January 1991 saw the first conservative publication in New Mexico hit the stands. I was raw as could be as an editor and had to learn "on the job." The first issue was a typographic and design disaster. I'm embarrassed to show you the cover—but there it is. More importantly, it was the content that mattered—and made a difference. This was the first time that the subject of Euthanasia had been addressed by a New Mexico publication that didn't give automatic preference to the Right to Die concept.

In the classic science fiction move, Logan’s Run, citizens of a futuristic city of domes were required by law to be terminated or “renewed” when turning thirty. Logan’s Run presented the moviegoer with the concept that in a future society where resources are limited each “older” person has to make room for the younger generation being born. It if sounds too much like a bad fantasy of a Hollywood writer, hang on.

During the last year some New Mexicans were alarmed at what seemed to be an increase in the number of seminars being held on the topics of Euthanasia and Right to Die laws. Those who attended the meetings felt the seminars were not just held to discuss the topic and let attendees mull over the material presented in an exchange of ideas. They were right. An effort was underway to educate people about euthanasia in hopes of rallying support for a change in the current law.

What is Euthanasia?
Euthanasia is often confused with the “right to die” concept of painless death or mercy killing. The popular concept of euthanasia is “death with dignity.” There are different forms of euthanasia that fall under three categories:

• Voluntary Euthanasia
• Involuntary Euthanasia
• Crypthanasia

While each form of euthanasia is different, they bear striking similarities in the reasons for being performed.

The first and most well known form of euthanasia is Voluntary Euthanasia. VE is defined as assisted death for the terminally ill or suffering. In New Mexico voluntary euthanasia is allowed through a Living Will, permitting individuals to let their wishes for specific types of medical care be known in advance of a serious accident or terminal illness. Living Wills inform doctors of the patient’s wishes for treatment when the patient is not able to designate a “guardian” or “agent” to make treatment decisions for him. As an example, patients who wish to be connected to respirators or feeding tubes may say so in a Living Will. Problems with Living Wills are usually found in the definition of terms. Current state law does not define “terminally ill” nor give a time clause as to when a patient with a terminal disease might be legally classified as “imminently terminal.” In the much-publicized Kevorkian case, Michigan doctor Jack Kevorkian provided a homemade suicide device to Janet Adkins so she could kill herself. Kevorkian cited her diagnosis of Alzheimer’s disease as “terminal” and reason enough to use his machine.

Another point of concern in the Living Will is the defining of food and water as medical treatment. Normally “nutrients and hydration” are not classified as medical treatment. But according to Professor Bob Schwartz of the University of New Mexico, food and water “can be medical treatment when given through a medical device.” However, unless someone executing a Living Will understands the implications of that definition, further suffering could result from removing food and water to fulfill the requirements of the Living Will.

Dauneen Dolce of the New Mexico chapter of Right to Life believes that definition could cause problems for patients and their families if used wrongly by an unscrupulous doctor. “Twelve states already have laws stating that food and water is medical treatment which can be prescribed or removed as the doctor deems necessary for the patient.” She asks the rhetorical question, “Does the family of a vegetative patient have to give consent to every treatment the doctor uses?”

While ill-intentioned doctors may perform euthanasia on the basis of the lack of definition in the current law, another amedment will be proposed to the current Right to Die Act that would take the move to voluntary euthanasia a step further.

In a Cutting Edge interview, Joanna Robinson of the Santa Fe chapter of the Hemlock Society plans on privately proposing with a team of medical professionals a new amendment to the Act. Part of that amendment repeats the “terminally ill by two physicians” requirement and adds, “Repeatedly requests assistance in self-delivery.” In layman’s language: Repeatedly requests the doctor to take the life of the patient. The new language would take euthanasia in New Mexico past the Living Will stage with doctors taking the life of patients upon mere request. Robinson is soliciting the testimony of physicians in an attempt to change the current law because, “If it looks like a medical movement, more legislators will take note.”

