New York will become the latest state to allow doctors to prescribe lethal medication to patients when its Medical Aid in Dying Act takes effect on Wednesday, allowing eligible adults to request and administer drugs to assist them in committing suicide.
Governor Kathy Hochul signed the legislation into law on February 6, following years of debate, making New York the 14th U.S. jurisdiction to permit the practice.
Under the statute, a mentally capable adult resident of New York who has been diagnosed with a terminal illness expected to result in death within six months may obtain a prescription for life-ending medication after meeting a series of procedural requirements.
To qualify, the patient must be at least 18 years old, a New York resident, and confirmed by both an attending physician and a consulting physician to have an incurable and irreversible condition that will produce death within six months.
Under the law, the individual must demonstrate decision-making capacity and make a voluntary, informed request free of coercion.
The process requires an oral request that is audio or video recorded and permanently stored in the medical record, followed by a signed written request witnessed by two people who cannot benefit financially from the patient’s death.
A mandatory evaluation by a psychologist or psychiatrist is required to confirm capacity, and a five-day waiting period applies between the writing and filling of the prescription unless the attending physician determines the patient is likely to die sooner.
The medication must be self-administered by the patient.
Participation by physicians, pharmacists, and other health care professionals is voluntary, and those who decline must facilitate a transfer of care.
“Medical aid in dying addresses deeply personal decisions that may arise for individuals facing a terminal illness and their loved ones,” State Health Commissioner Dr. James McDonald said in a press release. “This legislation reflects years of thoughtful planning and consideration, and the Department is committed to implementing the law thoughtfully and responsibly. As the effective date approaches, it is important that New Yorkers have the opportunity to review and understand measures designed to provide dignity and comfort at the end of life.”
Critics, particularly from pro-life organizations and religious institutions, have argued that this law opens the door to abuse, places vulnerable patients at risk of pressure, and fundamentally alters the role of medicine from healing to facilitating death.
In a recent development, a federal judge issued a consent order temporarily shielding four Catholic religious orders, the Diocese of Rockville Centre, and related ministries from enforcement of the law, after they argued that requirements to counsel or refer patients for assisted suicide would violate their religious beliefs.
The order provides relief ahead of the August 5 effective date while the lawsuit proceeds.
In July 2021, the Psychiatric Times published an article in opposition to assisted suicide and noted that “preliminary reports suggest increased rates of suicide in the general population of states that have legalized PAS (physician-assisted suicide). Specifically, ‘legalizing PAS has been associated with an increased rate of total suicides relative to other [non-PAS] states, and no decrease in non-assisted suicides.’ Similarly, suicide rates in the Netherlands (where medical euthanasia is legal) have accelerated, compared to neighboring countries that have not legalized medical euthanasia.”
They report that physician and ethicist Leon Kass, MD, has pointedly cautioned: “We must care for the dying, not make them dead.”
The American College of Physicians has said, “Physician-assisted suicide is neither a therapy nor a solution to difficult questions raised at the end of life. On the basis of substantive ethics, clinical practice, policy, and other concerns, the ACP does not support the legalization of physician-assisted suicide. … However, through high-quality care, effective communication, compassionate support, and the right resources, physicians can help patients control many aspects of how they live out life’s last chapter.”
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