Honolulu, Hawaii


RE: H.B. No. 650

H.D. 2

S.D. 1




Honorable Ronald D. Kouchi

President of the Senate

Thirty-Second State Legislature

Regular Session of 2023

State of Hawaii




Your Committee on Judiciary, to which was referred H.B. No. 650, H.D. 2, S.D. 1, entitled:




begs leave to report as follows:


The purpose and intent of this measure is to:


(1) Authorize licensed advanced practice registered nurses to practice medical-aid-in-dying;


(2) Authorize licensed advanced practice registered nurses and clinical nurse specialists with psychiatric or mental health training and licensed marriage and family therapists to provide counseling to a qualified patient;


(3) Reduce from twenty to five days, the mandatory waiting period between the two oral requests required for a qualified patient to obtain a prescription for medication that may be self-administered to end the patient's life in accordance with applicable state law; and


(4) Waive the mandatory waiting period 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 the Department of Health, Compassion & Choices, Stonewall Caucus of the Democratic Party of Hawaii, Board of Nursing, Hawaii American Nurses Association, Hawaii Association of Professional Nurses, Hawaii Society of Clinical Oncology, Hawaii Pacific Health, Hawaii Psychological Association, Hawaiian Islands Association for Marriage and Family Therapy, and thirty-five individuals. Your Committee received testimony in opposition to this measure from the Hawaii Family Forum, Americans United for Life, and nine individuals. Your Committee received comments on this measure from the Hawaii Medical Association, Hawaii State Center for Nursing, and two individuals.


Your Committee finds that the State's Our Care, Our Choice Act, enacted by the Legislature in 2018, allows certain terminally ill individuals to voluntarily request and receive prescription medication that allows them to die in a peaceful, humane, and dignified manner. Your Committee finds however, that the State's shortage of physicians has unintentionally created barriers and burdens for patients in accessing this compassionate care, particularly in rural areas and neighbor islands. Your Committee also finds that the State's mandatory waiting period is the longest in the nation among states that have enacted medical-aid-in-dying laws, and according to testimony received by your Committee, twenty-seven percent of terminally ill patients who requested the medication did not survive the twenty-day mandatory waiting period. This measure reduces these barriers by allowing additional medical practitioners to facilitate medical-aid-in-dying, reducing the mandatory waiting period, and waiving the mandatory waiting period for certain qualified patients.


As affirmed by the record of votes of the members of your Committee on Judiciary that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 650, H.D. 2, S.D. 1, and recommends that it pass Third Reading.



Respectfully submitted on behalf of the members of the Committee on Judiciary,