Hawaii is the 7th U.S. jurisdiction to enact a death with dignity statute. The Our Care, Our Choice Act went into effect on January 1, 2019.
In January 2021, SB839, a bill which seeks to remove barriers to accessing Hawaii’s Our Care Our Choice Act, was introduced. If passed, it will reduce the waiting period from 20 days to 15 days, will authorize attending providers to waive the 15 period if a patient is imminently dying, and will authorize advance-practice nurses and psychiatric mental health nurse practitioners to participate in patient processes to qualify. Hawai’i’s unique geography and limited number of physicians have proven to be a barrier for patient access.
See History below.
Resources and Additional Information
About the Statute and Implementation
- Full text of the Our Care, Our Choice Act
- Hawai‘i Department of Health
- Usage reports:
Resources for Patients
- Hawaii Department of Health’s information for patients
- How to access Our Care, Our Choice Act
- Forms for patients:
Resources for Physicians
- Hawaii Department of Health’s information for healthcare providers
- Forms for physicians:
In the 2020 session, a number of amendments to the Our Care, Our Choice Act were proposed; none advanced to enactment as the Hawaii legislature went into recess because of the coronavirus (COVID-19) crisis.
- Full text of SB2582
- Amendment SD1 – adds mental health nurse practitioners to the list of professionals capable of conducting mental health evaluations
- Bill summary:
- authorizes advanced practice registered nurses to practice medical aid in dying in accordance with their scope of practice and prescribing authority;
- reduces the mandatory waiting period between oral requests from 20 to 15 days; and
- waives the mandatory waiting period for those terminally ill individuals not expected to survive the mandatory waiting period;
- as amended, authorizes psychiatric mental health nurse practitioners, in addition to psychiatrists, psychologists, and clinical social workers, to provide counseling to a qualified patient
- Legislative history of SB2582
- Heard in Senate Commerce, Consumer Protection, and Health Committee on February 4, 2020 and passed with amendments 6 to 1
- Passed in the full Senate 19 to 4, with 2 excused, on February 28.
- Full text of HB2451 (companion to SB2582)
- Legislative history of HB2451
- Heard and passed (with amendments) 5 to 1 in House Health Committee on January 31, 2020; heard and passed (with amendments, HD1) in the House Commerce and Consumer Protection Committee 7 to 3 on February 2; heard and passed (with amendments, HD2) in the House Judiciary Committee 12 to 0 on February 12
- Full text of SB3047
- Bill summary:
- allows an advance directive to be a valid written request;
- allows an attending provider to waive the counseling referral requirement;
- allows an attending provider to perform duties through telehealth; and
- requires health insurance policies and contracts issued after 12/31/20 to provide coverage for services related to ending a patient’s life.
- Legislative history of SB3047
- Heard in Senate Commerce, Consumer Protection, and Health Committee on February 4, 2020, and deferred
In the 2019 legislative session, the Hawaii state legislature passed and Governor signed into law SB536, which clarified that “existing laws intended to curb over-access to and abuse of opioids do not apply to qualified patients who are prescribed or issued prescriptions pursuant to the State’s Our Care, Our Choice Act.”
On July 1, 2019, the Department of Health released the first report on the law’s implementation, covering the period from January to May 2019.
2002-2018: The Road to Our Care, Our Choice Act
Efforts to pass a death with dignity law in Hawai‘i date back almost two decades.