►
Description
House Health Subcommittee - March 16, 2021 - House Hearing Room 2
A
A
C
Thank
you,
mr
chairman,
good
afternoon
committee,
very
good
to
be
with
you
all.
Just
tell
you
a
brief
story.
When
I
was
13
years
old,
a
drunk
driver
hit
the
car
that
my
two
sisters
were
in
and
my
sister
just
turned
16
the
week
before,
and
she
had
major
head
trauma
from
the
crash.
That
was
on
a
monday.
They
flew
her
to
the
local
trauma
center
and
she
lived
on
life
support
until
thursday
through
that
time.
C
It's
an
incredibly
difficult
time
for
the
family
if
you've
lost
somebody
that
close
to
you
know
what
it
means
to
hurt
so
bad
that
you
don't
know
if
you're
gonna
breathe
and
it
was
devastating
to
us
and-
and
we
noticed
early
on
because
my
my
sister's
body
was
in
perfect
health
except
for
the
head
trauma
that
a
lot
of
people
are
very
interested
in
her
organs.
But
we
were
in
the
middle
of
of
of
grieving
and
trying
to
figure
out.
C
Is
there
any
chance
that
she
can
make
it
and
they
pressed
and
pressed
and
pressed
for
my
parents
to
donate
her
organs
because
she
she
was
only
allowed
because
of
life
support
and
she
had
brain
damage
that
was
so
significant
that
she
would
die
without
it.
But
in
the
middle
of
that
we
were
just
internal
emotional
terminal
and
we
did
not
do
anything
about
it.
We
we,
my
parents,
rejected
the
idea
of
donating
her
organs.
C
That
happened
when
I
was
13
and
all
my
life
I've
considered.
Could
we
have
not
done
it
better?
In
the
last
few
years
of
my
life,
I've
personally
known
people
who
are
on
the
waiting
list
for
an
organ
and
in
the
resolution
you
have
in
front
of
you,
you'll
see
that
there's
a
hundred
and
ten
thousand
americans
currently
on
the
waiting
list,
and
I
thought
of
the
pain
that
I've
gone
through
with
my
dad's
death,
my
sister's
death,
and
what,
if
there
was
something
that
could
heal
them.
C
Wouldn't
that
be
awesome-
and
I
don't
know
if
you
know
this
but
tennessee
because
of
vanderbilt-
it's
one
of
the
number
one
states
in
america
for
organ
transplants,
we're
getting
it
right,
people
coming
from
all
over
last
year
alone,
we
had
1100
organ
transplants
and
that
only
came
from
390
tennesseans,
so
committee.
What
I'm
trying
to
do
is
bring
awareness
to
study.
C
Now
you
don't
ever
know
when
this
might
be
something
part
of
your
life,
that
you
need
an
organ
somebody
you
love
needs
an
organ
or
what,
if
you
die
from
a
tragic
accident
or
something
crazy
like
that,
and
you
have
organs
that
are
in
perfectly
good
health
that
could
potentially
save
another
person's
life
and
my
opinion,
that's
very
pro-life
of
us.
So
I'm
just
bringing
a
resolution
and
I'm
hoping
to
get
this
out
in
tennessee
and
to
encourage
them.
You
know
what
study
this
little
bit.
C
Don't
wait
till
you
get
in
the
middle
of
a
situation
where
you're
trying
to
make
an
emotional
decision,
and
you
can't
make
an
emotional
decision.
What,
if
you
made
it
early
on
and
tennessee's,
got
it
pretty
easy?
You
can
just
put
it
on
your
driver's
license
if
you
want
to,
you,
can
put
it
in
your
will.
D
Thank
you,
mr
chairman,
and
thank
you,
mr
chairman,
for
doing
this.
I
think
those
personal
experiences
are
what
make
us
in
life.
The
experience
that
you
and
your
family
went
through
is
what
is
making
you
today,
and
I
think
you
are
a
very
touching
person
in
the
way
you
communicate
and
we
appreciate
it.
I
personally
would
like
to
say
that.
D
B
C
Thank
you,
mr
chairman,
and
I
want
to
piggyback
on
what
both
members
just
said
and
dr
kumar
said
how
incredibly
difficult
it
was
to
go
to
a
family
at
the
time.
Sometimes
it
was
rewarding,
but
that's
a
difficult.
That's
why
I'm
thinking
what
if
we
encourage
people
to
make
the
decision
before
you're
in
the
battle?
A
Okay,
further
comments
or
questions.
If
not,
I
would
like
to
say
we.
We
appreciate
your
insight
to
the
the
power
of
this
committee
is
to
look
past,
stigmas
and
stagnant
creativity
and
and
try
to
take
care
of
our
citizens
in
a
better
manner.
So
I
appreciate
that
we'll
be
voting
to
send
this
to
full
committee,
all
those
in
favor
say
aye
any
opposition
so
approved.
Thank
you.
Thank
you,
sir.
A
A
A
A
A
E
E
F
E
E
E
G
Thank
you.
Thank
you.
Chairman
wendell
be
happy
to
testify
on
on
quadriplegia
and,
and
I
think
a
lot
of
there
are
two
types
of
quadriplegia.
Obviously
one
is
neurological,
the
type
that
I
possess,
which
you
break
your
neck
paraplegic,
you
break
your
back
and
I
can
say
neurological.
This
would
apply
the
diagnosis
of
quadriplegia.
I
can
tell
you
what
I
think
the
aspects
of
this
this
type
of
oil
would
do
for
someone
in
my
situation,
especially
in
the
evening
times
when
I
I'm
up
all
day
long
and
I
get
really
violent.
