ON THIS MONTH'S EDITION OF "CONNECT NY", WE ARE EXPLORING END OF LIFE DECISIONS, INCLUDING THE RIGHTS OF TERMINALLY ILL NEW YORKERS AND THE RATES OF HOSPICE UTILIZIATION IN THE EMPIRE STATE.

ALL THAT, AND MORE, ON "CONNECT NY."

♪ WELCOME TO "CONNECT NY."

I'M DAVID LOMBARDO.

LATER IN THE EPISODE, WE WILL BRING YOU A DISPATCH FROM THE CAPITOL PRESSROOM IN ALBANY.

BUT FIRST, WE'RE DIVING INTO THIS MONTH'S TOPIC, WHICH IS END-OF-LIFE DECISIONS, INCLUDING LEGISLATION ENABLING TERMINALLY ILL NEW YORKERS TO END THEIR LIVES WITH THE HELP OF A DOCTOR.

AND OUR GUESTS IN THE STUDIO ARE STATE SENATOR RACHEL MAY, A SYRACUSE DEMOCRAT, JESSICA RODGERS, COALITIONS DIRECTOR FOR THE PATIENTS RIGHTS ACTION FUND, AND CORRINE CAREY, SENIOR CAMPAIGN DIRECTOR FOR COMPASSION AND CHOICES IN NEW YORK AND NEW JERSEY.

AND WE ARE GOING TO TALK A LOT ABOUT LEGISLATION THAT WAS NARROWLY APPROVED THIS YEAR BY DEMOCRATS IN THE LEGISLATURE AND IT IS CURRENTLY, AS WE TALK ON NOVEMBER 13, AWAITING THE GOVERNOR'S SIGNATURE BUT I WANT TO TALK ABOUT WHAT THE STATUS QUO LOOKS LIKE RIGHT NOW IF YOU ARE A TERMINALLY ILL NEW YORKER WHO IS POTENTIALLY LOOKING AT SUFFERING FOR YOUR FINAL DAYS AND MONTHS ON THE PLANET.

SO, JESSICA, WHAT DOES THAT EXPERIENCE LOOK LIKE RIGHT NOW?

AND ARE THERE OPTIONS FOR A PERSON TO POTENTIALLY END THEIR LIFE PREMATURELY?

>> I THINK RIGHT NOW THE LANDSCAPE FOR ANYONE WHO IS EXPERIENCING AN ADVERSE DIAGNOSIS OR TERMINAL ILLNESS OR DISABILITY IS APPROACHING THE MEDICAL SYSTEM HOPING THAT THEY WILL APPROPRIATELY ALLEVIATE ANY PAIN AND SUFFERING AND THAT YOUR DOCTOR WILL BE ON YOUR SIDE IN FINDING A SOLUTION TO WHATEVER IT IS THAT IS AILING YOU.

HERE IN NEW YORK WE OBVIOUSLY HAVE A PALLIATIVE CARE AND HOSPICE CARE AND, AS YOU MENTIONED, THE RATE OF UTILIZATION, OUR RATE HERE IS UNFORTUNATELY VERY LOW.

AND WHAT I HEAR FROM DOCTORS THAT ARE WORKING IN THAT FIELD, BE IS THAT THEY WISH THAT THEIR PATIENTS CAME TO THEM SOONER AND THAT THEIR PATIENTS OFTEN WISH THEY HAD COME TO HOSPICE CARE SOONER TO RECEIVE APPROPRIATE CARE.

>> AND CORRINE, WHAT IS YOUR PERSPECTIVE ON THE WAY THE LANDSCAPE LOOKS NOW AND ARE THERE CASES THAT YOU ARE AWARE OF WHERE PEOPLE ARE LOOKING TO DOCTORS OR FAMILY MEMBERS OR EVEN POTENTIALLY STRANGERS TO HELP SPEED UP THE END OF LIFE PROCESS?

>> ABSOLUTELY.

I THINK EVERYONE HOPES, AS JESSICA SAID, THAT THE MEDICAL ESTABLISHMENT CAN HELP ALLEVIATE PAIN AND SUFFERING AT THE END OF LIFE.

BUT SADLY, FOR TOO MANY PEOPLE, THAT ISN'T THE REALITY.

SO HOSPICE AND PALLIATIVE CARE ARE CERTAINLY AMAZING RESOURCES.

MY OWN FATHER GOT INTO HOSPICE FAR TOO LATE, 72 HOURS BEFORE HE DIED, BUT WE GOT A GLIMPSE OF WHAT AN AMAZING SERVICE THAT COULD BE AND IT CERTAINLY EASED MY EXPERIENCE OF MY FATHER'S DEATH.

BUT WHEN HOSPICE AND PALLIATIVE CARE ARE NOT ENOUGH TO ALLEVIATE SUFFERING, THERE ARE OTHER OPTIONS THAT NEW YORKERS CAN AVAIL THEMSELVES OF VOLUNTARILY STOPPING EATING AND DRINKING OR BEING SEDATED TO UNCONSCIOUSNESS UNTIL THE PERSON PASSES.

BUT MANY PEOPLE DON'T WANT THAT.

THEY DON'T WANT TO VIRTUALLY STARVE TO DEATH OR HAVE THEIR FAMILIES SIT BY THEIR BED SIDE AND WATCH.

AND THEY ALSO WANT TO BE ABLE TO COMMUNICATE WITH LOVED ONES AT THE END OF THEIR LIVES.

SO, FOR SOME PEOPLE, ALL OF THOSE OPTIONS ARE JUST NOT ENOUGH TO ALLOW THEM TO HAVE THE KIND OF DEATH EXPERIENCE THAT IS CONSISTENT WITH THE WAY THAT THEY LIVED.

AND THEY'RE BEGGING FOR THE OPTION OF MEDICAL AID IN DYING.

>> SENATOR, IN RESPONSE TO THE STATUS QUO, YOU CO-SPONSORED LEGISLATION KNOWN AS IN ITS CURRENT FORM MEDICAL AID IN DYING FOR, FOR VIEWERS IS BASICALLY LEGISLATION THAT ALLOWS TERMINALLY ILL, MENTALLY COMPETENT NEW YORKERS TO END THEIR LIVES WITH THE HELP OF A PHYSICIAN.

WE CAN GET INTO THE IMPLEMENTATION OF SOMETHING LIKE THAT AND THE DEFINITION OF SOME OF THOSE TERMS.

BUT WHY IS THAT THE RIGHT ANSWER, FROM YOUR PERSPECTIVE?

WHY IS THIS LEGISLATION EITHER PHILOSOPHICALLY OR AS IT IS WRITTEN, THE RIGHT ANSWER TO THE LANDSCAPE?

>> YEAH, SO THIS WASN'T AN EASY DECISION FOR MANY OF US WHO VOTED FOR IT.

I KNOW THAT, YOU KNOW, WE HEARD A LOT FROM PEOPLE ON BOTH SIDES OF THIS ISSUE, BUT FOR ME PERSONALLY, BECAUSE OF EXPERIENCES THAT I'VE HAD WITH MY FAMILY MEMBERS, BUT ALSO THE STORIES THAT WE WERE BEING TOLD BY PEOPLE: DOCTORS AND LOVED ONES WHO WERE COMING IN AND DESCRIBING THE ANGUISH PEOPLE WERE GOING THROUGH AT THE END OF THEIR LIVES.

IT JUST FELT LIKE WE ARE AT A PLACE WHERE WE CAN PUT TOGETHER LEGISLATION THAT MAKES SENSE.

THERE ARE PRECEDENTS IN OTHER PLACES THAT HAVE BEEN WORKING WELL AND IT FELT LIKE THE RIGHT TIME TO DO THIS.

>> WELL, JESSICA, WE CAN GET INTO THE LEGISLATION AND WHETHER IT'S THE RIGHT ANSWER, WHETHER THERE ARE FLAWS IN IT.

BUT FROM A PHILOSOPHICAL PERSPECTIVE, WHAT DO YOU THINK ABOUT THE STATE GETTING INVOLVED IN THIS TYPE OF QUESTION?

I MEAN PUTTING ASIDE WHETHER THE LEGISLATION ANSWERS ALL THE CONCERNS ABOUT SAFEGUARDS; FOR EXAMPLE, IS THIS SOMETHING WHERE THE STATE HAS A ROLE?

SOME SORT OF PHYSICIAN ASSISTED SUICIDE FOR THE RIGHT WAY FOR THE STATE TO GET INVOLVED?

>> NO.

WE ARE LOOKING AT SETTING UP A STATE-RUN TWO TIERED SYSTEM WHERE PEOPLE WITH LIFE THREATENING DISABILITIES ARE GOING TO RECEIVE A DIFFERENT STANDARD OF CARE THAN SOMEONE WITHOUT A LIFE THREATENING DISABILITY.

AND WE ALREADY HAVE A SYSTEM THAT, UNFORTUNATELY, DEVALUES THE LIVES OF PEOPLE WITH DISABILITIES.

>> I'M SORRY TO INTERRUPT YOU.

IN A PERFECT WORLD, IF ALL THE WOES OF OUR HEALTHCARE SYSTEM COULD BE ADDRESSED, IF EVERYONE HAD EQUAL ACCESS AND ENOUGH HEALTHCARE WORKERS FOR EXAMPLE, SOME SOMETHING THAT COULD BE THOUGHT ABOUT AS A POSITIVE SOLUTION?

IF WE PUT ASIDE WHAT REALITY MIGHT LOOK LIKE, IS THERE A VERSION OF THIS WHERE YOU THINK OKAY, THIS I GET THIS, THIS COULD WORK?

OR IS IT THE CASE FOR PHILOSOPHICAL REASONS, MORAL REASONS, YOU WOULDN'T WANT TO GO DOWN THIS PATH?

>> WELL DAVID, I UNFORTUNATELY I DON'T LIVE IN UTOPIA SO I DO HAVE TO EXIST IN THE UNEQUITABLE REALITY THAT WE HAVE.

DO I EVER THINK IT'S A GOOD IDEA FOR THE STATE TO SANCTION SUICIDE FOR SOME PEOPLE?

NO.

>> OKAY.

SO THEN LET'S TALK ABOUT YOUR CONCERNS.

IS THERE ANYTHING THAT YOU FIND PARTICULARLY GLARING, BASED ON WHAT HAS BEEN VOTED ON IN THE LEGISLATURE?

>> ABSOLUTELY.

THE LANGUAGE IN THE NEW YORK BILL MIRRORS THAT OF THE LANGUAGE IN OREGON AND IN COLORADO.

AND IN THOSE CASES, WE HAVE SEEN TREMENDOUS EXAMPLES OF ABUSE OF THE SUPPOSED SAFEGUARDS NOT WORKING THE WAY THAT THEY WERE SUPPOSED TO WORK.