Beyond Voluntary
Concern among those opposed to euthanasia is focused on the future. Opponents argue that once the dam is cracked it won’t be long before it bursts. Any move to free doctors and patients to perform euthanasia upon request could result in Involuntary Euthanasia when a patient’s life is removed with his knowledge, but against his will. Such actions might be unthinkable for many Americans, but the idea is by no means foreign. Former Governor of Colorado Richard Lamm once proposed that the elderly have a “duty to die.” Rita Marker, Director of the International Anti-Euthanasia Task Force in a November 1989 interview with Citizen Magazine told of Dr. Helga Kuthse, a philosopher from Australia, and her position to the World Federation of Right to Die Societies: “People can be encouraged to accept lethal injections by first starving a few patients and showing how painful it is.”

Involuntary euthanasia is common in Holland where euthanasia is popular among physicians and the public. Richard Fenigsen in his report, Euthanasia: How it Works, states that “More people die in [Holland] by involuntary than voluntary euthanasia.”

An example was provided to Cutting Edge when Susan Bowuwmeester was in Albuquerque visiting family. Susan’s grandmother-in-law, Ms. Gyzmiester was living in Rotterdam, Holland and was 90 years old when she was struck ill. The illness was not terminal, but she required constant medication and assistance since she was confined to bed for over two months. Because her family did not wish to take care of her daily needs, and because she was in pain, her sons asked the doctor to give her an injection that would “put her to sleep.” Under Gyzmiester’s protests of “I will not die, you will not kill me,” the arrangements were made and she was injected with the necessary solution at her home. Mr. Gyzmiester died in February of 1989.

When reflecting upon this story, Susan Bowuwmiester said, “I hope the people in the United States won’t let it come to this. It’s putting people to sleep like animals.”

Farmington, New Mexico physician Wilbur Tso feels that the current trend in the right to die movement is pointing us in that very direction. “Just because someone’s sick or ill we decided to put them to sleep? I think that’s where it’s headed.” Doctor Tso was asked to answer questions in a survey sent to him and other New Mexico doctors by the Hemlock Society. The purpose of the survey was to ascertain doctor’s feelings about euthanasia. At press time the National Hemlock Society office was not responding to our request for the survey results.

Involuntary euthanasia can also take place through a Durable Power of Attorney. According to Albuquerque attorney Tom McBride, “The DPA gives sweeping authority to the holder to make health care decisions. If a person is in a vegetative state or a coma the holder can withdraw food and water.” Such cases may almost be described as involuntary euthanasia by default. Unless the person filling out a Durable Power of Attorney is clear as to the document’s meaning, his or her wishes, which could change over time, could easily be violated. The same can be said of the Living Will.

Most euthanasia proponents argue that no one wants to see a person killed against their wishes – and that sounds logical. However, euthanasia, by definitions means, “mercy killing.” Even Joanna Robinson of Santa Fe’s Hemlock Society agrees. When speaking about who should actually perform the act of euthanasia she said, “It’s not that easy to kill somebody. People are not prepared for what death looks like. Spouses should not be allowed to perform euthanasia.” According to Robinson and most pro-euthanasia advocates, only licensed physicians are qualified to perform the task. Doctor Wilber Tso is adamant in his feeling that he “would vote against any legislation that would make doctors into killers, whether the patient is going to die anyway or not.” But are fears of the dam breaking legitimate?

The basis for these concerns is founded upon the experiences in Holland where euthanasia, even involuntary, is common; and that current New Mexico law does not define for a patient’s protection. Examples? The following terms have no legal definition in the current Right to Die Act that patients can count on as limits set for their doctors and family members:

• Terminall Ill
  At what time between diagnosis and imminent death is a patient legally “terminal?”
• Competent
  One what legal basis are families and doctors to make decisions about a patient’s competency? One UNM source told Cutting Edge that there is currently no procedure involving mental health professionals for determining the competency of a patient requesting death.
• Repeatedly Requests
  What constitutes a repeated request for self-delivery; several times in one day, a week, a month? Should such requests be honored if the patient is in pain since pain often affects judgment?
• Medical Treatment
  If delivered by means of a feeding tube surgically placed, is food and water classified as medicine? Dying or not, a patient’s need for food and water to maintain life and remain in relative comfort is essential. What exceptions therefore, should be included as sustenance apart from medical maintenance?

These are all aspects of the euthanasia question that have not been fully considered before drawing up new legislation.

