Legislation proposing amendments to aid-in-dying law stalls

  • TRAD

Legislation that aimed to amend Hawaii’s aid-in-dying law passed through the state Senate earlier this month but failed to gain traction in the House.

Enacted in 2019, the Our Care, Our Choice Act allows Hawaii residents 18 older who are diagnosed with a terminal illness and have a prognosis of six months or less to live to obtain an aid-in-dying prescription after two separate verbal requests to a physician, a written request with two witnesses and a mental health evaluation to ensure they are capable of making medical decisions for themselves.


Senate Bill 839 sought to permit advanced practice register nurses, or APRNs, to be attending or consulting providers and add psychiatric mental health nurse practitioners or clinical nurse specialists to those who could provide counseling consultations.

The measures also would have reduced the minimum waiting period between oral requests from 20 days to 15, and would have permitted the attending provider to waive the waiting period if they think the patient will die before the 15 days lapse.

SB 839 passed a third reading in the Senate 21-4 on March 9 and crossed over to the House, where it was referred to four committees: Health, Consumer Protection and Commerce, Judiciary and Hawaiian Affairs and Finance.

No committee meetings were scheduled in the House, and bills referred to three or more committees were required to be filed and in their second-to-last committee by March 19.

“We are incredibly frustrated and disappointed,” said Sam Trad, state director for Compassion and Choices, part of a national organization that advocates for end-of-life rights. “SB 839 is a bill that won the Senate floor vote by an overwhelming 21-4 (vote), is supported by the Hawaii Department of Health and many other organizations, physicians, medical providers and others. Yet, as the days go by, it has become clear that there are no plans to reassign SB 839 so that it would have a chance to become law. There is simply not enough time in the Legislative session to work through four committees. What this means is, House leadership is effectively declining to give our bill a fair hearing.

“We are not taking this lightly,” she continued. “This furtive ‘quadruple-referral’ tactic was employed on at least a dozen other bills this week, and we should all be deeply disturbed that the democratic process has been thwarted in this way.”

Trad said she has heard repeatedly that the measure stalled over concerns about APRNs’ scope of practice, a hesitancy she said most experts think is unfounded and insulting to APRNs, who already have skills needed to support patients in medical aid-in-dying.

“It’s heartbreaking that Hawaii’s rural terminally ill residents, like those in East Hawaii, have been denied a chance at equal access to the Our Care, Our Choice Act this year,” Trad said.

Trad said in February that it’s difficult, especially on the neighbor islands, to access the law and it can be difficult to find a provider, especially with the growing shortage of physicians.

Additionally, many doctors had patients who met the requirements and wanted medical aid-in-dying, but died during the mandatory waiting period, in ways they hoped to avoid, she said at that time.


An similar bill last year passed out of the Senate and was before the House when the COVID-19 pandemic hit and the legislation was shelved.

Email Stephanie Salmons at ssalmons@hawaiitribune-herald.com.

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