June 2020

State of the New Mexico Movement 

by Barak Wolff, Elizabeth Armijo, and Jill VonOsten, Coalition Steering Committee members

Background

Advocates in New Mexico have been working within the state for more than a decade to pass a medical aid in dying (MAID) bill. Medical aid in dying first emerged on the national stage in 1994 when Oregon voters passed the Death With Dignity Act ballot initiative. MAID is now authorized in 10 jurisdictions (Oregon, Washington, Montana, Vermont, California, Colorado, the District of Columbia, Hawaii, New Jersey, and Maine). Numerous polls reflect that the American public consistently supports medical aid in dying by large majorities across the demographic, geographic, political and religious spectra, including age, ethnicity, party and religious affiliation, people with disabilities, physicians, and gender identification.

MAID allows qualified, terminally ill adults to request and receive a prescription for medication that they may choose to take to bring about a peaceful death. To qualify, one must be an adult, have a prognosis of six months or less to live, be mentally capable, and be able to self-ingest the medication. The specific definitions, requirements, procedures, and safeguards are generally spelled out in each state law.

In 2012, the national end-of-life advocacy organization, Compassion & Choices, partnered with ACLU New Mexico in a lawsuit (Morris v. NM) to establish a constitutional right to medical aid in dying. The New Mexico End of Life Options Coalition was established in 2016 after the New Mexico Supreme Court ruled that medical aid in dying is not a constitutional right, but that it is an important policy that should be decided by the New Mexico Legislature. Click here to read more about the history of the Coalition and see a list of the current steering committee members. In 2017, the End of Life Options Act was introduced in the New Mexico Legislature, was successfully debated and passed by three different committees,  but then was narrowly defeated on the Senate Floor by a 22 to 20 vote.

In the summer of 2018, one of the state’s most high profile and vocal proponents for MAID Judge Elizabeth Whitefield, died from cancer without the option she desired. To honor her memory and her unwavering dedication to the cause, bill sponsors and champions, Representative Deborah Armstrong and Senator Liz Stefanics, were inspired to rename the bill. On December 12, 2018, the Elizabeth Whitefield End of Life Options Act was pre-filed  with the full support and backing of Governor Michelle Lujan Grisham. During the 2019 legislative session, the bill was passed by the House Health & Human Services Committee, the House Judiciary Committee and the Senate Public Affairs Committee. Unfortunately, it was not heard by either the full House or Senate and did not become law.

In the fall of 2019 as our New Mexico End of Life Options Coalition continued its advocacy and outreach efforts, our national partner Compassion & Choices, again contracted with a state-wide campaign organizer, in addition to their ongoing support of Elizabeth Armijo our long-time state coordinator. In this role, Jill VonOsten works with the Coalition Steering Committee to generate grassroots support as well as assess and identify areas of the state to strengthen communications and build support. Compassion & Choices also brought on Maria Otero, a bilingual Coalition member, to focus part-time on outreach in New Mexico’s rural areas, Spanish-speaking communities, and indigenous populations. These NM based resources have greatly assisted our Coalition Steering Committee in enhancing our outreach and advocacy efforts statewide.

Update of Recent Successes

With added capacity and renewed energy, the New Mexico End of Life Options Coalition has set a course in the past year to increase education and communication around end-of-life options and MAID. In order to be effective in passing a medical aid in dying bill in the upcoming 2021 New Mexico Legislature, our activities have been focused on outreach and communication that are inclusive and build diverse and wide-spread support from all corners of our state.

Along those lines and with the support of a grant from another of our national partners, the Death with Dignity National Center, we began distribution of a monthly newsletter in January 2020 to a large mailing list of supporters. The newsletter provides information on national end-of-life issues, updates on local activities, spotlights on advocates and volunteers, and book reviews on end-of-life topics. The Death with Dignity grant has also enabled us to upgrade and update our Coalition website on a regular basis. In addition, the Death with Dignity National Center has become a regular member of our Coalition Steering Committee. Our growth in 2020 includes a presence onto the social media platform of Facebook that has enabled us to reach new audiences and link them back to our website where our newsletter is permanently archived.

