End-of-Life Choice, Palliative Care and Counseling

Santa Fe woman joins lawsuit to clarify state law making assisted suicide a felonyby Jay

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By Phaedra Haywood
The New Mexican
May 9, 2012

When Aja Riggs first began experiencing what she thought were symptoms of early menopause last summer, she tried holistic remedies.

When they didn’t help, she had an ultrasound exam, after which her doctor told her she should probably also have a biopsy. In August, her doctor called to tell her she had uterine cancer.

“I thought there must be a mistake,” she said.

The doctor said the cancer was probably in an early stage and that if her uterus was removed, she would have about a 90 percent chance of survival. But when Riggs awoke after surgery, she learned that all her reproductive organs had been removed because the cancer had spread to her ovaries and lymph nodes.

On Wednesday, the 48-year-old announced she is joining a lawsuit filed by two Albuquerque doctors to clarify a state law that makes assisted suicide a felony. It seeks to clear the way for physicians to help terminally ill patients obtain prescription medication that would allow them to choose to end their own lives without the doctor having to fear prosecution.

It’s not that Riggs wants to die. She doesn’t. In fact, she’s not even classified as terminally ill — a designation meaning a person has six months or less left to live. But her cancer is rated Stage 3, and her doctor has discovered it is so aggressive that a new tumor grew even as she was undergoing chemotherapy.

“I’m in the active treatment phase, hoping to eventually get to a cure,” said Riggs, who worked as a professional organizer until last fall. “But that is less likely than that it will kill me.”

The suit was filed in Bernalillo County District Court in March by University Hospital doctors Katherine Morris and Aroop Mangalick, with legal assistance from the American Civil Liberties Union and the national nonprofit Compassion and Choices.

State law currently says, “Assisting suicide consists of deliberately aiding another in the taking of his own life. Whoever commits assisting suicide is guilty of a fourth degree felony.”

But “aid in dying is not suicide,” said Kathryn Tucker, director of legal affairs for Compassion and Choices. “People used to refer to it that way, but it’s terribly inaccurate.”

Suicide normally involves people who have a possibility of a full life in front of them but decide to cut that life short, Tucker said, often due to a mental health issue.

Aid in dying, she said, occurs when a physician writes a prescription for a lethal dose of a medication for a mentally competent, terminally ill patient, who can then choose whether or not, when and where to ingest the medication.

Patients on life support can decide to be removed from life support, the suit points out. And patients who meet certain pain criteria can ask for lethal doses of pain medication. But others don’t have the same control over their deaths, robbing them of their rights to due process and equal application of law under the New Mexico Constitution.

Tucker said most patients who choose aid in dying have been through a lot of treatment — including procedures such as surgery, radiation and chemotherapy — before making the decision to end their lives. “They’ve come to a point where there is nothing curative left, Tucker said. “If they choose to endure a little less suffering, is that suicide? No. It’s distinctly different.”

For Riggs — who has been through a radical hysterectomy, four rounds of chemotherapy, five weeks of five-times-a-week external radiation and three weeks of once-a-week internal radiation treatments, and is still in treatment — the difference between suicide and aid in dying is the hope that the treatment will work.

“I have been through a lot,” she said. “All with the goal of coming through alive, with that hope. If I get to the point where I’m terminal, if it’s no longer a choice between living and dying, it’s a choice over what kind of death.”

If it comes to that, Riggs said, “I would have more of a sense of peace of mind knowing that I have more control and more choices.”

Riggs said she believes there are different types of death, some that involve extreme suffering on the part of the patient and their loved ones, and others that are more “peaceful.”

Tucker said data compiled from the state of Oregon, where assisted dying is legal, show that more than a third of the patients who received prescriptions from physicians that would have allowed them to end their lives don’t take the medication.

“They just feel a great deal of comfort knowing [the pills] are there,” she said.

According to data compiled by the Oregon Public Health Division, the medication most often administered in aid-in-dying cases is secobarbital, a drug used to treat insomnia and relieve anxiety before surgery.

More than 50 percent of the patients who choose aid in dying have advanced forms of cancer, according to the data. About 70 percent of the patients who take the medication inform their families first, and about 95 percent of them die at home.

Riggs said she heard about the lawsuit on the radio. “I thought, this is great that they are doing this,” she said. She sent an email asking if there was anything she could do to help. She thought she might host a bake sale or stuff envelopes. Instead, she got a call from the plaintiffs asking her to join the case.

Riggs moved to Santa Fe from rural Missouri three years ago in search of a “big change” and has been studying art at Santa Fe Community College.

She said she’s had a really good life that included a supportive family and amazing friends. She’s not out there skydiving, trying to cross things off her bucket list. She has accepted the fact that she may die sooner than she imagined. And she finds more comfort in talking about the possibility than in denying it exists. But she’s not giving up.

“I’m not done,” she said. “I’m not done at all. I’m not ready to go.” She still wants to travel more. She wants to spend more time with the people she loves.

But, she said, the disease has forced her to focus more on the present moment and to revise her plans for the future. She had been saving money in hopes of buying a home one day.

“That was something I had looked forward to,” she said. “Not anymore. I’ve come to realize I’m not a homebuyer in this life. I’m probably more of a renter in this life.”