New York's Medical Aid in Dying Law Takes Effect

**Brian Lehrer** (0:10)
Brian Lehrer on WNYC. Now we'll turn to a new law that took effect in New York State last Wednesday, a decade after it was first introduced in Albany. It's the Medical Aid in Dying Act. And what it does is give terminally ill adults with six months or less to live the legal right to request medication to end their lives kind of on their own terms. Now there are definitely conditions that they have to meet, but that's the basic of what the law does. New York joins a dozen other states in Washington DC where this option exists. We've covered the debate over this law on the show over the years. Today, now that it's been enacted, we're going to talk about whether or not this option would be right for you or someone you love and how to figure that out. So we're just going to help you understand the law, who qualifies, how the process works step by step, where it fits alongside hospice and palliative care, how some of the concerns about coercion, people being coerced into this if they don't have a lot of power in the political or legal or medical system, can navigate that risk with two people well suited to walk us through it. Amy Paulin is the New York State Assembly member representing the 88th district, that's in Westchester, chair of the Assembly Health Committee, and the author and assembly sponsor of this law. Also, David Leven, Executive Director Emeritus and Senior Consultant at End of Life Choices New York, an organization that councils patients and families on exactly these decisions. Assembly member and Mr. Leven, welcome back to WNYC.

**Amy Paulin** (2:00)
Thank you so much.

**David Leven** (2:02)
Thank you for having us, Brian.

**Brian Lehrer** (2:04)
Assembly member Paulin, now that the law has been passed and there were negotiations and changes along the way to the final version, just say in plain English to our listeners in New York State, what exactly does this law allow and who is eligible?

**Amy Paulin** (2:21)
If you are within six months or if a doctor says to you, typically a cancer patient, that you only have six months to live, you are eligible. If you have a terminal illness that's going to result in death within six months, you are eligible for MADE, as we call it, Medical Aid in Dying, to be able to self-ingest medication that would end your life.

**Brian Lehrer** (2:51)
And so, David, a question about the language, as the Assembly member just framed it, obviously we're saying Medical Aid in Dying in this segment, and that is the term in the law. Well, listeners have also heard Assisted Suicide, Death with Dignity, Right to Die.
Are those all the same things? Should we think of them as all the same thing?

**David Leven** (3:15)
They are absolutely not, Brian.
Suicides are usually done by people who could continue to live, who have a mental illness, but they choose not to continue to live. Often, they are done impulsively, and violently, and without consultation with others. On the other hand, medical aid in dying is only for people who are dying. Their disease is killing them, and they are going to die in the very near future. And there are many people involved in the process, including at least two doctors, both of whom have to determine that the person is terminally ill and likely to die within six months, as Amy mentioned, and also have decision-making capacity and can self-administer the drugs. There also has to be a psychiatrist, psychologist or neurologist involved in the process who makes the determination that the person has decision-making capacity. And usually the process takes several weeks from the time that the request for medication is made until the time that the patient actually takes the medication, if they ever do. And about 35% of patients never, in fact, do take the medication. So for these patients who actually would prefer to continue to live, but can no longer do so, and it's only a matter of how they're going to die, this is a choice which enables them to die on their own terms, as you mentioned earlier.
And for them, unlike assisted suicide, where the event is usually tragic, this is self-empowering for the patient, and usually for family members as well.

**Brian Lehrer** (5:01)
Listeners, we're inviting your questions about New York's new Medical Aid and Dying Law and how it works. This segment is not for having the debate anymore. We had it multiple times over the number of years that it was in the legislature being considered by the legislature. Now it's the law. And so we are just inviting your questions with how to consider this. If you think you might want to consider this now or, you know, just hypothetically in the future for yourself or for someone you love, 212-433-WNYC or maybe we've even been through this process with a family member in New Jersey or another state where it's already legal. And you can give people who might be considering it in New York some advice about what to do, what not to do, and what it was actually like, what to be prepared for emotionally. You just heard David Leven say, you don't even have to go through with it once you're authorized.