Source: Reno Gazette-Journal
By Dr. Kirk Bronander
In the past 20 years, more than 175 state campaigns to legalize assisted suicide have been introduced. Most have failed and continue to fail, even in some of the most progressive states across the country. As a physician, I see assisted suicide as an unnecessary policy that harms rather than helps patients.
Due to a lobbying effort from an organization funded in large part by an out-of-state organization, Nevada legislators are being asked to consider the complex issue of assisted suicide, sometimes referred to as “aid in dying.” Regardless of the term used – physician aid in dying, end of life choices, assisted suicide – the proposed law being debated in Nevada results in allowing a doctor to prescribe a lethal overdose to a requesting patient; the patient takes those drugs with the intention of killing themselves, which is the very definition of suicide.
I am a board certified internal medicine physician and hospitalist, practicing medicine for well over 15 years. Me and many of my colleagues have been on the front-lines of life and death with our patients and their families, and have a unique perspective about how this proposal disrupts the practice of medicine.
Opposition to assisted suicide is broad-based and doesn’t just come from the medical or religious communities. Many of those opposed to assisted suicide include organizations representing people with disabilities and those with a more liberal or progressive viewpoint; if assisted suicide is legalized, for-profit health care and insurance companies will see it as an inexpensive alternative to providing services to those whose treatment is most expensive.
This fear is more than hypothetical: cases in Oregon have surfaced showing the Oregon Health Plan refusing to pay for more expensive potentially life-extending cancer treatments, but offered to pay for assisted suicide for cancer patients – who wanted the treatment, not assisted suicide. In California, one young mother with a terminal illness was denied certain treatment medication prescribed by her doctor. The coverage provider would however cover assisted suicide for a $1.25 copay.
First, let me note that doctor-prescribed suicide has nothing to do with someone choosing to discontinue treatment, being “hooked up to machines,” staying on life support. Assisted suicide is something distinctly different, and the bill being considered by the Nevada Legislature does not require any type of evaluation by a psychological or psychiatric professional screening for depression or mental illness, nor does it require that a member of the patient’s family be notified.
Every day doctors see patients that worry about being a burden, who struggle through a complex healthcare bureaucracy and face the deep-throes of chronic depression due to their illness. When we consider dramatic shifts in policy, like Nevada sanctioning doctors to prescribe lethal overdoses to patients, we can’t just look at examples of those people who have had access and means to the best care and support; we also need to consider the thousands of Nevadans that struggle for care, a question that is even less clear given the national debate surrounding healthcare coverage.
As a Reno doctor working with patients from all backgrounds, I witness these struggles each day. That experience only reinforces my belief that assisted suicide sends an implicit negative message to patients facing tremendously difficult circumstances, but it also is a dangerously dramatic change in public policy, particularly in a state as diverse ethnically and economically as ours. In Nevada, let’s continue to work for excellent, compassionate end of life care, and not allow lethal prescriptions and physician assisted suicide into our state.
Kirk Bronander is a physician and associate professor of medicine at the University of Nevada, Reno School of Medicine.
The views expressed by this author are his own and do not necessarily reflect the views or positions of the University of Nevada or the University of Nevada, Reno School of Medicine