Jules Netherland traveled from his home in the Bronx to the New York State Capitol in Albany several times in recent years, hoping to persuade the legislature to pass a medical aid-in-dying bill, allowing terminally ill patients to end their lives with a lethal prescription.
He spoke at rallies. With other members of the advocacy organization Compassion & Choices, he visited lawmakers' offices. In 2024, as the state Assembly debated the aid-in-dying bill, he helped unfurl a banner in the chamber gallery that read, “Stop the suffering.”
His activism was becoming difficult. Netherland, who is 59 years old and works for a nonprofit, was diagnosed with breast cancer in 2019. “I went through a full year of aggressive treatment,” she said. “Chemotherapy. A mastectomy. Radiation treatment every day of the week for five weeks. Six months of two oral medications.”
He recovered and felt well until the cancer returned a few years later. Although metastatic breast cancer is incurable, medications are keeping her disease at bay for now. Netherland feels lucky but also fatigued, struggling with brain fog, gastrointestinal symptoms and joint pain.
“My energy is really limited,” he said.
As he emailed and called lawmakers, Netherland feared he would die before the aid-in-dying bill, first introduced in New York in 2016, could become law.
'A decisive moment'
On June 9, 2025, after the Assembly passed the bill, Holland was in the state Senate chamber, watching the yes votes grow and watching it pass. Gov. Kathy Hochul signed an amended version in February; It is scheduled to come into force on August 5.
A similar law is scheduled to take effect in September in Illinois, which would become the 13th state (plus the District of Columbia) where medical assistance in dying is legal.
“A defining moment,” said Kevin Díaz, president of Compassion & Choices, which has led the long campaign for such laws. After nearly 30 years (Oregon's law, the first in the country, was enacted in 1997), the addition of two populous states means that nearly a third of Americans will live in one where medical aid in dying is legally available. “This shows that there is broad support for this model,” Díaz said.
Polls consistently support that claim. A Pew Research Center survey last spring found that nearly two-thirds of respondents did not consider the practice “morally wrong,” either because they thought it was acceptable or not a moral issue. Support crossed many political and religious lines: a narrow majority of Republicans and 76% of Democrats considered “physician-assisted death” (also sometimes called “physician-assisted suicide”) permissible; So did most non-evangelical white Catholics, Jews, and Protestants.
In New York, a Siena poll found that 54% of respondents supported aid in dying, including majorities of men and women, of all age groups, and of urban, suburban, and upstate residents. A plurality of Latinos supported him; Black respondents were narrowly opposed.
Passing these laws has become somewhat easier, said Thaddeus Pope, a bioethicist and professor at Mitchell Hamline School of Law in St. Paul, Minnesota, who tracks such policies. “You can say, ‘We’ve been in California for 10 years, Washington for 18 years, and Oregon for 29 years, and nothing bad has happened.’ It becomes more accepted.”
'You need A, B and C'
However, the legalization of medical aid in dying, or MAID, has been and continues to be a long and contentious process. Catholic leaders and many disability organizations are strongly opposed. (Pope Leo XIV personally asked Illinois Governor JB Pritzker not to sign the bill.)
The American Medical Association says “physician-assisted suicide is fundamentally incompatible with the physician's role as healer” and poses “serious social risks,” although several state medical organizations have chosen to remain neutral or, as in New York, support approval.
The Patients' Rights Action Fund, through a sister organization, has lawsuits pending or on appeal in California, Delaware and Colorado, arguing that aid-in-dying laws discriminate against people with disabilities by steering them toward physician-assisted suicide rather than treatment.
“This is a litigation strategy that we have developed to ultimately get to the Supreme Court,” said Matt Vallière, the group's executive director, who declined to say whether he would sue to block the Illinois and New York laws.
Even when extinction relief laws are successful, using them can be a challenge. In all states (except Montana, where it was legalized by a court decision, so there is no statute governing eligibility), aid in dying is only available to people with incurable illnesses who are expected to die within six months.
It typically involves oral and written requests to two doctors, with mandatory waiting periods between requests. Patients must have the mental capacity to make the decision, which disqualifies those with dementia, and must take the medication without assistance. (An amendment Hochul insisted on adds a psychologist or psychiatrist to the process.)
All but two states require patients to be residents. Oregon and Vermont dropped their residency requirements to resolve lawsuits brought by Compassion & Choices. (Courts ruled against a similar lawsuit in New Jersey.)
Additionally, any doctor, hospital, or health system can legally refuse to provide aid in dying, and religious institutions often choose not to. Those who participate can add their own requirements.
“The state can say, 'You need A, B, and C,' and Columbia-Presbyterian can say, 'We also want D, E, and F,'” said Pope, the Minnesota bioethicist.
Hotly debated, rarely used
Perhaps these restrictions, or the lack of public awareness, help explain why, despite the headlines and fervent debates, the number of people actually using the law is small in all states: generally 1% or less of the deaths recorded annually. Support for giving patients this type of autonomy at the end of life remains widespread, but the desire to exercise it personally apparently is not.
Still, after studies showed that many patients seeking MAID died before they could complete the process, the trend has been to loosen restrictions. California reduced its waiting period from 15 days to 48 hours; New Mexico allows physician assistants and advanced practice nurses to write prescriptions alongside doctors.
“Most states have changed their laws two or three times,” Pope said. “We have liberalized.” Telehealth can also facilitate access to participating physicians.
Compassion & Choices is planning legal challenges to end residency requirements in other states, Diaz said. It is also considering how to “make inroads in jurisdictions with a very different cultural and political environment,” he added, mentioning Florida and other southern states.
Medical aid in dying represents a shift in power, Díaz said. “The person who has to bear the burden of suffering should have the ability to decide when enough is enough,” he added.
Anne Gurnett Bander, 72, a retired research scientist in Carmel, New York, cared for her husband for four years as ALS (the relentlessly disabling neurological disorder also known as Lou Gehrig's disease) left him bedridden and dependent on feeding and breathing tubes. “When he died, all I could do was nod my head,” he recalled.
That's why being diagnosed with ALS last year was “my worst possible nightmare,” Gurnett Bander said. He was planning to fly to Switzerland, where the nonprofit Dignitas provides medical help for the dying, when he learned about the New York bill and began speaking publicly in favor of it, his voice breaking as his illness progressed.
Gurnett Bander and Netherland say they are hesitant to use lethal drugs to end their lives as their symptoms intensify. It is not uncommon for patients to complete the necessary steps, obtain the prescribed medication, decide that they do not need it after all, and die from their illnesses. But both women insist the choice should be theirs.
“It can offer a lot of peace of mind,” Netherland said. “I thought, ‘People should have this option.’ Now they will.”
The New Age is produced through a partnership with The New York Times.