G
You
know
hard
muscle
spasms
and
I
would
love
to
be
able
to
try
something
like
this
to
see
if
it
alleviate
any
kind
of
pain.
For
me
now,
there's
also
what's
called
a
traumatic
injury
with
with
quadriplegia,
where
you
lose
your
limbs
now,
neurologically,
you
still
don't
have
access
to
all
your
limbs.
People
say:
well,
you
move
your
arms
like
well
yeah.
I
have
biceps,
but
but
I
don't
have
triceps,
I
don't
have
wrists.
G
I'm
blessed
to
have
a
neurological
quadriplegic
when
it
comes
to
especially
someone
who's
lost,
all
four
of
their
limbs
and
and
especially
in
the
service
of
their
country,
and
when
you
get
to
a
situation
where
all
medical
science
cannot
help
you
this
person.
But
yet
there
is
something
out
there
that
can
medically
help
someone
recommended
by
a
doctor
legal
in
another
state
to
come
here
to
be
able
to
at
least
try
it.
It's
what
we
owe
a
veteran
that's
lost
their
limbs
for
this
country.
It's
what
we
owe
a
human
being.
G
D
D
Secondly,
I
find
this
justifiable
based
on
the
fact
that
quadriplegia
or
paraplegia,
with
muscle
spasms,
is
a
recognized
indication
approved
by
the
fda,
although
fda
approved
the
synth
in
the
synthetic
form,
but
there
are
four
indications
that
have
been
approved
by
the
fda
and
those
include
nausea
and
vomiting,
or
chemotherapy
muscle,
wasting
and
conditions
related
to
aids,
neuropathic
pain
and
muscle
spasms.
So
I
think
we
are
on
a
scientific
basis
to
recommend
medical
marijuana
for
this
condition.
D
E
The
response
of
those
discussions
was
that
this
bill
would
have
a
better
chance
if
I
did
not
broaden
the
scope,
because
they're,
certainly
from
my
perspective,
a
hesitancy
to
approve
marijuana
as
a
treatment
for
medical
conditions
in
tennessee,
for
whatever
reason-
and
we
can
debate
why-
that
is
40
to
44
jurisdictions,
have
approved
medical
marijuana
in
some
form
in
america.
We're
one
of
the
last
four
five
six
states
that
have
not
approved.
E
It
was
my
judgment
that
if
the
bill
is
narrowly
drawn
to
a
member
of
our
armed
forces,
who
is
injured
in
the
line
of
duty
and
cannot,
I
mean
I'll
defer
to
darren
but
basically
can't
feel
below
their
neck,
and
that
individual
would
certainly
not
be
a
threat
to
abuse
the
product.
Wouldn't
be
a
threat
to
the
public
that
maybe
we
can
ease
into
a
discussion
of
the
treatment.
The
humane
treatment
of
individuals
who
have.
E
Chronic
and
not
just
life-changing
but
excruciating
pain
in
many
many
instances
and
the
individuals
I
talked
to
that
are
in
this
category
have
asked
me
to
keep
it
narrow
to
maybe
get
this
through,
and
maybe
they
can
set
an
example
for
other
people.
That
tennesseans
are
responsible
and
are
reasonable
and
are
sober
and
will
approach
this
in
a
manner
where
it's
not
frightening
to
the
general
public,
because
apparently
the
general
public,
the
general
public's,
not
frightened
by
but
members.
E
E
But
hopefully,
if
we
keep
this
narrowly
drawn,
that
we
can
have
a
not
a
test
case
but
give
us
some
give
a
an
opportunity
to
show
what
the
medical
community,
as
well
as
the
clients
that
are
treated
by
this,
can
act
responsibly
and
it's
a
good
program.
Instead
of
something
negative,
maybe
a
verbose
response,
but
that's
the
best.
I
can
do.
E
Thank
you
very
much
and
the
reason
I
changed
it
partially
because
of
our
conversation,
I
have
everybody
in
the
building,
respects
your
medical
knowledge
and
you're
also
a
good
guy.
But
when
you
said
john
mark,
you
need
to
take
a
look
at
this
because
of
this
that
then
I
listened
to
you
and
I
followed
your
advice
and
that's
why
the
third
part
of
that
amendment's
here
is
because
you
said
you
need
to
do
this
and
you're
the
expert,
I'm
not
so
I
took
your
advice
and
that's
why
the
bill
is
drafted
as
it
is.
Thank.
D
F
Thank
you
again.
I
appreciate
you
bringing
this
bill
and
to
that
point,
if
you
had
it
more
broad
with
paraplegia,
I'm
I'm
I'm
with
you
on
on
that
one
as
well
and
two,
the
chairman's
point
muscle
spasms
and
then
phantom
pain,
the
neuropathic
pain
from
that
a
lot
of
times.
Opioids,
don't
touch
that
and
and
people
are
on
other
medications
for
that
antidepressants
things
like
that,
and
this
can
help
with
their
phantom
pain.
And
if
somebody
has
sacrificed
for
my
liberty,
I'm
off,
I'm
I'm
with
you
on
this
bill.
E
A
E
But
again
I'm
not.
This
is
not
directed
as
your
question
or
not
responsive
to
your
question
but
or
in
response,
but
it
it's.
I
won't
say
it's
farcical,
but
it's
not
reasonable
to
suggest
that
a
quadriplegic
is
going
to
be
causing
problems
as
a
result
of
receiving
cannabis
oil
and
that
to
me,
that's
that's
just
not
a
valid
argument,
and
maybe
we
can
take
the
first
step
with
this
bill
and
give
people
a
chance.