Our expanded communication efforts have also included having a regular presence in New Mexico’s leading newspapers through editorials, op-eds and letters to the editor; radio interviews, advertisements and public service addresses; and social media posts and digital ads. Rep. Debbie Armstrong was interviewed on the television show, Report from Santa Fe, on the local PBS Affiliate.  Just recently, billboards featuring messages to expand end-of-life options were leased along state highways in rural northwest, east and southeast areas of the state.

Another of the Coalition goals has been to build grassroots support across the state. In the last year alone, Compassion & Choices has reported an increase in the number of supporters in New Mexico from 5,317 to 6,238. There are currently three local action teams of volunteers that meet monthly. A new action team in Las Cruces was established and the number of members in the existing action teams in Silver City and Albuquerque were increased. In several other areas of the state there are groups of volunteers ready to jump into action when called upon. Each of these local action teams are represented on the Coalition’s Steering Committee.

Our volunteers are so committed to the passing of a MAID bill in New Mexico that they have turned out in large numbers to participate in volunteer and advocacy trainings, organizing meetings, joining action teams, setting up meetings to share resources and educate their lawmakers, and sharing their own personal stories of loved ones who needlessly suffered at end of life or used MAID in other states. A collection of stories from New Mexicans who shared their end-of-life experiences was compiled in this 2019 Storybook and handed out to state legislators. In the last year, we added ten new storytellers to the existing sixteen for a total of twenty-six.

Among our greatest efforts to increase grassroots support has been our presence in community events and statewide conferences and offering bilingual tools and resources. This year we participated in twenty-one outreach events including: booths and information tables at wellness, diversity and medical conferences; educational presentations at community events, senior centers, assisted living facilities, tribal communities and Pueblos; and informational sessions at luncheons, book clubs, churches, civic and leadership groups.

Many organizations have worked alongside the Coalition and our partners, Compassion & Choices and Death with Dignity National Center, to advance the movement. This year, we continue to seek new relationships with diverse partners statewide. In spring 2019, the New Mexico Medical Society and the Greater Albuquerque Medical Association dropped their opposition to MAID and discontinued use of the term “assisted suicide.” Dr. Steve Kanig, a former board member of the New Mexico Medical Society, joined the Coalition Steering Committee and testified at the legislature as an expert. In the spring of 2020, in association with the New Mexico Community Healthcare Worker Association, training on end-of-life options and advance directives was offered for community-based health providers.

Since 2017, we have worked to secure nonpartisan municipal resolutions in support of medical aid in dying. The Albuquerque, Santa Fe and Las Cruces City Councils all passed resolutions in support. We also secured endorsements and support from over a dozen statewide and local organizations.

Looking Forward

Passage of MAID legislation is within eyesight here in New Mexico. We will continue to conduct educational events, reach out to our rural and diverse communities, meet with lawmakers, obtain endorsements and garner support throughout New Mexico. We promise to keep you in the loop through action alerts, hearing notices, and upcoming events. If you are already receiving our newsletter, please pass it along for friends and family members to read and sign up for our mailing list.  Or consider joining our efforts and becoming a volunteer. Contact us here and we’ll get you set up.

We are in a unique moment in history. The current coronavirus pandemic will likely have a lasting and profound effect on how health care is delivered in this country. Our society is just beginning to understand important end-of-life realities — the immense value of telehealth to improve access to care, the critical importance of advance care planning for those final days and the duty of our healthcare system to clearly inform us of our options and honor our choices. By steadily widening majorities, Americans believe in their right to self-determination at life’s end and the New Mexico End of Life Options Coalition will continue working to protect and expand that right.

Hospice: A Critical End-of-Life Service (Part 1) 

By Libby Hopkins, MA, BSN, RN, CHPN, CHPCA

Editor’s Preface: This month we will begin a two-part look into the critical end-of-life service known as Hospice. Coalition steering committee member, Libby Hopkins, will walk us through the ins and outs of Hospice and other options to consider as people make their own decisions for end of life care.

