WHEREAS, pain management and palliative care for patients should be recognized as a priority, especially for the elderly and terminally ill; and

WHEREAS, all Hawaii hospitals are accredited by the Joint Commission for the Accreditation of Healthcare Organizations, which requires all hospital facilities to have adequate systems in place to assess and address patient pain needs; and

WHEREAS, palliative care, which involves focusing on the relief of distressing symptoms, including physical, psycho-social, emotional, and existential, has already gained the interest of Hawaii's clinical and invested professionals and educators; and

WHEREAS, physicians and nurses are the primary providers of appropriate pain management and palliative care; and

WHEREAS, the physicians of certain medical specialties encounter pain management and palliative care issues more frequently than others, depending upon the diseases treated by their specialties; and

WHEREAS, the availability of effective pain management and palliative care to patients is dependent upon sufficient knowledge by physicians and nurses regarding the assessment and management of pain and palliative care; and

WHEREAS, there is fear among physicians and nurses of regulatory scrutiny concerning the inappropriate prescribing of pain management drugs; and

WHEREAS, some physicians and nurses fear that excessive pain medication will cause addiction, respiratory depression, and can lead to respiratory arrest; and

WHEREAS, a patient who is suffering from a terminal illness, and who is experiencing great pain, has no legal barriers to obtaining medication from qualified practitioners to alleviate that suffering, even to the point of causing unconsciousness and hastening death; and

WHEREAS, the American Medical Association has stated that Physician Assisted Suicide (PAS) is fundamentally inconsistent with the physician's professional role; and

WHEREAS, the American Medical Association also stated that requests to physicians for PAS should serve as an indication to the physician that the patient's needs are unmet and further help is needed; and

WHEREAS, the American Nurses Association has stated that a nurse should not participate in assisted suicide, as such an act is in violation of the Code for Nurses and the ethical traditions of the profession; now, therefore,

BE IT RESOLVED by the Senate of the Twenty-Second Legislature of the State of Hawaii, Regular Session of 2003, that the Hawaii Medical Association and the Hawaii Nurses' Association coordinate with the University of Hawaii John A. Burns School of Medicine, and the University of Hawaii School of Nursing to establish pain management and palliative care training for physicians and nurses whose scope of practice include palliative care; and

BE IT FURTHER RESOLVED that the Hawaii Medical Association and the Hawaii Nurses' Association are requested to report individually to the Legislature no later than twenty days prior to the convening of the 2004 Regular Session with a progress report on the curriculum established, the target professionals to be trained, and the number of professionals trained to date, and a final report no later than twenty days prior to the covening of the 2005 Regular Session on the implementation of pain management and palliative care training; and

BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Hawaii Medical Association, the Hawaii Nurses' Association, the Dean of the University of Hawaii John A. Burns School of Medicine, and the Dean of the University of Hawaii School of Nursing.

Report Title:

Palliative Care and Pain Management