Noel Tiano, Th. D., on restoring one’s faith in politics

Democracy is Not a Spectator Sport

“M-M-Madam Chair… (I can do this… I know I can do this… ), I wholeheartedly support the passage of A.B. 158....”

This past March 21st, I testified before the Health and Human Services Committee of the Nevada Legislature in support of A.B. 158, which creates the Advance Directive (AD) registry on the Secretary of State’s Web site. This provision was created to benefit Nevadans who want an electronic file of their directives. I explained that “it provides consumers and professionals faster and more accurate access to their healthcare wishes. This bill is strictly voluntary and it assures the registry’s safeguards and confidentiality.” (There, I did it!)

Others also spoke in favor of the bill, including a Lutheran pastor, a lawyer, community representatives, and university faculty. The U.S. Living Will Registry estimates that while 75 percent of Americans are in favor of ADs, and between 25 to 30 percent have actually prepared such a directive, as many as 35 percent of the documents cannot be found when they are needed. As chaplains, we are familiar with end-of-life care dilemmas, particularly those brought upon by a lack of clear directives.

Early this year, our Center worked actively with an Assemblyman who sponsored A.B. 158, which initially enjoyed bipartisan support from over 30 legislators. With seven states already implementing their registries and existing private organizations, such as MedicAlert, Choices Bank, and DocuBank, the bill was supposed to be a “slam dunk” — no frills, no fuss legislation. Unfortunately, this was not the case. By mid-March we were bombarded with emails from right-to-life groups denouncing the bill. One charged that it would cause patients to die by dehydration and starvation. They proposed amendments, including changing the statute to regard artificial nutrition and hydration as “ordinary care” and not “life sustaining treatment.” In response we mobilized our statewide coalition with hospitals, hospices, clergy, educators, and lobbyists across Reno and Las Vegas to contact their legislators to support A.B. 158.

On March 21, the right-to-life groups came with their entourage and presented their arguments. Nevertheless, the hearing ended with an optimistic note, and by the following week the committee had approved it. However, for over two months, there was no committee action and we felt it desperately needed resuscitating. We later found out that the bill still had a pulse but the fiscal note of $500,000 was dropped. On Friday, June 1, the bill survived the Assembly with the vote split along party lines. Next stop was the Senate, which was very precarious because the Democrats and the Republicans numbered almost 50-50. On Saturday, our coalition made last-minute frantic calls. By 1 p.m. the bill passed the Health and Human Services Committee, and by 6 p.m. the whole Senate voted unanimously for it…with some seed money to boot! A couple of weeks later the Secretary of State visited me in my office to discuss the next steps, and on June 14, the Governor signed A.B. 158 into law.

To be sure, more work is needed to iron out the logistics, the educational campaign, and the financial needs of the project. For now I am just relishing in having taken a more active role in advocacy and health policy. I must say that this experience has restored my faith in the political process.

Do you have thoughts about advocacy you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.