The former head of the Nevada State Medical Association is fighting legislation to legalize assisted suicide because it creates "perverse incentives" for insurance companies.
Dr. Brian Callister, an associate professor at the University of Nevada-Reno School of Medicine, said that he decided to speak out on the issue after reaching out to insurance companies in California and Oregon to transfer two patients to other hospitals in order to receive life-saving treatment. The episode is now the focus of a campaign ad issued by opponents of assisted suicide.
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"The insurance medical directors I spoke with said they would not cover the life-saving procedure that we'd requested. But, hey, by the way, have you considered assisted suicide?" Callister says in the ad. "It's a lot cheaper to grab a couple drugs and kill you, than it is to provide you life-sustaining therapy."
Callister told the Washington Free Beacon that he feared those same situations could arise if Nevada passes the legislation. He also said that the medical industry has already made great strides in pain treatment and hospice care that rebut bill supporter's argument that assisted suicide is needed to alleviate suffering.
"We have the physicians, the medicines, and the skills to keep people comfortable in palliative care and hospice," he said in an interview. "Assisted suicide changes the way we care for patients. It creates a dangerous segue to perverse incentives for insurance companies and there's no going back from that."
The ad was released by the Patients Rights Action Fund. Marine Corps veteran J.J. Hanson founded the group after overcoming a terminal brain cancer diagnosis in 2014—and witnessing the media coverage of Brittany Maynard, including a shining profile in People. Maynard received the same diagnosis as Hanson, but opted to commit suicide in Oregon. He was angered by the disparate messages he received as a veteran and cancer patient.
"If a patient with a catastrophic injury at Walter Reed expressed a suicidal thought they would be getting robust treatment and help. You would never see the government offer assisted suicide as an option," he said. "A large number of states are putting forward different ways to fight veteran suicides and at the same time are debating assisted suicide for people like me."
Six states and the District of Columbia allow physicians to prescribe lethal medication to terminally ill patients. Bills to legalize assisted suicide are being debated in 14 states, while 15 others, from liberal Connecticut to conservative Utah, have already defeated legislation in 2017. Nevada became the centerpiece of the debate over the practice after the Senate passed assisted suicide by one vote in May. The bill is now up for debate in the state Assembly and is attracting partisans on both sides of the debate.
Kat West, the national director of policy and programs at Compassion & Choices, testified on behalf of the bill before the Nevada Assembly Committee on Health and Human Services on May 29. West gave up her career as a lawyer to join Compassion & Choices after witnessing her mother's painful death from cancer on May 30, 2010. She sees the debate as one of choice and autonomy, which is why she prefers the term "aid in dying" to assisted suicide.
"There's always been people that don’t want to choose medical aid in dying for themselves. That's their right, but they shouldn't push their views on other people," she says. "We want a full range of options."
West said she is skeptical of Dr. Callister's claim in the ad.
"There is absolutely no evidence that insurance companies are doing what Dr. Callister alleges," she said. "If we are all evidence-based [in the debate], let's just have an informed discussion. Let's not make baseless accusations."
Callister said that revealing the identities of the insurance companies could potentially violate the Health Insurance Portability and Accountability Act (HIPAA), a federal law that protects the privacy of patients. An attorney consulted on the ad confirmed that she advised Callister not to name the companies because of the other identifying comments made in the ad.
"Given the circumstances in this case, including the physician's specialty and the health care treatment at issue, we determined that the identification of a patient's insurance plan could potentially be used to identify a patient. In an effort to fully protect patient confidentiality, we advised our client not to disclose the health plan(s)," Terra Lord Parten, an attorney at McAfee & Taft, said in a statement.
Hanson, the founder of the Patients Rights Action Fund, is fighting more than just the Nevada bill. He discovered in October 2016 that his cancer had returned. In November, doctors told his wife Kristen that she was pregnant with the couple's second child. She is due on August 3. He has received aggressive treatment to combat the disease, which at one point left him unable to read or speak.
"I am passionate about this. Every day I'm talking to people because the other side, they have been at this for 20 years—we have a lot of work to do," he said.