspondingly.
This measure brings medical treatment decisions into today's
world of advances in medicine, patient rights, and attitudes
towards dying.

 
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                                   STAND. COM. REP. NO. 1102
                                   Page 2


     Your Committee requests the Committee on Judiciary to
examine the complexities surrounding spousal relationships and
decisions by a surrogate as provided in section   -6(b).

     Your Committee has amended this measure by:

     (1)  Revising the definition of "reasonably available" to
          provide for the seriousness and urgency of the
          patient's health care needs;

     (2)  Adding a definition of "non-designated surrogate";

     (3)  Providing for health care decisions by a non-designated
          surrogate;

     (4)  Requiring that a supervising health-care provider
          require an individual claiming the right to act as a
          surrogate provide a written declaration to establish
          the claimed authority;

     (5)  Clarifying the use of the optional form and moving that
          section to the end of the new chapter;

     (6)  Specifying that the patient must check a box for relief
          from pain even if it hastens death;

     (7)  Specifying who may act as a non-designated surrogate in
          the absence of a designation; and

     (8)  Requiring that the surrogate make a decision after
          consultation with the supervising health care provider.

     As affirmed by the record of votes of the members of your
Committee on Health and Human Services that is attached to this
report, your Committee is in accord with the intent and purpose
of H.B. No. 171, H.D. 2, as amended herein, and recommends that
it pass Second Reading in the form attached hereto as H.B.
No. 171, H.D. 2, S.D. 1, and be referred to the Committee on
Judiciary.

                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committee on Health and Human
                                   Services,



                                   ______________________________
                                   SUZANNE CHUN OAKLAND, Chair

 
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