TUESDAY, APRIL 29, 2025                                             11:04 A.M.



                                 ACTING SPEAKER HUNTER:  THE HOUSE WILL

                    COME TO ORDER.

                                 GOOD MORNING -- ALMOST AFTERNOON, COLLEAGUES.

                                 REVEREND JAHMEL ROBINSON WILL OFFER A PRAYER.

                                 REVEREND JAHMEL ROBINSON:  LET US PRAY.

                                 ETERNAL AND ALMIGHTY GOD, WE GATHER IN THIS SACRED

                    CHAMBER NOT MERELY AS LEGISLATORS, BUT AS STEWARDS OF JUSTICE, TRUTH,

                    AND PUBLIC GOOD.  WE ACKNOWLEDGE YOUR SOVEREIGNTY OVER THIS STATE,

                    AND SEEK YOUR WISDOM AS WE CARRY OUT THE DUTIES ENTRUSTED TO US BY

                    THE PEOPLE OF THE GREAT STATE OF NEW YORK.

                                 TODAY, O GOD, WE ASK THAT YOU CROWN THIS ASSEMBLY

                    WITH CLARITY OF THOUGHT, COMPASSION OF HEART, AND COURAGE AND

                    CONVICTION.  MAY EVERY DEBATE BE SEASONED WITH DIGNITY, EVERY

                                          1



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    DECISION BE ROOTED IN RIGHTEOUSNESS, AND EVERY LAW BE SHAPED BY LOVE

                    FOR THE LEAST, THE LAST, AND THE LOST.

                                 WE LIFT UP THE PEOPLE OF THE STATE FROM THE BUSTLING

                    BOROUGHS OF THE CITY TO THE QUIET CORNERS OF THE COUNTRYSIDE.

                                 LET OUR POLICIES PROTECT THE VULNERABLE, PROMOTE

                    EQUITY, AND PAVE THE WAY FOR OPPORTUNITY AND PEACE.

                                 WE ALSO LIFT UP THE DEDICATED STAFF WHO SERVE BEHIND

                    THE SCENES.  THOSE WHO RESEARCH, WRITE, COORDINATE, AND COMMUNICATE.

                    THEIR UNSEEN SACRIFICES AND STEADFAST SUPPORT ARE THE SCAFFOLDING THAT

                    HOLDS THIS GREAT WORK TOGETHER.  BLESS THEM WITH ENDURANCE, INSIGHT,

                    AND ENCOURAGEMENT AS THEY LABOR FOR THE COMMON GOOD.

                                 STRENGTHEN ALL WHO SERVE, ELECTED AND APPOINTED, WITH

                    A VISION BEYOND POLITICS, PURPOSE BEYOND POWER, AND PASSION FOR

                    PEOPLE.  REMIND US THAT OUR WORK HERE ECHOS BEYOND THE WALLS INTO THE

                    DAILY LIVES OF FAMILIES, COMMUNITIES, AND GENERATIONS TO COME.  AND

                    WHEN THE RECORD OF THIS DAY IS WRITTEN IN THE ARCHIVES OF TIME, MAY IT BE

                    SAID THAT IN THIS ASSEMBLY, HEARTS WERE GUIDED BY HEAVEN AND HANDS

                    WERE STRENGTHENED BY HOPE.  ORDER OUR STEPS, ALIGN OUR HEARTS, FORTIFY

                    OUR SPIRITS, AND LET JUSTICE ROLL DOWN LIKE WATERS AND RIGHTEOUSNESS LIKE

                    A MIGHTY STREAM.

                                 IN YOUR HOLY AND SOVEREIGN NAME WE PRAY.  AMEN.

                                 MEMBERS:  AMEN.

                                 ACTING SPEAKER HUNTER:  VISITORS ARE INVITED

                    TO JOIN MEMBERS IN THE PLEDGE OF ALLEGIANCE.