E
Certainly
our
veterans
deserve
that,
but
also
other
people
through
no
fault
their
own,
if
you're
injured
and
have
a
life-changing
injury
and
there's
a
product
that
well,
maybe
not
maybe
but
we'll
take
care
of
whatever
issues
you
have.
Why
should
robin
smith
or
darren,
jernigan
or
pat
marsh,
say?
No.
You
can't
have
that
because
my
jesuit's
better
than
yours
I
mean,
if
we're
really,
I
mean
conservative-
maybe
a
big
net,
to
throw
but
isn't
that
a
conservative
approach
to
let
people
make
their
own
decisions.
B
A
B
E
Here
to
push
any
drug,
I
mean
that's
that's
something
I
don't
have
the
expertise
to
do,
but
I
can
assure
you
there's
a
whole
generation
of
young
tennesseans
that
want
the
same
opportunity
that
young
israelis
have
now
that
young
canadians
have
now
that
young
australians
have
now
to
grow
and
produce
a
crop
and
a
product
to
sell
to
the
world.
I
mean
we've
been
selling
jack
daniels
across
the
world
for
the
last
200
years
and
it's
not
legal
there
or
it
hadn't
been
legal
there.
E
E
Why
would
they
not
be
able
to
sell
that
product
worldwide
when
it's
legal
somewhere
else?
I
mean
alcohol,
wasn't
legal
here
and
it
was
produced
here.
So
I
could
take
that
argument,
one
step
further
and
say
we
should
be
allowing
young
tennesseans
who
want
to
work
every
day
want
to
produce
a
product
to
let
them
do
that,
but
that's
another
discussion
for
another
day.
I
guess
and.
G
E
The
oil
had
to
be
purchased
in
a
jurisdiction
where
it
is
legal,
which
is
ninety
percent
of
america.
Now
ninety
percent
of
americans
have
access
to
it.
She'll
have
to
go
to
a
jurisdiction
where
it
is
legal
to
purchase
this
item,
and
this
will
be
a
defense
to
the
illegal
possession
of
it
in
tennessee
and.
A
You
send
pardon
me
for
interrupting,
but
the
you
send
the
money
to
that
state
and
then
actually
a
large
part
of
it
comes
through
the
postal
service.
Thank
you
have
further
comments
or
questions.
I
I
did
have
a
request
for
input
from
the
department
of
health
and
also
the
department
of
safety.
Did
anybody
want
to
come
forward
and
speak.
I
I
I
think
it's
very
easy
for
users
not
to
know
precisely
how
much
to
to
take
and
potentially
have
errors.
There
there's
been
discussion
about
smoking
it
it
can
be
vaporized
now
that
may
not
be
the
way
it's
prescribed,
but
that's
not
an
uncommon
way
to
take
it
in
places
in
people
who
do
there
was
some
discussion
about.
You
know,
starting
with
a
very
very
limited
population,
which
this
is.
I
Obviously
there
are
a
lot
of
philosophical
arguments
and
things
that
you
all
would
need
to
consider.
But
you
know
this
essentially
opens
up
medical
marijuana
to
or
excuse
me
thc
to
potentially
a
much
much
wider
population,
and
you
all
know
how
difficult
it
has
been
to
define
the
patient
population
and
limit
it
to
a
very
long
list
of
other
conditions.
G
I
G
I
Depends
very
much
on
the
person
how
much
they've
taken
in
the
past
and
therefore
sort
of
built
up
susceptibility
it.
You
know
overdose
can
lead
to
severe
confusion.
It
can
exacerbate
psychologic
conditions.
Some
people
do
end
up
in
the
emergency
room.
You
know
with,
I
think
the
adverse
effects
of
psychiatric.
I
I
I
K
Certainly,
we
understand
where
chairman
wendell
is
coming
from
with
this
bill
and
and
understand
that
our
biggest
concern
is
the
unregulated,
potentially
unregulated
amount
of
thc
oil,
the
the
concentration,
the
fact
that
it's
still
federally
illegal,
it's
not
processed
in
tennessee,
so
we're
worried
about
it
being
transported
across
state
lines
through
the
state
as
well,
unregulated
how
we
handle
that
and
certainly
impaired
driving.
I
know
you've
heard
thp
talk
about
it
for
years,
impaired
driving
any
most
of
the
st
well,
not
most.
A
If
none,
we
appreciate
your
testimony.
Thank
you
very
much
for
being
here.
Thank
you.
Thank
you
for
the
job
you
do.
We
appreciate
you
every
day,
thanks
sherman,
so
we
no
objections
will
go
back
into
session
and
mr
sponsor
you're
recognized
or
do
anybody
have
any
other
questions?
If
not,
we
will
be
voting
to
send
this
bill
to
full
committee
as
amended,
all
those
in
favor
say
aye
all
those
opposed
so
approved.
F
A
A
This
is
a
bill
similar
to
the
chairman
wendell's
bill,
to
frame
the
importance
of
an
issue
that
too
many
times
has
been
obscured
by
the
general
publicity
of
illegal
drugs
lumped
under
criminal
codes,
and
and
this
is
kind
of
a
family
issue
for
us.
We,
we
certainly
have
seen
lots
of
witnesses
up
here
that
that
are
in
really
difficult
health
situations
because
of
life-threatening
diseases.
A
That's
what
this
bill
is
about
to
corey
gunnels,
who
is
a
citizen
here
in
tennessee,
he's
43
years
old,
has
two
children,
a
wife
and
and
a
father,
doug
gunnels
that
I
think
has
contacted
many
of
you,
who's,
a
liaison
with
the
department
of
transportation,
and
I
won't
get
into
all
the
particulars.
