New York's former top attorney remains opposed to efforts to allow terminally ill people to end their own life nearly a decade after he defended the state's ban on the practice at the U.S. Supreme Court.

Former New York Attorney General Dennis Vacco was one of four panelists who spoke on the issue to attorneys in Albany during an educational event at the New York State Bar Association on Friday.

The measure, referred to as medical aid in dying by proponents or physician-assisted suicide by opponents, is expected to be revived next year in New York, which would become the 10th state to allow the practice.

The intent of the legislation is simple, but the safeguards included in the bill currently under consideration are not.

It would allow a terminally ill patient to be prescribed medication that could then be used to end their own life at the time of their choosing. It's intended to allow those individuals to choose when and how they end their own life, rather than waiting for their illness to take over.

Several provisions were included in the bill to avoid situations where an individual could be coerced into requesting a prescription or may not have the mental capacity to make that decision.

Individuals would first have to be deemed terminally ill, and that condition would have to be confirmed by an attending physician and a consulting doctor. Only individuals 18 or older would be eligible.

The individual seeking to end their own life would have to make both an oral and written request, with a form provided by law. The written request would have to be witnessed by at least two adults, one of whom couldn't be a relative or inheritor.

Individuals deemed to be suicidal would not be eligible.

Terminally ill patients also have to be made aware, under the law, of the alternative options to medical aid in dying. That could include hospice care, comprehensive pain management, palliative care and other treatment.

None of that is allowed under the state's current public health laws. Doctors who choose to help patients affirmatively end their own life, rather than stopping treatment, could face criminal charges under the current statute.

Supporters of the proposed law, called the Medical Aid in Dying Act, said Friday that terminally ill individuals in New York have been known to seek help from doctors with ending their own life regardless of the consequences.

Corinne Carey from Compassion and Choices, an advocacy group, argued on that the law would provide new autonomy for terminally ill patients.

"Decisions about death belong to the dying," Carey said. "Good public health policy allows those who are dying to engage in open and honest conversations with their doctors, their loved ones, and their faith leaders about their physical and spiritual needs at the end of life."

Vacco, a Republican who served concurrently with Gov. George Pataki, defended the state when it was sued by Dr. Timothy Quill over New York's ban on so-called physician-assisted suicide.

It's legal in New York for patients to refuse treatment that could prolong their life, but doctors cannot take steps that would essentially hasten the death of a patient. Quill, along with other doctors and a handful of patients, challenged the state's ban on the latter practice.

The case, Vacco v. Quill, eventually made it to the U.S. Supreme Court after the state's law was struck down by the U.S. Court of Appeals for the Second Circuit.

The New York Attorney General's Office, under Vacco, had argued that allowing doctors to help a patient end their life was not the same as ending life-saving treatment. The Supreme Court agreed.

Vacco said his position hasn't changed since then.

"The answer is … that treating the pain, including what we refer to as terminal sedation, is not morally, legally and ethically the same as physician-assisted suicide," Vacco said. "Where the line has presently been drawn by the New York state Legislature is the only rational place to put that line."

Vacco argued that, given the differences in public opinion and different considerations on the issue, the state should not change it's laws on medical aid in dying. The current statute, he said, goes far enough to allow choices for patients at the end of life.

His position was reflected two years ago in the New York Court of Appeal's decision, Myers v. Schneiderman. That decision was the result of a lawsuit against the state by three terminally ill patients who argued they had a constitutional right to request a prescription that would allow them to end their life. The Court of Appeals ruled that no such right existed in state law.

But the Court of Appeals also wrote that the Legislature could enact changes to the state's laws to allow medical aid in dying.

Gov. Andrew Cuomo urged lawmakers to consider the issue earlier this year, but it failed to come up for a vote before the session ended.

"I say pass the bill," Cuomo said. "It's a controversial issue, it's a difficult issue, but the older we get and the better medicine gets, the more we've seen people suffer for too, too long."

The next legislative session is set to begin in January, thereafter Democrats can take another shot at convincing their colleagues to support the measure.

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