Supporters hope new Legislature and changing attitudes toward patient autonomy will win approval for process already approved in 10 states
Written By Raga Justin
ALBANY — Cassandra Johnston was a preteen when Oregon became the first state to allow terminally ill patients to end their own lives through the use of physician-prescribed medication.
Though young, the 38-year-old Clifton Park resident recalled how much sense it made to her at the time. “I thought, ‘This is a step in the right direction,’” Johnston said.
The day after Thanksgiving last year, Johnston learned she had Stage 3 breast cancer. As she grappled with a condition that is by nature volatile and fast-moving, she began weighing her end-of-life options. But Johnston was shocked to discover that medically assisted death is not one of them, despite close to a decade of persistent advocacy from groups who want New York to follow 10 other states that have legalized this particular form of treatment.
“I told myself that it doesn’t matter what my prognosis is,” Johnston said. “What matters is that I devote the rest of my time and energy into making sure that we can get this bill passed. And hopefully it comes in time for me.”
Supporters of the bill say they are baffled that it has taken the state Legislature this long to consider the Medical Aid in Dying Act, first introduced in 2015. But they hope for more momentum this session, with a fresh class of younger legislators who may approach the idea of physician-assisted death with less reservations than older generations did.
Assemblywoman Amy Paulin, a Democrat from Westchester who sponsors the bill in the lower chamber, said it might fare better in the newly constituted Health Committee, which she will chair. New Democratic legislators may be more on board, she said, while some Republican legislators not on the committee have also indicated support should the bill make its way to the floor.
“This year is the year,” Paulin said. “We’re picking up a lot of momentum. I do think it’s winning over people’s minds.”
Some groups remain vocally opposed to the legislation, saying it could bring devastating consequences to some New Yorkers. Broadly made up of religious organizations and disability rights groups, a coalition called the New York Alliance Against Assisted Suicide has warned that if passed, the bill could be used to pressure people with disabilities, seniors or those in low-income communities to choose suicide.
They also warn of a “slippery slope.”
“It will not take long for what is now being billed as an option only for people with terminal illnesses to be available to anyone at all,” Dennis Poust, the director of the New York State Catholic Conference, said in a statement. “What we need is investments in palliative care and hospice, where people can be cared for with compassion and dignity, free of pain and fear as they reach their final days.”
Some medical groups have indicated support for the measure, including the New York State Academy of Family Physicians, while national organizations have tended to take neutral positions.
Advocates reiterate that the legislation contains safeguards to prevent the kind of abuse its opponents warn of. The law stipulates that adults seeking a medically assisted death must have a prognosis of six months or less to live because of a terminal illness. Patients must have the full capacity to understand what they are asking for, and must communicate that decision to their primary physician.
And the physician must believe that the patient is not suffering from a psychiatric or psychological disorder causing impaired judgment. A second physician will also need to sign off on the patient’s mental status and terminal illness.
“I get it, people are afraid,” said Corinne Carey, a regional campaign director for Compassion & Choices, a nonprofit that advocates for medically assisted death. “But the theoretical harms that people fear need to be evaluated next to the real harm, right now, for people who are dying and don’t have this option.”
Carey said the bill represents an additional boost to patient autonomy that will help prevent needless suffering.
Former Gov. Andrew Cuomo offered lukewarm support for the measure in 2019 that nevertheless revived interest and brought some hope to advocates. Carey said they have yet to hear the same from Gov. Kathy Hochul, though she added the push is largely concentrated in the Legislature.
“It’s in my hands now,” Paulin said. “I think at the end of the day, if the Legislature goes for it the governor will.”
“With perseverance, you get it — if it’s the right thing,” Paulin added. “I think this is the right thing.”
Johnston, who will soon head into her first round of chemotherapy, does not know if her cancer will spread, or if she may soon receive a call telling her she only has a certain amount of time to live.
If that happens, “All I can really envision is a death that does not involve unnecessary pain, or suffering, or trauma,” Johnston said. “The more I read the stories of people who have suffered, the more I think, ‘I never want that.’ But I don’t have that option right now.”