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 S.B. No. 1360 entitled:

begs leave to report as follows:

The purpose of this measure is to delete the requirement of a terminal condition diagnosis as the sole circumstance when "comfort care only" (do not resuscitate protocol) may be initiated by in-the-field emergency response personnel to persons whose heart or breathing have stopped.

Testimony supporting this measure was received from the Department of Health, Director of the University of Hawaii Elder Law Program, and one individual.

Your Committee finds that current law only recognizes "comfort care only" instructions (CCO) in emergency situations when the CCO includes a physician's declaration that the patient has a terminal condition. Without a terminal diagnosis, individuals cannot secure an identifying CCO bracelet or necklace to ensure their wishes are followed. This requirement does not allow for a patient to exercise self-determination. However, CCO's without diagnosis of a terminal condition are recognized in other venues, including patients in a hospital and an elder residing in a health-care facility. Emergency service personnel respond to patients without knowing their entire medical and personal history. Your Committee believes that this measure provides individuals the rightful control over the scope of emergency care they receive.

Your Committee has amended this measure by making technical, nonsubstantive amendments to reflect proper drafting style and to accurately reflect existing language of the Hawaii Revised Statutes.

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 S.B. No. 1360, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 1360, S.D. 1, and be referred to the Committee on Judiciary and Hawaiian Affairs.