                                 (WHEREUPON, ACTING SPEAKER HUNTER LED VISITORS AND

                                          2



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    MEMBERS IN THE PLEDGE OF ALLEGIANCE.)

                                 A QUORUM BEING PRESENT, THE CLERK WILL READ THE

                    JOURNAL OF MONDAY, APRIL 28TH.

                                 MRS. PEOPLES-STOKES.

                                 MRS. PEOPLES-STOKES:  MADAM SPEAKER, I MOVE

                    TO DISPENSE WITH THE FURTHER READING OF THE JOURNAL OF MONDAY, APRIL

                    THE 28TH AND THAT THE SAME STAND APPROVED.

                                 ACTING SPEAKER HUNTER:  WITHOUT OBJECTION,

                    SO ORDERED.

                                 MRS. PEOPLES-STOKES:  THANK YOU, MADAM

                    SPEAKER.

                                 TO THE GUESTS THAT ARE IN OUR CHAMBERS AS WELL AS OUR

                    COLLEAGUES, I'D LIKE TO SHARE A QUOTE WITH YOU TODAY.  THIS ONE COMES

                    FROM JAMES BALDWIN, A VERY WELL-KNOWN AFRICAN-AMERICAN WRITER AND

                    CIVIL RIGHTS ACTIVIST.

                                 HIS WORDS FOR US TODAY:  "NOT EVERYTHING THAT IS FACED

                    CAN BE CHANGED, BUT NOTHING CAN BE CHANGED UNTIL IT IS FACED."

                                 AGAIN, JAMES BALDWIN.

                                 MADAM SPEAKER, MEMBERS HAVE ON THEIR DESK A MAIN

                    CALENDAR, AND BEFORE ANY HOUSEKEEPING OR INTRODUCTIONS, WE'RE GONNA

                    BE CALLING FOR THE FOLLOWING COMMITTEES TO MEET:  WAYS AND MEANS,

                    FOLLOWED BY RULES.  THESE COMMITTEES ARE GONNA PRODUCE AN

                    A-CALENDAR, WHICH WE WILL TAKE UP TODAY.  WE'RE ALSO GONNA BE CALLING

                    FOR THE FOLLOWING COMMITTEES TO MEET AS WELL:  CHILDREN AND FAMILIES,

                    FOLLOWED BY EDUCATION, FOLLOWED BY SOCIAL SERVICES, FOLLOWED BY

                                          3



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    MENTAL HEALTH, AND CORPORATIONS.

                                 WE'RE GOING TO BEGIN OUR FLOOR WORK BY TAKING UP

                    RESOLUTIONS ON PAGE 3.  THERE MAY BE A NEED FOR ADDITIONAL FLOOR

                    ACTIVITY.  IF SO, MADAM SPEAKER, I WILL ACKNOWLEDGE IT AT THAT POINT.

                                 MAJORITY MEMBERS SHOULD CERTAINLY BE AWARE THAT

                    THERE WILL BE A NEED FOR A CONFERENCE IMMEDIATELY FOLLOWING THE

                    CONCLUSION OF OUR WORK ON THE FLOOR TODAY.  AND, AS ALWAYS, WE'LL

                    CHECK WITH OUR COLLEAGUES ON THE OTHER SIDE OF THE AISLE.

                                 THAT'S THE GENERAL OUTLINE OF WHERE WE'RE GOING TODAY,

                    MADAM SPEAKER.  IF YOU COULD BEGIN BY CALLING THE WAYS AND MEANS

                    COMMITTEE TO THE SPEAKER'S CONFERENCE ROOM.

                                 THANK YOU.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 WAYS AND MEANS COMMITTEE TO THE SPEAKER'S

                    CONFERENCE ROOM.  IMMEDIATE WAYS AND MEANS COMMITTEE TO THE

                    SPEAKER'S CONFERENCE ROOM.

                                 WE HAVE NO HOUSEKEEPING THIS MORNING, BUT PLENTY OF

                    INTRODUCTIONS.

