Honolulu, Hawaii

, 2023


RE: H.B. No. 650

H.D. 1





Honorable Scott K. Saiki

Speaker, House of Representatives

Thirty-Second State Legislature

Regular Session of 2023

State of Hawaii




Your Committee on Health & Homelessness, to which was referred H.B. No. 650 entitled:




begs leave to report as follows:


The purpose of this measure is to amend the Our Care, Our Choice Act to:


(1) Authorize advanced practice registered nurses to practice medical aid in dying in accordance with their scope of practice and prescribing authority;


(2) Authorize advanced practice registered nurses with a psychiatric or clinical nurse specialization to provide counseling to a qualified patient;


(3) Reduce the mandatory waiting period between oral requests from twenty days to five days; and


(4) Provide an expedited pathway for terminally ill qualified patients who are not expected to survive the mandatory waiting period.


Your Committee received testimony in support of this measure from Compassion & Choices; Hawaii Psychological Association; Hawaii Association of Professional Nurses; Hawaii-American Nurses Association; Hawaii Society of Clinical Oncology; The Hawaiian Islands Association for Marriage and Family Therapy; Stonewall Caucus of the Democratic Party of Hawaii; and numerous individuals. Your Committee received testimony in opposition to this measure from the Hawaii's Partnership for Appropriate and Compassionate Care, Hawaii Family Forum, and eight individuals. Your Committee received comments on this measure from the Department of Health, Board of Nursing, Hawaii State Center for Nursing, and two individuals.


Your Committee finds that the State's unique geography and on-going physician shortage has created barriers to access to qualified terminally ill adults who wish to receive medical aid in dying. Your Committee further finds that Hawaii has the longest mandatory waiting period amongst all ten medical aid in dying authorized states, and many patients do not survive the mandatory twenty days. This measure addresses the needs of terminally ill patients who wish to die in a peaceful, humane, and dignified manner by reducing the mandatory waiting period and authorizing appropriately qualified advanced practice registered nurses to administer medical aid in dying.


Your Committee has amended this measure by:


(1) Changing the effective date to June 30, 3000, to encourage further discussion; and


(2) Making technical, nonsubstantive amendments for the purposes of clarity, consistency, and style.


As affirmed by the record of votes of the members of your Committee on Health & Homelessness that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 650, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 650, H.D. 1, and be referred to your Committee on Consumer Protection & Commerce.



Respectfully submitted on behalf of the members of the

Committee on Health & Homelessness,