When New York's highest court ruled earlier this month that terminally ill people do not have a state constitutional right to doctor-assisted suicide, you might have expected advocates to be dejected.
However, advocates pushing the State Legislature to pass a law are snatching hope from defeat. Corinne Carey, New York campaign director for Compassion & Choices, said in an interview, "In some ways, this wasn't a surprise at all to us that the court said this is the legislature's job."
Three years of lobbying state lawmakers often ended with a noncommittal, "Let's see what the court says," Carey recalled. Now, the question is in the hands of legislators, and Compassion & Choices plans a strong push for becoming the seventh state to pass a law, in 2018. They've met with or are seeking meetings with all lawmakers and will lobby Gov. Andrew M. Cuomo. They plan rallies at the Capitol.
Terminally ill people should have the option to request pills from their physician to end their suffering, provided there are adequate safeguards. The Medical Aid in Dying Act proposed in New York would require two doctors to agree that a patient 18 or older has an incurable illness with no more than six months to live, and that he or she has the mental capacity to make such a decision.
Nobody but the patient could raise this option - not a family member, not a doctor. This is self-determination at a time when fears are profound: of suffering, of prolonged existence hooked up to hospital machines.
Many never take the prescription, but request it for peace of mind and a trace of control over their destinies. In Oregon, the state with the longest experience with assisted suicide, at nearly two decades, some 35 percent who had the life-ending pills didn't take them. They died from their illnesses. Oregon seems to exist on a separate planet in the view of many New Yorkers, but California is a closer cousin. Last year, the Golden State began allowing aid in dying. In the first six months California's law was in effect, 111 people ended their lives that way.
California doctors were caught off guard by the new law, said Dr. Jessica Zitter, a specialist in critical and palliative care in Oakland and author of "Extreme Measures: Finding a Better Path to the End of Life."
However, she and other California physicians report that the law has led to frank and vital conversations about patients' fears and needs, and what defines quality of life. "It has led to access to a lot more support for patients," Zitter said in an interview.
Sometimes physicians adjust patients' medicines or treatments. Before these conversations, patients might not have expressed how much pain they were in. Some opt to go to hospice earlier than they otherwise would have.
Carey of Compassion & Choices is taking heart from the West Coast experience. People often viewed assisted suicide or palliative care as either-or - either a lethal dose or more effort to ease symptoms. Now, Carey said, it's becoming clear that "we're better working together on end-of-life care."
Sponsored by Assemb. Amy Paulin (D-Scarsdale) and Sen. Diane Savino (D-Staten Island), New York's bill has 31 co-sponsors - and public support: 77 percent of New Yorkers told EaglePoint Strategies in September 2015 that they agree with access to assisted suicide.
Large health care groups are also shifting on this issue. The New York State Public Health Association and New York State Academy of Family Physicians favor the proposed law. The Hospice and Palliative Care Association of New York State has dialed back its opposition. One holdout is the largest New York physicians group, the Medical Society of the State of New York.
For this important option, 2018 may be the year.