Besides volunteering with the Coalition, Libby has a litany of initials following her name. She is a Registered Nurse and holds a BS in Nursing, a Master’s in Organizational Management and a Graduate Certificate in Applied Thanatology (the study of death, dying and mourning). She maintains certifications as a Hospice and Palliative Care Nurse, and a Hospice Compliance Professional. Libby is currently the Director of Quality Improvement for Hospice of New Mexico, but her long career consists of serving in leadership, clinical and education roles for multiple NM hospice organizations, including NM VA Healthcare System, Presbyterian Home Health and Hospice, and Hospice of the Sandias, among others. In addition to serving on the Coalition steering committee, Libby is active with the Conversation Project and volunteers with the Chevre Kaddisha: participating in the holy washing ceremony for Jewish bodies at local mortuaries. She is a community presenter (as has presented nationally and internationally) on topics related to serious illness, palliative and hospice care.

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Patient-centered care at end of life is my passion. Ever since I first learned about self-determination, health care decisions, living wills and advance directives, I have sought to help patients make informed decisions (preferably early and in writing) and chart their own courses for their own end-of-life experiences. Ensuring that patients have an understanding of, and access to, the entire continuum of options available to them without judgment or influence outside of their own chosen loved ones and are able to freely select experts and health care providers is key. Informed decision-making is particularly important when it comes to serious illness and end-of-life care, during which many patients are involved in the “Palliative Healthcare continuum”, which includes Hospice.

The Hospice philosophy is one of “Care, not Cure”, and exists to promote quality of life during the time an individual has remaining, whatever “quality” means to the patient, and to his or her “family” as defined by the person. Hospice epitomizes self-directed and patient-centered health care, and focuses on the entire human being: physical, emotional, spiritual, and psychosocial.

The first hospice, as we know it today, was developed by Dame Cicely Saunders in England in 1967.  Dean of Yale School of Nursing, Dr. Florence Wald studied with Dr. Saunders, and Wald ultimately founded the first hospice in the United States in 1974 in New Haven, Connecticut.  In 1983, Hospice became a benefit for Medicare recipients, and is now covered by Medicare Part A, Medicaid, many private insurances, and the VA. Hospice eligibility is tightly regulated by The Centers for Medicare and Medicaid Services (CMS) and to be eligible one must have a 6-month life expectancy (if the disease runs its normal course) and meet other specific criteria related to their terminal diagnosis.

 

What is Hospice and How Does It Relate to Palliative Care?

The Palliative Care continuum is the wide umbrella under which Hospice falls. Unlike hospice care, palliative care itself is not covered under the Medicare Hospice Benefit, does not require a 6-month life expectancy and does allow for continuation of active, aggressive medical treatment. Anyone diagnosed with a serious, chronic or life-limiting illness is eligible for a palliative care consultation which is reimbursable through most insurance policies, including Medicare.

The Palliative focus is on assisting patients and loved ones to make informed and self-determined decisions about their care and treatment. Palliative care is based on holistic care and quality of life, whatever that means to the individual and addresses physical, spiritual, emotional and psychosocial aspects of the patient and whomever he/she identifies as family. Early palliative care and intervention greatly improves the possibility of a self-determined care process for disease management and ultimately for end-of-life care with smooth transition to Hospice care if and when appropriate and elected by the patient or representative. As depicted below, all hospice care is palliative, but not all palliative care is hospice.

Hospice services can be provided wherever the patient lives, from the patient or family’s home, a nursing home or assisted living facility, a homeless shelter, or even in the streets if this is the patient’s desire and it is a safe circumstance for care provision.  While over 90 percent of hospice care is provided wherever the patient calls home, there are four levels of care covered by the Medicare Hospice Benefit:

• Routine Home Care – The most common level of care with regular visits by Hospice team members to home or facility;
• Continuous Care -– Brief and more intensive level of home care for acute treatment of intractable symptoms in the home;
• General Inpatient – Brief and more intensive level of care in hospital/facility to stabilize intractable symptoms that cannot be managed at home; and
• Respite Care – a 5-day period, which can occur periodically, where the patient is placed in a facility and continues to be visited by the Hospice team to provide respite and time out for loved ones/caregivers.

