Glenn Buckland doesn’t expect to live much beyond March.
The 56-year-old small-business owner from Rio Rancho was diagnosed with plasma cell leukemia in April 2019 and chose to stop chemotherapy last fall.
“It got to a place where I couldn’t walk. I couldn’t get up … without being in excruciating pain. So I made the decision to stop because I’m just kind of indifferent to the outcome of it. I want to be present and enjoy what’s going on right now. I’m not chasing life.”
When that’s no longer possible, Buckland would like some help, or at least some choice in the matter.
If House Bill 47 passes the New Mexico State Legislature, he will have that choice. The Elizabeth Whitefield End-of-Life Options Act would allow doctors to prescribe medication to “bring about a peaceful death” for patients with a “disease or condition that is incurable and irreversible and that … will result in death within six months.”
Advocates of the legislation are quick to differentiate it from suicide. They describe it as a legitimate choice made by someone who knows that the end of life is near and wants to leave the world on his or her own terms, without excess suffering.
The Catholic Church disagrees, viewing the distinction as nothing more than semantic trickery.
Efforts to pass an end-of-life options act in New Mexico began in earnest five years ago, after the state Supreme Court ruled in 2016 that the right to medical aid in dying isn’t guaranteed by New Mexico’s constitution.
The bill now making its way through the Roundhouse is the third legislative effort since then to secure that right. A similar proposal was narrowly defeated in 2017, and a 2019 version was pulled before it received a full floor vote. If this one passes, Governor Michelle Lujan Grisham has signaled that she will sign it.
Currently, eight other states plus the District of Columbia have legalized medical aid in dying, and Montana’s courts have ruled that doctors there aren’t forbidden from providing it. Oregon, the earliest adopter, reported that in 2019, 188 people chose to end their lives under its Death with Dignity Act. The figure accounted for about one-half of one percent of all deaths in the state that year.
Compassion & Choices, a national advocacy organization based in Oregon, anticipates that 25 more states may introduce similar bills this year, though most are not expected to pass.
As written, the New Mexico legislation requires an imminent terminal diagnosis. In addition, the patient must be of sound mind, make the request voluntarily, and be able to self-administer the medication. The proposed law provides a waiting period of 48 hours before the prescription can be filled; once it is, patients are free to choose to take or not take it. For those who do, the cause of death will be listed as “underlying terminal illness.”
I knew when I stopped chemo,
I’m going to have a period of time until the time I die when I’m going to feel great, because the chemo will have left my body. So I’m going to have three to six months of golf, or travel, when I’m going to live life — and then when I go, I go.
My care circle trusted me in my judgment and supports me in whatever I choose. … I can’t even express what it feels like to have all of this love that comes to me … It’s this outpouring of love. And for a guy who went his whole life feeling awkward and out of place, and I’ve never had a lot of friends, to experience all this at the age of 56, it’s transformational. It’s a gift of the cancer experience. I believe people can choose how they experience things, and this is how I choose to experience it.
The Catholic Church believes that suffering brings you closer to God. Well, that’s their business — that’s not how my God works. … For a person to be able to control that and do it on their terms … when you’ve been through the experience of getting the diagnosis and the treatments and having ports put in, you feel like you don’t have control over anything, and so here you are at your most vulnerable and you can’t even control how you die — all you can do is lay here and suffer and suffer. So where’s the compassion in that?
I don’t know what the future holds for me, but as soon as [the End of Life Options Act] passes and my doctor says ‘You’re within six months’ … I’m going to want to have those pills ready. And I may not even take them.
Medical aid in dying is nothing more than a euphemism.
You’re killing people. You can wrap it up any nice way you like, but you’re taking a life. From my point of view, life is a gift from God, and it’s a gift to be cherished and nourished, and even when it gets difficult it still has tremendous value.
We attend many people dying, and in their final days a lot of healing can take place, a lot of forgiveness. It’s an opportunity for people to reconcile with one another. … We can manage physical pain, and there is psychological and emotional and spiritual pain in dying, but that doesn’t make it bad. Pain is part of life and helps us grow. … There are ways of supporting and journeying with people at this time of their lives.
Only God can give life, and only God can take a life, and anyone who takes a life other than God is committing blasphemy, because they are standing in for God. The Bible says, “Thou shalt not kill,” period. There’s no asterisk there. … And I think there is inherent value in suffering — I don’t think we go looking for it — but if it comes our way, then I think we need to accept it; as a person of faith, I’d say it’s part of the sufferings of Christ, and it’s salvific, for the good of humanity. … The sanctity of life has to be kept sacred. Once you start making exceptions, you are on a path that’s going to lead to death and a very fearful society that I would not want to live in.
In hospice, we take care of patients at the end of life
… and we certainly have people where the medical environment says, “OK, that’s it, that’s all we have to offer,” and they say, “In that case, I want to be done. … I’ve got nothing else I want to do and I don’t want to suffer.” And people ask, “What are my options?” … So much of this is about people having some sense of control in their lives, and I think the statistics from states that have aid-in-dying options show that … that those who seek it out often don’t even use it. But the conversation about it is so valuable because it feels like giving people options so they know that they have some control.
