State lawmakers are once again considering a bill that touches on some of the most difficult questions New Yorkers face.
“We opened the champagne and we each had a glass, each one of us had a glass, and toasted her and told her that we loved her and how much she’d meant to us in our lives.”
Nancy Murphy is an 85-year-old hospice volunteer from Vermontville, a small community in the northern Adirondacks. Her sister, Joan Kline, chose to end her life in 2015.
“She was happy about all the places she’d been and the people that she’d met and the things that she’d done, and she was content so it was time,” Murphy said. “So, we gave her the medication and she drank it and closed her eyes and we held her hands and touched her body and in 20 minutes she was in a deep coma and in two hours she was gone.”
Kline, who lived in Middlebury, Vermont, was diagnosed with terminal ovarian cancer and given less than two months to live.
Kline chose to end her life under Vermont’s medical aid in dying law. Adopted in 2013, the law allows terminally ill and mentally competent adults with a prognosis of six months or less to live to request lethal medication.
Murphy says it allowed her family’s last moments with Kline to be joyful.
“We are grateful for the blessing that she had and the blessing she gave us as a family because so many people have bitter, terrible, terrible memories of the death of a loved one. And we don’t,” she said. “We have a beautiful memory of a loving, beautiful, peaceful passing. And I wish that for everyone. I wish everyone to have that option.”
In New York, advocates like Murphy have fought for years to pass a similar bill. This is the ninth year the Medical Aid in Dying Act has been introduced in the state legislature. Similar to Vermont’s law, the bill would require patients have two physicians confirm their diagnosis, prognosis and mental competence before they can receive life-ending drugs. The legislation would also require patients to make an oral and written request for the medication, which they must be able to self-administer.
Barbara Thomas is an advocate for the proposal. A former president of the Saratoga County League of Women Voters, Thomas has been involved in politics for decades.
Thomas says her late husband asked her to end his life when he was dying from cancer.
“My husband had an incurable brain cancer and he actually asked me to shoot him to put him out of his misery. So, I feel very committed to not letting other people suffer that way and I don’t want to suffer that way myself,” said Thomas.
Senator Brad Hoylman-Sigal of the 47th district is the lead sponsor and rallied for the bill at the capitol in Albany in March.
“It’s a healthcare issue because government and physicians and advocates all have a responsibility to limit, to reduce, to end human suffering and that’s what the Medical Aid in Dying Act does," said Hoylman-Sigal.
State Assemblywoman Amy Paulin, a fellow Democrat who is sponsoring the legislation in the lower chamber, says, like abortion, Medical Aid in Dying is about bodily autonomy.
“It is control over our bodies at our most vulnerable time,” Paulin said. “The time we are leaving this Earth.”
Ten states, including Vermont and New Jersey, and the District of Columbia have legalized the practice. Oregon was the first state to allow it under its 1997 Death with Dignity Act.
New York’s version faces opposition from religious organizations and disability rights advocates.
The New York State Catholic Conference, which lobbies on behalf of the Roman Catholic Church, says the legislation goes against the mission of health care. Bob Bellafiore is a spokesman for the organization.
“Doctors are trained to heal,” Bellafiore said. “Doctors are trained to help people even in cases where they have a terminal illness. There are mechanisms to helping people with a terminal illness. They’re called hospice and palliative care.”
Max Rodriguez, government affairs manager of the Center for Disability Rights in New York, argues the bill could exploit people with disabilities who can't afford health insurance.
“People with lower incomes, people in Black and brown communities get less than adequate health care a lot of the time and so what we're seeing is one of the big fears is the people who are not receiving adequate health care might be pressured into signing up for assisted suicide by insurance companies because better coverage or better treatment isn't offered,” Rodriguez said.
Bellafiore and Rodriguez say the bill doesn’t have adequate safeguards to ensure patients are competent when making their request. They argue people experiencing suicidal ideation could engage in the illegal practice of what’s often called “doctor shopping” to receive an eligible diagnosis.
“Everybody can think of a family member or friend or someone they know who has been in a situation where they were given six months and then lived 10 years,” Rodriguez said. “Again, there’s nothing to stop people from doctor shopping. Maybe your doctor will give you a 12-month prognosis and you know that if this is on the books all you need is somebody to sign off at six months and maybe you go to another doctor until you find somebody that agrees it is six months.”
New Jersey physician Dr. Deborah Pasik says she’s written about 100 life-ending prescriptions since the state legalized the option in 2019 and has never seen that happen.
Pasik says a quarter of her patients died or lost the ability to self-administer the medication less than 15 days after making their initial request. She disagrees with opponents who call the practice suicide.
“Medical aid in dying cannot be any farther from suicide. Those patients want to live as long as they can,” Pasik said. “They have their family’s support. The death is not violent. The death is not solitary and there is no mental illness involved.”
While lawmakers were working on the overdue budget, there was a notable development in the debate: the Medical Society of the State of New York, a nonprofit representing about 20,000 physicians and medical students in the state, had opposed the practice since 1992 but changed its position.
The medical society's president, Dr. Jerome Cohen, says the opposition came from concerns that doctors or government would coerce patients into ending their lives. But now, Cohen says, the group believes the practice allows doctors to alleviate suffering.
“There’s a recognition that we are a multicultural society and that there are groups of people that do want to have the option of shortening their lives in certain circumstances where their quality of life is just absolutely terrible with no provision or no means of reversing the processes which have been happening to them,” Cohen said.
Pasik says the procedure is a natural evolution.
“We as physicians have always helped our patients die within the legal parameters. We’ve turned off ventilators, we’ve stopped dialysis at the patient’s request. It’s the same thing.”
Pasik also points out that under the bill proposed in New York, doctors who oppose the practice are not legally required to prescribe life-ending drugs.
In Vermont, where medical aid in dying has been legal for over a decade, a recent state Health Department report found 203 people who requested the medication since the law passed were eligible. But the report says some individuals died of their terminal illness before obtaining the medication.
Democratic Vermont State Senator Virginia Lyons, the lead sponsor of the 2013 legislation, says no incidents of abuse have been reported.
“No one has to use this. It’s not compelling anyone to end their lives in any way. That’s a huge message for a state like New York that’s having difficulty in working with the bill,” Lyons said. “The bill is about civil rights and the rights of the patient to interact with their physicians and with their family and make decisions about end-of-life when they have six months to live.”
In New York, the bill’s chances of passing this session are uncertain. Democratic Senate Majority Leader Andrea Stewart-Cousins hasn’t weighed in on the bill and says the legislature has avoided discussions around death altogether. She spoke to reporters about the issue in March.
“We’re at that post-COVID time and I think people are starting to consider it more, but it’s just not the conversation that we have had,” Stewart-Cousins said. “But it’s not a conversation that we won’t have because I think people are more conscious and more comfortable having those discussions and I’m sure we will have it as well.”
Democratic New York Governor Kathy Hochul has not weighed in.
Nancy Murphy, whose sister used Vermont’s medical aid in dying law, says she will not rest until the practice is legal in New York.
“When you get to a certain age, you face a decision,” Murphy said. “Either you’re going to keep your brain going and your body going, or you’re gonna end up sitting in a rocking chair and have people bring food to you. You have to make the decision and if you’re gonna fight the fight, you fight the fight.”
WAMC News Intern J.T. Stone is a junior at the University at Albany majoring in journalism with minors in communication and leadership.