Given the holistic nature of Hospice, it is not surprising that the Hospice team consists of a multi- and interdisciplinary team including specialized physicians, nurse practitioners, nurses, hospice aides, social workers, chaplains, bereavement counselors and volunteers. Additional practitioners may include physical and occupational therapists, speech therapists and others. The Medicare Hospice Benefit is very comprehensive and includes the provision of hygiene supplies, wound and skin care supplies, incontinence products and the like; medical equipment such as hospital beds, wheelchairs, shower benches, oxygen machines and many others; and medications related to the terminal hospice diagnosis. The Medicare Hospice Benefit is inclusive and the hospice patient has no additional charges for services related to the Hospice diagnosis.

If one qualifies, it is always a patient’s choice, or his/her representative’s, whether or not to utilize the Medicare Hospice Benefit. It is also within the patient’s discretion to determine which hospice to choose, to change hospice care agencies, and even to withdraw from Hospice care altogether. Patients who choose to revoke the hospice benefit for any reason, for example to give aggressive cancer treatment another try, are entitled to be re-admitted to the same or a different hospice whenever they choose, as long as they continue to meet the Medicare eligibility criteria

Considerations When Selecting Hospice Care

Not all hospices are alike. While they all must follow certain very specific federal regulations set out by CMS, and are monitored by various state and other regulatory bodies, the fact is that there are many factors one must consider, i.e. location of services, quality of care, specific services provided, response time commitments, staff education and competence, education and support provided to loved ones while the patient is on service and after his or her death.

Patients in the United States have various end-of-life options, many of which are routine, readily available and legal in all states. Others depend on the laws of a given state, the patient’s specific illness, proximity to advanced medical resources, values and training of physicians and other providers, and many other variables which may limit or enhance accessibility. While all hospices must provide routine end-of-life inter-disciplinary comfort care as set forth by the Medicare Hospice Benefit, the following are some of the end-of-life care elements that those in the process of selecting a hospice may wish to inquire about, since some are not provided by all hospice agencies, or may be provided differently by various hospices:

• Pediatric Hospice program
• Expanded Volunteer Program (e.g. massage, Reiki, hair styling, special Veteran services, home-assistance, end-of-life vigil, legacy of life recording, music therapy, etc.)
• Expanded Bereavement Services (e.g. special groups for various types of grief, care for minorities, Spanish or other languages, qualified care for grieving children, etc.)
• Home Continuous Care if necessary and desired, and criteria met
• General Inpatient Hospice unit if necessary and desired, and criteria met
• Home ventilators, tracheostomy tubes, or feeding tubes and if so, under what circumstances
• Palliative interventions (e.g. radiation, blood transfusions, abdominal and chest drainage tubes)
• Antibiotics if desired and appropriate
• Interventions unrelated to hospice diagnosis
• Variety of methods of medication administration and symptom management
• Palliative Sedation (IV sedative medication to reduce consciousness to treat severe shortness of breath when other treatments have been ineffective)
• Voluntary Stopping of Eating and Drinking (VSED)
• Medical Aid in Dying (MAID) – this will be discussed more in Part 2

It is important to interview hospice agencies, and in some cases, you may wish to visit directly with a nurse or social worker in addition to the outreach liaisons who often coordinate admission logistics and paperwork and may not be licensed clinical professionals. There are a number of tools and questionnaires available to assist in asking salient questions when selecting a hospice provider. Here are two respected and widely used resources:

• Hospice Foundation of America – “How to Choose a Hospice Provider”
• National Hospice and Palliative Care Association – “Choosing a Quality Hospice for You and Your Loved Ones”

Additionally, CMS now has a website entitled “Hospice Compare”, which highlights and compares various care elements of hospice organizations, using data hospice agencies are required to submit to Medicare at regular intervals.

Hospices typically have access to the latest knowledge in pain and symptom management. In addition, they are staffed with Board certified Hospice and Palliative providers (some of whom have completed a Palliative Fellowship), specially trained personnel (many of whom are certified in Hospice and Palliative care), robust volunteer programs, and the latest equipment and methods of medication and treatment administration. Finally, Hospice directs its focus on patient-centered care – the person, his or her loved ones and their needs, and care and support of loved ones following the death. However, hospice care cannot meet all of the needs of every patient every time.

