Myers v Schneiderman – Aid in Dying Will Require a Legislative Overhaul to Be Recognized

The Court of Appeals issued a decision in September in Meyers v. Schneiderman, 2017 NY Slip Op 06412, 2017 N.Y. Lexis 2557 (2017), that asked whether there was a New York constitutional right to “aid-in-dying”.

It has been well-established that individuals have the right to refuse unwanted medical treatment.  This recognition was more firmly established with the case of Matter of Quinlan in 1976 and was recognized by the United States Supreme Court in Cruzan v. Director, Missouri Department of Health, 497 US 261 (1990).

New York has historically been actively involved in addressing the issues of medical ethics and a patient’s right to refuse treatment or seek aid-in-dying.  In 1914, New York had a landmark case that recognized the need for informed consent and involvement of the patient in determining the course of treatment in Schloendroff v. Society of New York Hospital, which held that “every human being of adult years and sound mind has a right to determine what shall be done with his own body.”  211 NY 125 (1914).  Fast forwarding to years later, in the late 1990s, Dr. Timothy E. Quill, along with other physicians and terminally ill patients, challenged New York’s ban on “physician assisted suicide”, now more commonly called “aid-in-dying”.  The US Supreme Court ultimately determined that the prohibition on assisting suicide did not violate the equal protection clause. Vacco v. Quill, 521 US 793 (1997) The Court found that there was a fundamental distinction due to causation and intent between a patient refusing life-sustaining treatment and ingesting lethal medication.  Id. at 801.

In 2015, several individuals and entities sued Attorney General Eric Schneiderman seeking a declaration that physicians who provide aid-in-dying to a mentally competent, terminally ill patient would not be held criminally liable under Penal Law 120.30 and 125.15 and an injunction to prohibit the prosecution of these physicians.  Plaintiffs include Sara Myers, who is terminally ill and was diagnosed in 2010 with amyotrophic lateral sclerosis (“ALS”), a terminal neurodegenerative condition that causes paralysis and has no cure; Eric Seiff, a former attorney who has been diagnosed with cancer; medical professionals who regularly treat terminally ill patients including Dr. Quill; and End of Life Choices New York, an advocacy organization.  Defendants quickly moved to dismiss the case and were successful in doing so.  Plaintiffs appealed.

Plaintiffs challenged the statutory construction of the Penal Law and that it violated their constitutional rights. Specifically, Plaintiffs challenged Penal Law §125.15, which finds any person, including a physician, guilty of manslaughter in the second degree who “intentionally causes or aids another person to commit suicide.” Plaintiffs also challenged Penal Law § 120.30, which states “[a] person is guilty of promoting a suicide attempt when he intentionally causes or aids another person to attempt suicide.”

The Court of Appeals first addressed the statutory construction argument and held that Penal Law 120.30 applies to anyone and does not exclude physicians, as argued by Plaintiffs.  2017 NY Slip Op. 06412, p. 6.  The Court of Appeals also rejected Plaintiffs’ claims that it violates the equal protection clause and due process clauses of the State Constitution.  Id. at p.7. The Court found no reason for a departure from the Supreme Court’s ruling on New York law in Vacco v. Quill regarding the equal protection clause. Id. at p.8.

As for the due process clause, Plaintiffs argued that they have a fundamental right to self-determination and to control their medical treatment which includes the right to choose aid-in-dying.  The Court cited to Washington v. Glucksberg, holding that there is not a fundamental liberty interest to committing suicide. Id. at p.8.  The Court noted that one’s right to refuse medical treatment and to choose among medical treatments has never been expanded to include a “â’right to die’ or still broader right to obtain assistance from another to end one’s life.” Id. at p.9.  Finding that the question only needed to be rationally related to a legitimate government interest, the Court looked to several other cases noting the historical trend that the State has an interest in preventing suicide, maintaining a physician’s role as healer, protecting vulnerable individuals and preventing “a possible slide towards euthanasia”. Id. at p.10-12.

Ultimately, the Court noted that this issue was better suited for the legislature, noting many other jurisdictions that permit the practice after careful legislative action.  Id. at p.13.

New York is not alone in its struggle with the issue of aid-in-dying, as the debate around the country has been renewed in the past few years.  Washington and Oregon have long had statutes on this issue, and Montana has allowed for it by court decision.  Vermont passed a law in May 2013.  Then, there was significant media attention that followed the tragic story of Brittany Maynard, a 29 year old married women who was diagnosed with a Stage IV malignant brain tumor.  She underwent a partial craniotomy and a partial resection of her temporal lobe but the tumor came back and was more aggressive.  Brittany was given six months to live.  As her home state of California did not permit aid-in-dying at the time, Brittany and her husband moved to Oregon so she could avail herself of Oregon’s Death with Dignity Act.  Brittany did choose to take the medication prescribed to her and died in November 2014.  Prior to her death, Brittany was a vocal supporter of aid-in-dying and took to social media to speak about her decision and condition.  Subsequently, her home state of California passed the End of Life Option Act in October 2015 and it went into effect on June 9, 2016.  Colorado passed a law in 2016 as well and the District of Columbia in 2017.  Several other states are considering laws on this issue.  New York is one such state considering the issue in the legislature. New York has the Medical Aid in Dying Act pending in the legislature, which would permit mentally competent, terminally ill patients to seek aid-in-dying. New York’s bill has several supporters but also several organizations that are actively against it.

As published in the Albany County Bar Association newsletter.