AND WE ALSO SEE THE DATA OUT OF OREGON AND OUT OF WASHINGTON THAT PEOPLE WHO ARE ASKING FOR THESE LETHAL DRUGS ARE NOT DOING SO FOR REASONS OF PAIN.

THAT HASN'T BEEN EVEN ONE OF THE TOP FIVE REASONS THAT PATIENTS SELF-REPORT ASKING FOR THESE DRUGS.

MORE THAN THAT, THEY SAY THINGS LIKE I DON'T WANT TO BE A BURDEN ON MY FRIENDS AND FAMILY.

SO WE ARE SETTING UP AN ENVIRONMENT WHERE SOMEONE WHO DOESN'T WANT TO BE A BURDEN, WHO FEELS LIKE THEY'RE A BURDEN ON THEIR LOVED ONES IS GOING INTO THEIR PHYSICIAN AND, INSTEAD OF RECEIVING APPROPRIATE STANDARDS OF CARE, INSTEAD OF RECEIVING MENTAL HEALTH INTERVENTIONS, THEIR DOCTOR, IN SOME CASES, IS INSTEAD ABANDONING THEM.

GIVING THEM LETHAL DRUGS TO GO HOME AND DIE AND THAT'S A REALLY DANGEROUS POSITION TO PUT OUR VULNERABLE LOVED ONES INTO.

>> CORRINE, WHAT DO YOU THINK ABOUT THE CHARACTERIZATION OF THE EXPERIENCE IN OREGON, WHICH HAS BEEN GOING ON FOR NEARLY THREE DECADES RIGHT NOW.

ACCORDING TO THE ASSEMBLY SPONSOR OF THIS BILL, DURING THE DEBATE, THEY ARGUE THEY HAVE A PRETTY GOOD TRACK RECORD.

HOW DO YOU VIEW IT?

>> I MEAN THEY HAVE A WONDERFUL TRACK RECORD.

THE ONLY TERRIBLE CASES THAT WE HEAR ABOUT ARE CASES WHERE THE BARRIERS TO ACCESSING MEDICAL AID IN DYING ARE TOO HIGH FOR PEOPLE; FOR EXAMPLE, IN OREGON, THE DIRECTOR FOR THE DISABILITY RIGHTS PROTECTION GROUP IN THAT STATE SAID IN HIS LAST EXAMPLE OF HOW THAT LAW IS WORKING IN OREGON, THAT THE ONLY COMPLAINTS THEY HAD RECEIVED FROM PEOPLE LIVING WITH A DISABILITY IS THAT THE SAFEGUARDS WERE TOO STRICT FOR THEM TO ACCESS THE LAW.

I THINK, WITH REGARD TO PEOPLE AND THEIR REASONS FOR NEEDING MEDICAL AID IN DYING, WE DON'T HAVE TO LOOK TO OTHER STATES.

WE HAVE HAD MORE THAN 35 ADVOCATES WALKING THE HALLS OF ALBANY, LIVING WITH TERMINAL ILLNESSES WHO ARE SAYING THAT THEY WANT MEDICAL AID IN DYING BECAUSE THEY FEAR THE KIND OF PAIN AND SUFFERING THAT THEY ARE ALREADY EXPERIENCING OR THAT THEY HAVE WITNESSED OTHER PEOPLE EXPERIENCING.

I WOULD ALSO SAY THOSE RESPONSES ARE RECORDED BY DOCTORS, NOT PATIENTS THEMSELVES.

AND THERE ARE A VARIETY OF REASONS WHY PEOPLE CHOOSE MEDICAL AID IN DYING.

AND PAIN IS ONE OF THEM.

IT MAY NOT BE THE TOP ONE FOR PEOPLE IN OREGON, BUT I CAN TELL YOU IT IS THE TOP FEAR FOR PEOPLE HERE IN NEW YORK WHO HAVE BEEN BEGGING FOR THIS OPTION.

>> WITH RESPECT TO CORRINE AND TO THE ADVOCATES THOUGH, THIS IS NOT A POLICY THAT IMPACTS THOSE 35 PEOPLE.

THIS IS A POLICY THAT IMPACTS EVERY NEW YORKER.

SO WHILE THEIR EXPERIENCES MAY BE ONE OF PAIN, THAT IS NOT THE REALITY FROM THE DATA THAT WE HAVE IN ALMOST THREE DECADES OF THIS BEING POLICY IN OREGON.

AND IN FACT WHAT WE SEE IN STATES LIKE OREGON AND COLORADO IS YOUNG WOMEN WITH ANOREXIA, WHICH IS A MENTAL HEALTH CONDITION, NOT A TERMINAL ONE, BEING GIVEN LETHAL DRUGS AND ABANDONED BY THEIR DOCTOR INSTEAD OF BEING GIVEN APPROPRIATE CARE.

AND THAT IS ENTIRELY LAWFUL THE WAY THAT THE BILL IS WRITTEN, INCLUDING THE BILL HERE IN NEW YORK.

>> I'M GOING TO INTERRUPT THERE AND JUST SAY LIKE THE DIFFERENCE BETWEEN A LIFE THREATENING DISABILITY, WHICH IS A TERM THAT YOU USED AND ACTUAL TERMINAL ILLNESS, THAT'S A PRETTY STRONG DIFFERENCE AND WE TRIED VERY HARD TO MAKE THAT DISTINCTION IN HERE.

AND DAVID, YOU USED THE WORD SUICIDE.

I THINK IT'S VERY MISLEADING TO USE THAT IN THIS CONTEXT BECAUSE SUICIDE TYPICALLY IS SOMETHING, YOU KNOW, PEOPLE DO ALONE.

IT'S TRAUMATIC FOR THEIR RELATIVES.

IT IS OFTEN VIOLENT.

IT IS-- THIS IS A VERY DIFFERENT KIND OF SITUATION.

>> IS THIS A DISTINCTION WITHOUT A DIFFERENCE THOUGH?

IT SEEMS LIKE THIS HAS BEEN A MESSAGING THING MORE THAN A SUBSTANTIVE DIFFERENCE BECAUSE PEOPLE ARE UNCOMFORTABLE WITH THE IDEA OF SUICIDE.

SUICIDE OFTEN IS SOMETHING THAT IS TRAUMATIC AND OBVIOUSLY IT CAN PROBABLY TAKE DIFFERENT FORMS.

SOME PEOPLE MIGHT SAY IT WAS THEIR TIME.

THEY WERE SUFFERING, ET CETERA.

BUT WHY MAKE A BIG DIFFERENCE?

WHY DOES THE LANGUAGE MATTER FROM YOUR PERSPECTIVE OTHER THAN TO GET PEOPLE ON BOARD?

>> BECAUSE IT CARRIES A LOT OF BAGGAGE, I THINK.

AND THE PURPOSE HERE IS THAT PEOPLE CAN HAVE PEACE.

THEY CAN BE IN COMMUNICATION WITH THEIR RELATIVES.

PEOPLE CAN UNDERSTAND THE PROCESS.

AND IT'S ABOUT-- MORE ABOUT CONTROL OF END OF LIFE RATHER THAN GIVING UP AT THE END OF LIFE, WHICH IS, YOU KNOW, SUICIDE.

>> I WANT TO TALK MORE ABOUT THE POINT, SAY ANOREXIA AS A RATIONALE FOR ENDING ONE'S LIFE.

>> SURE.

>> BECAUSE MY UNDERSTANDING IS THAT THE BILL SPECIFICALLY SAYS YOU HAVE TO BE WITHIN SIX MONTHS OF DYING.

SO 1: HOW DO YOU DETERMINE IF SOMEONE HAS SIX MONTHS TO LIVE?

2: IS THERE A REASON TO BELIEVE THAT ANOREXIA, FOR EXAMPLE, WON'T HAPPEN HERE IN NEW YORK?

>> I WANT TO GO BACK TO THE SUICIDE PIECE FIRST AND THEN I'LL ANSWER THE QUESTION ABOUT ANOREXIA.

I THINK THE MOST POWERFUL REASON WHY SUICIDE IS THE WRONG WAY TO THINK ABOUT THIS-- AND JUST TO BE CLEAR.

DEATH WITH DIGNITY IS AN ADVOCACY TERM.

ASSISTED SUICIDE IS THE ADVOCATE TERM.

MEDICAL AID IN DYING IS THE BILL.

IT HAS BEEN USED BY OPPONENTS TO ENFLAME THE ARGUMENT.

>> I THINK AS JOURNALISTS WE HAVE A RESPONSIBILITY TO USE SOME OF THE MOST REFLECTIVE WORDS OR SOMETHING LIKE THAT.

AND YOU KNOW, I WOULD TALK TO AN EDITOR AND THEY WOULD SAY THIS WOULD BE COUNTED AS SUICIDE BASED ON THE DEFINITIONS WE USE.

>> I WISH THEY WOULDN'T BECAUSE HERE IS THE REALITY.

PEOPLE WHO WANT MEDICAL AID IN DYING DESPERATELY WANT TO LIVE.

THEY HAVE DONE SO MUCH TO STAY ALIVE.

THE TREATMENTS THAT PEOPLE HAVE BEEN THROUGH, HUNDREDS OF CHEMO TREATMENTS, BRAIN SURGERY.

THEY WANT TO LIVE.

AND THAT'S THE DIFFERENCE.

THEY WANT TO DIE PEACEFULLY BECAUSE THEY KNOW THAT DEATH IS INEVITABLE.

>> BUT PUTTING ACROSS-- PUTTING ASIDE THE SEMANTICS ARGUMENT.

>> PUTTING ASIDE THE SEMANTICS AS YOU SAY.

>> I APPRECIATE YOU MOVING ON.

>> I WOULD SAY THAT, YOU KNOW, SOMEONE WHO IS SUFFERING FROM ANOREXIA IS NOT ELIGIBLE FOR MEDICAL AID IN DYING IN NEW YORK.

THERE ARE THOUGHT SCORES OF CASES IN COLORADO.

THERE WERE THREE SITUATIONS IN COLORADO THAT JESSICA IS REFERRING TO.

AND THOSE SITUATIONS HAVE BEEN INVESTIGATED.

THAT'S HOW THE SAFEGUARDS WORK F. THERE ARE QUESTIONS ABOUT HOW THESE CASES COME ABOUT, THEY'RE INVESTIGATED.

YOU KNOW, PEOPLE'S BODIES AND PEOPLE'S MEDICAL CONDITIONS ARE COMPLICATED.

ANOREXIA NERVOSA IS A COMPLICATED PSYCHOLOGICAL DISEASE.

IT HAS A HIGH MORTALITY RATE.

I DON'T KNOW.

JESSICA DOES NOT KNOW.

NONE OF US KNOW WHAT WAS HAPPENING IN THOSE THREE YOUNG WOMEN'S LIVES.

UNFORTUNATELY, THE EFFECTS OF ANOREXIA CAN SOMETIMES LEAD TO ORGAN FAILURE.

