Medical Aid in Dying is an option in end-of-life care for the terminally ill

New York State is taking a historic step forward in end-of-life care as it becomes the 13th state, along with the District of Columbia, to authorize Medical Aid in Dying for adults facing a terminal illness with less than six months to live.

This historic legislation reflects years of thoughtful planning and consideration. Governor Kathy Hochul took exceptional care, meeting with patients and their families, medical professionals, advocacy organizations and the legislature to ensure the law protects the dignity of those facing a terminal illness while ensuring no provider or religiously affiliated health facility is forced to participate.

Medical Aid in Dying is completely voluntary for both patients and providers. No physician, pharmacist or healthcare provider is under any obligation to offer or administer Medical Aid in Dying to a patient. This is reflected in the careful language of the law and in the guidance and proposed regulations established by the New York State Department of Health.

The Department has worked diligently and thoughtfully in the weeks since Governor Hochul signed the legislation to establish guidance and to propose regulations designed to provide dignity and comfort to those who choose to use Medical Aid in Dying.

The legislation and subsequent draft regulations contain protections to ensure the law is not misused or inappropriately applied. 

Medical Aid in Dying requires a recorded oral request by a terminally ill patient, a mental health evaluation, and a determination by an attending physician and a consulting physician that a patient has a terminal diagnosis expected to result in death with six months and has decision-making capacity. These steps are followed by a mandatory five-day waiting period between when a prescription is written and when it can be filled. Each step is an important safeguard to ensure patients who exercise this choice are doing so voluntarily and without coercion.

Decisions about end-of-life care are deeply personal and best reached on an individual basis in consultation with a patient’s doctor, family members and loved ones. Having a terminal diagnosis can feel like your life is out of control, having an option for Medical Aid in Dying can offer some measure of control for what can be perceived to be an uncontrollable situation.

Facing a terminal illness is a painful experience that should be met with compassion and understanding. For some patients, simply knowing the right to Medical Aid in Dying is available may strengthen their ability to endure immeasurable suffering and provide comfort where relief is often hard to find.

As Governor Kathy Hochul said, this decision only became possible after thoughtful deliberation with those who will be impacted the most; patients, patients’ families and the medical professionals dedicated to their care.

Insights from physicians and family members gracious enough to share their experiences with Medical Aid in Dying offer an important lesson we can all learn from – there is no substitute for having thoughtful, compassionate, and understanding conversations with loved ones about their health and their care that include end-of-life options, like palliative care and hospice.

 I encourage everyone to have conversations about health care decisions and advanced care planning with loved ones early and often.

Conversations about health and care planning can be difficult and complex, even before anything is wrong or needed, but addressing the subject and checking in regularly can help make moments when health care decisions need to be made quickly easier for you and your loved ones.

Dr. James McDonald, New York State Health Commissioner