Beyond Involuntary
The most extreme form of euthanasia is known as crypthanasia. Riehard Fenigsen in his report, Euthanasia: How it Works, defines crypthanasia as “Active euthanasia on sick people without their knowledge.” This is the ultimate form of euthanasia and best describes what euthanasia is all about. The handicapped, the elderly, and the terminally ill are done away with since their value is lessened by their infirmities. Some believe the Living Will will bring about involuntary euthanasia, and possibly crypthanasia.

Right to Life director Dauneen Dolce recalls, “The whole approach of the Living Will when it was introduced in the thirties (and rejected by the nation) was to introduce the idea of euthanasia.” Joanna Robinson, Santa Fe’s Hemlock Society President disagrees. “I don’t think these laws will set a precedent for broader sweeping laws.” But a legislative body does not always lay out the full implications of laws passed. Courts are in the practice of reinterpreting laws to take on broader meaning. Indeed, that is where the test will be. When asked why certain phrases in the current Right to Die act were not defined specifically, Robinson responded, “I don’t want the statutes to be specific. The courts will interpret the statutes.” Presumably, court definitions can change.

In the much publicized Cruzan case, Nancy Cruzan was said to be in a “vegetative state” because of severe brain damage. But was Nancy aware of her surroundings? In an interview with Citizen Magazine, Rita Marker cited court transcripts shwing that “those who cared for her testified under oath that she did respond. When they told her funny stories, she smiled.” Marker also cited Nancy’s discomfort during her menstrual cycles and attempts to form words.

Crypthanasia takes away a patient’s right to know their fate. It places the one performing the task in the role of a judge. Patients admitted to hospitals are examined by a doctor and without their knowledge are judged to be without hope of recovery or the ability to lead a normal life. The patient is then injected with a lethal solution, brining about death. The implications are broad. Who decided who dies and for what reason? Is it solely the doctor’s decision, the family, or the consensus of both? Would euthanasia or crypthanasia be performed on the basis of insurance coverage, or the lack thereof? Such pictures stir the mind to recall the Nazi atrocities of the forties when Jews and other disagreeable groups were put to death because of “imperfections.” If a patient is put to sleep because it is “in their best interest,” when does that application stop?

Euthanasia and crypthanasia could be used as solutions to many of society’s problems: The elderly population is increasing and medical and financial resources for there care and severely limited. Let them die. AIDS carriers are multiplying through illicit sexual behavior – why not kill off AIDS carriers in an effort to preserve the human race? Each rational could be justified by a “civil society” concerned with food shortages, disease spread, and the potential for human demise.

Justifying an Early Death
As decisions are made whether or not to shorten the life of a patient or family member, the rational for the deaths must be explained in a manner acceptable on three fronts:

• Compassion for the patient
• Compassion for the family
• The ability of all to care for the patient

Compassion is the most widely accepted reason to kill of a terminally ill or mentally deficient person. Euthanasia proponents argue that it is not reasonable to let someone suffer through the pain of a terminal illness or have their dignity stripped by remaining hooked up to machinery like a feeding tube. Similar logic is used to justify abortion when the unborn child is discovered to have Downs Syndrome or some birth defect. It is considered cruel to force a child to live with such a handicap. Such reasoning assumes that all pain is unbearable and devalues life. According to Dauneen Dolce, that is not true. “There are a lot of people who are fearful of pain and are in depression. Out of that depression they could make a wrong decision.”

Compassion for family members is also used to justify ending life early. Families don’t want to see their loved ones suffer. Death becomes better than life. The problem? Apart from the legal ramifications of the Living Will, what gives a family member the right to decide when their loved one’s life must come to an end because they are suffering “too much?” At what point does suffering take place and then justify prematurely ending life? What if, as in the case of Ms. Gyzmiester, though you are still suffering you still want to live and your family members disagree?

The ability to care for a patient is the most frightening aspect of the euthanasia issue. When resources are low, who gets treatment and who doesn’t? This is known as Health Care Rationing. Rob Schwartz says, “Once we realize there’s only so many health resources we may look at getting the most for our health care dollar.” For some the most for the health care dollar may mean depriving certain groups of their right to be treated, regardless of their age or societal status.