Should doctors be allowed to prescribe lethal medication at the request of terminally ill patients? 

New York Governor Kathy Hochul is poised to make a pivotal decision on whether to sign the Medical Aid in Dying (MAID) Act, a controversial bill that would allow terminally ill adults to end their lives through physician-prescribed lethal medication. The bill passed both houses of the state legislature earlier this year and now awaits Governor Hochul’s decision. If signed, New York will become the thirteenth jurisdiction in the U.S. to adopt such a law. 

In the bill’s justification section, the sponsors argue that patients deserve the right “to die with dignity, on their own terms,” and that they shouldn’t “be forced to relocate to another state or to leave the country to control how their lives end.” The bill’s main Senate sponsor, Sen. Brad Hoylman-Sigal, said the law “isn’t about ending a person’s life, but shortening their death.” Advocates further point to the bill robust safeguards designed to prevent potential abuse and highlight strong backing from the public and civic groups. 

Opponents argue that the bill sends a harmful message that disability or serious illness makes life less valuable, undermines broader suicide-prevention efforts, and conflicts with the medical profession’s healing mission. They express concerns that vulnerable individuals could face coercion from heirs, caregivers, or insurers motivated by financial considerations. They also argue that doctors’ judgments about prognosis can be inaccurate and the bill’s broad “six-month prognosis” threshold could sweep in conditions that are manageable with proper medical care. Canada’s recent expansion of its assisted-dying law beyond terminal cases is often cited as evidence of a potential slippery slope. Faith-based groups raise a moral objection to deliberately ending life.

The following Issue Brief outlines some of the basics you need to understand this complex topic. Let’s dig in …

What exactly does New York’s Medical Aid in Dying bill propose?

• Allows mentally competent, terminally ill adults (18+) to request a prescription for lethal medication from a physician.

• Patients must have a confirmed prognosis of six months or less to live, verified by two doctors.

• The patient must submit an oral and a written request to the attending physician. The written form must be witnessed by two independent adults who are not relatives, heirs, caregivers, medical staff, or designated agents.

• The patient must self-administer the medication.

• The bill includes safeguards, such as mandatory counseling referrals when mental capacity is uncertain, and criminal penalties for coercion.

The legal framework

• The Supreme Court has held that regulating assisted suicide is chiefly a matter for the states, not the federal government. There is no federal constitutional right to physician-assisted death. However, once a state legalizes it, the federal government may not override that choice without clear congressional authorization (Washington v. Glucksberg (1997); Gonzalez v. Oregon (2006)).
• The Court has drawn a bright line between withdrawing or refusing treatment (letting the underlying illness end life) and actively prescribing lethal medication (directly causing death). In Vacco v. Quill (1997), the Court held, “The distinction between letting a patient die and making that patient die is important, logical, rational, and well established: It comports with fundamental legal principles of causation, [ ] and intent.”
• NY’s Penal Law currently criminalizes “promoting a suicide attempt” (§ 120.30) and makes it a felony to “intentionally cause or aid another person to commit suicide.” (§ 125.15[3]). The MAID bill creates a safe harbor under Public Health Law § 2899-n, declaring that actions taken in compliance with the Act “shall not be construed … to constitute suicide, assisted suicide … or homicide.”

How does this bill compare to similar laws in other U.S. states?

• New York’s bill aligns with aid-in-dying statutes now used in Oregon (approved 1994, effective 1997), Washington, California, Colorado, Vermont, New Jersey, Maine, Hawaii, New Mexico, and Washington D.C. 
• All states require self-administration, terminal illness with a six-month prognosis, and at least two physician approvals. Some states, like Oregon, have a 15-day waiting period between the first and second requests. New York’s law allows for a shorter, potentially under 24-hour, waiting period. 
• Montana allows the practice only under the 2009 Baxter v. Montana court decision, not by legislation. The state Supreme Court (5-2) ruled that a doctor who provides lethal medication may raise the patient’s consent as a complete defense to homicide charges, finding “no indication in Montana law that physician aid in dying provided to terminally ill, mentally competent adult patients is against public policy.”
• According to the latest available data, roughly 10,000 people have died under medical aid-in-dying laws: Oregon (~3,243), California (~4,287), Washington (~2,768), Colorado (~1,442), others 300 or fewer each.

How does the U.S. approach compare internationally?

• Compared to international standards, U.S. laws are relatively conservative due to terminal illness and self-administration requirements.
• Canada: Legal since 2016, significantly expanded in 2021. Unlike the U.S., Canada’s law does not require a six-month prognosis, focusing instead on “enduring and intolerable physical or psychological suffering.” Mental illness-only eligibility has been delayed to 2027. It also permits physician administration (euthanasia) in addition to self-administration.
• Netherlands, Belgium, Luxembourg, Spain, Colombia, and Australia have broader eligibility criteria, including chronic and mental illnesses, not strictly terminal cases.

Which groups oppose New York’s bill—and what makes the coalition politically noteworthy?

• A rare left-right coalition has taken shape where disability-rights groups like Not Dead Yet and the Center for Disability Rights have joined forces with religious organizations, including the Catholic Conference and the Orthodox Jewish community, creating an unlikely alliance united by concerns about sanctity of life, coercion, and potential expansion.

• Intra-party divisions among Democrats underscore the bill’s complexity. The legislature overall is Democratic-controlled, but six Democratic state senators broke ranks, voting “no” alongside all Republicans in the Senate’s 35-27 vote. Roughly 20 Assembly Democrats also opposed the measure.

• The political hesitancy is in contrast with strong public support found in recent polls. YouGov (Jan 2024) registered 72 % support overall, including 73 % among voters with disabilities; Siena College (July  2025) recorded similar backing at 54-28; and City & State (May 2025) reported 65 % of Catholic New Yorkers in favor.

While researching this issue, I discussed the topic with several people, including my partner. To my surprise, he saw the issue as clear-cut. Even after all my research, I’m still unsure what the right policy should be—the competing concerns make it a very close call. Let us know what you think. Write to us at letters@cafe.com.