IT'S NOT ANOREXIA THAT IS TREATABLE THAT PEOPLE WERE PRESCRIBED MEDICAL AID IN DYING FOR.

IT WAS BECAUSE THEY WERE DYING.

AND THAT'S THE CASE.

YOU COULD HAVE ANY NUMBER OF MALADIES THAT, IF TREATMENT IS UNSUCCESSFUL, YOUR BODY BEGINS TO BREAK DOWN AND YOU BECOME TERMINAL.

AND I DON'T KNOW WHAT HAPPENED IN THOSE CASES.

BUT NONE OF US HERE AT THIS TABLE DO.

AND THAT'S THE PRACTICE OF MEDICINE.

AND SO I CAN SAY DEFINITIVELY THAT HERE IN NEW YORK, A PSYCHOLOGICAL DISORDER IS NOT-- DOES NOT RENDER YOU ELIGIBLE FOR MEDICAL AID IN DYING.

YOU HAVE TO HAVE A TERMINAL ILLNESS THAT IS INCURABLE AND IRREVERSIBLE.

IF THAT ILLNESS IS REVERSIBLE WITH TREATMENT, YOU ARE NOT ELIGIBLE BY THE LETTER OF THE LAW.

>> THAT'S ACTUALLY NOT TRUE.

BECAUSE NOTHING IN THE BILL REQUIRES TREATMENT.

AND THAT'S WHY IN OREGON WHICH HAS THE SAME LANGUAGE OF TERMINAL ILLNESS HAS A CASE STUDY WRITTEN ABOUT IN THE JOURNAL OF AID OF DYING IN MEDICINE A WOMAN HAD AN UNDERLYING CONDITION THAT WAS NOT TERMINAL AND SHE CHOSE TO GO THE ROUTE OF THE VOLUNTARY STOPPING OF EATING AND DRINKING AND SHE FOUND A PROVIDER WHO SAID, WELL, YES, IF YOU HAVE THIS SUICIDAL IDEATION, YOU INTEND TO CONTINUE NOT EATING AND DRINKING, YOU'RE TERMINAL AND HE PRESCRIBED HER LETHAL DRUGS UNDER THE LAW.

THAT WAS WRITTEN ABOUT AS A CASE STUDY.

AND THERE IS NOTHING IN THE NEW YORK LANGUAGE THAT DIFFERS FROM THE OREGON LANGUAGE THAT WOULD PREVENT THAT FROM HAPPENING HERE.

AND IN THE CASE OF ANOREXIA, WE KNOW ABOUT JANE ALLEN WHO WAS 28 AND VERY THANKFULLY HER FATHER STEPPED IN.

HE ACTUALLY DESTROYED THE DRUGS AND SHE HAD THE OPPORTUNITY TO GET THE HELP THAT SHE NEEDED TO RECOVER AND TO GET TO A MUCH BETTER PLACE IN HER LIFE.

VERY SADLY LAST YEAR SHE DIED FROM COMPLICATIONS OF MANY YEARS OF AN EATING DISORDER AND FOR HER PARENTS, FOR HER FAMILY AND HER LOVED ONES, THE QUESTION IS THERE OF IF SHE HAD INITIALLY HAD A DOCTOR THAT FOUGHT FOR HER INSTEAD OF ABANDONING HER, WOULD SHE HAVE GOTTEN HER HELP SOONER?

WE WILL NEVER KNOW THE ANSWER TO THAT.

BUT WE DO KNOW THAT SHE WASN'T TERMINAL AT THE TIME SHE WAS GIVEN LETHAL DRUGS AND WE KNOW THAT NOTHING EVER CAME OF THOSE INVESTIGATIONS.

NO DOCTOR WAS SANCTIONED FOR THAT BECAUSE THE BILL IS WRITTEN TO PROVIDE QUITE BROAD IMMUNITIES FOR ANY PROVIDERS THAT DO PARTICIPATE IN IT.

THIS BILL IS FOR THE DOCTORS.

IT'S CERTAINLY NOT TO PROTECT THE PATIENTS.

>> CORRINE?

>> I THINK I WANT TO GO BACK TO SOMETHING YOU SAID EARLIER ABOUT THE STATE GETTING INVOLVED.

THE STATE IS NOT GETTING INVOLVED HERE.

THEY'RE LIFTING A PROHIBITION ON DOCTORS PROVIDING PEOPLE WITH CARE AT THE END OF THEIR LIVES THAT THEY NEED.

>> THE STATE IS CARVING OUT, SAY A CAUSE OF DEATH THAT IS MAYBE NOT REFLECTIVE OF HOW A PERSON ACTUALLY DIES AND IS ACTUALLY GIVING, SAY, REQUIREMENTS TO LIFE INSURANCE COMPANIES, FOR EXAMPLE, SO THE STATE IS, YOU KNOW, REGULATING THIS PRACTICE AT THE VERY LEAST.

>> SURE.

AND THANK GOODNESS FOR THAT BECAUSE IT'S HAPPENING NOW UNDERGROUND.

THERE ARE INSTANCES WHERE PEOPLE ARE BEING GIVEN LETHAL DOSES OF MEDICATION.

IF DOCTORS ARE WILLING TO RISK THEIR LICENSES.

THAT SHOULD NOT BE HAPPENING.

YOU SHOULD NOT BE ABLE TO GET THE RELIEF THAT YOU NEED AT THE END OF LIFE BECAUSE YOUR DOCTOR IS WILLING TO RISK THEIR LICENSE.

THE LAW PROVIDES IMMUNITY FOR DOCTORS WHO COMPLY WITH EVERY ASPECT OF THE LAW.

AND IT'S IMPORTANT TO UNDERSTAND THAT PEOPLE HAVE THE ABILITY RIGHT NOW, IF THEY'RE DECISIONALLY CAPABLE TO STOP EATING AND DRINKING.

TO STOP TREATMENT.

AND FAR FROM ABANDONING PATIENTS AT THE END OF THEIR LIVES.

HOW MANY TIMES HAVE WE HEARD ON TELEVISION OR IN OUR OWN LIVES WHERE DOCTORS SAY THERE IS NOTHING MORE I CAN DO FOR YOU.

THAT'S ABANDONING THE PATIENT.

WALKING WITH THEM THROUGH THE JOURNEY OF THE END OF THEIR LIVES AND PROVIDING THEM PEACE IS ACTUALLY PROVIDING CARE.

>> I WANT TO TURN TO THE IDEA OF A PERSON'S CAPACITY TO MAKE THIS DECISION BECAUSE IT'S A BIG ONE AND PART OF THIS WHOLE DEFINITION IS TERMINALLY ILL, MENTALLY COMPETENT.

JESSICA, WHEN YOU THINK ABOUT THAT IDEA OF BEING ABLE TO MAKE THIS DECISION FOR YOURSELF, WHAT DO YOU THINK ABOUT THE SAFEGUARDS THAT ARE IN PLACE, WHICH INCLUDE ALLOWING SOMEONE ELSE TO STEP IN AND SAY, YOU KNOW, I HAVE QUESTIONS ABOUT THIS.

LET'S HAVE A REVIEW OF THIS PERSON'S COMPETENCY TO MAKE THAT DECISION.

IS THAT SYSTEM ADEQUATE AS FAR AS YOU SEE IT?

>> WELL, AGAIN, I JUST LOOK TO THE DATA THAT WE HAVE OF ALMOST 30 YEARS IN OREGON WHERE LESS THAN ONE PERCENT OF PATIENTS ARE REFERRED FOR THE MENTAL HEALTH EVALUATION.

AND ARE DOCTORS ADEQUATELY TRAINED TO IDENTIFY DEPRESSION IN PATIENTS WITH ADVERSE DIAGNOSES?

THAT'S A BIG QUESTION MARK.

WE SEE IN OREGON A SMALL MINORITY OF DOCTORS A: PARTICIPATE AT ALL AND IT IS A VERY SMALL NUMBER OF DOCTORS THAT WRITE THE VAST MAJORITY OF THESE PRECIPITATION PRESCRIPTIONS.

ARE THEY EQUIPPED TO ASSESS THE MENTAL CAPACITY OF PATIENTS THEY HAVE NO LONG STANDING RELATIONSHIP WITH?

THAT'S A BIG QUESTION THAT THE STATE SHOULD WONDER ABOUT?

>> WHAT DO YOU THINK ABOUT THE SAFEGUARD OF MENTAL COMPETENCY?

>> EVERY SINGLE DAY IN NEW YORK AND ACROSS THE COUNTRY, DOCTORS MAKE DETERMINATIONS ABOUT WHETHER A PATIENT HAS THE CAPACITY TO CONCEPT TO TREATMENT AND TO REFRAIN FROM TREATMENT.

EXPERIMENTAL TREATMENTS ENTAIL HIGH DEGREE OF RISK.

PEOPLE UNDERGOING SURGERIES AND MEDICAL PROCEDURES WITH A HIGH DEGREE OF RISK ARE ASSESSED BY DOCTORS ALL THE TIME ABOUT WHETHER THEY HAVE THE CAPACITY.

THIS IS NO DIFFERENT.

THIS IS AN END OF LIFE CHOICE THAT PEOPLE CAN MAKE JUST LIKE UNDERGOING PALLIATIVE SEDATION.

JUST LIKE STOPPING EATING AND DRINKING.

BUT IT PUTS THE CONTROL IN THE HANDS OF THE PATIENT WHERE IT BELONGS.

>> SENATOR MAY, WHEN YOU THINK ABOUT THE SAFEGUARDS THAT ARE IN PLACE, IT'S MY UNDERSTANDING THAT THE BILL LAYS OUT A ROLE FOR MENTAL HEALTH PROFESSIONALS TO DO AN EVALUATION IF THERE IS A QUESTION ABOUT THEIR COMPETENCY.

WHO DO YOU THINK IS THE RIGHT PERSON TO RAISE THOSE TYPES OF CONCERNS?

AND IS THERE A CASE TO BE MADE THAT WE SHOULD HAVE GUARDIANS IN PLACE THE WAY WE MIGHT HAVE FOR PEOPLE WHO SOCIETY DEEMS NOT TO BE COMPETENT, TO SAY I'VE MET WITH THIS PERSON.

DOCTOR, I WOULD LIKE YOU TO DO A SECOND REVIEW.

>> WELL, I THINK PART OF THE POINT IS TO HAVE A GUARD RAIL IF PEOPLE REALLY ARE NOT COMPETENT TO MAKE THAT DECISION, OTHER PEOPLE SHOULD NOT BE MAKING THE DECISION FOR THEM.

I DO-- LIKE THIS DOES ENTAIL THE PATIENT MAKING THE ORDER.

AND IT'S GOT TO BE WITNESSED BY TWO PEOPLE WHO ARE NOT THEIR SPOUSE OR THEIR DOCTOR.

IT'S WHEN PEOPLE, YOU KNOW, THEY'VE GOT TO DO IT IN A WAY THAT IS KIND OF OUT IN THE OPEN.