But
I
will
say
that
for
ten
years,
corey's
battled
a
neuroendocrine
carcinoma,
which
was
found
by
just
a
random
ct
scan
after
an
accident,
he
had
surgery
three
cycles
of
chemotherapy
35
radiations.
A
This
is
a
disease
that
has
a
five
year
survival
rate
of
about
50
percent.
So
it's
a
very
serious
condition.
He
went
four
years
clean
without
anything
the
tumors
came
back.
He
received
further
targeted
therapy
with
therapy
and
hormones
which
shrank
for
a
short
period
of
time.
In
2017,
new
tumors
came
back
and
and
one
blocked
as
vena
cava
90.
A
So
the
tumors
are
proliferating
in
his
extremities,
the
he
spoke
to
a
friend
of
a
friend
with
anecdotal
evidence
of
what's
called
rick
simpson
oil,
and
that's
what
this
bill
addresses
here.
As
the
previous
sponsor
mentioned,
he
did
not
draw
a
specific
mixture
or
percentage
of
thc
and,
and
we
did
neither
the
rick
simpson.
Oil
is
a-
is
a
general
label
for
for
different
substances.
A
He
went
online
and,
and
we
talked
about
the
the
limited
access
of
results
and
in
maybe
assessing
the
effectiveness
of
these
products
and
and
online.
He
found
40
000
members
of
facebook
programs,
some
of
them
that
had
his
own
disease
and
many
that
had
others
that
had
had
some
some
amount
of
success
and
and
and
some
with
the
neuroendocrine
cancer
itself
immediately
on
beginning
the
oil.
A
Thank
goodness
we're
not
the
ones
that
have
to
tell
him
that
we've
done
all
we
can,
and
but
I
do
know
that
we're
all
sensitive
to
that,
because
in
2015
we
passed
a
right
to
try
act
which
indemnifies
licensed
health
providers
solely
for
the
recommending
of
to
eligible
patients
regarding
the
access
of
treatment.
With
investigational
drugs
or
our
biological
products,
and
in
2014
and
15,
we
passed
the
possession
of
thc
oil,
which,
over
there
again
was,
was
considered
at
the
time
to
be
illegal.
A
F
F
A
And
what
this
amendment
does?
It
makes
the
bill.
It
requires
a
letter
from
a
patient's
primary
care,
physician
diagnosed
with
life-threatening
cancer
that
has
been
attested
to
and
of
a
licensed
cancer
center.
That's
rated
or
recognized
a
second
issue
item
that
it
has.
Is
it
attests
that
the
patient
received
conventional
methods
of
treatment
which
have
failed
and
it
is
signed
and
dated
by
a
physician
for
a
period
of
no
longer
than
a
year?
A
The
it
also
requires
proof
that
the
oil
was
purchased
where
rso
is
lawful
and,
as
I
say,
rick
simpson,
oil
is
not
a
specific
oil.
It's
a
a
family
of
full
cannabis
extracts
that
is,
as
one
of
our
witnesses
said,
can
vary,
but
in
states
that
it's
legal,
the
the
amounts
of
different
distillates
in
it
are
listed.
So
you
know
what
you're
getting
it's?
Not
it's,
not
you
just
buy
a
random
sample,
it's
tested
by
the
states
where
these
are
legal,
so
you
know
this
is
this.
A
This
bill
really
is
is
for
the
the
situation
where
we're
we're
addressing
measures
when
we
cease
to
improve
a
situation
that
people
are
in,
we
we're
in
that.
That
particular
amount
of
time
when,
when
the
months
days
and
years
that
can
go
in
between
constructive
treatment
and
actually
the
resolution
of
the
situation,
and
when
I
say
resolution
I
don't
mean
cure
the.
The
hope
is
that
that
there
will
be
that
there
will
be
benefits
up
until
that
point.
F
D
Thank
you.
Thank
you,
mr
chairman,
for
bringing
this
a
few
things
to
correct
what
we
approved
several
years
ago.
Here
was
cbd
oil,
not
thc
oil?
Oh
yes,
yes,
sir
okay.
Secondly,
mailing
thc
products
is
by
law
illegal,
because
u.s
postal
service
is
a
form,
is
a
branch
or
entity
under
the
jurisdiction
of
the
federal
government
so
or
other
mail
carriers.
Also
you,
your
ups,
fedex
and
so
on.
D
L
D
L
A
Yes,
yes,
the
the
certainly
and-
and
the
resolution
of
situations
like
this
is
is
I
don't
think
the
expectation
is
even
that
there
will
be
a
a
miraculous
recovery
of
even
a
percentage
of
the
original
health
status.
But-
and
somebody
actually
said-
why
would
you
give
these
folks
a
false
hope?
And
I
I
didn't
know
that
there
was
such
a
thing
as
false
hope
and
and
so
as
as
this
young
man
went
on
line
and
found
forty
thousand
other
people
that
that
were
searching
this
issue.
A
I
I
feel,
like
that's,
that's
pretty
strong
grounds,
the
the
fact
that
that
this
does
give
hope
to
people,
and
I
would
never
want
to
extend
and
that's
why
the
tennessee
medical
association
wanted
to
separate
the
medical
practice
from
having
to
make
recommendations
or
or
having
to
give
information,
because
the
understanding
is
that
no.
This
is
not
a
not
a
cure.
D
Thank
you
for
explaining
that.
I
think
it's
also
very
important
to
realize
that
this
bill
addresses
advanced
cancer
and
not
just
cancer,
because
we
see
marijuana
bills
that
come
through.
They
try
to
add
every
condition
that
might
have
been
mentioned
as
possibly
benefiting
from
marijuana
on
the
internet,
but
you're
dealing
with
advanced
cancer.
