Summary of New York Legislation (Provided by Compassion and Choices.org)

The Legislation Allows:

A terminally ill, mentally capable adult with a prognosis of 6 months or less to live to have the option to request, obtain and decide to ingest medication to die peacefully in their sleep if suffering is unbearable. The bill is modeled after the Oregon Death with Dignity Act, which has been in effect for 25 years without a single instance of abuse or coercion.

Eligibility Criteria

Just like the Oregon Death with Dignity Act, to be eligible, a person must: ●

Be an adult, age 18 or older

Have a medically-confirmed terminal illness that is incurable and irreversible and will likely cause death within six months

Be mentally capable of making an informed healthcare decision

Individuals are not eligible for medical aid in dying because of age or disability.

Core Safeguards and Regulatory Requirements

Two physicians must confirm that the person is terminally ill with a prognosis of 6 months or less to live, is making an informed healthcare decision, and is not being coerced.

The attending physician must inform the requesting individual about all of their end-of-life care options, including palliative care and hospice.

There is a mandatory mental health evaluation if either physician has concerns about the person’s mental capacity to make their own healthcare decisions. The mental health provider must confirm in writing the dying person’s capacity before a prescription can be written.

The individual must make an oral request for the medication, and a written request witnessed by two people.

The terminally ill person can withdraw their request for aid-in-dying medication, not take the medication once they have it, or otherwise change their mind at any point in time.

The individual must be able to self-ingest the medication.

No physician, health provider, or pharmacist is required to participate in medical aid in dying. Prescribing providers who comply with all aspects of the law receive civil and criminal immunity.

Anyone attempting to coerce a patient will face criminal prosecution.

Unused medication must be disposed of as required by state and federal laws.

Health insurance benefits are unaffected by the availability of medical aid in dying, and life insurance payments can’t be denied to the families of people who use the law.

The New York Health Commissioner is required to issue a publicly available annual report about the usage of the law. Patient and physician identifying information is kept confidential.

From a Teshuvah by Rabbi Elliot Dorff

P’sak Halakhah

1. Jewish law prohibits murder; active euthanasia (“mercy killing”), whether by a physician or a family member; suicide; and assisting a suicide.

2. As demonstrated, however, by the responsa on end-of-life care by Rabbis Avram Israel Reisner and Elliot N. Dorff, previously approved by the Committee on Jewish Law and Standards, machines and medications may be withheld or withdrawn from patients who do not benefit from them, as indicated by the patient’s own expressed evaluation personally now, through his or her advance directive, or through a proxy appointed in his or her advance directive for health care. According to Rabbi Dorff’s responsum but not Rabbi Reisner’s, artificial nutrition and hydration may also be withheld or withdrawn.

3. Those confronted with a request for aid in dying by being provided drugs that the patient him/herself will administer in those civil jurisdictions that permit this should first determine that:

a. The patient has a terminal, incurable disease, which, despite available treatments, will, in the opinion of at least two independent physicians, bring about the person’s death within six

months or shortly thereafter (depending on the statute in the jurisdiction) and that involves pain or suffering that cannot be quelled.

b. Monetary pressure is not the motivation for the request, whether that pressure is internal to the patient him/herself (“I do not want to squander the family’s resources on my futile care”), comes from family members who do not want to spend the family’s money on what they regard as futile medical interventions for a parent or other relative, or is applied by public or private insurance companies that will provide for medical aid-in-dying but not long-term care, which is much more expensive. Especially in the United States, which does not have universal health care, money is often part of the deliberations of a patient, family, doctors, and hospitals in deciding what medical interventions to use and for how long, but even countries with socialized medicine set limits as to what their health care coverage will provide, based in part on how much money the government is willing to spend on health care. To the greatest extent possible, however, money should not be the dominant factor motivating a person to seek aid in dying; uncontrollable pain, despite the availability and use of medical interventions, is the motive that justifies providing aid in dying.

c. If the patient is depressed or suffers from other psychological maladies, appropriate social, psychological, behavioral, and medical interventions to treat these conditions are employed rather than aid in dying.

d. Similarly, adequate pain medication to quell pain, to the extent that that is possible, is in use, and other necessary medical services have been and are being provided to alleviate the patient’s other symptoms or suffering.

e. While still conscious, the patient asks for aid in dying of his or her own free will, as determined in a private conversation between the patient and doctor with nobody other than an interpreter, if necessary, in the room.

f. The patient is mentally competent to ask for aid in dying, as demonstrated according to the requirements specified for mental competence for such decisions in the civil law of the relevant jurisdiction. This includes age restrictions.

4. In cases where all the requirements of (3) are met, patients who nevertheless ask for drugs that they themselves will administer to aid them in dying and are doing so despite taking all steps possible to live and are currently subject to, or are likely soon to be subject to, uncontrollable pain or suffering may be provided with medications that will aid them in dying. This is not “suicide” in the usual understanding of the term because their underlying disease is taking their lives, accompanied by uncontrollable pain. This is the isolated case in which I am arguing that aid in dying should be allowed. These are rare cases, as demonstrated by the experience of jurisdictions with experience in administering aid-in-dying laws, where only a very small percentage of deaths occur as a result of aid in dying (in 2019, 0.15% in California, 2% in

Canada, for example). Therefore, although family members, physicians, and rabbis should not suggest aid in dying, let alone encourage it, they should not object to it either if the patient

perseveres with the request. They should rather show understanding for such a decision by the person enduring such suffering. In these rare cases, we should recognize that Jewish law bans aid in dying but not rule according to it (הלכה ואין מורין כן) or recognize that Jewish law bans aidin dying but not interfere with it in these cases ( לאמיחובידםחכמים ).

5. A person who chooses aid in dying under the circumstances detailed in (3) above may be buried in a Jewish cemetery without prejudice because they are not committing suicide in the

usual sense; in fact, most people in this condition have fought to stay alive for a long time and often with considerable discomfort. It is their underlying disease or condition that is the

ultimate, even if not the proximate, cause of their death.

6. This responsum allows patients to request drugs to bring about their death when they suffer from uncontrollable pain and can administer the drugs themselves; it also permits physicians to

provide the drugs needed for this purpose. It does not authorize physicians to administer the drugs themselves. Nevertheless, after the fact, if physicians have done so, rabbis and others

should stand aside without judgment. Rabbis and others should provide support and comfort for patients and their families facing this condition, no matter how the patient dies.

7. This responsum declares that as we are interpreting Jewish law, physicians and hospitals in civil jurisdictions that allow aid in dying may provide it under the conditions described above in

accordance with Jewish law as well. At the same time, they are under no obligation in Jewish law to provide aid in dying, even to patients in uncontrollable pain. Out of compassion for such

patients and/or recognition that people have differing moral evaluations of aid dying in such cases, however, those doctors who refuse to provide aid in dying should refer the care of such patients to other physicians who will provide aid in dying, either directly or by transferring the case to another physician who will evaluate the case and make the referral to a third physician to

provide the necessary medications to bring about death.

8. All of these provisions apply only in those civil jurisdictions that perm