AND, YOU KNOW, WHO MAKES THOSE EVALUATIONS, I THINK THAT'S PART OF THE WHOLE CARE TEAM WOULD MAKE THAT DECISION.

BUT I WAS JUST GOING TO SAY... >> SURE.

>> ONE OF THE REASONS I VOTED FOR THIS BILL CAME OUT OF MY PERSONAL EXPERIENCE WHEN I WAS 30 YEARS OLD AND MY HUSBAND WAS DYING OF CANCER.

AND IT WAS A SITUATION WHERE HE WAS IN ENORMOUS PAIN.

AND I FINALLY FOUND A DOCTOR WHO WOULD GIVE HIM PALLIATIVE CARE, WHICH, BACK THEN, WAS NOT VERY COMMON.

AND HE GAVE US A PRESCRIPTION FOR MORPHINE AND I HAD TO GO SPEND HOURS IN A PHARMACY, WAITING FOR THAT TO BE-- WAITING FOR THE PHARMACIST TO GET THREE DIFFERENT APPROVALS TO ACTUALLY FILL THIS PRESCRIPTION.

HOURS WHEN MY HUSBAND COULD HAVE WELL DIED WHILE I WAS WAITING IN THE PHARMACY FOR HIM.

SO THOSE BARRIERS WE WERE HEARING ABOUT, THOSE ARE REAL.

LIKE THEY ARE PREVENTING FAMILY MEMBERS FROM BEING WITH THEIR LOVED ONES, THEY'RE PREVENTING THE PEOPLE WHO ARE-- WHO KNOW THEY'RE DYING FROM HAVING THAT KIND OF CONTROL OVER THOSE LAST HOURS OF THOSE LIVES.

I FEEL LIKE THIS IS REALLY IMPORTANT TO MAKE SURE THAT PEOPLE CAN HAVE SOME OF THAT CONTROL.

>> THANK YOU FOR SHARING THAT STORY.

JESSICA, I WANT TO COME BACK TO THE IDEA OF WHY SOMEONE MIGHT DO THIS.

AND FROM YOUR PERSPECTIVE, IT SEEMS LIKE YOU WERE HIGHLIGHTING PAIN AS BEING MAYBE THE ONLY REASONABLE RATIONALE FOR DOING THIS AND THAT IF IT WAS SOMETHING ELSE, THAT IS A PROBLEM.

WHY SHOULD SOMEONE HAVE TO, SAY, GIVE A SPECIFIC REASON AS TO WHY THEY WANT TO GO DOWN THIS ROUTE?

WHY DOES IT NEED TO BE SOMETHING APPROVED BY THE STATE?

WHY DO THEY NEED TO GO OFF A CHECKLIST?

WHY SHOULDN'T THAT BE A PERSONAL DECISION?

>> THEY DON'T HAVE TO HAVE A SPECIFIC REASON.

OREGON AND WASHINGTON ASK THE QUESTIONS OF PATIENTS AND THEY REPORT ON THAT SO THAT WE CAN LOOK AND SEE IF THIS IS WORKING THE WAY THAT PROPONENTS THINK THAT IT SHOULD.

AND WHAT WE SEE IN THOSE 30 YEARS OF INFORMATION IS THAT PAIN IS NOT HIGH ON THE LIST.

IT IS REASONS OF DISABILITY AND NOT WANTING TO BE A BURDEN.

SO AS THE STATE CONSIDERS WHETHER OR NOT THIS IS A POLICY THAT WE SHOULD IMPLEMENT, IT'S IMPORTANT TO UNDERSTAND WHAT ARE MOTIVATIONS?

ARE PEOPLE SEEKING OUT LETHAL DRUGS TO END THEIR LIFE BECAUSE THEY DON'T HAVE EQUITABLE ACCESS TO THE CARE AND SUPPORTS THAT THEY WANT AND THEY NEED?

ARE THERE SERVICES THAT WE CAN PROVIDE TO SOMEONE THAT COULD HELP THEM HAVE A HIGHER QUALITY OF LIFE INSTEAD OF HAVING TO LOOK AT WHAT REALLY IS SUICIDE, FRANKLY.

IT IS ENDING THEIR OWN LIFE.

>> DOES IT MATTER WHY A PERSON WANTS TO GO DOWN THAT ROAD?

I KNOW I HAVE HAD PEOPLE IN MY LIFE WHO HAVE SAID, I DON'T WANT TO END UP IN A NURSING HOME.

I DON'T WANT TO, YOU KNOW, BE OUT OF CONTROL OF MY BODY IF THEY HAVE A POSSIBILITY OF GETTING ALS OR SOMETHING LIKE THAT.

AND THEY TALK ABOUT MAKING A DECISION FOR THEMSELVES AND BEING IN A SITUATION WHERE THEY CAN PROACTIVELY TAKE CARE OF THIS SITUATION FOR THEMSELVES AS OPPOSED TO SOMETHING LIKE THIS, WHICH, YOU KNOW, RELIES ON SOMEONE ELSE.

SO DOES IT MATTER IF THEY'RE IN PAIN?

I MEAN HOW DIFFERENT IS THE SITUATION FOR YOU WHEN YOU THINK ABOUT THE REASONS WHY SOMEONE MIGHT DO THIS?

>> WELL, FRANKLY, I THINK ABOUT MY MOM, YOU KNOW, I THINK WE HAVE SIMILAR EXPERIENCES.

I WAS A CAREGIVER FOR MY MOTHER WHO HAD CANCER.

AND WE LIVED IN OREGON.

SHE HAD A TERMINAL DIAGNOSIS.

AND AS MANY PEOPLE DO, SHE OUTLIVED THAT TERMINAL DIAGNOSIS.

AND GROWING UP IN A STATE AND BEING A CAREGIVER IN A STATE WHERE THIS IS LEGAL, IT CHANGES YOUR RELATIONSHIP WITH YOUR DOCTOR BECAUSE NOW YOUR DOCTOR HAS THE ABILITY TO SAY, I AGREE WITH YOU.

YOU WOULD BE BETTER OFF IF I JUST WRITE THIS PRESCRIPTION.

>> THEY MIGHT BE THINKING THAT ALREADY AND THEY VERY OFTEN DO, PARTICULARLY WHEN PEOPLE HAVE DISABILITIES.

SO INTO THAT ENVIRONMENT WHY WOULD YOU INTRODUCE A POLICY THAT ALLOWS DOCTORS TO HELP END THE LIFE OF THEIR PATIENTS?

THAT'S NOT JUST ANOTHER TREATMENT PATH.

WE ARE TALKING ABOUT THE PATIENT COMMITTING SUICIDE.

>> CORRINE?

>> THERE ARE A FEW THINGS THAT WOULD I SAY TO THAT.

FIRST OF ALL, THIS LAW WILL ABSOLUTELY CHANGE OUR RELATIONSHIPS WITH OUR DOCTORS.

IT WILL ALLOW ALL OF US TO HAVE OPEN AND HONEST CONVERSATIONS ABOUT WHAT WE FEAR THE MOST AT THE END OF LIFE.

AND IT WILL ALLOW DOCTORS TO WALK WITH SOMEONE THROUGH THEIR ENTIRE JOURNEY.

SO I AGREE WITH THAT.

>> AND HOW DO YOU ENVISION THOSE CONVERSATIONS HAPPENING?

BECAUSE RIGHT NOW WHETHER IT'S JUST SOME BASIC STUFF, I'M NOT BASICALLY THE BEST COMMUNICATOR WITH MY DOCTOR AND Dr.

MUBAREK, YOU ARE NOT THE BEST EITHER.

WOULD WE HAVE TO HAVE DOCTORS TRAINED ON THIS?

WOULD THERE NEED TO BE SOME SORT OF REMINDER TO PATIENTS THAT YOU CAN BROACH THIS ISSUE?

HOW DO YOU ENVISION THAT HAPPENING IN A PRODUCTIVE AND POSITIVE WAY?

>> PUBLIC AWARENESS IS A HUGE ISSUE.

PEOPLE NEED TO BE AWARE OF THIS OPTION IN ORDER TO BRING IT UP WITH THEIR DOCTORS.

IT'S A PROBLEM THAT WE ARE FACING IN NEW JERSEY.

VERY FEW PEOPLE ACTUALLY USE MEDICAL AID IN DYING IN THE STATES THAT AUTHORIZE IT.

LESS THAN 1% OF ALL PEOPLE WHO DIE.

IN NEW JERSEY IN PARTICULAR, AN EXTRAORDINARILY LOW NUMBER PEOPLE HAVE USED IT 407 PEOPLE FROM 2019 TO THE LAST COLLECTED DATA IN 2024.

SO PUBLIC AWARENESS IS HUGE.

PEOPLE NEED TO UNDERSTAND IT BEFORE THEY CAN ASK THEIR DOCTOR.

BUT REALLY, THE DOCTORS WHO ARE PROVIDING THIS CARE, JESSICA SAID IT WAS A SMALL NUMBER, IT'S AN INCREASING NUMBER, WHO ARE GETTING COMFORTABLE WITH THIS ISSUE IN STATES LIKE OREGON AND WASHINGTON BUT THOSE DOCTORS ARE SEEKING OUT TRAINING ON THEIR OWN.

THERE ARE NOT DOCTORS WHO ARE CHOMPING AT THE BIT TO DO THIS.

IT IS SOMETHING THAT THEY TAKE VERY SERIOUSLY.

THEY SEEK OUT TRAINING.

AND WHAT WE'VE SEEN IN STATES THAT HAVE MEDICAL AID IN DYING IS THAT END OF LIFE CARE APPROVED FOR EVERYONE WHEN THIS LAW GOES INTO EFFECT BECAUSE THERE ARE MORE CONVERSATIONS ABOUT WHAT THE END OF LIFE EXPERIENCE LOOKS LIKE AND WHAT PATIENTS CAN DO.

AND SO WE SEE HOSPICE UTILIZATION RATES GO UP.

WE SEE PALLIATIVE CARE IMPROVE.

SO THERE ARE TANGIBLE BENEFITS FOR EVERYONE EVEN THOSE WHO DON'T USE MEDICAL AID IN DYING IN THOSE STATES.

>> WELL, SENATOR, I WANT TO TURN TO THE ISSUE OF OVERSIGHT.

RIGHT NOW THE LEGISLATURE PASSES HUNDREDS OF BILLS EACH YEAR THAT BECOME LAW AND REALLY ONLY A HANDFUL OF THEM MIGHT SEE A HEARING IN THE AFTERMATH OF THIS.

SO WITH A TOPIC LIKE THIS WHERE IMPLEMENTATION IS SO IMPORTANT, WHAT DO YOU VIEW AS THE LEGISLATURE'S ROLE TOWARDS OVERSIGHT IN THE AFTERMATH?