Many enter hospice with the expectation of avoiding a “bad death,” or at least one free from pain and suffering. But a “good death” means something different to each individual, because each person suffers differently, values different things, and has a different physical, spiritual, emotional, psychosocial, and experiential makeup. Over the years, hospice patients have shared with me what a “good death” means to them.  Some examples include: never becoming incontinent or having a catheter; never becoming dependent on others for their basic needs; not living when unable to recognize others or communicate their needs; being able to plan exactly when, where and with whom they would like to be with them when they die; not becoming disfigured; not wanting to die in the throes of continued seizures; never becoming bed bound; and dying before any pain or physical suffering could even start.

No entity or service can alleviate all aspects of individual suffering and meet the self-determined wishes of every individual, despite best efforts. Hospice is definitely a robust, comprehensive, and patient-centered set of services and with these options for care, the vast majority of people can achieve the type of end-of-life experience they seek, aka “a good death.”  And as with most things, the earlier you consider your choices for care, the more options you will have available to you, and the more likely it is you will achieve the kind of death you desire.

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Editor’s note: Next month, look for Part 2 of our focus on Hospice, where we will explore how some hospice organizations are adjusting to meet the needs of patients in states where medical aid in dying is authorized.   

The 2021 Political Season Begins: NM Senate Primary Wins Exceed Expectations

By Barak Wolff, Coalition Steering Committee member

In the May newsletter, several articles indicated that the New Mexico Primary Elections would give us a better idea of the magnitude of the challenge and where to focus our political energies (and contributions) in the November General Election. This kind of analysis is critical to maximize our chances of having sufficient votes to pass the Elizabeth Whitefield End of Life Options Act during the 2021 legislative session.

We are thrilled to report that when the dust settled, returns showed that there were a number of major upsets, some totally unexpected, that if coupled with similar wins in November, may give us a solid advantage in the Senate going into the legislative session next year.

As some of you may recall, back in 2017 when we first tried to pass the End of Life Options Act, our bill was defeated by a close 22-20 vote in the full Senate. The tally revealed that seven of the negative votes were cast by conservative Democrats who voted with all but one Republican to vote down our bill. Although medical aid in dying (MAID) is not a partisan issue, unfortunately it often plays out that way…similar to other challenging social issues such as abortion, gun safety, etc. Although our 2019 campaign never got to a floor vote in either the House or Senate, our sense is that the same partisan divide existed and a number of conservative Democrats having strong concerns about MAID on religious or philosophical grounds. The recent Primary Election was the first time that all of the conservative Democrats in the Senate who voted against our MAID bill had primary challengers who campaigned on a more Progressive platform

It is exciting to announce that five of these challengers, all first-time candidates for state office, defeated those incumbents, three of whom were powerful leaders and/or committee chairs with many terms of service in the Senate. Here is a summary of these unprecedented upsets:

Senate District (SD) 5 (representing Los Alamos, Rio Arriba, Sandoval and Santa Fe Counties)
Leo Jaramillo (D) defeated incumbent Richard Martinez (D) in the Democratic primary. Jaramillo voiced his support of MAID in the May 2020 Albuquerque Journal candidate questionnaire and Martinez, who was Chair of the Senate Judiciary Committee at the time, voted against MAID on the Senate Floor in 2017. Jaramillowill face Libertarian Lee Weinland and Republican Diamantina Prado Storment from Chama in November.  The views of these two candidates regarding MAID are unknown, but will be requested.

SD 28 (representing Catron, Grant and Socorro Counties)
In this Democratic race, Siah Correa-Hemphill defeated incumbent (by appointment) Gabriel Ramos who had voiced his opposition to medical aid in dying (MAID) in the May 2020 Albuquerque Journal questionnaire. Correa-Hemphill has strongly voiced her support for MAID and will now face small businessman and rancher from Catron County, James Williams (R) in November. Williams has not publicly indicated his stance on MAID, but it will be solicited.

SD 30 (Cibola, Socorro, McKinley and Valencia Counties)
Pam Cordova (D) defeated incumbent Clemente Sanchez (D). Sanchez who had voted against SB 252 on the Senate Floor in 2017. Cordova responded to the Journal questionnaire supporting autonomy, saying “I believe these are difficult and personal decisions between individuals, families and doctors, free from government interference.”  Pam Cordova will face Joshua Sanchez (R), a small business owner from Belen, in November. His position on MAID will be solicited. 

