Catholic Nuns Challenge New York’s Assisted Suicide Law Over Mandate To Counsel Patients

Four congregations of Catholic nuns who have spent generations tending to the sick and dying across New York State are fighting in federal court to avoid becoming, in their telling, agents of the very deaths they are called to prevent.The Little Sisters of the Poor, the Carmelite Sisters for the Aged and Infirm, the Dominican Sisters of Hawthorne, and the Missionary Sisters of St. Benedict, joined by the Diocese of Rockville Centre, Bishop John O. Barres, and the hospital system Catholic Health, filed suit July 17 against New York’s Medical Aid in Dying, or MAID Act, which allows terminally ill adults to obtain lethal drugs to end their lives. The law is scheduled to take effect Wednesday, and the sisters want a judge to halt it before then.Under the law, adult New Yorkers with six months or less to live can ask for medication to end their own lives, so long as two physicians sign off on both the diagnosis and the patient’s mental capacity to make that call. It puts New York among roughly a dozen states with similar statutes on the books.Supporters note that New York’s version comes with extra safeguards that Governor Kathy Hochul insisted upon during negotiations before she’d sign it.At issue is a provision that Becket, the religious liberty law firm representing the plaintiffs, calls a “Suicide Counseling Mandate.” Rather than simply legalizing the practice, Albany constructed a system that pulls every health care provider in the state into its machinery, whether or not they object on religious grounds. That troubles legal scholars on both sides of the assisted-dying debate.“If New York law requires them to participate in evaluating eligibility or helping patients get MAID medications, then the N.Y. law probably does violate the First Amendment,” an expert on medical law and clinical ethics who is a professor of law at Mitchell Hamline School of Law, Thaddeus Pope, tells The New York Sun in a written exchange.He also notes that “religiously affiliated organizations were generally successful in similar challenges to requirements” in California and New Mexico.So, can nuns who have devoted their lives to comforting the dying be required by a state to also walk those same patients toward the door marked suicide?The New York law’s law does include language allowing institutions and individuals to opt out of the practice based on sincerely held religious or moral convictions. But Mr. Pope says that language “may be narrower than in other MAID statutes, like California’s,” meaning it may give religious objectors less room to step back.The hardest problem, he says, is the duty to inform patients about the option in the first place. A federal court facing that same question in Vermont in 2017 sought a middle ground: objectors don’t have to counsel patients themselves, yet they do have to point them toward outside resources where they can learn about the option.A Mandate The Sisters Never SoughtNew York’s Medical Aid in Dying Act authorizes providers to prescribe lethal drugs to terminally ill patients. The state, however, goes further than assisted-suicide pioneers like Oregon in one key respect: Oregon’s law lets providers decline to raise the option at all, while New York requires healthcare providers to inform patients of, and counsel them affirmatively about, the option to end their lives, regardless of whether the patient asked.Catholic hospitals and nursing homes are not required to hand over the drugs themselves. However, under the law as written, they must still facilitate the process, and where a facility will not perform the final act, it must refer the patient to a “willing” provider instead.In other words, a Catholic facility in New York can say no to writing the prescription, but it cannot fully step away from the process.Becket’s complaint spells out how far that facilitation goes: Individual physicians are exempted only from the very last step, meaning nuns and Catholic doctors could still be compelled to proactively inform and counsel patients about the “benefits” of suicide and participate throughout the multi-step process of qualifying them for life-ending drugs.The stakes for the orders are not hypothetical. The Dominican Sisters of Hawthorne run Rosary Hill Home, which has cared for roughly 45,000 low-income cancer patients over the decades, while the Little Sisters of the Poor has welcomed low-income New Yorkers into their homes since 1868.The Superior General of the Dominican Sisters of Hawthorne, Mother Marie Edward, said in a statement accompanying the filing that “for over 125 years, we have ministered to the poor who are dying of cancer as if they were Christ Himself,” highlighting that the order’s calling is “to offer comfort, prayer, and loving medical care to those in their final days — not death.”The complaint also leans on federal law: The Carmelite Sisters, the Little Sisters of the Poor, and Catholic Health all receive federal health care funding directly. The suit argues that the money comes