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Lawmakers again take up bill to allow doctors to prescribe life-ending drugs to terminally ill patients

Megan Messerly
Megan Messerly
Health CareLegislature
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Scanned images as seen in the imaging room during a ribbon cutting event at Dignity Health West Flamingo Campus, 9892 W. Flamingo Road, on Thursday, Aug. 10, 2017.

A deeply divisive bill that would allow terminally ill patients to take life-ending drugs as prescribed by their doctors resurfaced in the Legislature on Monday after facing opposition from Republicans and Democrats when it was proposed two years ago.

The legislation, which was heard in the Senate Health and Human Services Committee during an emotional three-hour hearing on Monday, would allow patients diagnosed with a condition that cannot be cured and will result in death within six months to self-administer a controlled substance as prescribed by a physician to end his or her life. To be eligible, the patient would have to be at least 18, competent, a Nevada resident, diagnosed with a terminal condition by two physicians and voluntarily affirm that no one is coercing him or her in making the decision.

Similar legislation divided Republicans and Democrats last session when it passed 11-10 in the Senate. Democrats largely supported the measure, as did Republican Sen. Pete Goicoechea and nonpartisan Sen. Patricia Farley, while most Republicans were in opposition, along with Democratic Sens. Aaron Ford and Mo Denis.

The bill never made it to a final vote in 2017 after it died in an Assembly committee, but former Gov. Brian Sandoval would have been unlikely to sign the measure into law because he opposes the policy. A spokeswoman for Gov. Steve Sisolak did not answer a question about whether the governor would sign a physician-aid-in-dying bill into law.

“As is the case with all other bills going through the legislative process, the governor looks forward to reviewing this legislation,” Sisolak spokeswoman Helen Kalla said in an email.

Under Nevada law, terminally ill patients are only allowed to refuse treatment to keep them alive or resuscitate them but not to actively take a drug to end their lives.

To date, six states and the District of Columbia have passed similar physician-aid-in-dying laws, including California, Colorado, Hawaii, Oregon, Vermont and Washington. Supporters often refer to such laws as “death with dignity,” while opponents characterize them as “physician-assisted suicide.”

A poll taken by the left-leaning Public Policy Polling firm in 2017 found that 72 percent of the 602 Nevadans sampled support legislation that would “allow a terminally ill adult patient to obtain a physician's prescription for medication to end his or her life, voluntarily and with informed choice.”

The legislation, SB165, specifically affirms the right of terminally ill patients “who have suffered prolonged and unbearable pain as well as the loss of physical control at the end of their lives” to a “peaceful and dignified death.” Supporters of the measure, including state Sen. David Parks who introduced the legislation, argued during the hearing that it would give agency to patients suffering from a terminal disease to end their lives on their terms.

“I have been asked by people from all across Nevada in many different legislative districts to pass this legislation,” Parks said. “Some are cancer patients who want to have the peace of mind knowing they can control their final days. Others are Nevadans who are healthy now but want to know if they are diagnosed with a terminal illness and after exploring all traditional options they will have a legal safe and peaceful option to them available to them to control the end of their life on their own terms.”

Advocate Dan Diaz, whose wife Brittany Maynard attracted national attention after she moved to Oregon to take advantage of the state’s physician-aid-in-dying law when she was diagnosed with terminal brain cancer, told lawmakers on the committee that it is not a “right to life or a right to choose situation” for terminally ill patients.

“Brittany’s option is only between two different methods of dying,” said Diaz, who now travels around the country pushing for other states to enact laws like Oregon’s. “One would be gentle. The other would be filled with unrelenting pain.”

During the hearing, supporters argued that the bill would just create one additional option for terminally ill patients by establishing best practice guidelines with appropriate safeguards. No physician would be required to participate in the process of ending his or her patient’s life under the legislation.

Under the legislation, the cause of death of a patient who chooses to self-administer a life-ending drug would be listed as the terminal condition with which he or she was diagnosed, something that supporters argue is accurate because the patient wouldn’t be asking for drugs from a physician if not for his or her terminal condition. But opponents argue that the act of someone taking his or her life should be ruled a suicide, no matter the circumstances.

Opponents of the bill also argued that the legislation doesn’t protect grieving patients who may not be of sound mind after receiving a terminal diagnosis to make a decision to end their lives and could allow relatives to take advantage of their dying family members. They also expressed concerns that it puts too much power in the hands of doctors and creates perverse incentives for insurance companies to encourage patients to choose death over costly, ongoing treatment.

“I’m the guy that had the two cases where the insurance companies told me by telephone that they would not accept the transfer of my two patients to California and Oregon, respectively, but, ‘By the way have you talked to them about assisted suicide?’” Dr. Brian Callister told lawmakers. “This is not about freedom and choice and autonomy.”

Kristen Hanson, an advocate with the Patients Rights Action Fund opposing the legislation, said that she was there testifying on behalf of her husband, J.J., who was diagnosed with glioblastoma, the most aggressive form of brain cancer. She said that three different doctors told them that he had four months left to live, but they didn’t listen.

“J.J. had great success with treatment … During that time our son created priceless memories with him,” said Hanson, who added that if the measure had been law at the time her husband could’ve had the legal drugs on his nightstand.

“If he had suicide pills, he said that he might have taken them,” Hanson said.

The Nevada State Medical Association testified as neutral on the legislation because the American Medical Association believes that physician-aid-in-dying proposals conflict with medical ethics.

“Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer,” O’Mara said, reading from the AMA’s code of medical ethics opinion.

Lawmakers did not take any immediate action on the bill on Monday, and a vote on whether to advance it to the full Senate will be held at a later date.

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