SD 35 (Doña Ana, Hidalgo, Luna and Sierra Counties)
Neomi Martinez-Parra (D) defeated 31-year incumbent John Arthur Smith (D). In the Journal profiles, Martinez-Parra voiced her support of MAID and Smith voiced his opposition to MAID. He also voted against the measure on the Senate floor during the 2017 legislative session. Martinez-Parra will run against Republican Crystal Diamond from Elephant Butte who did not respond to the May 2020 questionnaire.  Her position on MAID will be requested.

SD 38 (Doña Ana County)
Carrie Hamblin (D) defeated 19-year incumbent Mary Kay Papen(D). While Senator Papen voted in favor of MAID on the Senate Floor in 2017, she has not been supportive of other right to choose issues. Hamblin, on the other hand, has clearly voiced her support, stating to the Journal: “Allowing someone to die with dignity is one of the most humane things we can do.”  Hamblin will face Charles Wendler (R) of Las Cruces in November. His stance on MAID will be solicited.

Since every House and Senate incumbent is up for re-election this year, there are many more races that were contested in the recent primaries and will be on the ballot again in the November General Election. Some of these incumbents have no opposition, but most do. Over the next few months, we will highlight other contested races for both the Senate and House and call out their positions on MAID

Ultimately the results from these November elections will decide whether or not the Elizabeth Whitefield End of Life Options Act will pass both houses and then be sent to Governor Michelle Lujan Grisham’s desk for signing into law. Thankfully, as we all know, the Governor is a clear and enthusiastic supporter of MAID. Just as in these recent primaries, our public support, with or without political contributions, for candidates who agree with medial aid in dying will make a critical difference to the success of our 2021 campaign.  Stay tuned…

Countdown

Time flies and it’s just 7 months until the 2021 Legislative session is set to begin. We are counting down and providing supporters with actions they can take each month to show their support and advocate for the passage of medical aid in dying legislation.

In light of the pandemic, C&C has created a COVID-19 Toolkit to help navigate care preferences at life’s end during this difficult time. This toolkit is now available in English and Spanish.

Action Item: Please help us meet our goal of reducing disparities in end-of-life planning and healthcare that negatively impacts Spanish-speaking population in the U.S. by sharing the Spanish-language version of this toolkit with lawmakers and Spanish-speaking individuals and communities.

Outreach

Collaboration with the Mexican Consulate

As COVID-19 continues to claim more and more lives, a new initiative between Compassion & Choice’s and the Mexican Consulate’s Secretary of Foreign Affairs (SRE) will help U.S. based Mexican immigrants learn about their full range of end-of-life care options. Hispanics in America are 18% of the US population, but account for 25% of COVID deaths.

This historic collaboration between the Mexican Consulate and C&C was, in large part, the brainchild of our own NM Coalition steering committee member, Maria Ulloa Otero. Maria, who serves as the National Constituency Manager for Compassion & Choices, says “the goal is to reduce the disparities in end-of-life planning and healthcare that negatively impact the Mexican community living in the United States. We are living in very difficult times, and we must ensure that Mexican immigrant families are well informed about their care options at the end of life.

End-of-life planning and education will be offered as part of the Mexican Consulate’s national health outreach program, Ventanillas de Salud (Windows of Health), which serves over one million individuals and their families located in at least twenty-three cities across the U.S., including Albuquerque. C&C tools such as the bilingual End-of-Life Decisions Guide Toolkit and COVID-19 Advance Directive addendum will be central to the outreach. You can read more about this important collaboration here.

Las Cruces

The Las Cruces Action Team has been creatively finding ways to engage the community and their State legislative candidates while still observing social distancing guidelines. Last month, team members wrote emails to the primary candidates running for State House and Senate seats from Doña Ana and surrounding counties to ask their stance on medical aid in dying. They successfully received responses from most of those running for the seats.

The team also attended online community meetings and even provided a presentation on Zoom (web conferencing) to the Interagency Council which is a network of social service providers in Doña Ana County. Mary Kay Brady, the Action Team leader, will present to the Las Cruces Palliative Care Coalition later this month on her recently recorded MIDEO® – recording your end of life wishes on video – that we reported on in our newsletter last month.

