Medical Aid in Dying Upholds Choices and Autonomy for Terminally Ill Patients

By Adam Herbst, Esq. | June 1, 2024

As someone who has dedicated my career to leading aging and long-term care initiatives, I firmly believe that personal choice and patient autonomy are foundational to a humane and effective healthcare system.

Healthcare professionals—whether doctors, nurses, or other providers—must prioritize treating patients as individuals, respecting their dignity, and acknowledging their unique needs and wishes. It’s essential that they listen attentively to patients, ensuring they fully understand their diagnosis, prognosis, and treatment options. Ultimately, the patient must be empowered to decide the course of their treatment.

When it comes to terminal illness, the principles of dignity, respect, autonomy, and personal choice become even more critical. Patients facing the end of life should have control over their care and treatment to the greatest extent possible. This belief underpins my strong support for the State Legislature passing the Medical Aid in Dying Act. It’s time for New York to join the 10 other states, including Maine, New Jersey, and Vermont, as well as Washington, D.C., in offering this compassionate end-of-life care option for terminally ill patients.

Medical aid in dying is a choice that affects a very small number of people. In jurisdictions where it’s authorized, less than 1% of yearly deaths involve this option. To qualify, a patient must be 18 or older, have a terminal illness that is incurable and irreversible, be capable of making medical decisions, and have a prognosis of six months or less to live. These criteria must be verified by two physicians. Importantly, the request for medical aid in dying must come from the patient, and only the patient can decide to self-ingest the prescribed medication. These safeguards ensure the process is secure and ethical.

Currently, patients have the right to decline or stop treatment at any time. For instance, if I were on a ventilator and chose to have it removed, I could request that, fully aware of the consequences. The choice is mine. Similarly, if I were in hospice care with only days or weeks to live and the palliative care wasn’t sufficient to control my pain, shouldn’t I have the option to take a prescription that allows me to die peacefully and comfortably, surrounded by my loved ones?

Allowing medical aid in dying upholds patient choice and autonomy, treating individuals with the dignity and respect they deserve. It’s crucial to understand that for those opposed to medical aid in dying, nothing will change once this legislation becomes law in New York. No patient has to choose it, and doctors who oppose it don’t have to prescribe it. This law simply adds another option for end-of-life care, respecting the diversity of beliefs and choices among patients and healthcare providers.

The inclusion of a conscience clause in the legislation ensures that healthcare providers who have moral or ethical objections to medical aid in dying are not compelled to participate. This safeguard respects the diverse perspectives within the medical community and helps build broader support for the legislation. By ensuring that participation is entirely voluntary, we can honor both patient autonomy and the conscience rights of healthcare professionals.

The support for this compassionate option among New Yorkers and healthcare professionals is significant. It is also backed by the New York State Bar Association and the Women’s Bar Association of New York. Including medical aid in dying among end-of-life care options—alongside hospice and palliative care—will create a more compassionate and consistent healthcare policy.

However, passing the Medical Aid in Dying Act is just one piece of the puzzle. We must also expand and strengthen our hospice and palliative care systems. These services play a crucial role in providing comfort and dignity to those at the end of their lives. By improving access to high-quality hospice and palliative care, we can ensure that all patients receive the compassionate and comprehensive support they need during their final days.

In my role overseeing aging and long-term care, I have seen firsthand the profound importance of honoring end-of-life wishes. The MOLST (Medical Orders for Life-Sustaining Treatment) program is a prime example of how respecting patient choices can profoundly impact their quality of life. We need to continue innovating in end-of-life care to ensure that every patient’s voice is heard and their wishes are honored.

Medical aid in dying is about dignity, respect, autonomy, and personal choice. The Legislature should pass it now, so no more New Yorkers are forced to needlessly suffer. By integrating medical aid in dying with expanded hospice and palliative care, we can create a holistic approach that truly honors the preferences and dignity of every patient at the end of life. It’s time to innovate and ensure that our end-of-life care respects the deeply personal decisions of our patients.

Adam Herbst is a former Deputy Commissioner at the New York State Department of Health.