This is really my dilemma: I have seen people who, most of us would say — someone who is nonverbal, can’t communicate in any way, is fully bed-bound, fed, everything else — what’s the quality of their life? And yet, I’ve seen our hospice team fall in love with some of those people. Like, they are still really making a difference in the world, and that kind of thing is so profound to me, because it says, you know, even when you thought there was no value to be had from your life, there’s value to be had. … And of course we have no idea what the value might be to [the patient], because we have no way of understanding them. … And so I see, on the one hand, everybody should have the right to choose, and on the other hand I have my own sense about how every human has value until the very moment when they, you know, and probably beyond …
My grandpa, his name was Vincent Distasio.
He was an artist, like a man-of-all-trades. He used to be a science teacher, he used to build adobe houses … but painting was his main love. He loved good food, he loved to travel … he was very active … people knew him as the old guy riding his bike. … He was diagnosed with Stage 4 acute myeloid leukemia (in March 2017) and … it was downhill really fast. He was always really independent and prided himself on not needing any assistance, but now he couldn’t do any normal daily tasks anymore, and he was in a lot of pain. He always had said he didn’t want to spend his last days in a hospital, and said, “I just want to be home with my family, in my house.”
He would scream even from the smallest of movements … It hurt to sit … he was peeing blood and had a constant nosebleed. He said, “It feels like people are drilling holes into my bones.” When [hospice workers] tried to get him to take the pain pills, they made him feel even more sick and out of it. He really wanted aid in dying, he was in such desperation to get away from the pain. … He left a suicide note [which read, in part], “I hate to do this to loved ones … Have to make a decision, too much pain … I am so sorry. I love you all.”
If he would have had the option [for aid in dying], he would’ve waited for the family to come in, we would have all been at his house, he could have seen all his loved ones … It would have been better for everyone. We could have had our goodbyes and known he wasn’t suffering anymore — and just mainly him not being alone. He died in his bathtub. … He couldn’t have even asked someone to be there with him, law-wise … That’s really what upset me, is that no one should have to die alone like that.
By the end of [my mom’s] life she needed 24/7 care.
… I know she wanted aid in dying, but it wasn’t available … At the end, she was in a coma for three days. And that last night she had extreme agitation. I had never seen anything like what she was going through, so when she finally passed, it was just like Thank goodness …
One thing I feel strongly about the New Mexico bill is that there are protections in place. I know it’s not for everybody. I don’t want anybody who doesn’t want this to be worried that this is going to happen to them … But as a hospice social worker, I heard some very distressing stories of people who really wanted to have the choice and ended up doing some rather desperate things [to end their lives] because they couldn’t legally do it. … It’s about choice, about what is important to you as an individual, how it is that you want to move yourself through this world, from this world.
For the disability rights organizations
, you have to understand that when there’s been a history of people with disabilities’ lives not being valued, when they’ve been mistreated, when they’ve been utilized for experimental procedures, it creates a history of fear.
Our main concerns with this legislation as it’s written have been alleviated. We wanted to make sure that end of life was imminent … that if there were any question of diminished capacity or mental illness that would impair their ability to make a decision, that there would be a current evaluation done. … We wanted to make sure there was data collected on this.
But the main things were to make sure that people were informed, that it was voluntary and that [death] was imminent. Disability rights organizations are in favor of self-determination … and end-of-life decisions and options, they should have those just like anybody else … They shouldn’t have to needlessly suffer when that isn’t what they want. So we feel like it’s best to take a neutral position on this, because we do understand the fears.
I’ve been in health care for 45 years
… in hospice and geriatrics, including doing end-of-life caregiving and witnessing death for a number of family and friends. I’ve seen great suffering, and found myself, as much as I hated to say goodbye, with a sense of relief that they were no longer suffering.
I also have an adult daughter who’s had cancer since she was a teenager, that’s now advanced Stage 4 … and I do not want her to suffer. So it’s now even more personal, that she have the option when the time comes to die with dignity and with control over the end of her life … She is a supporter. Her father also has cancer; it’s in remission now, but he contemplated moving to another state that had [legal aid in dying] — that’s an act of desperation, leaving all your family and support to go somewhere where you can control the end of your days.
I’ve followed the Oregon law for a long time, and the reports from there … Many people get [the medication] and don’t even take it. Just the fact that they get it and have control relieves that extreme anxiety that adds to the suffering. We call this the End-of-Life Options Act, not an aid-in-dying act, because it requires that the provider explains what all the options are so that people are not just making a rash decision out of suffering that could be managed. Studies also show that where this is legal, there is greater use of hospice, because doctors have to talk to you about it and people are asking about it, so there is, I think, a better quality of care overall at the end of life when you have all the options on the table. … We’ve got a wide coalition statewide … I think we’re going to have the votes.