Rural Area Billboards

Later this month, billboards will be installed in three remote locations in the state. The billboards, funded by C&C, feature Rio Rancho resident Glenn Buckland, and include a message of self-determination and compassionate options at end of life. The three billboards will be located on Hwy 550 between Bernalillo and Cuba, on U.S. 1-40 near Santa Rosa, and Hwy 285 between Roswell and Artesia.

These locations in the northwest, eastern and southeastern parts of the states were selected based on an assessment conducted last fall when we looked for areas in the state where there had been gaps in our outreach, but that offered new opportunities to promote end-of-life planning and options. C&C State organizer, Jill VonOsten says it is “always a challenge to reach rural residents because there are limited opportunities to gather as a community. These selected locations are highly traveled by those living in rural areas and the billboards allow us to introduce ourselves and the website to those residents.”

Education in Rural and Indigenous Communities 

Our efforts to reach rural New Mexicans got a boost this month. Just before the pandemic, Maria Otero through her NM-based organization Nuestra Salud, had received approval from the NM Dept. of Health (DOH) to provide an end-of-life educational course to Community Health Workers throughout the state. A Community Health Worker (CHW) serves as a bridge between the community and healthcare, government and social service system and provides an especially critical link in rural and indigenous communities in NM where healthcare resources are scarce.

CHW’s are required to have continuing education and this course, available in English and Spanish, offers 1 unit of continuing ed credit. This month, the NM DOH approved that this course could also be provided via webinar and available “on demand.” The first scheduled webinar was offered on June 11.

Online Training for Advocates  

Are you a supporter of death with dignity and want to learn more about how to become an advocate? Death with Dignity National Center is offering a webinar in three parts, called Dignity50 Roadmap Series, to help train beginning grassroots advocates.

The three sessions will introduce model language and terminology, cover different points of view and provide an overview of the legislative process.  Specifically, the training will help participants learn:

• why Oregon’s ground-breaking Death with Dignity Act is the model all other states have used;
• how to recognize opposition messaging and how they might respond; and
• what the legislative process looks like and how grassroots advocates can affect change at the state level.

The online series repeats monthly and begins at 9:30 a.m. (Mountain). It generally runs on the first, second and third Tuesdays of each month unless otherwise noted on the session announcements. Valerie Lovelace is the trainer and she led the effort to pass an aid in dying law in Maine. Sign up here.

Movie Review 

Review by: Mary Kay Brady, Action Team Leader Las Cruces

As the pandemic has forced many of us inside and into isolation, I found a side perk… it’s a great time to step up my book reading and movie watching!

Just now, I finished watching a compelling story directed by Mike Nichols and starring Emma Thompson, entitled Wit. The movie is based on the 1999 Pulitzer Prize winning play of the same title by Margaret Edson. This 2001 film provides a stunning story of the treatment of one person with metastatic Stage IV ovarian cancer.

The main character, Vivian Bearing a professor of English literature, endures 8 “full treatments” of chemotherapy to the delight of one of her young doctors who is into his research trying to find out why cancer cells continue growing and growing. Thank heaven for a kindly nurse who insists on honoring her DNR status. Not to be a spoiler, but Vivian dies at the end of the film reciting, in voiceover, John Dunne’s sonnet, “Death be not proud.”

Death be not proud, though some have called thee
Mighty and dreadful, for, thou art not so;
For those whom thou think’st thou dost overthrow
Die not, poor Death, not yet canst thou kill me.

From rest and sleep, which but thy picture be,
Much pleasure; then from thee much more must flow,
And soonest our best men with thee do go,
Rest of their bones, and soul’s delivery.

Thou’rt slave to fate, chance, kings, and desperate men,
And dost with poison, war, and sickness dwell;
And poppy, or charms can make us sleep well
And better than thy stroke; why swell’st thou then?

One short sleep past, we wake eternally.
And death shall be no more; Death, thou shalt die.

If you haven’t completed your end-of-life documents, this movie will compel you to do so. My tears were flowing as this fine woman’s life ended. She had suffered so much and the humiliation of her disease and treatment was shocking. Is this how any of us wishes to have their life end?