ALBANY, N.Y. (WRGB) — New York’s Medical Aid in Dying Act officially took effect Wednesday, allowing eligible terminally ill adults to request medication to end their lives under strict legal requirements.
The law, one of the most closely debated measures in Albany in recent years, gives mentally capable adults with a terminal illness and a prognosis of six months or less to live the option of obtaining life-ending medication. Supporters say it provides patients with greater autonomy at the end of life, while opponents have argued it could place pressure on vulnerable people to end their lives prematurely.
Assemblymember Amy Paulin, who sponsored the legislation, spent years advocating for its passage, driven by her own family’s experience.
Paulin said watching her sister die from ovarian cancer reinforced her belief that terminally ill patients should have more end-of-life-choices.
“She would often, while she was in such pain, scream at the top of her lungs, ‘When am I going to die already?” said Paulin.
She added that for many patients, simply having the option provides comfort.
“They say that only about 40% or less of people actually take it because these are people who want to live. They’re not people who want to die,” Paulin said.
State Health Commissioner Dr. James McDonald said the law includes 13 safeguards designed to ensure the decision is voluntary.
“Because no one should be coerced into this,” McDonald told CBS6.
To qualify, patients must be evaluated by two physicians who independently determine they have a terminal illness with six months or less to live. They also must undergo a mental health evaluation by a licensed psychologist or psychiatrist to confirm they are capable of making the decision.
“It’s also important to know there’s a waiting period of at least five days from when the prescription’s written and when the prescription can be obtained,” said McDonald.
Patients are required to submit a written request witnessed by two people who cannot financially benefit from the patient’s death.
“It’s also important for people to know that when they fill out the form they’re attesting to this and they have to comply with the law,” McDonald said when asked who would verify that information.
Another requirement unique to New York is that patients must make a recorded oral request, either by audio or video. That recording becomes part of the patient’s medical record.
“That recording could be on a phone, but it has to be stored in the patient’s medical record,” McDonald said.
The state Department of Health has also developed reporting requirements, standardized forms and guidance for health care providers to document requests and ensure patients understand all available end-of-life care options, including hospice and palliative care.
While eligibility requirements are clearly defined, advocates say one of the biggest hurdles may be finding physicians willing to participate.
Participation in the law is voluntary for physicians, hospitals and other health care providers.
“I would say the biggest challenges will be access to doctors, especially early on,” said Mandi Zucker, executive director of End of Life Choices New York.
Zucker said her organization’s information line has seen call volume triple in recent months as patients and families seek information about the new law.
“We have been networking and developing relationships with doctors around the state. We’re not publishing their names for a lot of different reasons, but if patients are interested they can call us,” Zucker said.
Patients would need to find two separate physicians as well as a licensed psychologist or psychiatrist willing to do the assessment.
“There is an expectation that [physicians] would be knowledgeable about the law and perhaps refer someone appropriately to a provider who would provide this,” said McDonald.
Cost will be another big challenge for some, according to Zucker.
“Things related to Medical Aid in Dying are typically not covered [by insurance],” said Zucker. “Certainly not covered by federally funded insurances like Medicare.”
The Department of Health has posted regulations, forms and guidance for patients and providers on its website outlining the law’s eligibility requirements and implementation.
Medical Aid in DyingPDF previewPreview PDF
Medical Aid in Dying law informational presentation provided by NYSDOH