STAND

STAND. COM. REP. NO.1121

Honolulu, Hawaii

, 2003

RE: H.B. No. 651

H.D. 2

S.D. 1

Honorable Robert Bunda

President of the Senate

Twenty-Second State Legislature

Regular Session of 2003

State of Hawaii

Sir:

Your Committee on Health, to which was referred H.B. No. 651, H.D. 2, entitled:

"A BILL FOR AN ACT RELATING TO INFORMED CONSENT,"

begs leave to report as follows:

The purpose of this measure is to update the provisions relating to a health care provider's duty to inform a patient regarding medical treatment to provide consistency with the rules adopted by the Board of Medical Examiners (BME).

Testimony supporting this measure was received from HAPI's Physicians' Indemnity Plan, Cancer Institute of Maui, Hawaii Medical Service Association, Hawaii Association of Health Plans, Healthcare Association of Hawaii, Kaiser Permanente, Medical Insurance Exchange of California, Hawaii Medical Association, Hawaii Psychiatric Medical Association, and four individuals. Opposing testimony was received from the Consumer Lawyers of Hawaii and one individual.

Your Committee finds that Hawaii's laws relating to informed consent are outdated and has not kept up with the changing pace of the medical and legal communities. The existing statutory language originated from rules adopted by the BME in 1979. Since then, the BME has revised their rules many times to reflect the current legal and medical standards. Unfortunately, the statutes have yet to reflect the current standards and practices. Your Committee finds that this measure updates and revises statutory law to reflect current medical and legal standards and practices relating to informing a patient about medical treatments. In reviewing the proposed amendments, your Committee felt it was important to maintain the current patient-oriented standard of informed consent and not revert to a profession-oriented standard.

Your Committee has amended this measure by replacing its contents with the provisions of the Senate version, Senate Bill No. 624, S.D. 1, with modifications. As amended, this measure:

(1) Mandates disclosure of specific information to a patient, rather than relying on general standards of medical practice, prior to obtaining consent to a medical, surgical, diagnostic, or therapeutic treatment or procedure;

(2) Specifies that recognized material risks of serious complications or mortality associated with the treatment or procedure must be disclosed;

(3) Defines "legal surrogate" as an agent designated in a power of attorney for health care or surrogate designated or selected in accordance with chapter 327E, Hawaii Revised Statutes;

(4) Sets the effective date of this measure at January 1, 2004, rather than July 1, 2050; and

(5) Replaces the language in section 671-3(a), Hawaii Revised Statutes, to a "patient is not competent" to "patient lacks the capacity".

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. 651, H.D. 2, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 651, H.D. 2, S.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,

		____________________________ ROSALYN H. BAKER, Chair