Public Health New Mexico
1:56 pm
Tue January 14, 2014

Judge Rules Physician Aid in Dying is Legal

Hamed Saber via Compfight cc
Hamed Saber via Compfight cc

A District Court judge ruled today that it's legal for doctors in New Mexico to prescribe medication so patients with terminal illnesses can end their own lives.

Judge Nan Nash wrote: "If decisions made in the shadow of one's imminent death regarding how they and their loved ones will face that death are not fundamental and at the core of these constitutional guarantees, then what decisions are?" 

It's called "aid in dying"—not "assisted suicide." One distinction being that patients would administer the life-ending medicine themselves. 

Though New Mexico had an Assisted Suicide Statute on the books, advocates argued the law does not encompass aid in dying. "If it does does indeed cover this practice, we believe the statute is unconstitutional," said Laura Schauer-Ives, legal director with the local chapter of the American Civil Liberties Union, which argued the case.

There are several key differences, she said. First, motivation—in aid-in-dying cases, the person wants to live but is facing imminent death and looks to avoid a loss of autonomy and increased pain. Second, the nature of the act—patients aren't typically alone, and go through a collaborative process with their families and physicians. Finally, she said, the effect on survivors is different, and these situations don't typically bring on immense regret and guilt.

Dr. Katherine Morris, a surgical oncologist, was one of two doctors who, along with a patient, filed a complaint with the state for clarification. Three years ago, she moved to New Mexico from Oregon, where physician aid in dying is legal. While in Oregon, she was twice asked to prescribe a lethal dose of medication to a terminally ill patient. 

"The first time someone asked me, it took a fair amount of soul-searching," Morris said. "It was the hardest decision I ever made in my career."

Morris said she's seen good deaths, and she's seen bad deaths.

The good ones, she says, are peaceful—event transcendental. The patient's family is gathered around, and they're hurting, but they're supporting each other. "They're crying and they're joking. They're together. And they're with the person when they go."

Bad deaths, she says, happen when the family has to watch traumatic and futile life-prolonging procedures.

"It was my patients that really taught me how important it was for some patients that are really facing the end of life to have that control and to be able to say, 'I accept that I am actively in the dying process, and this is how I want to do it. I want to die at home.' "

The New Mexico Conference of Catholic Bishops has led the charge opposing aid in dying. Executive Director Allen Sanchez said there are obvious religious objections, but there are logical and ethical issues at play as well. He likened it to the death penalty debate and said human error is too much of a factor to allow doctors and patients to make irreversible life-and-death decisions. 

"You're giving a great amount of power to a very small group of people. We know that there's mistakes made by physicians, and you just have to look at the amount of malpractice lawsuits that are filed every year."

Compassion is an important part of being a human being, Sanchez said, but in some cases, assisted suicide is damaging to a person's dignity.  

In the Catholic faith, Sanchez added, this is a pro-life issue, "from the womb to the tomb." The Conference of Catholic Bishops opposes the death penalty, too, he said. "You have to balance this religiously with pain" and medications must be available for the management of pain. Along those lines, Sanchez said, the bishops chose not to oppose medical marijuana legalization for that reason.

Under Catholic doctrine, treatments can be withheld, Sanchez added, if they're futile. Artificial means of sustaining a person's life can be removed, allowing the person to die, he said. "Pope Francis is talking about this right now, the real issues of people suffering and trying to alleviate suffering. With that good intention, we have to make sure that doesn't take us down a road also of taking somebody's life when they may be able to recover."

Today's ruling will likely be appealed and appear before the state Supreme Court.