Partnering with People of Nevada on Proposed Patient Self-Determination Act

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We are proud to support Nevada Senators David Parks (D-Las Vegas) and Ben Kieckhefer (R-Carson City, Washoe) and the people of Nevada in proposing a Death with Dignity law to provide a peaceful and dignified death for those suffering from terminal illnesses. Senate Bill 336, the Nevada Patient Self-Determination Act, says that, in certain narrow circumstances, mentally competent terminally ill adults who are within the final six months of their lives will be allowed to peacefully end their lives. The Act provides strict safeguards, protects against coercion, and allows eligible terminally ill patients to spend their final days and moments at peace, surrounded by their family members and loved ones.

The Oregon Experience

“Twenty years ago last November, Oregon voters were the first to approve the Death with Dignity law after which the proposed Nevada legislation is modeled. The Oregon Death with Dignity Act has been implemented carefully and has helped to spur a national conversation about end-of-life care that will continue this year in Carson City,” said Peg Sandeen, Executive Director of the Death With Dignity National Center. “Our model legislation has been passed in Washington and Vermont, and those states are seeing the same careful implementation controlled by patients seeking to end their lives peacefully. This law has worked exactly as intended everywhere it has been adopted.”

The numerous safeguards in this law have worked well in Oregon for 18 years, in Washington for 7, and in Vermont for two. There have been no reports of coercion, failure, or misdeeds in any of these states. Far more people ask their doctor about the law than actually use it, but many find comfort knowing the law is available if their symptoms cannot be controlled. The legislation proposed by Senators Parks and Kieckhefer, together with their co-sponsors, provides peace of mind and control for the terminally ill while safeguarding against coercion for those who are vulnerable.

The Time Is Right for Nevada

“The Death with Dignity National Center is pleased to have assisted in drafting the proposed Nevada Patient Self-Determination Act. We will assist the Nevada efforts by providing our full political and strategic expertise from the successful campaigns in Oregon, Washington, and Vermont,” said Sandeen. “The time is right for Nevada to adopt this law. The Silver State has long been a leader in protecting individual rights, and it is thanks to this leadership that we are proud to join these efforts today.”

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Allow Doctors to Support Patient Wishes

Why should anyone—the state, the medical profession, or anyone else—presume to tell someone else how much suffering they must endure while dying? Doctors should stand with their patients, not against them.

- Dr. Marcia Angell

This statement gets right to the heart of the matter, doesn’t it? People deserve more options at the end of their lives and doctors should be allowed to help their patients get the end-of-life care they want.

Dr. Angell is former editor of the New England Journal of Medicine and a senior lecturer at Harvard Medical School. Her quote is from a guest article published in the Health & Wellness section of the Boston Globe. Throughout her life, Dr. Angell has had extensive professional and personal experiences with difficult end-of-life care decisions. These experiences have shaped why she supports safe and legal assisted dying through Death with Dignity laws.

From time to time, she encounters medical colleagues who disagree with her positing, “a doctor’s role is only as a healer.” In the article, she addresses this concern:

When death is imminent and dying patients find their suffering unbearable, then the physician’s role should shift from healing to relieving suffering in accord with the patient’s wishes. This is not a matter of life versus death, but about the manner of dying, and it’s not primarily about doctors, but about patients.

Another common claim Dr. Angell has encountered is, “Good palliative care can relieve all suffering, so permitting assisted dying is unnecessary.” She counters with several facts:

Probably most dying patients, even when suffering greatly, would choose to live as long as possible. That courage and grace should be protected and honored, and we should put every effort into treating their symptoms. (Palliative care in Oregon is among the best in the country.) But not all suffering can be relieved. Most pain can, but other symptoms can be harder to deal with—symptoms such as weakness, loss of control of bodily functions, shortness of breath, and nausea—and the drugs to treat them often produce side effects that are as debilitating as the problems they treat. Even worse for many patients is the existential suffering. They know that their condition will grow worse day after day until their deaths, that their course is inexorably downhill, and they find it meaningless to soldier on.

This echoes how Dr. Kate Morris explained the Hippocratic Oath in one of her interviews in the documentary How to Die in Oregon:

“First do no harm” is going to be different for every patient. Harm for some patients is saying, “No, no, no. You’ve got to do this the way your body decides as opposed to the way you decide.”

Death with Dignity laws are about giving patients more options for their end-of-life care. As Dr. Angell explains, “No physician is required to participate in assisted dying; he or she may refuse for any reason whatsoever. This is a choice, not a requirement, for both patients and physicians.”

The entire process is voluntary for all involved—patients, physicians, and pharmacists. Truly, why would anyone feel it’s their place to deny a dying person as many options as possible? Whose life is it anyway?

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