Congratulations to the many groups and individuals who worked to defeat Nevada’s assisted suicide bill SB 165. SB 165 passed in the Nevada Senate Health and Human Services Committee (3 – 2) on March 25.
A few days ago, a well researched article by Dr Kirk Bronander, a professor of medicine at the University of Nevada, Reno School of Medicine and director of academic hospitalists for UNR Med., titled: Physician assisted suicide a flawed process was published in the Reno Gazette.
In his article Dr. Bronander first challenged the concept of a six month prognosis. He wrote:
The fact is that physicians frequently make errors with diagnosis and predicting timing of death in terminal conditions. My family has personal experience with this: My father was diagnosed with a malignant brain cancer (glioblastoma) and given a prognosis of less than six months to live. He survived for almost four years after his diagnosis. This is also well-documented in the medical literature: A study of hospice patients in the Chicago area showed that of 468 predictions of timing of death, only 20 percent were accurate. Inaccurate diagnoses or prognoses coupled with PAS will result in patients dying that may have years of life remaining.
Dr. Bronander then questioned the ability to regulate the lethal assisted suicide prescriptions. He wrote:
I trust many of my colleagues but there are always going to be some physicians that are unscrupulous, incompetent or unethical. That means this type of law can easily be abused. In Reno, Dr. Robert Rand contributed to the death at least one patient by overprescribing opioids. He did this for years even though opioids are the most highly regulated medications we can prescribe. The lethal drugs used for suicide will be much less scrutinized since there is no requirement for the federal government to monitor them. The law itself will protect the identity of the prescribing doctor, so no one will ever be able to determine if abuse is occurring. Do you trust every physician in Nevada?
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Dr. Bronander then examines the effect legalizing assisted suicide has on the elderly and people who become depressed. He wrote:
Unfortunately, many elderly and terminal patients feel they are a burden to loved ones and this law will encourage suicide as an answer. The statistics from Oregon in 2017 (which has a similar law to the one proposed in Nevada) are clear that the reasons stated for obtaining the lethal prescription are for reasons other than pain. “Losing autonomy” is No. 1 and “burden on family, friends/caregivers” is a more frequent reason than “inadequate pain control,” which is sixth on the list.
Many patients diagnosed with a terminal condition are depressed and there is no requirement to refer to psychiatry or counseling in the law. The Oregon statistics show that only 3.8 percent of patients receiving lethal drugs were referred for psychiatric evaluation while a 2008 study conducted in Oregon found 25 percent of patients requesting assisted suicide were clinically depressed. Depression is a treatable condition; obviously a completed suicide is not treatable.
Thankfully, Nevada’s assisted suicide bill is dead in 2019. Sadly, the assisted suicide lobby will likely introduce another bill in 2020. Hopefully Dr Bronander’s research will help Nevada, and other states, defeat future assisted suicide bills.
The NCET named Dr Kirk Bronander educator of the year in 2018.
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Author: Alex Schadenberg