Medical Aid in Dying Is Now Legal in New York: A Physician’s Perspective

Medical Aid in Dying Is Now Legal in New York: A Physician’s Perspective

Last month, New York's Medical Aid in Dying law went into effect. I have followed the expansion of medical aid in dying across the country and around the world for years, but this one feels particularly meaningful to me.

I was born and raised in New York and later returned to the state for medical school. Years ago, when I was applying for fellowship in hospice and palliative medicine, I wrote that I was drawn to the field by a desire to help patients both live and die well. At the time, I had no idea that medical aid in dying would eventually become such an important part of my career.

But having cared for hundreds of patients electing for assisted dying, I have seen the profound impact it can have. I’m honored that I’ve been able to shape my practice, Autonomy Health, around supporting patients’ wishes in an ethical and equitable manner.

Much of my work today involves caring for people who are approaching the end of life and considering whether medical aid in dying is right for them. That work has shaped the way I think about autonomy, suffering, and the role medicine should play when someone is dying.

It has also made me a strong believer that people facing terminal illness should have meaningful choices about how they live their remaining time and, within appropriate safeguards, how they die.

There is no single definition of a good death

One of the clearest lessons I have learned from caring for dying people is that there is no universal definition of a good death.

For some people, living as long as possible is the priority. Others hope to remain at home, surrounded by family, and allow their illness to take its natural course. Some are willing to tolerate significant changes in their bodies or independence in exchange for additional time. Others are not.

I do not think medicine should decide which of those choices is correct.

Our role should be to understand the person in front of us: what they value, what they fear, what gives their life meaning, and what they consider an unacceptable level of suffering. We can then help them understand their options and make decisions that remain consistent with who they are.

Medical aid in dying is one of those options.

New York's law now allows eligible terminally ill adults to request medication that they may choose to self-administer. The law includes safeguards intended to ensure that the decision is informed, voluntary, and made by someone with the capacity to make their own medical decisions.

For me, the importance of the law is not that it creates a particular kind of death. It is that it recognizes that people may have very different ideas about what a good death means for them.

What comes next for medical aid in dying in New York

The passage of a law is only the beginning.

Meaningful access will depend on whether patients know this option exists and whether physicians, hospices, pharmacists, and health systems understand how the process works. New York will now begin working through many of the same clinical and practical questions that other states have faced.

Those questions matter. So do the experiences of the patients and families who will eventually navigate this process.

I am excited to watch that work unfold in the state where I grew up, and I hope my own experiences can contribute in some small way to the conversation.

Over the coming months, I plan to write more about medical aid in dying, the people who consider it, the families who accompany them, and the lessons this work has taught me about suffering, autonomy, and the end of life.

These are difficult subjects, but they deserve thoughtful discussion. And thoughtful discussion can only happen when these questions are part of our broader consciousness—when we are willing to think about death, suffering, autonomy, and what we would want for ourselves and the people we love before we are forced to confront them in a moment of crisis.

My hope is that this series can contribute to that conversation by keeping these questions visible and by sharing some of what I have learned from the patients and families who have allowed me to accompany them at the end of life.

Donald Moore, MD
Hospice & Palliative Medicine Physician
Autonomy Health