COMMENTARY: God-like powers

Nevada’s hearing on Assembly Bill 346, which allows doctors and advance practice nurses to prescribe lethal drugs to terminally ill patients, was frustratingly biased compared to similar hearings in other states. The Legislature’s Special Committee on End-of-Life Care is stacked with those who support the proposal, and the time alloted for favorable statements was nearly triple that provided to opposing ones.

In addition, the bill summary was more pro-propaganda than factual, and extended favorable “expert” testimony was not countered by an opposition expert. All proponents testified, but more than 30 opponents, including me, were not given the chance.

There are other problems. The 15-day waiting period under AB346 period is waivable if one practitioner, without needing end-of-life expertise or second opinion, states death is near — an egregious provision, as cognition and swallowing ability are usually compromised near death.

Complaints about excessive pain or symptoms should never be a reason to seek lethal drugs. This indicates inadequate palliative care proficiency. An “expert” proponent described prescribing lethal drugs for patients with nerve pain unresponsive to morphine. However, other remedies, not morphine, are effective for nerve pain. Assisted suicide should never be a solution for deficient practitioner knowledge. Patients in significant pain lack capacity to consent for lethal drugs, highlighting informed consent violations with this process.

Nevada’s palliative care is likely insufficient to meet state needs. Those in disadvantaged communities may encounter barriers to receiving palliative care. This bill would be disastrous for underserved populations if lethal prescriptions became more accessible than palliative care.

This bill gives new choices and power to health practitioners, not patients, by allowing them to subjectively place those wishing to hasten death into either a protected group given standard mental health treatment or a marginalized group with terminal illness who can be abandoned to lethal drugs. This discriminates against the disabled and undermines autonomy by violating the equality of persons.

In 2023, an Oregon patient named Cody voluntarily stopped eating and drinking to commit suicide because of dementia. A doctor said dehydration would cause her death shortly, waived the waiting period and prescribed lethal drugs which Cody ingested. Dehydration is not “incurable” or “irreversible,” as legally required. How many others with non-terminal diagnoses have used this “bridge” to lethal prescriptions? No sanctions for wrongly prescribed lethal drugs have been reported, as health departments have no investigative or enforcement authority.

Doctors must falsify the death certificate, naming the underlying disease, not lethal drugs, as the cause of death. It is incredulous when, like Cody, patients have no terminal disease. What cause is listed?

Health-care practitioners, in whom vulnerable patients must be able to trust, should never be granted god-like powers to decide which disabilities make life worthless and then assist with termination of those so judged.

Kill AB346, not Nevadans.

Dr. Sharon Quick is president of Physicians for Compassionate Care Education Foundation, an organization without religious or political affiliation that advocates for the vulnerable at end of life. She is retired from pediatric anesthesia and critical care and testifies on end-of-life legislation in numerous states.