with statutory protections barring its use for anything tied to hastening a patient’s death.A version of the Medical Aid in Dying Act bill had been introduced in Albany every year since 2016, but it was not until February 6 that Ms. Hochul signed one into law, making New York the 14th jurisdiction in the country to authorize the practice. Ms. Hochul negotiated a set of added safeguards before agreeing to sign, including a five-day waiting period between prescription and dispensing; a mandatory recorded request from the patient; and a required mental health evaluation.Because the law does not take effect until August 5, no patient has yet obtained lethal medication under it, and there is no data yet on how many New Yorkers may ultimately use it.A Familiar Foe, One More RoundThis, however, is not the first time the Little Sisters of the Poor have gone to federal court over religious objections to a state mandate. The order previously won at the Supreme Court in a fight over the Affordable Care Act’s contraception requirement, and Becket is separately representing the sisters before the Third Circuit in a bid to revive a Trump-era exemption that has since been narrowed by a court.A senior counsel at Becket, Adèle Keim, said in a statement that “for generations, these Catholic Sisters and their health care ministries have devoted their lives to caring for New Yorkers at their lowest moments.” She argues that the new law “forces the Sisters to offer their patients assisted suicide counseling” against their vocation.Another Becket attorney on the case, Laura Slavis, told the Federalist that patients “actively seek out” the sisters’ facilities precisely because they “share the same beliefs” and want to die in accordance with them — beliefs, she said, that New York is now stripping away.Ms. Hochul’s office, asked about the suit, would not address the litigation directly yet noted the statute allows only terminally ill New Yorkers with a prognosis of six months or less to make what it called a voluntary, informed decision.Supporters of the law have framed it in similar terms since before it was signed: Ms. Hochul has said the measure gives dying New Yorkers “the choice to endure less suffering, not by shortening their lives, but by shortening their deaths,” a position she has tied publicly to watching her own mother suffer from ALS.Advocacy groups that pushed for the law, including Compassion & Choices, argue it restores autonomy to patients in their final months rather than compelling anyone to die, noting the medication must be self-administered and cannot be given to a patient by anyone else.Yet, the nuns’ suit isn’t the only one in the works. A separate coalition called End Assisted Suicide filed its own federal challenge in Brooklyn in June, arguing on different grounds — that the law discriminates against people with disabilities in violation of the Americans with Disabilities Act, the Affordable Care Act, and the Rehabilitation Act, among other statutes.The executive director of Not Dead Yet, a national disability rights organization that opposes legalizing assisted suicide, Ian McIntosh, tells the Sun that “disability rights advocates know that assisted suicide laws are all about disability.”He argues that layering a legal mandate on top of “pre-existing disability bias, medical futility judgments and unequal access to care” creates what he calls “a perfect storm where our most vulnerable people aren’t choosing death — they’re being steered toward it.”Despite the two federal lawsuits challenging the Medical Aid in Dying Act, there is no injunction yet in place to stop it from taking hold on August 5.Where the sisters’ suit says the mandate strips away patient autonomy, the Catholic League has characterized it in even bleaker terms.“This is a flagrant violation of the First Amendment religious rights of the plaintiffs,” the president of the Catholic League, Bill Donohue, tells the Sun, calling the requirement “morally unacceptable” under Catholic teaching and “a violation of the Fifth Commandment.”Mr. Donohue points to controversial MAID laws in Europe and Canada as evidence against reassurances that the law contains adequate safeguards, contending that “all the talk about ‘guardrails’ is a ruse.”Mr. Pope, for his part, is careful to note that some level of participation has long been asked of conscientious objectors in health care generally. At minimum, for example, an objector is required to transfer a patient’s records to a provider willing to proceed. Courts, he says, have had to balance religious objections against patient access, though he agrees the counseling question is the harder one. It is precisely that question that a federal judge in Albany must now resolve before the law takes effect.“Doctors are pledged to save lives, not take them,” Mr. Donohue adds. “The message it sends to physicians and their patients is confusing about their role and expectations.”

Catholic Nuns Challenge New York’s Assisted Suicide Law Over Mandate To Counsel Patients

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