>> WELL, CLEARLY THIS IS ONE WHERE IT IS INCREDIBLY IMPORTANT THAT WE DO THAT AND I WOULD SAY THIS LEGISLATURE HAS BEEN MORE ACTIVE IN TERMS OF HOLDING HEARINGS AND TRYING TO PROVIDE OVERSIGHT ON BILLS THAT WE PASSED.

SO I WOULD ANTICIPATE THAT WOULD HAPPEN HERE, BUT I ALSO WANT TO POINT OUT THAT THROUGHOUT THE BILL, THE LANGUAGE OF GOOD FAITH IS USED.

AND THE IDEA IS THAT YOU WERE SAYING THIS IS FOR PROTECTING DOCTORS.

BUT IT'S FOR PROTECTING DOCTORS WHO ARE ACTING IN GOOD FAITH.

AND WE HOPE THAT NOT ONLY LEGISLATIVE OVERSIGHT BUT LEGAL OVERSIGHT WILL BE ACTIVE IN IDENTIFYING PEOPLE WHO MIGHT NOT BE ACTING IN GOOD FAITH IN THIS REGARD OR ANY REGARD.

>> AND IS THERE A WAY TO HAVE OVERSIGHT THAT IS NOT NECESSARILY REACTIVE, BUT PROACTIVE?

BECAUSE THERE IS ONE THING TO SAY HEY, WE LOOKED AT THE NUMBERS AND HERE IS OUR ANNUAL REPORT ON WHAT HAPPENED IT DOESN'T DO A LOT OF GOOD FOR PEOPLE IF THERE WAS ANY SORT OF ISSUES AFTER THE FACT?

>> RIGHT.

I BELIEVE-- I WENT THROUGH THIS MULTIPLE TIMES BEFORE DECIDING TO SIGN ON TO THIS BILL AND DECIDING TO VOTE FOR IT, THAT THE LANGUAGE IS IN THE BILL TO DO AS MUCH OF THAT AS IS POSSIBLE IN TERMS OF PROACTIVE PREVENTION OF ABUSE AND THEN, IF ABUSE DOES HAPPEN, THAT'S WHEN THE OVERSIGHT KICKS IN.

>> JESSICA, IF THIS DID BECOME LAW, WHAT ARE THE ELEMENT OF THIS THAT WOULD YOU WANT TO BE MONITORED TO ADDRESS SOME OF THE CONCERNS YOU HAVE RAISED?

WHAT ARE THE RED FLAGS PEOPLE MIGHT WANT TO BE ON THE LOOKOUT FOR POTENTIALLY.

>> THERE IS NOTHING IN THE BILL THAT IS GOING TO PROTECT YOUNG WOMEN LIKE JANE ALLEN?

THE NEW YORK BILL IS WEAKER THAN THE COLORADO BILL THERE IS NOT A RESIDENCY REQUIREMENT OR A WAITING PERIOD.

YOU CAN REQUEST DRUGS ON ONE DAY AND FEASIBLY HAVE THEM THE NEXT.

AND FROM A DOCTOR THAT HAVE YOU NO RELATIONSHIP WITH.

SO THERE IS NOTHING IN THIS BILL THAT WILL ADEQUATELY PROTECT PATIENTS.

AND AS WE LOOK BACK, WE JUST HAVE TO SAY HOW MANY JANE ALLENS ARE WE WILLING TO SACRIFICE, RIGHT?

HOW MANY PEOPLE ARE WE OKAY WITH DYING BADLY UNDER THIS BILL?

>> WELL, CORRINE I'LL GIVE YOU A SECOND TO ANSWER THAT.

BUT IN TERMS OF OVERSIGHT THOUGH, IS THERE A MECHANISM YOU WOULD WANT TO PUT IN PLACE?

TRACKING RESIDENCY AND HOW PEOPLE ARE MOVING IN AND OUT OF THE STATE?

I MEAN IS THERE SOMETHING THAT YOU WOULD WANT TO SEE EITHER THE LEGISLATURE OR STATE AGENCY OFFICIALS DO?

>> I WOULD LOVE TO SEE BETTER REPORTING.

BUT WE HAVE CASES, YOU KNOW, OUT OF NEW MEXICO.

THEY HAVE REPORTING REQUIREMENTS IN THEIR LAW.

THEY HAVE NEVER RELEASED AN ANNUAL REPORT.

WASHINGTON HAS REPORTING REQUIREMENTS IN THEIR LAW AND THEY ANNOUNCED DUE TO BUDGET CUTS THEY WON'T DO THEM ANYMORE.

IT'S HARD TO SAY WHAT WE COULD PUT INTO THE LAW THAT WOULDN'T JUST NOT HAPPEN OR WOULD BE CHANGED QUICKLY AFTER.

>> A FEW THINGS.

ONE 69 THINGS THAT IS SO INTERESTING TO ME IS THAT WE TALK ABOUT HYPOTHETICAL FEARS ABOUT HOW THE LAW WOULD PLAY OUT WHEN WE HAVEN'T EVEN SEEN THE DEPARTMENT OF HEALTH REGULATIONS ABOUT WHAT REPORTING MIGHT LOOK LIKE.

BUT WE NEED TO WEIGH THAT AGAINST THE ACTUAL HARMS THAT ARE HAPPENING TO NEW YORK FAMILIES AND TERMINALLY ILL PEOPLE RIGHT NOW.

TO BE CLEAR.

SOMEONE WITH TREATABLE ANOREXIA NERVOSA IS ELIGIBLE UNDER MEDICAL AID IN DYING UNDER NEW YORK'S LAW.

NEW YORK'S LAW IS NOT WEAKER THAN COLORADO IN THAT RESPECT.

I FAIL TO UNDERSTAND HOW A RESIDENCY REQUIREMENT IS A SAFEGUARD TO PROTECT AGAINST SOMETHING LIKE THAT.

THE SAFEGUARD IS THAT YOU MUST HAVE A TERMINAL ILLNESS THAT IS INCURABLE AND IRREVERSIBLE.

IF YOU CAN TREAT THE CONDITION, EVEN IF THE PERSON DECIDES NOT TO TREAT IT, OR CAN'T AFFORD TREATMENT, THAT PERSON IS INELIGIBLE FOR MEDICAL AID IN DYING.

THAT'S GOT TO BE SOMETHING THAT PEOPLE TAKE IN AND HEAR AND UNDERSTAND.

THERE IS NO SCENARIO IN WHICH SOMEONE CAN REQUEST MEDICAL AID IN DYING ONE DAY AND GET THE PRESCRIPTION THE NEXT DAY MUCH THE AVERAGE TIME THAT IT TAKES SOMEONE TO ACCESS A PRESCRIPTION IS SIX WEEKS.

YOU NEED ONE DOCTOR AS YOUR ATTENDING PHYSICIAN.

AND YOU NEED A CONSULTING DOCTOR.

SOMETIMES IT IS VERY DIFFICULT TO FIND A CONSULTING DOCTOR WHO IS WILLING TO PARTICIPATE IN MEDICAL AID IN DYING BECAUSE ONE OF THE OTHER IMPORTANT SAFEGUARDS IS THAT THIS IS ENTIRELY VOLUNTARY FOR EVERYONE: THE PATIENT, THE HOSPICE, THE NURSE, THE DOCTOR, THE PHARMACIST.

EVERYONE.

SO I THINK IT'S REALLY IMPORTANT TO UNDERSTAND THAT THESE ARE PROCESSES THAT TAKE A WHILE.

IT'S NOT AN INSTANTANEOUS GRANTING OF A REQUEST AND SOMEONE IS DYING.

MANY TIMES PEOPLE HAVE PUT MONTHS AND MONTHS OF THOUGHT INTO THIS AND WAS WE HAVE FOUND AND WHAT CALIFORNIA RECENTLY DID AS THEY LIFTED THE SUNSET PROVISION ON THIS LAW AND MADE IT PERMANENT IS THAT THEY ALSO HAD TO AMEND THEIR WAITING PERIOD TO ALLOW PEOPLE ACCESS TO MEDICAL AID IN DYING WHO MIGHT DIE BEFORE THE WAITING PERIOD IS LIFTED BECAUSE IT TOOK SO LONG TO GET THE WITNESSES, THE DOCTORS ALL IN PLACE.

>> IF I MAY, DAVID-- >> 30 SECONDS.

>> 30 SIXTH.

THAT IS NOT TRUE ACCORDING TO THE JOURNAL OF AID IN BUYING MEDICINE.

THERE ARE CASE STUDIES OF PEOPLE GETTING THOSE DRUGS CERTAINLY BY THE NEXT DAY.

MAYBE NOT EVERY TIME BUT IT CAN HAPPEN UNDER THIS POLICY AND UNDER THIS BILL THAT THE GOVERNOR IS CONSIDERING.

>> AND IT SEEMS LIKE THOUGH, WITH A LOT OF THE ANECDOTES THAT YOU BRING UP, DO YOU FEEL LIKE AN ENTIRE SYSTEM SERVING THE STATE OF 19 MILLION PEOPLE SHOULD BE FRAMED AROUND ANECDOTAL EXAMPLES?

>> I FEEL LIKE IT SHOULD BE FRAMED AROUND THE DATA.

AND SO THE DATA THAT WE HAVE FROM THE OREGON REPORTS AND FROM ALL THE STATE REPORTS, THE DATA THAT WE HAVE FROM PRACTITIONERS THAT WRITE FOR THE JOURNAL OF AID IN DYING MEDICINE SHOULD ABSOLUTELY GUIDE OUR POLICY DECISIONS HERE.

>> I GUESS THE SAME QUESTION FOR YOU, CORRINE.

HOW IMPORTANT SHOULD WE TAKE THOSE ANECDOTAL EVENTS BECAUSE THEY'RE POTENTIAL TRAGEDIES.

SHOULD THAT BE THE WAY WE STEER STATEWIDE POLICY?

>> I THINK WE HAVE TO WEIGH THE HYPOTHETICAL FEARS AGAINST THE REAL HARM THAT NEW YORKERS ARE EXPERIENCING.

THERE ARE PEOPLE WHO ARE BEGGING FOR THIS OPTION.

AND THE VAST MAJORITY OF VOTERS WANT THIS.

2-1 IN SEVEN POLLS HAVE BEEN DONE ACROSS THE STATE.

AND WE CANNOT IGNORE THE FACT THAT IN 10 AND A HALF YEARS OF THIS CAMPAIGN, MORE THAN 62 STATEWIDE ORGANIZATIONS REPRESENTING DOCTORS, PSYCHIATRISTS, NURSES, HAVE ALL SIGNED ON TO THIS BILL.

HOW DO YOU HAVE A POLICY THAT YOU SAY IS NOT WORKING, BUT IS STUDIED BY THE NEW YORK STATE BAR ASSOCIATION, WHICH HELD SIX MONTHS OF HEARINGS, HEARING FROM OPPONENTS, HEARING FROM SUPPORTERS.

