On Tuesday, April 29, the New York State Assembly passed the inaptly named Medical Aid in Dying Act by a vote of 81-67, with some 20 Democrats breaking ranks to join Republicans in opposition. Though it must still pass the senate and receive Governor Kathy Hochul’s signature, this is the first time that an assisted-suicide bill has cleared one of the state’s legislative chambers, signaling a troubling turn in New York’s approach to end-of-life care.
As written, the bill would allow patients to make a written request for a lethal drug cocktail if they have “an incurable and irreversible illness or condition” that gives them six months or less to live. Approval is subject to the judgment of two physicians, who must “examine the patient and the patient’s relevant medical records” to confirm that he has such a terminal illness.
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Doctors’ assessments aren’t infallible. Stories abound of patients given months to live, only to thrive for years. But instead of instilling hope, New York would offer guaranteed destruction—with few safeguards.
The bill fails to require that patients be psychiatrically evaluated before opting for suicide, deferring to the discretion of the two evaluating physicians. Nor does it outline a mechanism to ensure recovery of the lethal drug cocktail from individuals who request it, but then decide against suicide, raising the possibility of deadly compounds falling into the wrong hands.
Further, the Medical Aid in Dying Act does not require that physicians conduct the medical examination in-person—that is, virtual assessments are allowed. New York might thus become a destination for “suicide tourism”—the practice of traveling to a place where assisted suicide is legal to end one’s life—much like Switzerland. Virtual evaluations open the door for inaccurate diagnoses and doctor shopping.
Proponents have tried and failed for years to legalize assisted suicide in New York. Some claimed that the state constitution’s Equal Protection and Due Process clauses guaranteed patients a right to obtain a prescription for lethal doses of drugs. But in the 2017 case Myers v. Schneiderman, a unanimous New York Court of Appeals rejected that argument. Though it left the door open for legislative action, it recognized that the state had a “significant interest in preserving life and preventing suicide, a serious public health problem.”
The Medical Aid in Dying Act’s champions claim that it provides a compassionate option for those suffering and in pain during their final months. But their argument fails on several grounds. For one, the bill does not condition eligibility on feeling pain. A person who suddenly learns he has a form of terminal cancer is eligible almost immediately, even without painful symptoms. Likewise, the gravely ill who don’t experience pain in their final days are nevertheless eligible for assisted suicide under the bill.
What’s more, in recent decades, pain-management medications and techniques—particularly hospice and palliative care—have improved dramatically. If the desire to end one’s life once stemmed from a wish to escape suffering, medical progress has now weakened that rationale. Modern therapies enable doctors to preserve their role as healers and uphold the Hippocratic Oath.
But even if one accepts proponents’ claims at face value, the Medical Aid in Dying Act sends a troubling message: that life ceases to be worth living when it becomes too difficult or nears its end. This message runs counter to the state’s suicide-prevention efforts—especially those aimed at the growing number of young people struggling with mental illness. Why, they might ask, does some suffering justify suicide, while other forms do not?
It’s little surprise that many people with disabilities and their advocacy groups strongly oppose New York’s effort. The state’s Association on Independent Living, for example, wrote that “experience in other states demonstrates that so-called ‘safeguards’ are quickly eroded, leading to expansions of eligibility and a growing normalization of suicide for people who could otherwise live meaningful lives with appropriate supports.”
They’re right. Jurisdictions that have legalized assisted suicide, such as the Netherlands, shows how eligibility criteria can expand. In December, the Guardian profiled a 22-year-old Dutch woman who was granted permission to end her life at a hospice because of “unbearable mental suffering,” with “no prospect of improvement,” only to cancel the procedure at the last moment and reassess her life. Others haven’t been as fortunate. In 2023, 22 individuals under the age of 30 lost their lives in the Netherlands on such psychiatric grounds.
Countries that practice assisted suicide have also seen it become an increasingly normal manner of death. About 5.8 percent of the Netherlands’ deaths now result from assisted suicide, and the country has considered expanding its law to give healthy seniors 75 or older the option of assisted suicide following six months of counseling. In Canada, about 15,300 people died through its Medical Assistance in Dying process in 2023, about 4.7 percent of all deaths. Some Canadians have requested assisted dying because of fears of homelessness and social isolation.
A humane society does not treat the sick, disabled, or aged as burdens. It honors their dignity by meeting their needs without shame or apology until the end of their natural lives. The obligations they place on others are not undue; they are the price of civilization.
New York should reject the logic of despair. A compassionate government does not offer its sick a cup of hemlock. It affirms the dignity of the dying by choosing life.
Photo: Penpak Ngamsathain / Moment via Getty Images