                                 MS. ROMERO FOR THE PURPOSES OF AN INTRODUCTION.

                                 MS. ROMERO:  THANK YOU.

                                 I RISE TODAY WITH GREAT PRIDE TO INTRODUCE ONE OF MY

                    MENTORS AND CONSTITUENTS OF THE 109TH ASSEMBLY DISTRICT, THE

                    HONORABLE REVEREND JAHMEL K. ROBINSON, AND HIS FAMILY AND

                    COLLEAGUES, PLEASE.

                                 THE REVEREND ROBINSON WAS BORN AND RAISED IN THE

                                          4



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    CITY OF ALBANY, NEW YORK.  GROWING UP, HE WORKED TO TRANSFORM HIS

                    COMMUNITY THROUGH SERVICE.  INSPIRED BY HIS MOTHER AND GRANDMOTHER,

                    AND HAVING GROWN UP IN A SINGLE-PARENT HOUSEHOLD, JAHMEL

                    CONSISTENTLY STROVE TO CREATE POSITIVE CHANGE FOR HIMSELF AND OTHERS.

                                 HE PURSED HIGHER EDUCATION AND SOUGHT TO SUPPORT HIS

                    COMMUNITY THROUGH HIS CHILDHOOD CHURCH, METROPOLITAN NEW

                    TESTAMENT MISSION BAPTIST CHURCH.  THROUGH THE CHURCH HE WORKED

                    WITH THE HOME MISSION FOOD PANTRY, VISITED NURSING HOMES, AND AIDED

                    LOCAL SENIOR CITIZENS.  HE WEARS MANY HATS IN HIS COMMUNITY WORK,

                    INCLUDING SERVING ON THE ALBANY COMMON COUNCIL AND AS THE PASTOR

                    OF MT. ZION BAPTIST CHURCH.  AND HE WORKS TO ADDRESS SOCIAL

                    DETERMINANTS OF HEALTH IN THE HEALTH SPACE.  HE ALSO SERVED AS THE

                    DIRECTOR OF MINISTRY OPERATIONS AT THE METROPOLITAN NEW -- NEW

                    TESTAMENT MISSION BAPTIST CHURCH, AND AS THE VICE PRESIDENT OF GREEN

                    TECH HIGH CHARTER SCHOOL BOARD OF TRUSTEES.

                                 AS A COUNCILMAN, REVEREND ROBINSON REPRESENTS THE

                    RESIDENTS OF THE 5TH WARD, REPRESENTING THE PEOPLE OF ARBOR HILL, WEST

                    HILL, AND WEST END NEIGHBORHOODS.  HE'S A STRONG ADVOCATE FOR

                    REDUCING POVERTY, ELIMINATING BLIGHT, AND INVESTING IN HIS

                    NEIGHBORHOODS, AND HAS BEEN VERY PROACTIVE ABOUT SUPPORTING AND

                    WRITING LEGISLATION TO ADDRESS THESE CONCERNS.

                                 HE'S JOINED TODAY BY DENISE RHODES, ASSOCIATE

                    MINISTER AT MT. ZION BAPTIST CHURCH; PEARL DRAKE, HIS GRANDMOTHER;

                    TAMMY ALEXANDER, REVEREND ROBINSON'S MOTHER; LYNETTE ROBINSON,

                    REVEREND ROBINSON'S WIFE, AS WELL.

                                          5



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 IT'S AN HONOR TO HAVE REVEREND ROBINSON IN THE

                    CHAMBER AND TO HAVE HIM PROVIDE THE INVOCATION FOR TONIGHT -- TODAY'S

                    PROCEEDINGS.  BUT IT'S ESPECIALLY IMPORTANT BECAUSE THE REVEREND HAS

                    BEEN A REAL MENTOR FOR ME THROUGH MY LIFE -- AND I SEE MY TIME IS UP.

