The New Mexico End-of-life Options Act, which the Legislature rejected in 2017 but has been considering again this year, is woefully misnamed.
Options will become fewer should this bill become law, because the only course of action it facilitates is death. The bill does nothing to expand access to lifesaving treatments or palliative care that relieves the pain and discomfort associated with serious illness. It won’t promote in-home support so that people can continue to live in their own homes regardless of increasing disability that often accompanies illness. This bill just authorizes health care providers to write lethal prescriptions for terminally ill people and grants broad legal immunity to everyone involved in their deaths.
The proposed bill would exist in a medical system where there already is enormous pressure to reduce costs. While corporate profits soar, many people struggle to obtain basic care. In addition, many practitioners still have “quality-of-life” prejudices against elders and people with disabilities, considering them less worthy of care and resources.
The assisted suicide experience in Oregon is not as benign as proponents have suggested. To the contrary, it is deeply disturbing. For example, there have been instances where insurers have denied payments for treatments that might be life-prolonging and offered to pay for drugs to cause a person’s death instead. A person facing serious illness needs more support, not less, and to be denied coverage for needed treatment would be devastating.
The effect of the bill’s so-called right-to-know provision, which requires a health care provider — be it a doctor, nurse or physician assistant — to tell a patient deemed terminally ill of his option to die, may be equally demoralizing. The requirement fails to take into account the unequal power dynamics of the provider/patient relationship and the potentially negative impact it could have on a patient if a medical authority brings up assisted suicide as a legitimate or appropriate option. It wrongfully implies that assisted suicide is part of the normal panoply of treatment alternatives. The bill would not just allow assisted suicide, but in effect promotes it as one acceptable treatment among many.
Another profound concern is the broad swath of the population who will be eligible under the bill. The bill defines terminal illness as a “disease or condition that is incurable and irreversible and that, in accordance with reasonable medical judgment, will result in death” within six months. But terminal predictions are notoriously inaccurate.
Putting aside the fact that medical judgment is often wrong, the definition of “terminal illness” also suggests that it could include a case of a treatable illness where death would result without treatment. An Oregon health official has stated that a terminal illness can include a condition for which there is lifesaving treatment available but the person is uninsured or cannot afford it. This expanded view of terminal illness may therefore include diabetes and other chronic conditions that can be managed with proper treatment.
Perhaps most concerning, like the Oregon law, is the minimal oversight in the bill, which applies only to the prescribing of the lethal drugs but not after the drugs have been acquired. Disinterested parties need not be present to ensure the drugs are self-administered. It has been estimated that 1 in 10 elderly New Mexicans are abused, usually by family members. What would prevent cases where a person is encouraged, pressured, tricked or forced into taking the pills by someone who has an emotional, practical or financial incentive for having him or her die sooner rather than later?
Offering death to people who need help in paying for standard treatments or who have ongoing disabilities, terminal or otherwise, is not progress — it is a setback. Assisted suicide is bad public policy that will increase existing health care inequities. New Mexicans have rejected it before and should reject it again.
Frances Ozur Cole lives with congenital narrowing of the spinal column and serves as current president of United Spinal Association’s New Mexico chapter, working to increase disability awareness and the importance of accessibility. She is also a member of Not Dead Yet, a national disability group that opposes legalization of assisted suicide.