Nevada's Bold Gambit: A Constitutional Fight for Medical Freedom and the Right to Hope

The Proposal on the Table

In a move that could fundamentally reshape the landscape of American healthcare, a political action committee named Freedom to Try Medical Innovation for Nevada has filed a proposed constitutional amendment. The core objective is audacious: to establish Nevada as a “safe haven” for potentially life-altering medical treatments that have not received approval from the U.S. Food and Drug Administration (FDA). This initiative is not conceived in a vacuum; it is a direct expansion of existing “Right to Try” legislation, which has been enacted in a majority of states, including Nevada in 2015 under former Governor Brian Sandoval, and at the federal level during the Trump administration. These laws were designed to grant terminally ill patients a legal pathway to seek experimental therapies when all conventional options have been exhausted.

However, the architect of this new proposal, Dan Montano, the founder and CEO of the Las Vegas-based biotech firm Zhittya Genesis Medicine, dismisses the current Right to Try framework as “completely worthless.” He argues that while the laws ostensibly grant a right, they leave in place a bureaucratic machinery—primarily the FDA—that effectively says “no.” Montano points to stark FDA data showing that between 2018 and 2022, fewer than two dozen investigational drugs were successfully made available to patients through the existing federal Right to Try pathway. This stark statistic underscores the immense chasm between legislative intent and practical reality.

The Mechanics of Freedom to Try

The proposed amendment is structurally significant and far more expansive than its predecessors. It explicitly establishes that all people in Nevada possess the right to make decisions regarding their own medical care and treatment, crucially removing the limitation to only those with a terminal diagnosis. This broadens the potential impact from a last-resort option for the dying to a proactive choice for a wider range of patients. To facilitate this, the amendment grants broad legal immunity in civil cases to medical providers and others involved with these experimental products, provided their studies have been approved by a state-licensed physician and an independent institutional review board (IRB). This provision is a double-edged sword, aiming to protect innovators from frivolous lawsuits while raising profound questions about patient recourse. Furthermore, the amendment would prohibit the state and local municipalities from imposing additional regulatory requirements on this nascent industry, effectively creating a deregulated zone for medical innovation within Nevada’s borders.

The path to enactment is deliberately challenging, reflecting the gravity of amending a state constitution. The Freedom to Try PAC must gather 148,788 signatures by June 24 to qualify for the November 2024 general election ballot. If voters approve it this year, the measure must return for a second vote in the 2028 general election. Only after securing a second mandate from the people would the amendment take effect. Montano has stated he is prepared to spend upwards of $2 million to see this through, highlighting his personal and financial commitment to the cause.

The Vision and The Critique

Dan Montano’s vision extends beyond Nevada’s borders. He sees this amendment as a powerful economic driver, attracting biotech and healthcare companies from across the globe to set up operations in a state where regulatory barriers are minimized. But his ultimate goal is even more transformative: to create a real-world laboratory where developing treatments can prove their effectiveness on a large scale. He hopes that undeniable success stories emerging from Nevada will force the FDA to reconsider its entire drug approval paradigm, which he describes as nearly impossible to overcome.

Montano cites a Tufts University study indicating that it takes roughly two decades and over $2.2 billion to shepherd a drug through the FDA’s approval process. “It is a sum that only big pharma—only big pharma—can come up with,” he argues, contending that this financial barrier effectively shelves countless “amazing breakthroughs” discovered in recent decades and prevents drugs approved in Europe and Asia from ever reaching American patients. He contrasts this with his experience as an investment banker, where tech startups could launch, innovate, and succeed in a fraction of the time, free from such paralyzing oversight.

A Principled Defense of Liberty and Life

From the perspective of unwavering support for individual liberty, the principles enshrined in the Bill of Rights, and a healthy skepticism of centralized power, the Nevada Freedom to Try initiative represents a profoundly important and morally justified rebellion. The core of this debate touches upon the most fundamental of American values: the right to self-determination. When faced with a terminal or debilitating illness, the decision to pursue an unproven treatment is arguably the most personal and desperate choice an individual can make. For a government agency to stand as the sole gatekeeper between a patient and a potential cure is an unacceptable infringement on personal autonomy. The preamble to the Constitution speaks of securing the “Blessings of Liberty,” and what greater blessing of liberty is there than the freedom to fight for one’s own life?

The current FDA system, while born from a noble intention to protect citizens from snake oil salesmen, has metastasized into a paternalistic leviathan that often prioritizes theoretical risk over tangible, imminent death. The Cato Institute research cited by Montano is a damning indictment of this status quo: it found that 12 times more people die waiting for a drug to be approved that later becomes available than die from drugs already on the market. This is not merely a statistic; it is a quiet, bureaucratic massacre. Each number represents a father, a mother, a child whose hope was extinguished not by disease alone, but by red tape. This is a tragedy that strikes at the very heart of a free society, where citizens are treated as capable adults, not as children who need to be protected from their own informed decisions.

The argument that this amendment carries risks is valid, but it is also a specious distraction from the greater, more certain risk of the current system: death by delay. As Montano aptly notes, “Freedom to do medical innovation has risk. But I will tell you this: Allowing gambling has risk, allowing alcohol has risk.” A free society is not a risk-free society. It is a society that trusts its citizens to weigh risks and rewards for themselves, guided by their physicians and their own moral compass. The proposed safeguards—approval by a licensed physician and an independent IRB—provide a critical ethical foundation, ensuring that this is not a descent into medical anarchy but a structured, accountable pathway for innovation.

The False Choice Between Safety and Freedom

Opponents will inevitably frame this as a choice between safety and freedom. This is a false dichotomy. The true choice is between a system that guarantees stagnation and a system that permits progress. The history of medicine is replete with examples of bold innovators like Jonas Salk, who, as Montano recalled, tested his polio vaccine on his own children—an act that would be unthinkable under today’s regulatory regime. Salk’s gamble saved countless lives and essentially eradicated a terrifying disease. How many future Salisks are being stifled by the FDA’s glacial pace and exorbitant costs? How many cures are languishing in laboratory notebooks because the path to market is financially insurmountable for all but the largest corporations?

Montano’s vision to dose 100,000 type-2 diabetes patients with his company’s treatment before the 2028 election is precisely the kind of ambitious, real-world evidence that could shatter the FDA’s cautious orthodoxy. If successful, it would not only provide a powerful rebuttal to critics but also demonstrate the incredible potential of freeing medical innovation from its bureaucratic shackles. This is not about abandoning safety; it is about redefining it to include the safety that comes from rapid access to life-saving treatments.

Conclusion: A Necessary Rebellion for Human Dignity

The Nevada Freedom to Try amendment is more than a ballot measure; it is a manifesto for medical liberty. It is a declaration that the right to try to save one’s own life is an inalienable right, not a privilege granted by a government agency. It aligns perfectly with the deeply ingrained American principles of federalism and experimentation, allowing a single state to serve as a laboratory of democracy where new ideas can be tested. While the risks must be acknowledged and managed through the stipulated ethical safeguards, the potential reward—the acceleration of cures, the restoration of hope, and the reaffirmation of individual sovereignty—is immeasurably greater. This is a courageous stand for human dignity against the cold, impersonal machinery of the administrative state. It is a fight worth having, and its success in Nevada could ignite a nationwide movement to restore medical freedom to the American people, where it rightfully belongs.