Shortly after penning an op-ed in the Times Union explaining how New York State Governor Kathy Hochul came to support medical aid in dying, she announced an agreement with the Legislature to make medical aid in dying available to terminally ill New Yorkers with less than six months to live after amending the legislation with safeguards and guardrails to prevent abuse or coercion. This comes after careful reflection and deliberation with the bill’s sponsors, advocacy organizations, and most importantly, everyday New Yorkers who shared personal experiences with the Governor, who is a devout Catholic. The bill, with the agreed-upon amendments, will be passed and signed in January, and the law will go into effect six months later.

Announcing the agreement, Governor Hochul stated,

“Such as life and so is death — two forces in life that are inevitable. And so I was moved by their courage and I wanted to help them put an end to a decades long journey and say, ‘You can rest now. Your loved one has been honored in a way that is profound. And to the extent that you’re still wounded, suffering, questioning yourself, may you rest in peace yourself in this life, may you not have that trauma and that angst any longer.’ That’s what I wish for all my friends here….

“That there could be coercion, duress, and pressure put on people. And I was concerned about that and I said, “How can we get out from under that?” That everyone will know that someone who makes that decision did it of free will, not under pressure. And so, those are some of the constraints I put around this….

“So we have our safeguards, you can read them all, but this is one of the toughest decisions I’ve ever made as Governor. So I spent a lot of time on this, talked to a lot of people, but I want these people behind me to know, it was their stories that touched my heart the most. Because who am I to deny you or your loved one what they’re begging for at the end of their life?

“I couldn’t do that any longer, and that is why I’m here to announce that we have reached an agreement, and I thank the legislators for listening to me and my concerns and to reconfirm that New York will always continue to be a bastion of freedom to worship, to speak your mind, freedom of choice. It’s time we finally extend those freedoms to the terminally ill and their families.”

Here is the text of the op-ed that can be viewed online, explaining how she came to this most difficult decision:

Two and a half centuries ago, our founding fathers established a vision of a country based on limited government and broad individual rights that together protect rights of speech, worship, privacy and bodily autonomy. Proudly, New York has long led the fights championing the rights of individuals, from civil rights to labor rights, LGBTQ rights, women’s rights, and reproductive rights. In the true spirit of this country, government has a responsibility to protect, not interfere, with an individual’s deeply personal decisions.

This is the context in which I have considered the Medical Aid in Dying Act, a bill to allow suffering terminally ill individuals with less than six months left to live the right to medical aid to speed up the inevitable.

During this journey I listened to New Yorkers who are in the throes of pain and suffering. I heard from their children, who are watching a parent endure a slow, devastating decline. I heard stories of a parent or spouse pleading for an end to the suffering and how difficult it was to reply, “We can’t in New York.”

This was heartbreaking, and it hit close to home. I watched my own mom die from ALS. I watched that vicious disease steal away the strong woman who raised me as it took her ability to walk, to eat, to speak and, ultimately, to live. I am all too familiar with the pain of seeing someone you love suffer and feeling powerless to stop it.  

At the same time, there are individuals of many faiths who believe that deliberately shortening one’s life violates the sanctity of life. I understand and respect those views. But as I have spoken with people tormented by pain, I have come to see this as a matter of individual choice that does not have to be about shortening life but rather about shortening dying. And I do not believe that in every instance condemning someone to excruciating pain and suffering preserves the dignity and sanctity of life. 

I reflected on this during a Catholic funeral Mass for a family friend where the priest spoke of the welcome home to eternal life. I was taught that God is merciful and compassionate, and so must we be. This includes permitting a merciful option to those facing the unimaginable and searching for comfort in their final months in this life.

So after careful deliberation, I decided to support legalizing medical aid in dying in very specific circumstances and with significant protections included in the law to ensure it is not misused or broadly applied.

The bill passed by the Legislature already allowed individual doctors and religiously affiliated health facilities to decline to offer medical aid in dying. In my view, those protections were essential but not sufficient. I proposed additional guardrails that also protect family members, caregivers and doctors, and I am pleased that the bill’s sponsors and legislative leaders agreed to include them in the bill I will ultimately sign once the Legislature returns to Albany and approves the amended language. 

These guardrails address the concerns of some who fear that vulnerable populations, including those with disabilities or the elderly, will be pressured into a decision they would not have made on their own. Confirmation from a medical doctor that the individual truly had less than six months to live, and from a psychologist or psychiatrist that the patient is capable of making the decision and not under duress, will now be required. 

There will be a mandatory five-day waiting period to provide the patient the chance to change their mind, and both a written and recorded oral request to confirm free will is present, with anyone who may benefit financially disqualified from being a witness or interpreter. 

Outpatient facilities associated with religious hospitals may elect not to offer medical aid in dying, and the effective date of the bill has been extended to ensure time for regulations and training.

Finally, this is a right afforded to New Yorkers only.

These are fundamental protections to ensure vulnerable people aren’t pressured, misled or left without alternatives.

The Medical Aid in Dying Act will afford terminally ill New Yorkers the right to spend their final days not under sterile hospital lights but with sunlight streaming through their bedroom window. The right to spend their final days not hearing the droning hum of hospital machines but instead the laughter of their grandkids echoing in the next room. The right to tell their family they love them and be able to hear those precious words in return.  

I am grateful to the advocates, families and legislative supporters, especially bill sponsors Sen. Brad Hoylman-Sigal and Assemblymember Amy Paulin, who worked hard to make this happen in a thoughtful and responsible way. And I hope those who are disappointed by this outcome know this was a difficult decision for me personally. It was not made lightly. It was guided by a genuine and deeply held belief that government must respect the rights and will of the people it serves. I hope that those who oppose this legislation will be able to look with compassion on those who may make a choice they would not make for themselves. And isn’t that, at heart, what the choice and freedom our young nation promised its people 250 years ago is all about?

Kathy Hochul is the 57th governor of New York.