A Long Road to Relief choice on their websites and in any relevant printed material. Providers, facilities and pharmacists who choose not to participate in aid in dying, no matter the reason, must refer their patients to providers who will or agencies that can help them find providers who will, and to transfer medical records upon request. Organizations cannot compel a health care provider to participate or punish them for not participating. They can restrict clinicians from providing aid in dying in their roles within the organization, but not where the provider acts on their own time and outside of the “course and scope of the provider’s affiliation with the sanctioning health care entity.” A significant percentage of primary care clinicians in New Mexico are advanced practice nurses and physician assistants who have extensive prescribing rights in other areas of medicine. In order to avoid effectively excluding patients in frontier counties, medical doctors, osteopathic doctors, advanced practice nurses and physician assistants are all legally allowed to
prescribe aid in dying medication. No clinician may do so alone, however. Two clinicians must confirm the terminal diagnosis, and the prescribing provider must verify that the patient is mentally capable and is freely and voluntarily making the request. When there’s any doubt as to the patient’s mental capacity or mental health, a mental health care professional must evaluate the patient. Only if they are found to be mentally capable and free of any mental health condition that might influence their decision-making regarding the act of taking life-ending medication can the prescription go forward. No one will get a prescription after “having a bad day,” or even a series of bad days. Even after a patient’s eligibility is verified, there is a waiting period to fill the prescription. In other states, the waiting period is too long. Many people die during the 15 days between their second request and when the prescription is filled. In light of that problem, New Mexico has a 48-hour waiting period, which can be waived.
The law applies to all residents of New Mexico, regardless of how long they have lived here. The vagueness of “resident” is intentional. Yes, some people might move here to access aid in dying from states where it is forbidden; it also accommodates residents who live off the grid without tax returns or driver’s licenses. Under the new bill, assisting suicide remains a fourth-degree felony, but attending an aid in dying death is legally protected. Family, friends and caregivers can gather to support a dying loved one using the law without fear of prosecution. The bill stipulates that “actions taken in accordance with the End-of-Life Options Act shall not be construed, for any purpose, to constitute suicide, assisted suicide, euthanasia, mercy killing, homicide or adult abuse under the law.” “For any purpose” includes the nullification of insurance policies, wills and other legal contracts. No one ever has to use aid in dying—not even after they fill the prescription. A journal of the American Medical Association studied use patterns of aid
Calloway holds onto the branches of a tree for balance on her front porch Sept. 21, 2020. In the mornings, she stands on the porch and rings Tibetan wind chimes, continuing a ritual started by her late mother, Tova Calloway. “Now [my dad] has passed her Tibetan chimes to me, I go outside and do that every morning, and I think about my mom and my sister,” she says. “Even just that simple moment is a ‘thank you’ to life.”
in dying over 18 years in Oregon, the US state where it has been legal the longest. Between 1998 and 2015, 1,545 people received prescriptions for lethal doses of medication under the Death with Dignity Act. Of those, 991 had used it, while over a third—554—did not. Similar statistics have been seen in other states that allow aid in dying. For many patients, the main issue is peace of mind. As Riggs put it, “I understand people can’t really know how they’ll feel until they actually get there. So I don’t know for sure how I will feel as I get closer to death. But I do know I want to have the choice.”
Five Minutes before Midnight
After watching the Senate vote, Calloway’s elation quickly progressed to a more complicated experience. Even when the End-of-Life Options Act becomes law in June, Calloway and others with degenerative neurological illnesses like amyotrophic lateral sclerosis (ALS), dementia and Alzheimer’s disease will not be eligible to use it. Doctors can’t reasonably predict how much time she has left. By the time Calloway is six months from her death from MS, she expects to be either physically unable to take the medication herself or mentally unable to request it. In other countries, including Switzerland, the Netherlands and Canada, a mentally competent person can qualify for aid in dying on the basis of suffering alone, regardless of whether they have a terminal illness. Of these countries, only Switzerland extends the option for voluntary assisted death to non-citizens. To be approved for voluntary assisted death at Pegosos Association in Switzerland, Calloway has undergone the extensive review of her medical records and the psychiatric evaluations. It’s a process she has to repeat every six months until she leaves. She’s waiting as long as she can. Like others who are faced with losing their cognitive abilities or the voluntary use of their bodies, the question of when to go to Pegosos is fraught. Such patients say they want to go at “five minutes before midnight,” the last moment they possibly can before they lose the ability to make the choice. When the day comes, she will be in a foreign country instead of at home. “How jarring is that?” she asks. “The only good thing about it is I know them really well and they’re amazing people, amazing compassionate doctors and activists.” When asked if she was afraid, Calloway says: “When we die, that’s the death of our ignorance…Our true reality is something that survives the body.”
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