                                 BUT ONE REALLY QUICK THING IS THAT HE'S BEEN SUCH A

                    CALM AND THOUGHTFUL LEADER, AND WE'RE BOTH CAUCUS CHAIRS OF THE

                    ALBANY BLACK AND -- BLACK AND HISPANIC CAUCUS.  AND IT MEANS SO

                    MUCH TO BE FULL CIRCLE HERE WITH REVEREND ROBINSON IN MY TIME AS A

                    ZION MEMBER HERE, AND TO SEE HIM HERE AND GIVE THE INVOCATION.  IT

                    MEANS SO MUCH TO ME.

                                 PLEASE, MADAM SPEAKER AND MY COLLEAGUES, MAY YOU

                    GRANT HIM THE CORDIALITIES OF THE HOUSE AND THE GOOD GRACES OF NEW

                    YORK STATE.

                                 THANK YOU.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 ON BEHALF OF MS. ROMERO, THE SPEAKER AND ALL

                    MEMBERS, WE WELCOME YOU, REVEREND ROBINSON, TO THE PEOPLE'S

                    HOUSE, THE ASSEMBLY CHAMBER, EXTEND THE PRIVILEGES OF THE FLOOR TO

                    YOU.  THANK YOU SO VERY MUCH FOR YOUR GRACIOUS WORDS THIS MORNING.

                    WE WILL NEED THEM THROUGH OUR -- THE COURSE OF OUR WORK TODAY.  WE

                    HOPE YOU ENJOY OUR PROCEEDINGS.  THANK YOU SO VERY MUCH FOR JOINING

                    US.

                                 (APPLAUSE)

                                 MR. BENEDETTO FOR THE PURPOSES OF AN ANNOUNCEMENT

                    [SIC].

                                          6



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. BENEDETTO:  THANK YOU, MADAM CHAIR [SIC],

                    FOR ALLOWING ME TO SPEAK HERE THIS MORNING.

                                 I'M VERY PROUD TO HAVE WITH ME TODAY, COMING UP TO

                    ALBANY, IS THE ASSISTANT COMMISSIONER OF THE NEW YORK CITY POLICE

                    DEPARTMENT PUBLIC RELATIONS UNIT, MR. ALDEN FOSTER.  COMMISSIONER

                    FOSTER IS HERE WITH SOME VERY SPECIAL GUESTS THAT HE BROUGHT WITH HIM

                    FROM A HIGH SCHOOL IN MY DISTRICT; A HIGH SCHOOL WHICH OUR SPEAKER,

                    CARL HEASTIE, GRADUATED FROM, TRUMAN HIGH SCHOOL.  IT IS A HIGH

                    SCHOOL THAT I HAVE VISITED MANY TIMES TO SEE THE FINE PERFORMANCE OF

                    THE STUDENTS THAT ATTEND THAT SCHOOL.  AND SOME OF THE GOODS STUDENTS

                    HAVE COME UP HERE TODAY.  SOME ARE PRELAW STUDENTS, ECONOMIC

                    INTERESTED STUDENTS, WHO HAVE COME UP HERE TO ALBANY TO SEE HOW WE

                    DO BUSINESS UP HERE IN THIS WONDERFUL CHAMBER.

                                 SO WOULD YOU PLEASE, MADAM CHAIR [SIC], EXTEND THE

                    CORDIALITIES OF THE HOUSE TO THESE FINE STUDENTS FROM TRUMAN HIGH

                    SCHOOL.  AND, MR. SPEAKER, IF YOU WOULD ALSO GIVE THEM SOME NICE

                    WORDS TO ENCOURAGE THESE FINE, NEW YOUNG PEOPLE.

                                 SPEAKER HEASTIE:  SO IT'S -- IT'S ALWAYS A

                    PRIVILEGE FOR US TO WELCOME ANY VISITORS HERE TO THE PEOPLE'S HOUSE.

