In recent years, the conversation surrounding end-of-life choices has gained traction, prompting many states to reevaluate their stance on the right to die. Currently, ten states and the District of Columbia have laws that allow for “medical aid” to end one’s life. New York, known generally for its progressive policies, has embarked on a lengthy journey to provide its residents with more autonomy over their end-of-life decisions.

While New York has long recognized the existence of a person’s fundamental right to self-determination over their own body and the type of medical treatment they receive, it has been over a year since the New York State legislature introduced the Medical Aid in Dying Act for the eighth year in a row. This blog article delves into the evolving landscape of the right to die in New York, the public discourse, including the opposition, and the implications for individuals facing life-altering decisions.

New York, known generally for its progressive policies, has embarked on a lengthy journey to provide its residents with more autonomy over their end-of-life decisions.

What is Medical Aid in Dying?

The latest iteration here in New York was legislation entitled “Medical Aid in Dying Act” (A995/S2445), which was introduced over a year ago. The law and the intention behind it would allow mentally competent, terminally ill adults to self-administer medication to bring about a “peaceful” death. In short, the law would allow mentally capable adults who have been diagnosed with an illness that is both incurable and irreversible and with a prognosis of six months or less to live to end their own lives.

Controversy Surrounding End-of-Life Legislation:

New York has witnessed both increasing and waning interest in end-of-life legislation in the last eight years and arguably decades before that. Nearly every year, a bill has been brought forth to address the right of a terminally ill patient to hasten the end of their life, offering what supporters claim is a dignified choice for those facing unbearably suffering. Each version of the legislation outlines strict eligibility criteria, ensuring that only mentally competent individuals with a prognosis of six months or less to live can access this option. However, such legal measures have sparked a robust public discourse on the right to die in New York.

The right to die in New York has sparked robust public discourse for the past eight years, with advocates emphasizing autonomy for terminally ill patients and critics expressing concerns about ethical, religious, and ‘slippery slope’ issues.

Advocates’ Perspective:

Advocates argue that individuals facing terminal illnesses deserve the autonomy to decide the terms of their death. The patients and their families, including many in the medical community, have argued that patients alone should be permitted to maintain control over the most intimate aspect of their lives and end the pain and suffering that many with terminal illnesses endure. In addition, there has been much criticism of the very American methodology of continuing treatment for terminal illnesses when the same treatment in other countries has long ago been abandoned in favor of a more humane death.

Opponents’ Concerns:

Opponents, on the other hand, express concerns that range from objection from a religious standpoint to ethical concerns regarding the sanctity of life. Many critics also worry that the passage of such legislation could lead to a ‘slippery slope’ of the criteria to qualify for medical aid to die, which will expand over time, thus placing the more vulnerable population at risk. Other criticisms include- a fear of abuse or coercion to end one’s life, resulting in individuals who might feel pressured to choose assisted death due to external factors, such as financial burdens, family dynamics, or societal expectations. Considering the cost of long-term care alone has risen between 10% and 20% each year in the last decade, financial concerns could have a very real impact on one’s decision-making process as it relates to the continuation of a life facing a terminal diagnosis and the hardship that often accompanies such a condition.

Opponents express concerns ranging from religious objections to ethical concerns about the sanctity of life. Critics fear a ‘slippery slope’ in qualifying criteria, potentially putting vulnerable populations at risk. Other worries include coercion, abuse, and the impact of financial burdens on decision-making.

Alternative Approaches and Criticisms:

Those in the scientific and research communities have also argued that investing in medical research for such terminal conditions and palliative care are both a better approach to addressing end-of-life suffering rather than legalizing medically assisted death that the stalled New York legislation would address.

Obviously, the various positions are valid, but they also shed light on the complex interplay of morality, ethics, and personal freedoms as it relates to the continuation of a terminal life.

What is available in the meantime?

While the right-to-die debate continues in New York, there are options for our residents. According to the NIH, palliative care and hospice services have seen increased support and funding. Palliative care aims to provide holistic and compassionate care for those with life-limiting illnesses. By bolstering these services and educating the public on hospice and palliative care services, New York seeks to ensure that individuals facing terminal conditions have access to comprehensive support, regardless of their stance on assisted dying. Organizations like Befriending Death are excellent resources for those faced with trying to parse through the details of life-limiting illnesses and the resources available to them (learn more about Befriending Death and its founder, Eileen Spillane, through my podcast interview).

While the right-to-die debate continues, New York residents have options such as palliative care and hospice services. These services have seen increased support and funding, providing comprehensive support for individuals facing terminal conditions.

Conclusion:

As our state lawmakers, patient advocates, and medical professionals navigate the ethical and moral dimensions of aiding patients in their end-of-life choices, it cannot be understated the importance of open communication between the patient, their doctor, and the patient’s advocate, including documenting one’s wishes with respect to their end-of-life care. Now more than ever, it is vital that patients have their wishes for long-term care memorialized into a proper healthcare proxy and advanced healthcare directives so that their chosen advocates can articulate their wishes, even if they are unable to do so independently, while the debate on the right to die rages on.