D
I
think
that's
well
defined
and
there
is
a
sense
of
comfort
when
people
are
suffering
to
that
degree
and
they
find,
as
you
say,
hope-
and
you
were-
you
explained
it
to
me-
that
hope
can
also
be
a
placebo,
and
I
think,
considering
that
it's
it's
it's
a
reasonable
thing
to
do,
that
we
are
confining
it
to
advanced
cancer.
We
are
not
giving
people
false
hope
about
cure.
The
only
other
concern
will
be.
D
A
Well,
it
is
to
make
a
comment,
as
I
say,
the
the
rick
simpson.
Oil
is
not
a
specific
brand.
It
was
generally
applied
to
a
a
large
array
of
cannabis
distillates,
and
so
this
is
essentially
what
we're
looking
at
here.
So
it's
in
the
vernacular
and
and
the
atmosphere
of
cannabis
products.
It
is
considered
a
distillate
and
it
comes
in
in
particular
percentages
of
thc
and
that's
that's
all
established
in
the
states.
F
F
Orally,
so
we
do
have
it
defined
in
here.
Any
further
questions
on
the
amendment:
okay,
seeing
none.
We
are
going
to
vote
on
amendment
zero,
zero,
four
one,
three,
two,
all
those
in
favor
say:
aye,
aye,
aye
opposed
eyes
have
it.
We
are
back
on
the
bill.
As
amendment
amended
representative
smith,
you
us.
B
A
I
don't
think
the
term
was
advanced
cancer.
I
I
think
the
the
term
was
life-threatening
life-threatening
cancer
which
I
guess
would
have
to
be
a
determination
of
the
rated
or
recognized
licensed
cancer
center,
and-
and
so
I
think,
the
the
physician
is
allowed
to
designate
that,
but
the
tma
wanted
to
make
sure
that
the
responsibility
didn't
fall
on
the
physician,
to
recommend
or
to
counsel
on
on
potential
usage.
B
I
do
have
a
couple
of
follow-ups
because
I
I
want
to
support
your
bill.
I
really
do,
but
I
also
know
that
you
know
I'm
sitting
here
and
I'm
terminal,
I'm
I'm
every
one
of
us
has
a
terminal,
disorder
and,
and
so
I'm
concerned,
just
from
the
perspective
of
you
know,
volkswagen
is
in
my
district
and
as
they
have
people
standing
on
their
multi-million
dollar
assembly
lines,
most
likely.
Someone,
unfortunately,
is
struggling
with
a
type
of
cancer
and
what
liabilities
are
transferred,
and
so
I'm
trying
to
understand
exactly.
B
You
know
what
this
patient
might
look
like
clinically.
Would
they
would
they
be
working?
Would
they
not
be
working?
Would
they
be
driving?
You
know
what
levels
of
thc
could
they
potentially
absorb,
and
these
are
the
questions.
I
know
that
you
don't
have
the
answers
to,
but
but
to
the
degree
that
we
can.
B
What
I
don't
want
to
do
is
create
unintended
consequences
by
law
that
transfers
liability
onto
an
employer
that
they
can't
do
anything
about,
and
so
that's
a
concern
and
I'll.
Let
you
answer
that,
but
if
I
might,
mr
chairman,
follow
up
on
the
rso
oil,
is
there
anything
that
fixes
this
definition
in
a
static
way,
so
that
there
are
not
other
solutions
that
could
change
their
ingredients
to
meet
this,
but
not
really
because
you
know
when
I
first
read:
rso
oil,
I
thought
is
that
robin
smith
oil
is
that
what
is
that
you
know?
B
A
Full
extract
cannabis
oil.
Now
the
gentleman
that
first
started
making
this
popular
in
the
70s
was
named,
rick
simpson
and
so
rick
simpson,
distilled
this
oil
down
and
and
sold
it
or
gave
it
to
people
for
medicinal
purposes,
and
so
ever
since
then,
the
the
general
definition
has
been
full
extract,
cannabis,
oil
and,
of
course
it
does
come
in
different
percentages
and
the
previous
sponsor
had
to
face
the
same
issue
in
writing
his
bill.
A
A
They
order
a
rick
simpson
type
of
extract
oil
that
has
that
percentage
in
it
and
that's
that's
kind
of
how
they
determine
the
dosage
and
the
usage
and,
as
as
we
heard
from
the
department
of
health,
it's
very
rare-
and
I
don't
know
if
it
even
happens-
that
that
a
an
overdose
of
of
cannabis
material
causes
death
causes
some
issues,
but
he
he
said,
death
wasn't
typically
one
of
them.
So
that's
that's
pretty
much
the
reason
we
came
up
with
that
definition.
F
A
And-
and
let
me
say,
let
me
just
describe
this
young
man
situation.
He
of
course
went
through
all
these
treatments
and
that's
what
this
is
for.
Somebody
that's
gone
through
treatment
that
no
longer
is
successful.
Well,
he
long
ago
had
lost
his
job.
They
they
couldn't
keep
him
on
because
of
the
the
extreme
side
effects
that
that
these
strange
and
mysterious
chemotherapy
programs
they
tried,
and-
and
so
I
don't
know
that-
he's
had
a
driver's
license
for
a
long
time.
A
But
right
now
he's
struggling
for
his
life
and
and
has
been
for
several
months,
and-
and
I
don't-
I
don't
think
I
think.
Typically,
the
people
that
are
in
this
kind
of
situation
have
long
ceased
to
to
be
able
to
function
at
a
job
or
or
in
any
other
place,
so
that
I'm
I'm
going
by
this
one
as
as
having
received
treatment
which
no
longer
works
and-
and
I
think
that's
that's-
the
intent
of
the
bill.
