In emotional testimony at the Nevada Legislature, advocates and opponents spoke out regarding the End of Life Options Act (SB239), the state’s most recent iteration to legalize medical aid in dying. State Sen. Edgar Flores (D) sponsored the bill along with 18 other legislators.
Similar legislation has been brought forth each session since 2017, but has typically failed after passing out of committee. But patients with terminal prognoses are pleading with state lawmakers, saying that they can’t wait another session for this to become law.
On March 14, SB239 had a hearing in the Senate Health and Human Services committee. Hanna Olivas, a Las Vegas woman diagnosed with a rare cancer called multiple myeloma, testified in support.
“I'm a mother of five children ages 10 to 30. And this is a conversation that I've had with my entire family since diagnosis and the incurable disease that I have,” she said. “I was told five years tops. I surpassed that. But I can truly tell you that I have watched several other people with similar diseases to mine utilize the bill in other states.”
Olivas was joined by another mother of four from Las Vegas, Lynda Brooks-Bracey. Brooks-Bracey, 57, was diagnosed with metastatic pancreatic cancer and has been told she only has months to live.
“I prefer not to die at this particular time. But unfortunately, even though I consider my age quite young, my diagnosis says differently,” she testified. “This bill may not become law in time for me, but I believe it should become law for those in need. And there are many people in Nevada in need right now.”
According to Compassion and Choices, an advocacy group for this legislation, more than one in five Americans (22%) live in a jurisdiction that allows medical aid in dying.
Ten other states plus Washington, DC have already authorized the practice. They include California, Colorado, Hawaii, Maine, Montana, New Mexico, New Jersey, Oregon, Vermont, and Washington.
Polling from 2021 also indicated about three-quarters of Nevadans supported the policy, according to Public Policy Polling. Details of SB239 via Compassion and Choices can be viewed here.
Regardless, several testified in Carson City against the proposal, including one internal medicine physician.
“Their proponents always argued that it works in other states. One of the major flaws is that we don't know how it's working because healthcare privacy laws prevent us from questioning anything,” he said.
Opponents also argued a terminal prognosis can be subjective and likened it to “assisted suicide.” Supporters of the bill said that phrasing is offensive.
“I don't even want to say that word because that word is offensive to people like Linda Brooks-Bracey, and like Hanna Olivas and other terminally ill Nevadans,” said Patricia G. Portillo, communications director for Compassion and Choices Nevada. “They don't want to die. They want to live and this illness is ending their life. They just want to die without the suffering that the illness will take them to.”
SB239 outlines that only adults with a terminal prognosis of six months or less and who are mentally capable may request a prescription from their physician to end their life on their terms, as supporters put it.
Dr. Johanna Koch is the medical director of Summit View Hospice in Reno. She practices medicine in both California and Nevada, meaning she can prescribe the medication to aid dying in one state, but not the other.
“I just think it is the single most reassuring piece of news we can give a patient on our hospice service is to let them know they have this option,” said Dr. Koch. “Most patients don't actually follow through on it, but knowing that it's there gives them so much peace of mind.”
She explained how the process works, stressing physicians can’t actually administer the drug and aren’t allowed to. It must all be done by the patient themselves.
It comes as a powder that’s mixed with two ounces of water and it doesn’t taste good, Dr. Koch said. The physician usually recommends about an ounce of popsicle or sorbet both before and after the mixture to cool the mouth. The patient is typically asleep in three to five minutes and deceased within two to three hours, she said.
“I don't administer it, no physician is allowed to administer it, a patient is required to first of all request it on their own without anybody pressuring them,” Dr. Koch said. “And in order to assure that that is the case, we actually have to isolate the patient alone, nobody else in the room and clarify with them that this is their goal, not somebody else's. And then they have to be able to physically ingest the medication by themselves. Nobody can help them, that would be inappropriate and create conflict.”
In all her years in hospice, Dr. Koch estimated she’s cared for approximately 3000 patients and has prescribed medical aid in dying for less than 30, she said. And of that less than 30, she said only about 20 have taken it.
SB239 is next scheduled for a work session with the Senate Health and Human Services committee on April 4.