New York Legalizes Medical Aid In Dying After Decade-long Battle

ALBANY, New York — New Yorkers with no more than six months to live who meet a strict set of requirements are now able to request life-ending medication from their health care providers.

The controversial Medical Aid in Dying Act went into effect Wednesday, paving the way for New Yorkers with terminal illnesses to request lethal medication. New York becomes the 14th state, along with the District of Columbia, to legalize medical aid in dying. Advocates continue to push similar legislation in more than a dozen other states.

The law takes effect after a decade-long fight by supporters facing fierce opposition from the Catholic Church, disability rights advocates and some health care providers.

Democratic Gov. Kathy Hochul took into account some of their concerns when negotiating amendments to the law with bill sponsors former Sen. Brad Hoylman-Sigal and Assemblymember Amy Paulin, before signing it in February.

As a result, New York’s law is one of the strictest in the country with safeguards such as multiple patient requests, a residency requirement and a mental health evaluation. To qualify, a person must be at least 18 years old; have a medically confirmed terminal illness that is likely to cause death within six months; be of sound mind and be physically capable of self-administering the lethal medication.

Kevin Diaz, president and CEO of Compassion & Choices, a national end-of-life advocacy group, said while they were disappointed by additional safeguards added through negotiations — such as the residency requirement and mental health evaluation — his organization has worked closely with the state on the implementation process.

“Our relationship with the officials in New York has been good, and a collaborative one. There are a lot of people, a lot of organizations who are really trying to make sure that this is one of many options that exist for people who are facing end-of-life decisions,” Diaz said. “The goal is really to make sure that people have that full array of options because medical aid in dying ultimately is something that very few people pursue, but it gives people comfort knowing that it's available.”

After the law was signed by Hochul, the state Department of Health was charged with drafting a framework for its implementation. Health officials announced guidance for how to request and administer the life-ending medications last month, which prompted several legal challenges aimed at barring implementation of the law.

A lawsuit alleging the legislation violated state disability rights laws was dismissed by a federal judge last week. However, four orders of Catholic nuns succeeded in securing a temporary court order Thursday exempting them from participation in the medical aid in dying law. It bars the state from requiring the Carmelite sisters and their employees from providing counseling, making referrals, documenting requests for lethal medication or assisting in eligibility determinations.

Hochul spokesperson Nicolette Simmonds said the law already included protections for religious institutions that don’t want to play any role in helping terminally ill patients end their lives.

“While we cannot comment on any pending litigation, under this historic legislation participation is entirely voluntary, and religious facilities have the right to opt out if they choose to do so,” Simmonds said in a statement.

Becket, a nonprofit religious liberty group, filed the lawsuit on behalf of the Carmelite Sisters. Adèle Keim, senior counsel for Becket, said the nuns are concerned by the state’s choice to have providers opt out of participating in aid in dying, rather than an opt-in system used in most other states. She also noted that while they can opt out of actively participating, it’s unclear if the state will require them to inform eligible patients of the life-ending option.

“The sisters and the health care providers that are in this lawsuit are coming into court and saying, ‘We don't want to have to tell our patients at their lowest moment that they could just end it all. We don't think that's treatment. We want to walk beside them to the end of their lives, and we don't want to be seen as encouraging them to give up and to despair’,” Keim said.

Advocates are celebrating their win, but also have their sights set on expanding the end-of-life offering to more states. Diaz said he’s hoping to see other states with pending legislation, such as Maryland, Massachusetts, Virginia and Minnesota, follow suit. While New York was one of the longest fights, he’s hopeful that growing support will lead to swifter passage in other states.

“We are pushing everywhere and we really want to make sure that people’s wishes are respected and known,” Diaz said. “What we want them to have is those options to have the best possible care, whether that's hospice or palliative or whatever.”