B
B
We
have
specific
definitions
of
practicing
medicine
and
while
I
hear
that
the
tma
does
not
want
the
responsibility
of
making
this
determination,
whether
this
works
or
not,
we're
essentially
saying
it's
up
to
word
of
mouth,
whether
someone
uses
something
that
in
the
federal
law
is
deemed
illegal,
and
I
want
to
make
sure
that
we're
not
constructing
a
precarious
situation.
Unintentionally,
I
want
to
vote
for
your
bill.
B
I'm
not
going
to
oppose
your
bill.
Let's
put
it
this
way.
I
just
have
some
deep
concerns
that
is
so
subjective,
very
subjective
that
we
may
be
putting
a
bill
in
code,
letting
something
happen
where
there
are
some
really
sick
people
that
are
hurting.
Don't
disagree
with
that
I've
given
marinol,
I
mean
I've
given
medical
marijuana,
but
I
also
know
that
there
are
more
effective.
B
You
know
diluents
and
solutions.
So
my
concern-
I
just
want
to
go
on
the
record
to
say
we
need
the
us
congress
to
move
this
to
a
class
that
can
be
studied,
and
I
think
that
we
need
to
follow
this
very
carefully
and
make
sure
that
we're
quick
to
amend
things
if
we
find
that
it's
too
broad.
But
thank
you
so
much.
Dr
ramsey.
F
J
Thank
you,
chairman
elizabeth
stroker,
legislative
director,
and
and
thank
you
to
the
chairman
and
the
sponsor
as
well.
I
think
everyone
kind
of
knows
where
law
enforcement
is
coming
from
and
and
we
do
get
what
everyone
is
saying
and
so
I'll
kind
of.
Let
the
colonel
reiterate
what
we
talked
about
on
the
last
bill,
but
really
kind
of
for
the
most
part
again.
J
Is
that
it's
it's
still
an
illegal
substance,
and
it
doesn't
say
you
can't
you
can't
drive
while
you're
taking
it,
even
though
someone
may
not
be
able
to
drive,
and
so
there
is
that
concern
that
someone
may
not
know
it
may
not
that
it
may
impair
them,
driving
and
so
I'll.
Let
the
colonel
kind
of
clarify
more
on
that,
but
it
really
is
the
same
concerns
as
with
the
last
bill
as
well.
K
Thanks
elizabeth
chairman,
colonel
colonel
matt
perry
tennessee
highway
patrol
again,
I
we
completely
understand
the
you
know.
The
purpose
sponsor
of
chairman
and
our
biggest
concern
is
impaired.
Driving
the
unregulated,
unregulated
use,
the
illegal
use
of
anything
that
becomes
legal,
is
illegally
used
and
and
and
abused,
and
that's
our
biggest
concern
and
impaired
driving
a
lot
of
people.
Don't
know
that
you
know
you
take
the
the
prescribed
amount
of
a
any
narcotic
or
a
scheduled
drug
or
an
opioid.
K
G
D
Thank
you.
Thank
you,
mr
chairman.
I
hesitate,
but
it
has
to
be
brought
up
the
concern
about
diversion.
It
applies
to
the
previous
bill
also,
especially
in
the
previous
bill,
a
quadriplegic
person
somebody
has
to
handle
it
for
them,
and
I
guess
you
depend
on
the
honesty
of
that
person,
but
diversion
is
a
concern.
Is
it.
K
F
H
Thank
you,
chairman
patrick
powell,
with
department
of
health
and
again
chief
medical
officer,
dr
tim
jones.
The
department
is
opposed
to
this
bill.
Much
like
the
last
bill,
we've
kind
of
drawn
our
line
in
the
sand
that
you
know
pro
substances
that
have
been
approved
and
gone
through
the
safety
and
efficacy
processes
of
the
fda.
H
I
Sorry,
the
only
thing
I'll
add
to
what
I
said
before
is
this
question
about
life-threatening
cancer
just
to
emphasize
that
that
does
not
mean
terminal
cancer.
I
mean
most
cancers
are
life-threatening
but
can
be
treated.
I
mean
in
my
office
there's
a
person
with
breast
cancer.
A
person
with
colon
cancer
both
are
very
unlikely
to
kill
them
they're
functional
they
drove
to
work.
I
So
you
know,
based
on
that
you're
talking
about
a
with
that
definition,
you're
talking
about
a
very,
very
large
group
of
people,
all
of
us,
no
people
who
would
qualify
by
that
definition
and
obviously
the
wider.
The
group
that
can
obtain
it,
the
higher
risk
of
diversion,
as
was
mentioned
a
moment
ago,.
D
D
So
just
saying
life-threatening
is
not
enough,
and
I
thought
it
did
say
advanced,
but
it
does
not
if
we
were
if
we
wanted
to
help
people
who
are
have
certain
symptoms
that
are
not
being
relieved
by
conventional
medicines
and
do
have
advanced
cancer,
I
don't
know
it
doesn't
have
to
be
stage
four.
It
can
be
stage
three
and
disabling
and
so
on.
Kindly
give
us
an
opinion
if
you
feel
at
liberty
to
do
so
legally
and
secondly,
you're
not
going
to
tell
us
what
we
need
to
put
in
you.
I
F
H
And
I
was
just
saying
that,
generally,
our
stance
has
been
on
thc
and
marijuana
that
we
would
like
things
to
go
through
the
fda,
safety
and
efficacy
processes,
obviously
with
rick
simpson
oil.
In
this
case,
that
is
not
the
case.
It
hasn't
been
granted
an
emergency.