AND HAVE THEM ALL COME OUT IN SUPPORT?

THE MEDICAL SOCIETY OF THE STATE OF NEW YORK, THE NEW YORK STATE ACADEMY OF FAMILY PHYSICIANS, THE NEW YORK STATE NURSES ASSOCIATION, THE NEW YORK STATE BAR ASSOCIATION, THE LEGAL OF WOMEN VOTERS.

I COULD GO ON AND ON AND ON.

ALL OF THESE GROUPS LOOKED AT THE DATA.

THEY EVALUATED THE DATA AGAINST THE REAL HARM THAT IS HAPPENING RIGHT NOW TO NEW YORK FAMILIES AND THEY CAME OUT IN STRONG SUPPORT OF THIS BILL.

I THINK THAT SPEAKS VOLUMES.

>> I WOULD SAY SOME OF THOSE GROUPS, TOO, WERE INITIALLY OPPOSED AND-- >> FOR YEARS.

>> BEFORE WE GO I IMAGINE THERE ARE SOME GROUPS, JESSICA, YOU WOULD LIKE TO MENTION THAT ARE OPPOSED TO?

>> CERTAINLY AS THE STATE SENATE WAS VOTING THIS JUNE, THE SAME WEEKEND THE AMERICAN MEDICAL ASSOCIATION REAFFIRMED THEIR OPPOSITION.

AMERICAN COLLEGE OF PHYSICIANS.

OTHER STATE MEDICAL GROUPS, CERTAINLY ALL OF THE DISABILITY GROUPS HAVE COME OUT IN STRONG OPPOSITION.

>> THAT'S ACTUALLY NOT TRUE, DAVID.

>> ARE THERE SOME IN FAVOR?

>> THE ARC OF NEW YORK IS IN FAVOR OF GIVING PEOPLE THE RIGHT TO MEDICAL AID IN DYING.

THAT'S THE OLDEST AND LARGEST DISABILITY RIGHTS ORGANIZATION IN THE COUNTRY.

THE RESOURCE CENTER FOR INDEPENDENT LIVING IN UTICA, ONE OF THE LARGEST DISABILITY SERVICES ORGANIZATIONS HAS A POSITION OF NEUTRALITY AND THAT POSITION SAYS THAT THIS DECISION SHOULD BE MADE BY A PERSON IN CONSULTATION WITH THEIR DOCTOR, WHICH IS WHAT THIS BILL DOES.

>> I WOULD NOTE CERTAINLY NEW YORK ARC ACTUALLY SUPPORTS THE CONCEPT WITH SPECIFIC PROVISIONS THAT WOULD PROTECT PEOPLE WHO HAVE INTELLECTUAL DISABILITIES WHICH THIS BILL DOESN'T ACTUALLY HAVE ANY OF THEIR RECOMMENDED PROVISIONS.

I DO WANT TO NOTE ON THE ASPECT ABOUT TREATMENT.

THIS BILL DOES NOT REQUIRE TREATMENT.

SO, AGAIN, IF YOU LOOK AT THE JOURNAL OF AID IN DYING MEDICINE, THEY VERY SPECIFICALLY WRITE OUT THAT IF SOMETHING IS TREATABLE, BUT THE PATIENT DOES NOT PURSUE TREATMENT, WHETHER THEY DON'T WANT TO, WHETHER THEY CAN'T AFFORD IT, UNDER THE LANGUAGE OF THIS BILL, THEIR CONDITION WOULD BE CONSIDERED TERMINAL BECAUSE YOU CANNOT FORCE TREATMENT ON SOMEONE WHO DOES NOT WANT IT.

THAT'S WHY CONDITIONS LIKE ANOREXIA CAN QUALIFY AND THEY WOULD QUALIFY HERE.

>> AS WE HAVE HEARD, THERE IS A STARK DISAGREEMENT ABOUT WHETHER ANOREXIA QUALIFIES AND I WOULD ENCOURAGE IF VIEWERS ARE INTERESTED IN KNOWING MORE ABOUT THIS, LOOK UP OUR GUESTS.

THEY WILL HAVE ACCESS TO INFORMATION ON THEIR RESPECTIVE WEBSITES.

DO YOUR RESEARCH, GO ONLINE, THE BILL IS THERE.

YOU CAN READ IT.

IT'S PRETTY DENSE.

BUT WE GOT TO MOVE ON.

AND BEFORE WE DO, WE ARE GOING SHARE A DISPATCH FROM "THE CAPITOL PRESSROOM" IN ALBANY WHERE I HAD A CONVERSATION ABOUT THE EVOLVING RACE FOR GOVERNOR OF NEW YORK.

I HOPE YOU ENJOY THIS POSSIBLY RECURRING SEGMENT.

>> THIS IS "THE CAPITOL PRESSROOM" STUDIO AND WE ARE JOINED IN OUR HUMBLE ABODE BY BILL MAHONEY, A CAPITOL REPORTER FOR POLITICO NEW YORK WHO IS HERE TO TALK ABOUT THE LATEST DEVELOPMENTS FOR THE RACE OF THE GOVERNOR OF NEW YORK.

WE GOT A LITTLES CLARITY IN THE RACE IN NOVEMBER WITH REPRESENTATIVE ELISE STEFANIK, AFTER MONTHS OF PLAYING FOOTSY WITH THE POSSIBLE RUN, FINALLY ANNOUNCING HER BID A FEW DAYS AFTER THE 2025 ELECTIONS.

WHAT ARE YOUR INITIAL THOUGHTS ABOUT THIS CAMPAIGN LAUNCH THAT WE HAVE SEEN SO FAR?

>> WELL, IT WAS ABOUT AS EXPECTED.

IT HAPPENED A FEW DAYS AFTER THE ELECTION RESULTS CAME IN EARLIER THIS MONTH.

AND A LOT OF WHAT SHE MENTIONED FOCUSED AS MUCH ON NEW YORK CITY MAYOR ELECT MAMDANI AS GOVERNOR HOCHUL AND A LOT WHAT HAVE SHE SAID ABOUT HOCHUL IS ABOUT MAMDANI.

SO IT IS TIED TO THE WHOLE IDEA THAT NEW YORK STATE IS MOVING IN THE WRONG DIRECTION THANKS IN PART A COMMUNIST ANTI-SEMITE WHATEVER ELSE SHE CALLS HIM.

>> HER WORDS, NOT THE ONES WE WOULD USE OR HE WOULD USE TO DESCRIBE HIMSELF.

>> SHE IS CHARACTERIZING US AS WE'VE GOT THIS PERSON IN A BIG IMPORTANT POSITION IN NEW YORK STATE NOW AND WE NEED A GOVERNOR TO STAND UP TO HIM.

AND KATHY HOCHUL IS NOT IT.

SO SHE TIED IN LAUNCH DIRECTLY INTO THE RESULTS THAT WE SAW A FEW DAYS PRIOR.

>> THIS IS A STATE WHERE DEMOCRATS DRAMATICALLY OUTNUMBER REPUBLICANS.

UNAFFILIATED VOTERS MAKE UP A LARGER SHARE OF THE ENROLLMENT THAN REPUBLICAN VOTERS.

AND IN PAST ELECTIONS, 2022, THEN NEW GOVERNOR KATHY HOCHUL GOT ABOUT 70% OF THE VOTE IN NEW YORK CITY, ABOUT 52 OR 53% STATEWIDE.

AND IN THE SUBSEQUENT PRESIDENTIAL ELECTION YEAR, RUNNING ON THE DEMOCRATIC TICKETS KAMALA HARRIS GOT ABOUT 70% IN NEW YORK CITY AND DID A LITTLE BIT BETTER IN THE ENTIRE STATE THAN HOCHUL DID.

SO WHAT DOES THAT TELL US ABOUT A POSSIBLE CEILING FOR A REPUBLICAN RUNNING STATEWIDE IN NEW YORK OR SHOULD WE THINK WERE IT IN REVERSE AND THAT DONALD TRUMP SET THE FLOOR FOR A REPUBLICAN.

>> THAT IS THE BIG QUESTION FOR NEXT YEAR.

WE CERTAINLY SAW IN 2022-2024 DEMOCRATIC VICTORIES ACROSS THE BOARD.

WE ARE NOW AT 30 STATE STRAIGHT WIDE VOTES HAVE GONE TO DEMOCRATS IN NEW YORK.

GOING BACK TO 2004.

SOME OF THESE HAVE NOT BEEN CLOSE.

WE HAVE SEEN PROBABLY MANY MORE OF THEM TOP 60% THAN ANYTHING THAT WOULD BE WITHIN, YOU KNOW,LEAVING ROOM FOR DAUGHTER AS THE POLLS STARTED TO TRICKLE IN.

USUALLY BLOWOUTS MORE OFTEN THAN NOT.

WE SAW IN 22022-2024 SOME INROADS, LONG ISLAND THAT HAD BEEN A BATTLE GROUND SHIFTED BLUE AND TOOK A HARD SWING TO THE RIGHT AND HAS NOT MOVED BACK YET.

>> REPUBLICANS DID WELL THERE IN 2025 AS WELL.

>> BUT IN 2022 AND 2024 WE SAW SOME REPUBLICAN INROADS IN NEW YORK CITY.

IT IS NOT ENOUGH TO SAY NEW YORK CITY IS COMPETITIVE, BUT IT MIGHT BE LESS OF A BLOWOUT NOW BECAUSE OF GAINS IN PLACES LIKE SOME ASIAN COMMUNITIES AND QUEENS AND BROOKLYN.

SLIGHTLY SMALLER MARGINS THAN IN THE PAST IN THE BRONX AND LONG ISLAND, WHICH WAS MAYBE PURPLE A DECADE AGO IS AS RED AS ANYWHERE IN THE STATE.

SO THAT COULD BE PART OF THE STRATEGY.

CERTAINLY TRYING TO BUILD ON THOSE GAINS THAT WE HAVE SEEN FOR REPUBLICANS IN RECENT YEARS AND TRY TO MINIMIZE THE BLOWOUT IN NEW YORK CITY.

IF YOU COULD GET 40% OF THE VOTE THERE, THEN ALL OF A SUDDEN YOU HAVE A VERY CLEAR PATH TO STATEWIDE VICTORY.

>> DOES ANYTHING STAND OUT TO YOU IN THE INITIAL DAYS AND MINUTES OF THE ELISE STEFANIK CAMPAIGN THAT SUGGESTS THIS IS A CAMPAIGN NOT JUST FOCUSED ON RUNNING UP THE SCORE IN SAY UPSTATE NEW YORK WHERE REPUBLICANS HAVE TRADITIONALLY DONE BETTER THAN THEIR DEMOCRATS AND THAT SHE IS INTERESTED IN MAYBE CUTTING THE MARGIN OF A DEMOCRATIC WIN IN NEW YORK CITY AND REALLY RUNNING UP THE SCORE IN THE NEW YORK CITY SUBURBS?

