On September 8, 2017, the NY Court of Appeals ruled that terminally ill people do not have a fundamental state constitutional right to physician-assisted suicide. The decision stated, “Aid-in-dying falls squarely within the ordinary meaning of the statutory prohibition on assisting a suicide.” The court added that state law is clear in prohibiting anyone, including doctors, from assisting in suicide. To date, no state has recognized assisted suicide as a fundamental right.
The court ruled “that state lawmakers had a rational reason for passing a ban on assisted suicide and that the ban doesn’t violate the state constitution.” In addition, the court ruled that it would not block the NY Legislature from passing legislation banning physician-assisted death.
New York’s Catholic Conference hailed the decision as a “significant victory.” "The decision is a significant victory for those who would be most at risk of abuse and most susceptible to pressure to take their own lives, including the isolated elderly, persons with disabilities and those who are depressed and overcome with hopelessness,” said Kathleen M. Gallagher of the Catholic Conference, which represents the church’s bishops in the state.
The court pointed out that New York law does allow terminally ill patients to decline life-sustaining medical assistance, but, it does not permit anyone to assist in ending patients’ lives. There are specific laws that govern end-of-life decisions in New York, including Health Care Proxy, Family Health Care Decisions Act (FHCDA), Medical Orders for Life-Sustaining Treatment (MOLST) and Surrogate Court Proceedings Act §1750-b. These laws include patient protections to ensure these end-of-life decisions are person-centered and grounded in ethical principles.
The MOLST program helps seriously ill patients who might die in the next year ensure they receive care reflecting their values, beliefs, goals for care and their end-of-life treatment preferences will be honored. Using a standardized process, completion of the MOLST includes conversations between the patient/family/loved ones and their physician/care team to define the patient’s goals for end-of-life care and review possible treatment options using shared decision-making that is well informed. Once completed, the MOLST is a set of medical orders that clearly set forth the patient’s preferences for life-sustaining treatment. A palliative care plan must support the MOLST. These medical orders must be followed by all healthcare professionals, including EMS, in all settings. New York's Catholic Conference supports appropriate use of the MOLST.
eMOLST, the secure web-based application for MOLST – found at NYSeMOLSTregistry.com – serves as New York’s eMOLST Registry. The completion process adds an additional layer of structure and quality assurance to MOLST. eMOLST is essential to be sure the process is done correctly.
MOLST is a key pillar of palliative care. The time is now to move towards universal access to high-quality palliative care for persons with serious illness and statewide eMOLST implementation.