You
saw
authorization,
it
hasn't
been
given
an
approval
by
the
fda,
and
so
it
is
a
largely
unknown
and
obviously
still
illegal
on
the
federal
and
safety
brought
up
product
that
would
be
being
offered
as
medicine
and
in
wide
ranging
thc
amounts
that
really
have
no
known
dosage.
F
F
H
D
F
A
F
A
M
Good
afternoon
committee,
what
I'm
bringing
to
you
today
is
a
classic
case
of
trained
professionals
who
do
good
things
for
people
having
a
disagreement
and
what
they're
disagreeing
upon
is
the
use
of
the
term
anesthesiologist,
to
quote
my
good
friend
from
chattanooga,
to
paraphrase
that
if
everyone
calls
themselves
an
anesthesiologist,
no
one's
an
anesthesiologist,
and
so
what
this
is
looking
to
do
is
to
provide
parameters
around
that
term.
I
myself
I'm
an
engineer.
I
have
a
license
from
the
state
of
tennessee.
M
I'm
graduated
from
a
four-year
bet,
abet
accredited
school
and
used
two
engineers
were
the
term
engineer
for
in
a
profession
was
limited
to
someone
who
met
those
qualifications.
You
find
a
network
engineer.
You
can
find
a
change
engineer.
You
can
find
a
social
engineer.
There's
all
everybody
has
stolen
that
and
watered
down
that
term
to
where
really
what
is
an
engineer
other
than
some
type
of
generic
problem
solver,
that's
really
what
what
it's
turned
out
to
be.
In
this
case.
M
It
stems
from
a
disagreement
between
professions
between
the
medical
and
dental
profession.
The
it's
brought
to
light
in
2020
when
our
board
of
dentistry
adopted
rules,
officially
recognizing
the
dental
anesthesiologists
and
the
tennessee
society
of
anesthesiologists,
or
the
medical
anesthesiologists
took
exception
to
that.
M
I
got
word
this
past
week
that
the
new
hampshire
supreme
court
decided
in
favor
of
anesthesiologists
being
a
medical
field
profession
and
there-
and
I
know
that
that's
that's
not
here,
but
at
the
same
time
it
does
show
that
people
who
have
been
looking
at
this
agree
that
there
is
a
distinct
difference,
and
so
today
we're
asking
for
y'all
to
clarify
to
allow
this
bill
to
clarify
the
difference
between
the
two
and
I
know
that
y'all
been
on
some
pretty
heavy
subjects.
This
is
very
important
to
the
people
who
practice
this
profession.
M
M
Whenever
I
had
my
colonoscopy
or
I
had
another
treatment,
I
was
glad
that
I
didn't
ask
what
their
profession
professional
designation
was.
I
was
trusting
that
they
were
qualified,
but
in
the
realm
of
professional
accreditation
it
does
matter,
and
so
that's
what
we're
here
to
submit
to
you.
I
know
that
we've
got
people
who
are
willing
who
would
like
to
speak
to
this.
A
Okay,
thank
you
for
that
explanation
and-
and
I
I
think
maybe
there
had
been
a
discussion
earlier
in
the
year
to
try
to
work
this
out
with
compromises
which
didn't
go
anywhere
and
and
so
I
I
think
this
is
something
we
need
to
look
at,
have
any
questions
of
the
sponsor
from
the
members
before
we
go
out
of
session
and
hear
from
the
expert
witness
yes,
sir.
Yes,.
M
N
N
In
most
cases,
patients
are
relieved
and
reassured
when
they
meet
their
anesthesia
care
team.
A
highly
trained
certified
registered
nurse
anesthetist
and
the
physician
ultimately
responsible
for
their
anesthesia
care,
their
anesthesiologist,
the
tennessee
medical
association
and
the
tennessee
society
of
anesthesiologists
have
enormous
respect
for
the
profession
of
dentistry
dentists,
have
earned
that
respect
through
long
years
of
education,
training
and
experience,
and
an
ongoing
commitment
to
patient
care
inherent
in
the
relationship
between
physicians
or
dentists
and
their
patients
is
a
clear
understanding
by
the
patient
of
their
professional
qualifications.
N
Last
november,
the
tennessee
board
of
dentistry
voted
to
add
a
new
dental
specialty
certification
for
individuals
wishing
to
prep
wishing
to
practice
dentistry
under
the
title.
Dental
anesthesiologist.
This
designation
is
in
conflict
with
the
term
anesthesiologist
clearly
defined
by
the
general
assembly
for
many
years
in
the
tennessee
code
and
has
thus
created
a
conflict
in
the
law
house.
Bill
1350,
seeks
to
address
and
remedy
this
conflict.
N
The
bill
does
not
in
any
way
restrict
the
practice
of
dentistry
or
the
ability
of
the
board
of
dentistry
to
issue
permits
for
dentists,
administering
anesthesia
and
dental
offices
in
the
healthcare
setting.
The
term
anesthesiologist
has
a
specific
meeting.
A
physician
who
has
successfully
completed
the
education
and
training
needed
to
specialize
in
the
entire
field
of
anesthesiology.
N
In
addition
to
providing
care
for
patients
undergoing
anesthesia,
anesthesiology
encompasses
the
entire
science
and
medicine
related
to
the
clinical
basis
of
anesthesia
care,
resuscitation
critical
care
and
the
management
of
acute
and
chronic
pain.
Anesthesiologists
are
the
undisputed
experts
in
perioperative
medicine,
not
just
the
administration
of
anesthesia
during
surgery
to
become
an
anesthesiologist.
An
individual
must
first
obtain
a
bachelor's
degree
for
which
they
must,
which
must
include
a
year
biology
physics,
general
chemistry
and
organic
chemistry.
