Prism0%
In New York, who will get to take advantage of medical aid in dying? 4%
By Ben Rappaport0%
7/30/2026, 9:16:36 AM
BS Summary: This article contains 11 faulty reasoning types, including Framing Effect, Anchoring Bias, and Hasty Generalization, with Availability Heuristic as the most egregious example at 13.5% saturation with 275 hits. Analysis detected 856 faulty-reasoning hits from 2,041 analyzed words, generating a BS Score of 17.3% and a BS Rank of 4% (21,524 of 22,405 articles). This article is better (less manipulative) than 96.10% of the article peer group.
When Kiki Jackson first heard the phrase “medical aid in dying,” she scrunched her face in suspicion.
Jackson, a 74-year-old lifelong resident of Harlem, was listening to a group discussion at a local senior center about New York’s new Medical Aid in Dying Act.
For her and about a dozen other Black community members in attendance, the idea of terminally ill adults having the right to end their lives evoked troubling experiences with the medical system.
Jackson recalled how doctors had dismissed her temporal lobe seizures as a byproduct of aging and faulty memory, and how her best friend once begged a technician for help when a mammography machine squeezed her breast so tightly it later became infected.
Jackson, a Christian like many others at the discussion, also felt that medical aid in dying conflicted with her faith.
“ That’s like taking your own life,” she said.
“God frowns on that.”
Jackson’s apprehensions are emblematic of how many older Black New Yorkers view the right to die.
The Medical Aid in Dying Act, which is set to go into effect on Aug. 5, will give New Yorkers medically deemed to have less than six months to live the ability to control when they die, end pain that cannot be managed with palliative care, and help loved ones better process grief, advocates say.
At the same time, some of those same advocates argue that the law’s restrictions and the costs of pursuing medical aid in dying—sometimes referred to as MAID—could exacerbate medical racism that fuels distrust of the healthcare system among communities of color.
“Do you really want this to happen within a system that you already have issues with?”
Jackson said.
“You have more control within your own sphere, within your own home.
It’s a difficult question.”
Research aggregating over 20 years of data from 13 states and Washington, D.C., where similar laws are on the books, reveals that the people who’ve utilized medical aid in dying are overwhelmingly white, college-educated, and able to pay out of pocket.
Didi Sanchez, an aging researcher and bioethicist at Columbia University, led the discussion Jackson attended at the A.
Philip Randolph Senior Center in April.
She wasn’t surprised by the skepticism Jackson and the rest of the group expressed, she told Prism.
“Conversations about medical aid in dying just cannot happen without trust,” said Sanchez, a MAID proponent who has held discussions about end-of-life planning in communities of color for decades.
“And in my community, that mistrust of the medical system doesn’t just come from Tuskegee‑level atrocities.
It comes from everyday visits where people feel like no one is really listening to them.”
The law came to New York after decades of lobbying and activism by several national and local advocacy organizations, including Compassion & Choices, Death With Dignity, and End of Life Choices New York.
The bill, which was first introduced in the Legislature in 2016, failed session after session for nearly a decade.
The momentum began to shift in 2025, after previously hesitant medical societies like the Medical Society of the State of New York and the New York State Academy of Family Physicians joined sponsoring legislators.
Public opinion was also favorable to the bill: Polling commissioned by Death With Dignity in 2024 showed that nearly two-thirds of New Yorkers supported MAID, including 66% and 69% of Black and Hispanic residents, respectively.
Despite the upswell in support for medical aid in dying in New York, there has been strong pushback from disability rights and Catholic groups, which have filed separate federal lawsuits to block the law.
Both lawsuits are pending, but there are no injunctions currently stopping the law from taking effect.
The legislation that passed is among the most restrictive of its kind in the country.
Among the law’s requirements are a mandatory five-day waiting period between when a prescription is written and filled; an oral request from the patient recorded by video or audio; a mental health evaluation; and an in-person doctor’s visit in which two physicians must determine a terminal illness.
Patients must also be New York residents.
Doctors, pharmacists, and hospice providers are also not required to participate in MAID; they can opt out for any reason at any time so long as they arrange for the transfer of the patient.
In contrast, nearby New Jersey—where medical aid in dying has been legal since 2019—has none of these stipulations, aside from a residency requirement and a terminal diagnosis.
Oregon and Vermont are the only states that do not have residency requirements, meaning that people from out of state can travel there to receive MAID.
The procedure is also expensive.
The medication alone typically costs $600 to $800 out of pocket, according to the Academy of Aid-in-Dying Medicine, and is not covered by Medicare, Medicaid, or most private insurers.
Most people who utilize medical aid in dying use private concierge doctors because few in-network doctors or pharmacies are willing to prescribe the medication, increasing the total cost to thousands of dollars.
For some advocates, these barriers raise questions about who can realistically access MAID as part of their end-of-life care.
“If I were dying, I would like to have access to anything and everything that could make me suffer less,” Sanchez said.
“Doesn’t that sound humane?
It’s that simple.
But choice has to exist within a system that truly supports patients.
Otherwise it’s not really a free choice.”
Sanchez said that while MAID can give dying people and their families the autonomy to reduce unnecessary suffering, she fears that in New York, the option could become a two‑tier system that only benefits affluent white patients.
“Those that do want it in communities that don’t have access to private doctors, private insurers, they’re not going to have access,” Sanchez said.
