Unlike previous laws or proposals to permit assisted suicide, HB 171 represents the next stage in assisted-suicide advocates’ plans to normalize deaths by lethal prescription within medical practice.[1] HB 171 dispenses with second opinions, waiting periods, multiple requests, reporting requirements and other elements which assisted-suicide advocates had formerly described as necessary safeguards.[2] It is intended to make assisted suicide subject only to “best practices” ˗˗ actions to be judged in accordance with the “standard of care” criteria.[3]
A non-physician could diagnose a patient and prescribe the drugs to bring about the patient’s death.
The bill permits an “attending health care provider,” which includes not only a physician but also an advanced practice nurse or a physician’s assistant,[4] to diagnose a patient’s terminal illness. It also authorizes such individuals to prescribe the lethal drugs for assisted suicide, called “medical aid in dying.”[5]
There are no requirements for a second opinion by a consulting health care provider.
All actions are carried out by a single attending health care provider, without any requirement of a second opinion. Those actions include diagnosing the patient, informing the patient about the availability of “medical aid in dying,” assessing the patient’s capacity, and prescribing the lethal drugs.
Only one request is needed prior to receiving a prescription for the lethal drugs.
An attending health care provider can prescribe the intentionally lethal drugs for a patient who signs one preprinted non-witnessed request form.[6] This request is no more stringent than requests that one must sign when receiving a flu shot from a pharmacy.
There is no waiting period between the time that the patient is diagnosed and the time that the prescription is written.
An attending health care provider can give a patient the terminal diagnosis, deem the patient eligible for assisted suicide, inform the patient of the availability of assisted suicide and write the prescription for the lethal dose of drugs on the same day – without the patient ever recovering from the initial shock of being informed of the terminal diagnosis.
“Terminal illness” is so broadly defined that a very frail individual or a severely disabled individual could be given a lethal prescription.
Unlike other laws and proposals, “‘terminal illness’ is defined as a disease or condition that is incurable and irreversible and that, in accordance with reasonable medical judgment, will result in death within a reasonably foreseeable period of time.“[7] This includes a condition which may be incurable and irreversible but is controllable. Yet, the person would still be considered terminally ill under this bill. The prognosis of death within a “reasonably foreseeable period of time” is so excruciatingly elastic that it could encompass many conditions from extreme frailty to a spinal cord injury.
An attending health care provider could prescribe a deadly overdose of drugs to an adult patient who is mentally ill or depressed.
The attending health care provider can prescribe the drugs as long as the patient has “capacity,” which is defined as the patient’s ability to understand and appreciate the nature and consequences[8] of requesting the drugs. Many mentally ill or depressed individuals are very capable of understanding and appreciating the nature of their decisions
Health care facilities are not immune from sanctions if they do not wish to participate in carrying out the law.
Only individuals have immunity if they decline to participate.[9] No similar immunity is granted to facilities that have policies that would preclude participation.
Individuals filling out death certificates would be required to falsify the cause of death.
Although the patient’s death would be the result of the administered lethal drug overdose, the proposed law requires that the patient’s underlying illness or condition be listed as the cause of death on the death certificate.[10]
New Mexico could easily become a national suicide destination.
Nothing in the proposed law requires that an individual be a resident of New Mexico to qualify for doctor-prescribed suicide in the state.
Provision of life-ending drugs would become a “medical treatment.”
This would give insurance programs the opportunity to cut costs by denying payment of more expensive treatments while approving coverage for the less costly lethal drug prescription. If the bill is approved, will health insurance programs do the right thing – or the cheap thing?
[1] See, for example, Kathryn L. Tucker, “End of Life Liberty in DC,” Jurist, December 15, 2016. Available at: http://www.jurist.org/hotline/2016/12/end-of-life-liberty-in-dc.php. (Last accessed January 24, 2017.) Tucker was the legal director of Compassion and Choices (formerly the Hemlock Society) and now serves as Executive Director of the End of Life Liberty Project (ELLP) which she founded.
Tucker, who has been a leading promoter of Oregon-style assisted suicide bills now claims that the “safeguards” included in the Oregon law and similar laws and proposals are “burdens and restrictions” that impose heavy governmental intrusion into the practice of medicine. She states that future enactments of such laws should be left to standard of care and best practices.
[2] Such previous laws and proposals have been based on Oregon’s “Death with Dignity Act.” Available at: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ors.aspx.
[3] “Standard of care” is the level at which the average, prudent provider in a given community would practice. It is how similarly qualified practitioners would have managed the patient’s care under the same or similar circumstances.
[4] Section 2 B.
[5] Section 2 D.
[6] Section 5.
[7] Section 2 F. (Emphasis added.)
[8] Section 2 C.
[9] Section 8.
[10] Section 4.
Copyright © 2017
Patients Right Council
http://www.patientsrightscouncil.org
