Steps for Using the End-of-Life Options Act
About the Process
Confirmation of Terminal Status by Two Providers
For Nurse Practitioners or PAs
If the prescribing provider for an individual not enrolled in hospice is an advanced practice nurse or physician assistant, they must obtain written confirmation from a consulting physician of…
- The patient’s terminal prognosis,
- Their mental capability to make end-of-life care decisions and
- Their ability to self-administer medical aid-in-dying medication before a prescription can be written.
Hospice-related Eligibility
Informed Consent
Confirmed Mental Capacity
The Form
The individual must fill out the “Request to End My Life in a Peaceful Manner” form and present it to their qualified clinician. The form is available in English, Spanish, Navajo/Diné, and Vietnamese (see below).
Waiting Period
About the Process
Elizabeth Whitefield End-of-Life Options Act: Information for New Mexico Residents).-
In addition to meeting the eligibility criteria, there is a process that must be followed in order to qualify for a prescription for aid-in-dying medication. Download this document made available by Compassion and Choices..
The Form:
‘Request to End My Life in a Peaceful Manner’
The individual must fill out the “Request to End My Life in a Peaceful Manner” form and present it to their qualified clinician. This form is now available in English, dual language Spanish & English, Navajo (Diné bizaad) and Vietnamese.