Soon, New Mexico could be the fifth state in the country to allow its doctors to assist terminally ill patients in hastening their deaths by prescribing them medications – just one of the ways New Mexicans can assert some control over decisions surrounding end-of-life issues, such as estate planning and funeral choices, experts say.
These experts advocate for choice and conversation about death and dying, giving people the tools to take control of the dying process, just as doctors may soon have more control over how they help their patients through it.
If 2nd District Judge Nan Nash decides this month in favor of the two oncologists and one terminally ill cancer patient who brought the suit, prescribing fatal drugs to terminally ill patients will no longer be a fourth-degree felony.
Doctors in four other states can legally do it: Vermont, Montana, Oregon and Washington.
The New Mexico Conference of Catholic Bishops opposes the plaintiffs’ suit: “Our laws are meant to protect life,” the organization’s website states. “The Catholic Church teaches that we are stewards of life and in heeding God’s command, ‘Thou shall not kill.’”
But other local experts, such as Albuquerque’s own “Doyenne of Death” Gail Rubin, and a lawyer/psychologist who co-wrote a brief supporting the plaintiffs, support it.
Rubin, who has a death-oriented weekly Internet radio program on the RockStar Radio Network, recently received a certificate in thanatology. She holds Death Cafés nearly every month at Sheila’s Sweets, a coffee shop in the Northeast Heights, where about half a dozen people gather to discuss issues of death such as green burials and whether death is a door or a window.
“I totally agree with the oncologists who are trying to help relieve suffering,” she says of Katherine Morris and Aroop Mangalik, the two doctors who are plaintiffs, joined by uterine cancer patient Aja Riggs, of Santa Fe, who wants the option to have a lethal dose of medication, should she choose to take it.
“That it is an aid in dying, rather than committing suicide, because when you have cancer that is throughout your body, it’s a question of timing,” Rubin says. “Physician aid in dying is taking hospice and comfort care another step forward and saying, ‘I’m ready to go now … let me have the drugs that allow me to do that.’ I’m glad New Mexico is on the forefront of considering these issues.”
Attorney and psychologist Larry Spring, who co-wrote a friend-of-the-court brief in support of the plaintiffs with Rob Schwartz, a San Franscico law professor nationally recognized as a specialist in heath care law, says patients should have access to medically prescribed life-ending medications, even if they decide not to take them.
“A number of people when they are given the prescription don’t take the medication; some just like the notion that they can decide what the circumstance of their end will be,” he says in a phone interview.
In addition to a physician helping patients to die, there are ways people can help themselves and their loved ones to have more control over the final decisions regarding their death.
Some experts say that planning, putting things in writing, making purchases in advance of one’s death and letting loved ones know specific wishes about what to do with one’s belongings are other ways that people can take control of the dying process.
Darnell Smith, a funeral director with Daniels Family Funeral Services, says, “Planning for your funeral, you should keep in mind cost. Planning helps with the cost.”
He recommends people purchase burial insurance prior to their death, so that surviving family members don’t end up having to pay final expenses. “I tell people pre-planning is nothing but purchasing an insurance policy, because funeral homes cannot handle payments prior to the death.” Taking out an insurance policy that will pay for things like the cost of a casket and for digging and filling in the hole into which it will go ranges in price depending on the person’s age and health, he says.
Adds Lynn McKeever, a lawyer whose practice focuses on helping clients plan wills and estates, “The traditional way of looking at estate planning is what you want someone to carry out for you when you are not able to do it. A lot of people are facing not being able to take care of themselves, so I focus my practice on getting ready.”
One thing she suggests is having a will, which can cost as little as $500. She also recommends having someone to designate as power of attorney. “It lets somebody else stand in your place and sign things for you … it’s the ability to have somebody manage your assets, whether it’s real property, brokerage accounts, or even the fiduciary duties toward another person if you’re serving as a guardian or trustee.”
Another must-do, says Erin Marshall, campaign manager for Compassion and Choices, the country’s oldest nonprofit organization focusing on advocating for choice and conversation related to death and dying, is to take time to discuss these issues. “The average person,” she says, “spends more time planning for vacation than they do planning for end of life. That causes stress in a time that can be difficult or tragic, even.”
An advance directive, which is a document that includes a written statement of preferences and durable power of attorney for heath care, should be filled out. It can be downloaded online, then easily emailed to family or an attorney, she says. “Advance directives should be updated every five to seven years,” she adds.
Rubin agrees that people’s wishes may shift with age, making updating legal documents important. “When you are a younger person, you may want everything possible done to save your life,” she says. “An older person may say, ‘Let me just go in peace.’ These are attitudes that may evolve and change over the course of one’s lifetime.”