New York is poised to become the twelfth state in the country to authorize medical aid in dying with a physician’s prescription for lethal medication to be self-administered by the patient. On June 9, 2025, the New York Senate passed the bill on its third reading after earlier passage in the Assembly on April 29. The legislative session ended on June 17, and the legislation now awaits Governor Hochul’s decision whether to sign or veto it. If approved, the New York Medical Aid in Dying Act “shall take effect immediately.”
The New York Act declares that action taken pursuant to its provisions shall not constitute “suicide, assisted suicide, attempted suicide, promoting a suicide attempt, euthanasia, mercy killing, or homicide under the law, including as an accomplice or accessory or otherwise.” The legislation overrules the long-standing interpretation of New York criminal law prohibiting physician assisted suicide. In its 1997 opinion in Vacco v. Quill, the Supreme Court of the United States rejected a federal Equal Protection Clause challenge to the suicide statutes since New York law authorized a physician to participate in a patient’s request for the withholding or withdrawing of life-supporting medical treatment even if death were an inevitable consequence. In Vacco’s companion case of Washington v. Glucksberg, decided under the Due Process Clause, the Court stated: “Throughout the Nation, Americans are engaged in an earnest and profound debate about the morality, legality, and practicality of physician-assisted suicide. Our holding permits this debate to continue, as it should in a democratic society.” In his concurring opinion in Glucksberg, Justice Souter emphasized that the legislature was in the best position to address the claim concerning physician-assisted suicide and that it should be addressed by the legislature. This stance was embraced by the New York State Court of Appeals in its 2016 decision of Meyers v. Scheinderman. It stated that “[t]he assisted suicide statutes apply to anyone who assists an attempted or completed suicide” and that a physician who intentionally prescribes a lethal dosage of a drug is “‘promoting a suicide attempt’ or ‘aid[ing] another person to commit suicide’” in violation of the statute. But while rejecting the plaintiffs’ proposed statutory construction and their state constitutional challenge to the New York suicide statute, the Court of Appeals stated: “Plaintiffs’ claims are better addressed to the Legislature.” However, attempts in multiple legislative sessions to enact some form of medical aid in dying were unsuccessful dating back to at least 2016.
As passed by the Legislature, the New York Act resembles many of the provisions commonly found in comparable legislation in other states. Central among these are that the prescription for lethal medication is only available to an adult over the age of 18 who has decision-making capacity, has a diagnosis of a terminal condition expected to lead to death within six months confirmed by the second opinion of a consulting physician, makes a voluntary and informed decision to request the prescription, and is able to self-administer the medication. Self-administer means ingesting the medication and excludes lethal injection or lethal infusion. The request for the medication cannot be made through a surrogate or advance directive. The death certificate is to list the underlying disease as the cause of death. The Act explicitly states that a physician or other healthcare provider has no duty to participate in providing lethal medication to a patient. It also permits private healthcare facilities to prohibit the prescribing, dispensing, order or self-administering of medication while a patient is being treated or is resident in the facility provided that the facility has a formally adopted policy to this effect based on sincerely held religious beliefs or moral convictions central to the facility’s operating principles.
However, the New York Act differs from the legislation in most other states in some significant respects. For example, unlike the New Jersey statute, there is no requirement for repeated requests for the medication with a mandated waiting period before the prescription can be issued. Perhaps more importantly, to be a “qualified individual” to receive the medication under the Act, there is no residency requirement. This is a distinct difference from the New Jersey statute and from all other states except Oregon and Vermont. In a previous blog post, the implications of medical tourism were described with a risk of criminal exposure for physicians caring for out of state patients who return to self-ingest the medication in their home states which persist in the characterization of physician-assisted suicide as a criminal offense. The possible consequences have not yet been tested. A challenge to New Jersey’s residential requirement was rejected in Govatos v. Murphy based in part on the State’s legitimate interest in protecting New Jersey healthcare providers from liability in another state for conduct that would be a crime there. Briefing on the appeal to the Third Circuit has been completed and the case awaits the scheduling of oral argument. The New York Act does not have a provision similar to New York’s “shield law” for reproductive care services as “a legally protected health activity if the service or care is permitted under the laws of this state, regardless of the patient’s location.”