>> WELL, CERTAINLY WHAT WE HAVE SEEN FROM HER SO FAR HAS BEEN A HEAVY FOCUS ON MAMDANI AS WE MENTIONED.

AND IF THERE IS THE TYPICAL PATH FOR A NEW YORK CITY MAYOR AS WE HAVE SEEN WITH THE VAST MARKET OF MAYORS OVER THE CENTURIES WHERE THEY START OFF, THEY MIGHT BE FAIRLY WELL LIKED.

MAMDANI IS NOT AS POPULAR AS DE BLASIO WAS 12 YEARS AGO WHEN HE STARTED HIS FIRST TERM.

AND IT DOESN'T TAKE LONG FOR PEOPLE TO START GRUMBLING ABOUT THEIR GARBAGE COLLECTION, THE STREETS BEING BACKED UP OR WHATEVER COMPLAINTS THEY HAVE WITH CITY HALL THAT ALL COMES BACK TO THE MAYOR.

IT ALMOST ALWAYS STARTS TO GO DOWN.

SO I THINK PART OF HER STRATEGY IS BANKING THAT HE WILL BE VERY UNPOPULAR AND SHE WILL BE THE ANTI-MAMDANI CANDIDATE AND WHAT SHE HOPES WILL BE A CITY THAT DOES NOT LIKE ZOHRAN MAMDANI.

THAT IS A QUESTION WE HAVE TO LEARN.

DOES HE BUILD ON HIS POPULARITY OR MOVE IN THE OTHER DIRECTION.

THAT IS AN EFFECTIVE TALKING POINT IN NEW YORK CITY.

>> WHILE THERE IS CLEARLY A PATH, ALBEIT A CHALLENGING ONE FOR REPUBLICAN TO WIN STATEWIDE IN NEW YORK, ONE OF THE POTENTIAL PROBLEMS THAT REPUBLICAN MIGHT FACE IS A PRIMARY.

AND AS OF RIGHT NOW, ELISE STEFANIK IS THE ONLY DECLARED CANDIDATE, BUT NASSAU COUNTY EXECUTIVE BRUCE BLAKEMAN, A REPUBLICAN FRESH OFF A REELECTION WIN A FEW DAYS AGO, HAS SAID, I'M INTERESTED IN MAYBE POSSIBLY CONSIDERING A RUN FOR GOVERNOR.

HOW, IF AT ALL, DOES A PRIMARY COMPLICATES THIS PICTURE?

IS THIS THE CASE WHERE HEY, I'M BATTLE TESTED NOW, I EMERGE, WHETHER I'M BLAKEMAN OR STEFANIK AND I'M IN A BETTER POSITION OR COULD A PRIMARY END UP HURTING THEIR CHANCES IN A GENERAL ELECTION?

>> IT IS CERTAINLY A LITTLE BIT OF BOTH WHERE I DON'T THINK STEFANIK IS RUNNING TO THE CENTER IN THIS RACE, LIKE SOME CANDIDATES HAVE IN THE PAST.

WHERE THEY COMPLAIN THAT A PRIMARY KIND OF FORCES THEM TO DEBATE THINGS FARTHER TO THE EXTREMES THAN THEY WOULD LIKE TO BECAUSE THEY WANT TO BE FOCUSED ON THE MIDDLE 50% AND WE HAVE SEEN SOMETHING FROM STEFANIK INDICATE THAT SHE IS TRYING TO GET DEMOCRATIC VOTERS CROSSING OVER AND SHE IS FOCUSING ON HEAVILY WINNING PEOPLE WHO ARE OPEN TO REPUBLICANS.

SO I DON'T THINK THAT IS GOING TO CHANGE HER STRATEGY TOO MUCH.

BUT IT IS A DRAIN ON RESOURCES IF HE MOUNTS A REAL PRIMARY CHALLENGE, SHE WILL START SPENDING DOWN HER WAR FUND AND LESS TO SPEND ON THE GENERAL CERTAINLY.

>> AND IT SEEMS LIKE WHERE TRADITIONALLY PRIMARIES ARE ABOUT APPEALING TO THOSE BASE VOTERS WHO ARE MAYBE THE MOST IDEOLOGICALLY PURE OF A PARTY, WITH THE REPUBLICANS RIGHT NOW, THE IDENTITY SEEMS TO BE WRAPPED UP PRIMARILY AROUND PRESIDENT TRUMP SO IT IS A RACE TO BE WHO IS THE MOST CLOSELY ALIGNED WITH DONALD TRUMP WHO COULD POTENTIALLY HAVE DOWNSIDES RUNNING IN A GENERAL.

AND IN SOME WAYS IT'S A PRIMARY ONE VOTER WHO ACTUALLY MATTERS AND HE MOVED OUT THE NEW YORK STATE QUITE A FEW YEARS AGO NOW.

LIKE HE IS CLOSE TO BOTH OF THEM AND HAS WORKED WITH BOTH OF THEM IN THE PAST.

AND IF HE ENDORSES ONE OF THEM, THEN I THINK AT THAT POINT, WHICH EVER CANDIDATE THE GOING TO BE THE HEAVY FAVORITE AND THE OTHER ONE WILL HAVE A VERY HARD PATH AHEAD IF THEY KEEP ON RUNNING.

>> CONVERSELY ON THE DEMOCRATIC SIDE, GOVERNOR KATHY HOCHUL IS FACING A POTENTIAL PRIMARY FROM HER LIEUTENANT GOVERNOR DELGADO.

SO IN ADDITION TO THE PRIMARY THERE IS GOING TO BE THE LEGISLATIVE SESSION.

SO ARE THERE OPPORTUNITIES WHERE SHE MIGHT GET PULLED TO HER LEFT AND POTENTIALLY ALIENATE GENERAL ELECTION VOTERS AS WELL?

>> WELL CERTAINLY WE'LL SEE WHAT HAPPENS WITH HER RELATIONSHIP WITH MAMDANI HERSELF.

SHE HAS STARTED OFF ON AS GOOD A FOOT AS SHE COULD HOPED FOR WITH HIM.

>> ONLY OCCASIONALLY GETTING YELLED AT BY HIS SUPPORTERS.

>> YES THERE WILL BE A LOT OF THINGS LIKE TAX HIKES AND MORE SPENDING IN A YEAR WHERE OUR SPENDING PICTURE MAY BE COMPLICATED BY MORE FEDERAL CUTS.

SO IT WILL BE TRICKY TO SEE IF SHE CAN GET THROUGH THE BUDGET WITH KEEPING HIS PART OF THE PARTY HAPPY OR AT LEAST NOT ANGRY, WITHOUT MOVING A LOT FURTHER TO THE LEFT ON ISSUES LIKE TAXES THAN SHE HAS IN THE PAST.

>> SHE NEEDS THOSE PEOPLE TO SHOW UP IN NOVEMBER.

FINALLY THOUGH, WHAT ABOUT THE MOOD THAT WE MIGHT BE ABLE TO EXPECT IN 2026?

HISTORICALLY MID TERM ELECTIONS ARE NOT GOOD FOR THE PARTY THAT OCCUPIES THE WHITE HOUSE.

WE HAVE SEEN THAT TREND HERE IN NEW YORK.

SO DOES THAT SUGGEST THAT 2026 IS JUST GOING TO BE A BETTER ATMOSPHERE FOR DEMOCRATS AND REPUBLICANS WILL NECESSARILY BE PUSHING AGAINST SOME OF THE WINS THAT WERE IN THEIR BACK IN 2022.

>> THAT'S THE BIG QUESTION.

WE SAW EARLIER THIS MONTH IT WAS ONE OF THE BEST DEMOCRATIC NIGHTS IN NEW YORK STATE AND THIS WEIRD QUIET PART OF THE ELECTION CYCLE FOR NEW YORK STATE EVER.

THERE WERE A LOT OF COUNTY LEGISLATORS IN PLACES LIKE DUTCHESS AND ONONDAGA THAT ARE KEY PURPLISH COUNTIES THAT ARE GOOD BELLWEATHERS OF THE MOOD-OF-THE-STATE THAT HAD THE BEST DEMOCRATIC NIGHT IN 50 YEARS OR MORE IN SOME CASES.

ULSTER COUNTY AND OTHER CASES THAT HAVE REPUBLICANS THEORETICALLY WOULD WANT TO MAKE INROADS BACK THERE IF THEY WANTED TO START GAINING GROUND IN THE HUDSON VALLEY AND IN PLACES LIKE PAT RYAN'S DISTRICT THAT ELECTED THE BIGGEST DEMOCRATIC MAJORITY IN THE HISTORY EVER.

OUTSIDE OF NASSAU COUNTY IT WAS PRETTY MUCH EVERYWHERE IN THE STATE MOVEMENT TO THE LEFT.

SOME COUNTIES 17 POINTS, NOT QUITE THAT MUCH EVERYWHERE OBVIOUSLY BUT IT DOES SEEM LIKE AS OF NOW, THE WINS ARE AT THE DEMOCRATS BACKS.

THE QUESTION BECOMES IS THAT STILL THE CASE NEXT YEAR OR IS MAMDANI A BIG BIGGER ISSUE IN NEW YORK CITY THAN TRUMP?

THAT'S WHAT REPUBLICANS ARE HOPING TO.

>> WE ONLY HAVE A FEW SECOND LEFT BUT THAT SEEMS TO SPEAK IN THE WAY THE ELECTIONS HAVE BECOME MORE NATIONALIZED.

YOU ARE NOT HANGING YOUR VOTE ON THE LOCAL CANDIDATES BUT BEING MOTIVATED BY WHAT YOU ARE SEEING IN THE NATIONAL SCALE?

>> IT'S TRUE.

CERTAINLY.

BUT I DON'T THINK THAT HAS CHANGED DRASTICALLY SINCE 2021 OR 2023.

IN THOSE YEARS IT WAS A BIG SHIFT TO THE LEFT WHICH MIGHT INDICATE THAT AS OF THIS MONTH, 12 MONTHS BEFORE THE GUBERNATORIAL ELECTION, DEMOCRATS IN NEW YORK ARE MORE EAGER TO SHOW UP THAN REPUBLICANS.

>> IN ADDITION TO THE GUBERNATORIAL RACE WE WILL HAVE DOWNBALLOT CONGRESSIONAL RACES.

A LOT TO TALK ABOUT IN THE FUTURE.

WE HAVE TO LEAVE IT THERE.

WE HAVE BEEN SPEAKING WITH BILL MAHONEY OF POLITICO NEW YORK.

BACK TO YOU IN THE STUDIO, DAVE.

>> WE ARE BACK AND IN THE TIME WE HAVE LEFT, I WANT TO TALK ABOUT SOMETHING WE MENTIONED EARLIER.

HOSPICE SERVICES, THE CARE DESIGNED TO MAKE THE END OF LIFE A LITTLE EASIER FOR A TERMINALLY PERSON AND THEIR FAMILY.