“Where is this information being disseminated?
It’s in groups that are highly educated, [and] that are not brown and Black.”
A 2022 study found that over 5,300 people have used medical aid in dying since 1997.
Of those, 96% were white, and 72% had a college education.
The data backs up her concerns.
A 2022 study published in the Journal of the American Geriatrics Society found that since the first medical aid in dying law was passed in Oregon in 1997, over 5,300 people have chosen this end-of-life option.
Of those, 96% were white, and 72% had a college education.
People of color are more likely to experience harm and neglect when they seek medical care, creating a distrust of medical institutions that can extend to medical aid in dying.
More than half of Black Americans believe the U.S. healthcare system was designed to hold them back, according to a 2024 Pew Research Center poll .
As a result, some might be reluctant to seek medical care when they need it.
Research also shows that Black people have lower life expectancy and higher infant mortality rates compared with white people; they are also more likely to develop chronic diseases and other health issues.
“It’s more than anything about the relationships that we have with our medical institutions,” said Jeff Gardere, a psychologist and board member of Compassion & Choices .
“That’s where that medical mistrust comes in, because I think a lot of Black and brown people feel that nobody really cares.”
Gloria Thomas Anderson, founder of Advance Care Planning for African Americans , has seen medical malpractice firsthand.
In 2006, when she was 51, she had adrenal failure that was misdiagnosed by a white doctor as high blood pressure.
And when her brother was 56, he was given the wrong medication during a visit to the emergency room and eventually died.
These experiences showed her the importance of having conversations in Black households about the medical system and end-of-life decisions, she told Prism.
“ The bigger picture is institutionalized racism,” Anderson said.
“For something like MAID, my gut says that we would not, as a people, be willing to do anything that’s going to end our life, because we’ve had such a hell of a life.”
Bridging the knowledge gap
To address distrust of medical aid in dying among communities of color, experts told Prism that education is key: both through medical institutions and community outreach.
“There’s a lack of clarity on how medical aid in dying fits into end-of-life conversations.
It’s not part of routine care for palliative care or hospice or geriatrics,” said Elissa Kozlov, an assistant professor at the Rutgers School of Public Health who specializes in improving outcomes for older adults with serious illnesses.
Kozlov co-authored a 2025 study of more than 3,000 adults that found that over half could not correctly say whether medical aid in dying was legal where they lived.
The study also found that 43% Asian, 42% Hispanic, and 34% Black respondents said they would definitely or probably consider medical aid in dying if they received a diagnosis of terminal illness—a significantly different racial breakdown from who actually utilizes the option.
“Whenever you see a resourced population is the one accessing things as disproportionately as we see in MAID, you have to ask questions about access,” Kozlov said.
When a state legalizes medical aid in dying, there’s no uniform guidance for how healthcare providers should administer it, Kozlov said, leading individual doctors and institutions to make their own choices.
So even when patients want to utilize medical aid in dying, they might hit a wall with clinicians who don’t know how to administer it, experts told Prism.
“Medical aid in dying is not standardly taught in medical schools,” said Sarah Kiskadden-Bechtel, executive director of the Academy of Aid-in-Dying Medicine .
“Most folks graduating medical school and residency don’t have fundamental education on what this practice involves.”
Where that educational infrastructure does exist, it tends to be inside large, well-resourced health systems.
Organizations like Kaiser Permanente and Sutter Health in states with long-established laws, like California, have developed protocols that make medical aid in dying navigable within their networks.
For patients who rely on safety-net hospitals, federally qualified health centers, or community clinics, however, those pathways largely don’t exist.
According to a 2019 survey commissioned by Compassion & Choices, 56% of New York doctors support medical aid in dying.
In June, the New York State Department of Health proposed regulations for how medical practitioners should approach MAID.
If approved, those regulations would require physicians who prescribe MAID medication to report it to the department and share anonymized patient information, including age, gender, and where the medications were ingested.
Notably, they would not need to disclose the patient’s race or ethnicity.
“I’m really hoping that New York is part of that snowball effect in terms of really informing the medical community,” Kiskadden-Bechtel said.
Back in Harlem, Sanchez is approaching MAID education on a community level.
For many people of color who’ve felt dismissed or forced to self-advocate in medical settings, she said, the idea of a doctor helping them die is like allowing the system to commit the ultimate injustice.
When you say medical aid in dying to communities that haven’t even been aware this happens, the picture in their mind is a system that will use it … to free up [hospital] beds.
Didi Sanchez, Columbia University aging researcher and bioethicist
“When you say medical aid in dying to communities that haven’t even been aware this happens,” Sanchez said, “the picture in their mind is a system that will use it—now that there’s a legal way—to free up [hospital] beds.”
She works to unpack this medical distrust at the senior center through regular conversations about end-of-life planning and a book club.
The group has been reading “Medical Apartheid” by Harriet Washington, a landmark 2007 book about the history of medical experimentation on Black Americans.
Sanchez’s discussion group has helped Kiki Jackson begin to recognize the importance of thoughtful end-of-life care.
“If I’m dying, I don’t want to linger,” Jackson said.
“I’ve seen too many of my friends linger and the pain they felt.
It left me with difficult memories and a guilt—I still have that guilt—that I should’ve done something about it.
If it’s up to me, I hope I can have that choice when my time comes.”
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