Deciding the end

The notion of people being able to control the circumstances of their own deaths has been an incremental process in Nevada.

In 1977 the Nevada Legislature enacted Assembly Bill 8, sponsored by Assemblymember Steve Coulter of Washoe County. It permitted the voluntary end to life-sustaining procedures for people who are terminally ill.

in 1997, Coulter’s “living will” law was supplemented by AB 29, sponsored by Assm. Gene Segerblom of Clark County. It allowed patients to direct that they not be revived from cardiac or respiratory arrest and prohibited interference with the patient’s directive. It further gave legal protection to those who carried out the patient’s wishes.

In 2019, there is new legislation—Senate Bill 165, sponsored by Sen. David Parks of Clark County, which makes physician-assisted suicide legal for terminally ill patients.

At the legislature, Hanna Olivas of Las Vegas described living with multiple myeloma—incurable cancer of the blood—and breast cancer.

“When our Lord calls me, I do not want to be connected to machines, catheters and tubes that will cause more pain in my spine, bones, body, nausea and vomiting that only debilitate my relatively young, 44-year-old body,” she said in a prepared statement. “I want to die peacefully, surrounded by my husband and our two sons, two daughters and precious grandchildren holding my hand in prayer. The last words I want to hear are ’We love you, mom. We love you grandma.’”

In direct contrast, Kristen Hanson last month said in testimony before the Senate Health and Human Services Committee that her husband J.J. was alive past his medical prognosis by three years. He spent some of those years working against physician-assisted suicide for others, writing in a 2006 term paper, “I can’t help but think about if I had the choice to request assisted suicide drugs, and if I had used those drugs during those difficult moments, I would have lost the opportunity to make memories with my wife and son. Assisted suicide is a decision that you can’t unmake. My wife would be without a husband and my son without a father.”

In Oregon, where assisted suicide was enacted by public vote in 1997, the law works like the Parks bill, allowing citizens to obtain from physicians prescriptions for self-administered, lethal doses of medications. After 18 years of experience with the new statute, a 2015 opinion survey was commissioned by the Oregon Public Health Division.

Of those surveyed, some had multiple reasons for using the option. The leading reason was “Losing autonomy” which was given by 91.6 percent, followed by “Less able to engage in activities making life enjoyable,” which drew 89.7 percent, and then “Loss of dignity” at 98 percent. Not until fourth place at 48.2 percent, was a medical reason given—“loss of bodily functions.”

One finding was that not everyone who chose the option may have followed through with using it, according to the report: “Since the law was passed in 1997, a total of 1,545 people have had prescriptions written under the [law], and 991 patients have died from ingesting the medications.” Some may just not have been reported back, but some may have decided not to use the medications.

Respect

Dolores Huerta and Cesar Chavez started the United Farm Workers union. She was standing next to Robert Kennedy when he made his final speech and followed him into the kitchen. She is now working to enact assisted suicide laws in four state legislatures—New Mexico, Nevada, New Jersey and New York—because of her experiences with a dying husband and a dying mother.

“And I thought about this issue for a long time, being a Catholic,” she said. “My mother went through a lot of suffering. She had cancer. A doctor said she had six months to live. She ended up having six weeks to live. But those six weeks were just a horrible, horrible thing for her and her family. Just seeing her suffer the way that she did. … I think it is something that no individual that is terminally ill should have to go through.”

Though the measure has passed the Senate and is believed likely to pass the Assembly, the kind of dramatic testimony heard in Carson City makes for very uncomfortable choices by state legislators. On some issues there is room for compromise or understanding by one side of the other. Those things are harder to come by on this issue. In a West Wing episode, the choice faced by legislators was laid out starkly by scriptwriter Deborah Cahn: “You know how this thing polls? Forty-eight percent of Americans consider it a right. Forty-six percent of Americans consider it morally reprehensible. It is the definition of a lose-lose issue.”

Still, while there has been good attendance at hearings on the bill, it has been in the dozens, by contrast with gun background checks, which drew hundreds. Because of restraint by the players, S.B. 165 has not been a divisive issue. The two sides have tried to stay away from the overheated rhetoric that has been heard on other issues. On this issue, at least, there is the kind of mutual respect that once was common in politics. One news release sent out from an Alexandria, Virginia, public relations firm for opponents of the measure, notifying reporters of a news conference in Carson City, contained no strong language, merely a reference to “the dangers of assisted suicide.”

Huerta’s multi-state tour of legislatures is called an “End of Life Options FOR ALL” education tour. But the Parks bill does not make suicide legal in all situations. There must be a medical finding of terminal illness. That still leaves those seniors who are alone and lonely, miserable at the ends of their lives when they outlive all relatives and friends. Controlling the circumstances of death is still an incremental process.