New Yorkers received a dubious holiday gift last week when Gov. Kathy Hochul announced she would sign a bill legalizing assisted suicide (also known as \u201cMedical Aid in Dying\u201d or \u201cMAiD\u201d). Beginning this summer, New Yorkers who have been told by a doctor that they have six months or less to live will be able to request lethal prescriptions, which they can self-administer at the time and place of their choosing.<\/p>\n
New York\u2019s journey to becoming the 13th state to legalize physician-assisted suicide has been a long one. First introduced in 2015, the state\u2019s \u201cMAiD Act\u201d failed to pass an Assembly vote every year until this one. Narrowly passed by the Senate in June, the bill had been awaiting the governor\u2019s signature for months, with both opponents and advocates fearing the meaning behind the delay.<\/p>\n
In a press conference, Hochul said<\/a> signing the bill was \u201cone of the toughest decisions [she\u2019s] ever made as governor,\u201d acknowledging the concerns of many constituents about the effect the bill could have on the most vulnerable. As originally written, the bill would have made New York\u2019s assisted suicide law one of the most permissive in the country, with no waiting period between request and access to lethal drugs, no required screening for depression, and minimal reporting requirements. Hochul\u2019s signature is conditional upon the passage of amendments designed to tighten requirements and prevent abuse. But even with guardrails, the decision to sanction deliberate self-killing and legalize a procedure that the American Medical Association this summer called \u201cfundamentally incompatible with the physician\u2019s role as a healer<\/a>,\u201d is a watershed moment.\u00a0<\/p>\n Hochul\u2019s decision comes as a blow to all those in New York who believe in the sanctity of life. New York\u2019s Catholic bishops and Timothy Cardinal Dolan (New York\u2019s archbishop from 2009 until his retirement last week) responded with a statement<\/a> reiterating that physician-assisted suicide \u201cis a grave moral evil\u201d and suggesting that the passage of the bill undermines Hochul\u2019s other anti-suicide efforts. Many Jewish<\/a> leaders<\/a> also lobbied against the bill, and religious opposition seemed to prompt Hochul, who is Catholic, to respond<\/a> in religious terms: \u201cI was taught that God is merciful and compassionate, and so must we be. This includes permitting a merciful option to those facing the unimaginable and searching for comfort in their final months in this life.\u201d<\/p>\n But mercy is not what many people see in physician-assisted suicide. \u201cShe really, really did not understand where the disability community was coming from,\u201d said Sharon Shapiro-Lacks, board member for the Brooklyn Center for Independence for the Disabled, who is herself disabled, in an interview. \u201cKathy Hochul could not get that this is not a religious issue, that we were objecting to the systemic issue that doctors would be making the call as to who has a rational cause to want to end their life prematurely.\u201d<\/p>\n While severe pain is often used as a reason to legalize assisted suicide\u2014and is indeed one reason<\/a> some patients seek it\u2014many requests for lethal doses also come from those who fear loss of independence<\/a>. Indeed, what many in the disabled community fear is a world where a loss of autonomy is seen as a valid reason to die.<\/p>\n \u201cPeople are more scared of losing their capacities more than of the pain,\u201d argues Shapiro-Lacks, who has been fighting for disability rights for more than 40 years. \u201cThroughout my life, I\u2019ve been told, \u2018Oh my, you\u2019re remarkable, I could never live like that. If I had to be in a wheelchair, I don\u2019t know what I would do.\u2019 And that always bothered me, because that kind of inspiration is a backhanded compliment. What it actually says is, \u2018I wouldn\u2019t live if I were you.\u2019\u201d<\/p>\n According to Shapiro-Lacks, a choice to end one\u2019s life because of a terminal illness is not a free choice unless one has access to an array of supportive options for the remainder of one\u2019s life. At a time when New York is seeing a caregiver shortage<\/a>, a breakdown in the state\u2019s home care program<\/a>, a crackdown on opioid prescriptions that relieve chronic pain<\/a>, and abysmal Medicare utilization of hospice<\/a>, the basics for supportive end-of-life care are barely there.\u00a0<\/p>\n Some physicians fear that the structure of the medical system will not encourage attentive and nuanced care to those in distress. \u201cThere is in fact danger that many of our patients will be coerced into death,\u201d said Dr. Lydia Dugdale, a physician and ethicist at Columbia University, in an interview. \u201cThe number one drive in medicine is efficiency, and that\u2019s not going to leave ample space for properly evaluating someone\u2019s mental health or working through death anxiety.\u201d<\/p>\n Those who trust the proposed guardrails to prevent abuse should look at what\u2019s happened in other states, says Jessica Rodgers, coalitions director for Patients\u2019 Rights Action Fund, a national nonprofit fighting assisted suicide. \u201cIn every state where [assisted suicide] is passed, the work is to organize to fight expansion.\u201d Compassion and Choices, a well-funded nonprofit advocating for assisted suicide, has sued multiple states to remove residency requirements, and multiple states have quietly rolled back guardrails after the fact. Oregon and Vermont have removed their residency requirements<\/a>. In 2023, Washington reduced its waiting period and expanded the list of eligible prescribers of lethal doses<\/a> to include nurse practitioners and physician\u2019s assistants. In Vermont, there has been an attempt to allow naturopaths to provide assisted suicide<\/a>, though so far it has not succeeded. California reduced its waiting period from 15 days to 48 hours<\/a>.<\/p>\n \u201cThe future is in litigation,\u201d Rodgers says. Shapiro-Lacks agrees: \u201cWe\u2019re going to have to try the best we can to put even more guardrails around it and prevent the dissolution of existing guardrails. We are going to be very vigilant around that. Also, we need to educate people about their intrinsic value and how they can lead meaningful lives, with supports, technology and pain relief, as they lose their capacities over time.\u201d<\/p>\n How much support anti-suicide advocates will have in New York remains to be seen. Black and Hispanic populations largely oppose<\/a> assisted suicide, and the Chair of the New York State Black, Puerto Rican, Hispanic, and Asian Legislative Caucus argued that the bill would \u201ctarget vulnerable communities of color<\/a>.\u201d Hochul seems to have dismissed these voices, along with those of the disabled\u2014though after a delay that lends credence to her claim that she found the decision difficult. She seems unlikely to have purchased much political favor with her approval\u2014while a majority of New Yorkers<\/a> approve of assisted suicide, it is not a make-or-break electoral issue, and the bill only narrowly passed in the legislature, with more than 20 Democrats voting against the bill in each house. Perhaps the story of the bill\u2019s passage is the story of how a small but vocal minority of highly engaged activists won by their persistence.<\/p>\n With new bishops in Albany and the archdiocese of New York, the Catholic Church in the state has a chance for a fresh response. Will new leadership focus on end-of-life issues as much as on abortion? Will there be consequences for the Catholic lawmakers who voted for what the Church considers grave evil? Will young people respond as they see their grandparents end their lives?<\/p>\n