February 14, 2019

Full House to vote on medical aid in dying

Matthew Reichbach

A bill to allow medical aid in dying is headed for a vote in the New Mexico House of Representatives after a committee of lawmakers on Wednesday tweaked the legislation, requiring a physician to be included among the two health care professionals needed to sign off on a terminally ill patient’s decision to end their life.

House Bill 90 has prompted some of the most emotional discussions of the legislative session, raising issues of life, death and the government’s role in deeply personal medical decisions. The bill also has prompted several rounds of amendments by lawmakers weighing exactly how the process should work for patients seeking such a choice.

Under what is known as the End of Life Options Act, a terminally ill patient who is mentally competent and has only six months to live could ask a prescribing health care provider for drugs that would allow him to end his own life.

The patient would have to speak with a health care provider about alternatives, such as further treatment, and make the request in writing with witnesses. The patient also would have to be able to administer the drugs himself.

Another health care provider would have to examine the patient, too, and provide a second opinion.

Qualifying providers include medical doctors, osteopathic physicians, advanced practice nurses and physician assistants.

But under a version of the bill backed by the House Judiciary Committee on Wednesday, one of the two providers in each case would have to be a medical doctor.

The committee also approved changes prohibiting insurers from basing coverage decisions on the availability of medical aid in dying. That appeared to be a response to critics who argue that the practice would create a sort of perverse incentive for insurers to promote the option over costlier end-of-life care or lengthy treatment.

The House Judiciary Committee voted 9-3 along party lines to send the bill to the whole chamber. If it passes the House, the bill would go to the state Senate.

The Senate rejected a similar measure in 2017 on a vote of 22-20. And it could be a tight vote again.

For proponents, the bill is a matter of personal choice, with many New Mexicans who have attended hearings on the issue sharing their own medical challenges and hopes for a choice on how to end their lives if faced with a long, painful death.

“This bill is about choices. Choices for patients and choices for health care providers,” said the bill’s sponsor, Rep. Debbie Armstrong, D-Albuquerque.

But critics have expressed concern about the possibilities they see for abuse or error.

“I just don’t think we ought to participate in overruling the chance we might be wrong,” Rep. Jim Townsend, R-Artesia, said during Wednesday’s committee hearing. “… Once you start this, I don’t know where you stop.”

If lawmakers approve the bill, New Mexico would join six states and the District of Columbia that allow medical aid in dying. Montana does not prohibit medical aid in dying but does not expressly allow it, either.

The legislation comes after a state Supreme Court decision that determined medical aid in dying is not currently allowed under the New Mexico Constitution and suggested that it is up to lawmakers to determine whether to allow the practice as well as how to regulate it.