N
N
There's
a
total
of
12
years
of
education
and
16
000
hours
eligible
to
become
eligible
for
written
boards,
they're
accredited
by
the
american
board
of
anesthesiology,
which
is
the
standard
for
admission
to
a
medical
staff
in
a
hospital
in
comparing
pearson.
The
education
and
training
of
physicians
and
dentists,
they're,
similar
in
respects
of
undergraduate
education,
but
dental
school
curriculums
and
medical
school
curriculums
are
very
different.
A
F
F
So
that's
that's
already
there,
and
so
when
you
say
the
word
anesthesiologist,
it
is
a
medical
doctor.
It's
in
the
medical
practice
is
that
correct,
correct,
and
so
it
is
someone
that
has
gone
to
college
they've
gone
to
medical
school
and
then
they
have
completed
their
anesthesiology
residency,
correct,
correct,
and
so,
when
you
put
a
qualifier,
if
you
use
the
term
anesthesiologist,
that's
what
that
means.
When
you
put
a
qualifier
on
front
of
that,
that
means
more
training,
correct,
correct.
F
So
the
board
of
anesthesia
and
american
side
of
anesthesiologist
recognizes
several
fellowships
obstetric
anesthesiologist
pediatric
anesthesiologist.
I
cannot
find
anywhere
where
the
asa
recognizes
in
the
united
states
or
canada,
where
there's
a
program
where
they
recognize
a
dental
anesthesiologist.
N
The
there
has
been
a
reference
in
one
one
publication
that
where
they
referenced
the
american
society
of
dental
anesthesiology,
but
those
programs
are
not
part,
are
not
considered
in
terms
of
qualifications
for
anesthesia
training
in
a
hospital
or
in
a
in
a
hospital,
certainly
in
tennessee,
because
they
must
be
board
certified
by
the
american
board
of
medical
specialties.
Okay,.
N
Excuse
me,
but
when
you
use
a
modifier,
that
implies
that
the
the
physician
has
had
additional
training
like
a
fellowship.
Dental
anesthesiologist
in
tennessee
is
defined
by
the
dental
board,
require
only
two
years
of
post
graduate
training
after
their
dental
school.
So
there's
a
substantial
it's
the
only
modifier
that
that
implies
less
training
rather
than
more
training
all
right.
Thank
you.
B
So
just
for
the
record,
because
one
of
the
things
I
learned
as
being
a
ut
grad,
you
know
I'm
a
volunteer
because
I
graduated
from
the
university
of
tennessee,
but
I
also
volunteer
almost
daily,
whether
it's
at
my
church
and
other
things.
So
one
of
the
things
that
if
you
could
speak
to
your
the
purpose
of
this
bill,
is
to
limit
the
term
anesthesiologist
and
not
the
term
anesthesiology.
B
And
I
know
that's
a
a
very
vague
thing.
But
one
of
the
things
I've
heard
from
from
other
specialists
is
they're
concerned
about
putting
a
box
around
the
term
anesthesiology
the
study
of
anesthesia,
as
opposed
to
the
application
in
the
the
practice
use.
And
if
that's
something
that
that
we
need
to
get
legal
to
expand
on
happy
to
do
that.
But
thank
you,
dr
young.
N
Now
that
this
this
bill
specifically
refers
to
the
individual
calling
themselves
an
anesthesiologist,
and
if
I
can,
the
the
dental
board
issues
permits
for
anesthesia
care
in
a
dental
office,
they
require
one
year
of
additional
training
after
dental
school
to
perform
general
anesthesia
in
an
office.
What
the
dental
board
voted
for
was
to
recognize
dental
anti-anesthesiologists,
which
require
two
years
of
postgraduate
training.
N
Now
a
dentist
may
also
employ
an
anesthesiologist
from
a
hospital
with
much
more
training
also
to
work
in
an
office.
So
you
can
see
how
patients
might
confuse
the
two,
because
there
could
be
two
different
people
referred
to
as
anesthesiologists
even
working
the
same
office
with
vastly
different
levels
of
experience.
F
L
Thank
you,
mr
chairman,
and
I
and
appreciate
you
coming
to
to
testify
today.
You
know
as
I
as
I
listen
to
this
and
I
think
of
the
word
anesthesiologist
and
and
that
right
now
the
the
dental
anesthesiologist
are
recognized.
I
I
kind
of,
in
my
opinion,
the
the
the
adding
the
word
dental
to
it
should
be
distinction
enough.
I
mean
I
I
don't
in
my
opinion,
I'm
not
sure
that
somebody's
gonna
get
confused
between
the
two.
L
I
would
never
have
a
surgery
and
ask
a
dental
anesthesiologist
to
come,
perform
that
you
know
the
anesthesia
for
it,
and
so
I'm
just
there's
a
lot
of
words
out
there.
Just
like
chairman
vaughn
mentioned
the
word
engineer
I
mean
it
has
many
different
applications
and
even
the
word
doctor
can
be
used
in
many
different
settings.
But
you
know
I've
never
confused
someone
a
doctor
of
education
with
someone
who
is
a
physician.
Who
is
what
most
people
refer
to
when
they
when
they
use
the
word
doctor?
L
N
E
A
Thank
you
further
comments
or
questions
of
ours,
dr
young,
if
none
thank
you,
dr
young,
thank
you,
mr
chairman,
and
I'm
told
that
we're
gonna
be
so
short
on
time
that
we're
probably
going
to
have
to
adjourn.
We
have
at
least
four
other
folks
to
give
testimony.
I'm
very
sorry,
I
know
some
of
you
have
come
a
distance
and
made
plans
for
this.