SO, CORRINE, AS I THINK WE REFERENCED EARLIER, NEW YORK DOES NOT DO A GREAT JOB OF ENSURING PEOPLE ARE UTILIZING THESE SERVICES.

MOST STUDIES SAY WE ARE AROUND THE BOTTOM OF STATES IN THE COUNTRY.

>> LAST AMONG STATES.

>> I WAS BEING GENEROUS.

WHY DO YOU THINK THAT IS?

ANECDOTALLY OR BASED ON EVIDENCE IS THERE A REASON TO THINK WHY NEW YORKERS JUST, YOU KNOW, WON'T UTILIZE THESE SERVICES?

CAN-DO SPIRIT?

WE DON'T WANT TO ACCEPT THE END IS NEAR?

WHAT IS IT?

>> THREE BASIC REASONS WHY WE RANK LAST IN TERMS OF HOSPICE UTILIZATION.

THE FIRST IS REALLY AWARENESS AND UNDERSTANDING AMONG PATIENTS ABOUT WHAT HOSPICE IS.

AND HOW HELPFUL IT CAN BE TO PEOPLE AT THE END OF LIFE.

ANOTHER IS PHYSICIANS RELUCTANCE TO REFER PEOPLE TO HOSPICE.

AND PARTICULARLY REFER PEOPLE TO HOSPICE IN A TIMELY MANNER.

THE AVERAGE LENGTH OF STAY IN HOSPICE IN NEW YORK IS 17 DAYS.

MY OWN PARTY FATHER WAS IN HOSPICE 72 HOURS.

YOU CAN BARELY GET A GLIMPSE OF WHAT HOSPICE HAS TO OFFER WHICH IS REALLY A SURROUNDING CARE TEAM THAT PROVIDES NOT ONLY MEDICAL SUPPORT BUT PSYCHOLOGICAL SUPPORT, SPIRITUAL SUPPORT FOR PEOPLE AND THEIR FAMILIES AT THE END OF LIFE.

THE OTHER ISSUE THAT I THINK IS A BARRIER FOR ACCESS TO HOSPICE IS REALLY THE AVAILABILITY OF QUALITY HOSPICE THROUGHOUT THE STATE.

AND IT'S A COMPLICATED WORKFORCE ISSUE.

HOSPICE IS PAID FOR BY MEDICARE AND WHENEVER THE STATE STEPS IN TO PROVIDE HELP TO THE WORKFORCE, THEY DO IT THROUGH MEDICAID AND SO THERE IS A DISCONNECT THERE THAT I THINK THE ADMINISTRATION, THE EXECUTIVE IS STARTING TO UNDERSTAND.

AND SO THERE IS A CONCERTED EFFORT AMONG MANY ADVOCACY GROUPS, OURS INCLUDES, COMPASSIONATE CHOICES IN TRYING TO GET THE EXECUTIVE AND THE STATE LEGISLATURE TO UNDERSTAND HOW TO PROVIDE REAL SUPPORTS TO THE WORKFORCE AND MAKE HOSPICE MORE AVAILABLE TO PEOPLE.

>> LUCKILY WE HAVE A MEMBER OF THE LEGISLATURE HERE.

SENATOR, WHAT SEEMS TO BE MAYBE LOW HANGING FRUIT WHEN IT COMES TO LEGISLATIVE RESPONSES TO THIS ISSUE?

IS IT A SIMPLE AS EVERY OTHER HEALTHCARE ISSUE WHERE WE NEED TO SPEND MORE ON IT OR ARE THERE SAY REGULATORY BURDENS THAT NEED TO BE ADDRESSED, FOR EXAMPLE?

>> CLEARLY THE FUNDING ISSUE IS ONE.

BUT IT'S ALSO HOSPICE IS A CONSTELLATION OF SERVICES.

AND WHEN YOU HAVE-- IT'S NOT ONE PERSON-- MANY ARE COMING AND PROVIDING HOSPICE CARE.

IT'S, YOU KNOW-- >> A CARE TEAM.

>> A WHOLE CARE TEAM.

AND THAT IS ALWAYS HARDER TO INCENTIVIZE IN SOME WAY AT THE, YOU KNOW, THROUGH LEGISLATION OR THAT KIND OF THING.

SO DEVELOPING THE WORKFORCE.

WE HAVE BEEN DOING SOME THINGS TO TRY TO FUND MORE WORKFORCE DEVELOPMENT.

WE, YOU KNOW,HELPING THOSE CARE TEAMS KIND OF COALESCE AND MAKING SURE THAT EVERY REGION OF THE STATE HAS THESE RESOURCES.

BUT, YOU KNOW, I CHAIR THE COMMISSION ON RURAL RESOURCES.

RURAL AREAS, IT'S VERY HARD TO PUT TOGETHER HOSPICE CARE TEAMS BECAUSE, JUST THAT WHOLE CONSTELLATION OF RESOURCES IS NOT AVAILABLE.

SO THIS IS A THORNIER PROBLEM.

I WOULD SAY HOME CARE IS HARD ENOUGH.

AND THEN HOSPICE CARE IS HOME CARE SQUARED BASICALLY.

SO IT IS REALLY A DIFFICULT ONE.

BUT I KNOW WE ARE TRYING TO PUT MORE MONEY IN VARIOUS PLACES IN THE BUDGET TO SUPPORT THIS AND TO DO WHAT WE CAN TO GET REGULATORY BARRIERS REDUCED.

>> ONE OF THE RESPONSES WE HAVE SEEN FROM THE LEGISLATURE THOUGH WAS TO APPROVE LEGISLATION THAT DEALS WITH FOR-PROFIT HOSPICE FACILITIES AND BASICALLY TRYING TO LIMIT THEIR FOOTPRINT TO BASICALLY WHAT IS THE EXISTING FOOTPRINT.

CORRINE MENTIONED THERE ARE ISSUES WITH ACCESS.

SO WHY DOES IT MAKE SENSE TO LIMIT DIFFERENT STAKEHOLDERS THAT MIGHT WANT TO GET INTO THIS SPACE?

>> >> THE WHOLE FOR-PROFIT ISSUE IN HEALTHCARE IS A VERY COMPLICATED ONE AND YOU CERTAINLY DON'T WANT TO HAVE A SITUATION WHERE PEOPLE ARE COERCED IN ONE WAY OR ANOTHER INTO THE DECISION TO GO INTO HOSPICE IS ALSO A DECISION NOT TO PURSUE FURTHER TREATMENT FOR YOUR ILLNESS.

AND SO THAT'S A BIG DECISION AND YOU DON'T WANT THERE TO BE A WHOLE KIND OF FOR-PROFIT MOTIVE FOR PEOPLE TO BE PUSHED INTO THAT.

SO THE IDEA IS TO MAKE SURE THAT WE ARE DOING THIS IN A WAY THAT IS FOR THE BENEFIT OF THE PATIENT AND NOT SOMEONE ELSE.

>> JESSICA, HOW DO YOU THINK ABOUT THIS LANDSCAPE, WHETHER IT'S THE LACK OF UTILIZATION OR POSSIBLE ANSWERS TO IT?

DOES ANYTHING COME FRONT MIND TO YOU?

>> I'M GRATEFUL FOR GOOD HOSPICE CARE.

MY MOTHER HAD IT.

MY GRANDFATHER IS RECEIVING IT RIGHT NOW.

IT IS NEAR AND DEAR TO ME TO LOOK AROUND AND REALIZE NOT ALL OF OUR VULNERABLE NEIGHBORS HAVE THE SAME ACCESS.

SO FOR ME I LOOK AT IT AND I SAY WE CAN'T EVEN GET THIS RIGHT.

WE CAN'T MAKE SURE THAT PEOPLE HAVE EQUITABLE ACCESS TO THE CARE AND TREATMENT THAT THEY DESERVE AND WE ARE LOOKING AT INTRODUCING A STATE SANCTIONED SUICIDE POLICY.

THIS IS NOT-- >> I THOUGHT WE WERE GOING TO SEE A PIVOT THERE.

BUT I GUESS CORRINE WITH THE TIME WE HAVE LEFT THEN, HOW DO YOU THINK ABOUT THEN THESE MOVING PARTS OF HOSPICE AND THE LEGISLATION WE TALKED ABOUT EARLIER?

I MEAN DO WE NEED TO BE THINKING ABOUT AS A HOLISTIC RESPONSE TO END OF LIFE CARE?

>> I THINK WE DO.

AND THAT'S WHY THE BILL REQUIRES THAT ANYONE ASKING FOR MEDICAL AID IN DYING BE COUNSELED ON ALL OF THEIR AVAILABLE OPTIONS.

AND THAT'S IMPORTANT BECAUSE WE KNOW, AND WE HAVE ALL ACKNOWLEDGED THAT PHYSICIANS DON'T OFFER HOSPICE IN ALL CASES TO PEOPLE WHO COULD BENEFIT FROM IT.

SO THIS BILL PROVIDES AN ADDITIONAL REQUIREMENT THAT SPARKS THAT CONVERSATION AND IN FACT WE KNOW THAT IN THE STATES THAT HAVE MEDICAL AID IN DYING, OVER 8 5%% OF THE PEOPLE WHO ASK FOR MEDICAL AID IN DYING ARE RECEIVING HOSPICE CARE.

>> YOU USED THE WORD CONVERSATION.

AND I THINK THAT COMES DOWN TO THE THING I WANT TO GET ACROSS.

PEOPLE AGREEING OR DISAGREEING ABOUT HAVING THIS CONVERSATION ABOUT END OF LIFE AND WHAT PEOPLE ARE GOING THROUGH AND BRINGING THESE ISSUES TO THE FOREFRONT IS IMPORTANT.

YOU KNOW, PEOPLE HEAR DIFFERENT POINTS OF VIEW.

THEY THINK ABOUT IT BECAUSE IT'S NOT AN EASY TOPIC.

SO I REALLY APPRECIATE EVERYONE COMING TO THE TABLE TODAY TO HAVE WHAT IS AN EMOTIONAL CONVERSATION, GRANDPARENTS, SPOUSES, PARENTS, YOU KNOW, I REALLY APPRECIATE IT.

BUT ON THAT NOTE, THAT'S ALL THE TIME WE HAVE TODAY.

MY THANKS TO MY PANELISTS STATE SENATOR RACHEL MAY, A SYRACUSE DEMOCRAT, JESSICA RODGERS, OF THE PATIENTS RIGHTS ACTION FUND, AND CORRINE CAREY, OF COMPASSION AND CHOICES IN NEW YORK AND NEW JERSEY.

AND IF YOU WANT MORE CONNECT NEW YORK CONTENT - VISIT WCNY.ORG/CONNECT_NY, AND MAKE SURE TO CHECK OUT THE WCNY YOUTUBE PAGE.

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ON BEHALF OF THE ENTIRE TEAM AT WCNY - I'M DAVID LOMBARDO -