The New York Medical Aid in Dying (MAID) Act was introduced 10 years ago and it is time for the legislature to pass it.

MAID was first legalized in Oregon in 1993 with its “Death with Dignity Act.” Since then, nearly identical versions, with multiple refinements, have been passed in 10 states and Washington D.C. With over 120 state years of experience, there have been no substantiated instances of abuse or coercion in spite of the opposition’s ardent desire to find some.

The proposed New York state legislation has numerous safeguards: to qualify, one must be diagnosed with an incurable and irreversible disease with less than six months life expectancy confirmed by two physicians; the patient must be determined to be of sound mind, and not be suffering from significant mental illness that would interfere with making this decision (such as depression, schizophrenia); there must be both a written request and an oral request; neither age, infirmity nor disability qualify; one must be informed of all options including palliative care, hospice and voluntary stopping eating and drinking (VSED); one can change one’s mind or withdraw at any time and there is no obligation to take the medication if it is obtained. Most importantly, the medication must be ingested by the individual themselves, it cannot be administered by anyone else, a significant distinction from euthanasia. No health care provider, pharmacist or institution can be required to participate. There are many additional safeguards.

In states that have passed MAID legislation, hospice utilization is among the highest. New York state consistently ranks 48th to 50th among all states. The availability of MAID promotes important conversations regarding one’s values, beliefs and wishes leading to increased use of hospice. Better support for all peoples’ health care needs (not just “life-threatening illness”) should certainly be supported through comprehensive health care for all. As is the case with most disparities in our society, the poor, less educated and other disadvantaged groups utilize MAID at lower rates than those with greater resources. People who elect MAID do not want to die; they have no choice. They are seeking some control to end unbearable terminal suffering on their own terms. This usually occurs with family and loved ones present. This is certainly not the case for those who tragically take their own lives by suicide.

There is widespread support for this legislation by New Yorkers across every demographic including geography, faith, churchgoing, party affiliation, gender, race, education and age. According to the 2018 Quinnipiac survey, 63% of New Yorkers support the legislation with 29% opposed. The largest group of primary care physicians in New York State, the New York Academy of Family physicians, supports the legislation. A 2018 Web MD/Medscape survey of New York physicians, when given the specifics of the legislation, showed support by 67% versus 19% opposed. Sixty-three percent of New York doctors indicated they would like to have this option for themselves.

Despite claims that people living with disabilities oppose this bill, recent polling shows that 79% of people living with disabilities support medical aid in dying. In fact, the ARC New York, one of the leading organizations serving New Yorkers with developmental disabilities, supports MAID. Those with disabilities want equal rights and resent being patronized. This past year, the Medical Society of the State of New York, the New York Nurses Association and the New York State Bar Association have all come out supporting this bill.

In my 43 years of medical practice as a family physician and hospice medical director, I have had the privilege and responsibility of caring for many patients and families at the end of life. Advances in hospice and palliative care have improved this difficult journey. Sadly, such care is not sufficient for all patients regardless of how good this care may be. For such individuals, the option for a peaceful end to their intractable suffering through MAID should be available. Though chosen by few, such availability gives peace of mind to many. Such momentous and personal decisions at life’s end should be left to the individual and their loved ones and not prohibited the State.

The words of Saranac Lake’s founding father and esteemed physician Dr Edward Livingston Trudeau, “To cure sometimes, to relieve often, to comfort always” are exquisitely applicable to MAID, which should be available to all New Yorkers.

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Jay S. Federman worked as a family physician and hospice medical director for 43 years. He lives in Saranac Lake.