Report Title:




Authorizes patients with irremediable conditions to elect a painless death with dignity.



S.B. NO.












SECTION 1. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:



   -1 Short title. This chapter may be cited as the death with dignity law.

   -2 Purpose. The purpose of this chapter is to provide in certain circumstances for the administration of death with dignity to persons who request it and who are suffering from an irremediable condition, and to enable persons to request in advance the administration of death with dignity in the event of their suffering from such a condition at a future date.

   -3 Definitions. As used in this chapter:

"Death with dignity" means the painless inducement of death.

"Declaration" means a witnessed declaration in writing made substantially in the form set forth in section    -5.

"Irremediable condition" means a serious physical illness or impairment medically thought in the patient's case to be incurable and expected to cause the patient severe distress or render the patient incapable of rational existence.

"Physician" means a person licensed to practice medicine or surgery pursuant to chapter 453.

"Qualified patient" means an adult patient in respect of whom two physicians, one being of consultant status, have certified in writing that the patient appears to them to be suffering from an irremediable condition.

   -4 Authorization of death with dignity. Notwithstanding any other law to the contrary and subject to this chapter, it shall be lawful for a physician to administer death with dignity to a qualified patient who has made a declaration that is for the time being in force.

   -5 Declaration; form. The declaration authorizing death with dignity shall be executed by the qualified patient and witnessed by two witnesses. The form of the declaration shall be substantially as follows:

"I declare that I subscribe to the statements set out under the following paragraphs:

(1) If I should at any time suffer from a serious physical illness or impairment medically thought in my case to be incurable and expected to cause me severe distress or render me incapable of rational existence, I request the administration of death with dignity at a time or in circumstances to be indicated or specified by me or, if it is apparent that I have become incapable of giving directions, at the direction of the physician in charge of my case.

(2) In the event of my suffering from any of the conditions specified above, I request that no active steps be taken, and in particular that no resuscitatory techniques be used, to prolong my life or restore me to consciousness.

(3) This declaration is to remain in force unless I revoke it, which I may do at any time, and any request I may make concerning action to be taken or withheld in connection with this declaration will be made without further formalities.

I wish it to be understood that I have confidence in the good faith of my relatives, and physicians, and fear degeneration and indignity far more than I fear premature death. I ask and authorize the physician in charge of my case to bear these statements in mind when considering what my wishes would be in any uncertain situation.

_____________________________(signature of declarant)

We testify that the above-named declarant signed this declaration in our presence, and appeared to appreciate its significance. We do not know of any pressure being brought on the declarant to make a declaration, and we believe that it is made by the declarant's own wish. So far as we are aware, we are entitled to attest this declaration and do not stand to benefit by the death of the declarant.

______________________________(signature of witness)

______________________________(signature of witness)"

   -6 Effective date and duration of declaration. (a) Except as otherwise provided in subsection (b), a declaration shall come into force thirty days after being made and shall remain in force, unless revoked, for three years.

(b) A declaration re-executed within the twelve months preceding its date of expiration shall remain in force, unless revoked, during the lifetime of the declarant.

   -7 Revocation of declaration. A declaration may be revoked at any time by destruction or by notice of cancellation shown on its face, effected, in either case, by the declarant or by the declarant's order.

   -8 Duties and rights of physicians and nurses. (a) Before causing death with dignity to be administered to a mentally responsible patient, the physician in charge shall ascertain to a reasonable satisfaction that the declaration and all steps proposed to be taken under it accord with the patient's wishes.

(b) Death with dignity shall be deemed to be administered by a physician if treatment prescribed by a physician is given to the patient by a registered nurse.

(c) No person shall be under any duty, whether by contract or by any statutory or other legal requirement, to participate in any treatment authorized by this chapter to which the person has a conscientious objection.

   -9 Nonliability of physicians and nurses. (a) A physician or nurse who, acting in good faith, causes death with dignity to be administered to a qualified patient in accordance with this chapter and with what the person so acting believes to be the patient's declaration and wishes, shall under no circumstances be subject to any civil liability and shall not be guilty of any criminal offense.

(b) Physicians and nurses who have taken part in the administration of death with dignity in accordance with this chapter shall be deemed not to be in breach of any professional oath or affirmation.

   -10 Offenses; penalties. (a) It shall be an offense punishable by imprisonment for life to wilfully conceal, destroy, falsify, or forge a declaration with intent to create a false impression of another person's wishes with regard to death with dignity.

(b) A person witnessing a declaration who wilfully signs a statement knowing it to be false shall be guilty of the offense of perjury and subject to the penalties prescribed therefor.

   -11 Insurance policies. No policy of insurance that has been in force for twelve months shall be impaired or rendered ineffective by the administration of death with dignity to the insured.

   -12 Administration of drugs to patients suffering severe distress. For the purpose of removing any doubt as to its legal effect, it is declared that a patient suffering from an irremediable condition medically thought in the patient's case to be terminal shall be entitled to the administration of whatever quantity of drugs may be required to keep the patient free from pain, and such a patient in whose case severe distress cannot be otherwise relieved, if the patient so requests, shall be entitled to drugs rendering the patient continuously unconscious.

   -13 Rules. The director of health shall adopt rules in accordance with chapter 91, necessary for the purposes of this chapter, including rules for:

(1) The determination of classes of persons who may or may not sign or witness a declaration;

(2) For appointing, with their consent, hospital physicians having responsibility in relation to patients who have made or wish to make declarations; and

(3) For the prescribing of any matters the director thinks necessary under this chapter.

   -14 No effect. This chapter shall not affect the validity or administration of chapter 327D."

SECTION 2. Section 327D-13, Hawaii Revised Statutes, is repealed.

["[327D-13] Mercy killing or euthanasia prohibited. Nothing in the chapter shall be construed to condone, authorize, or approve mercy killing or euthanasia."]

SECTION 3. Statutory material to be repealed is bracketed and stricken.

SECTION 4. This Act shall take effect upon its approval.