January 29, 2019

Panel adds time frame to aid-in-dying bill

The New Mexico State Capitol, or Roundhouse Wikicommons.

A legislative committee decided Monday that medical professionals would have to determine a patient has no more than six months to live before prescribing drugs that would help the patient end his or her own life.

By tweaking the bill to give it a time frame, lawmakers who support the measure hope to add New Mexico to a short list of states that permit medical assistance in dying.

Critics had raised concerns about exactly which patients would qualify under House Bill 90. It was originally written to allow medical aid in dying for patients diagnosed with a terminal illness and expected to die in the foreseeable future.

Other states with similar laws limit medical aid in dying to patients only expected to live for only a particular period.

“It makes it easier for everyone to understand,” the bill’s sponsor, Rep. Debbie Armstrong, D-Albuquerque, said of the change after a crowded and emotional hearing on the controversial legislation.

Unclear is whether this change and another approved Monday by Armstrong’s House Health and Human Services Committee will help ensure the bill’s passage.

Critics continue to raise religious objections and question whether the proposed process can ever adequately protect patients from coercion.

A version of the bill that was also limited to patients with a prognosis of six months failed by a couple votes in the state Senate during 2017. Several Democrats joined Republicans in opposing that measure.

For now, though, House Bill 90 will continue to wend through the Legislature.

After three hours of public comment and committee deliberation, panel members voted 4-3 along party lines to advance the modified bill. It goes next to the House Judiciary Committee.

Armstrong maintained that the six-month window is arbitrary. But, he said, it fits with the practice of certifying patients as eligible for hospice care.

Advocates have raised concerns that writing too many limitations into the law may defeat its purpose and leave patients unable to use medical aid in dying before they lose faculties or all quality of life.

“Some eligible patients suffer needlessly,” said Kim Callinan, CEO of Compassion and Choices, a national advocacy group that has called for writing patient safeguards into legislation while not creating too many limits.

Armstrong also amended the bill on Monday to remove all references to what advocates call tele-medicine.

As the bill was originally filed, a patient could have used tele-medicine to get a second opinion. Armstrong had said the provision would be a help in a rural state like New Mexico, where doctors can be spread thin. But the Department of Health noted in an analysis for lawmakers that this provision might require changing other laws on tele-medicine.

Still, the bill faces opposition, particularly from socially conservative lawmakers.

Rep. Gregg Schmedes, R-Tijeras, raised concerns about the rights of medical professionals.

The law would allow them to decline to assist a patient seeking medical aid in dying. But the bill says those health-care provider should refer the patient to someone who would.

This would still amount to helping with the process, Schmedes said.

More broadly, Republican lawmakers have raised concerns that the bill does not provide enough safeguards to prevent patients from being coerced into seeking medical aid in dying.

Under the bill, a patient could ask a health-care professional such as a doctor or advanced practice nurse for medical aid in dying if given a prognosis of six months. The medical professional would have to determine the patient has the capacity to make the request.

An Alzheimer’s patient would not qualify, for example. The patient would have to make the request in writing, and with two witnesses signing on. The patient would have to be able to administer the drugs on her own. The patient would also have to get a second opinion. And the prescribing medical professional would have to discuss other options with the patient, such as hospice or palliative care.

Eight other states allow for medical aid in dying.