                    THIS IS CALLED THE PEOPLE'S HOUSE.  BUT, OF COURSE, THIS IS A SPECIAL

                    MOMENT FOR ME BECAUSE THESE AMAZING YOUNGSTERS ARE FROM THE SAME

                    HIGH SCHOOL THAT I GRADUATED FROM, TRUMAN HIGH SCHOOL IN THE BRONX.

                                 AND, SO, THEY'RE UP HERE TO OBSERVE HOW GOVERNMENT

                    WORKS, AND I TRIED TO GIVE THEM A LITTLE BIT OF A HISTORY LESSON OF HOW I

                    GOT HERE.  AND EVEN THOUGH MY POLITIC CAREER STARTED OFF WITH LOTS OF

                                          7



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    LOSSES, THAT YOU JUST NEVER KNOW WHERE YOU'RE GONNA GO IN THIS LIFE.

                                 BUT I REALLY WANT TO APPLAUD ALL OF YOU FOR COMING UP

                    HERE, WANTING TO SEE HOW GOVERNMENT WORKS.  I KNOW THERE'S A LOT OF

                    THINGS THAT YOU ALL COULD BE DOING, LOOKING AT OTHER THINGS, THESE

                    DEVICES THAT SEEM TO HAVE CAUGHT THE EYE.  BUT IT JUST -- IT REALLY WARMS

                    MY HEART TO SEE MY HIGH SCHOOL UP HERE.

                                 SO CONSIDER YOURSELVES TO HAVE ALL OF THE PRIVILEGES OF

                    THE FLOOR AND THE HOUSE, AND YOU ALL CAN COME BACK HERE ANY TIME,

                    BECAUSE, LIKE I SAID, THIS IS THE PEOPLE'S HOUSE.

                                 SO THANK YOU ALL FOR BEING HERE.

                                 (APPLAUSE)

                                 ACTING SPEAKER HUNTER:  MS. HYNDMAN FOR

                    THE PURPOSES OF AN INTRODUCTION.

                                 MS. HYNDMAN:  THANK YOU, MADAM SPEAKER.

                                 TODAY -- APRIL IS ALSO KNOWN AS COMMUNITY COLLEGE

                    MONTH, WHICH IS A TIME TO RECOGNIZE AND CELEBRATE THE VITAL ROLE THAT

                    THESE INSTITUTIONS PLAY AND STRENGTHEN LOCAL ECONOMIES, EXPAND AND

                    ACCESS TO EDUCATION, AND FOSTERING LIFELONG LEARNING.

                                 I WOULD LIKE TO INTRODUCE -- BECAUSE I DON'T WANT THE

                    BUZZER TO GO ON ME -- SO IF -- IF MY GUESTS TODAY COULD STAND -- TO

                    INTRODUCE THE PRESIDENT OF ADIRONDACK COMMUNITY COLLEGE, DR.

                    DUFFY; PRESIDENT OF CORNING COMMUNITY COLLEGE, DR. MULLANEY AND

                    MR. PINDEL, PROFESSOR OF BIOLOGY; HUDSON VALLEY COMMUNITY COLLEGE,

                    MR. COPLIN; ONONDAGA [SIC] COMMUNITY COLLEGE, ANASTASIA URTZ, WHO

                    IS THE INCOMING PRESIDENT OF ADIRONDACK COMMUNITY COLLEGE EFFECTIVE

                                          8



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    JULY 1ST; ORANGE [SIC] COMMUNITY COLLEGE PRESIDENT, DR. YOUNG, AND

                    ERIC -- ERIKA HACKMAN, THE PROVOST; SULLIVAN [SIC] COMMUNITY

                    COLLEGE PRESIDENT, DR. DAVID POTASH; TOMPKINS CORTLAND COMMUNITY

                    COLLEGE, DR. AMY KREMENEK; AND ULSTER COMMUNITY COLLEGE

                    PRESIDENT, DR. ALISON BUCKLEY.

                                 I'D ALSO LIKE TO INTRODUCE ANN FLEMING BROWN,

                    SCHENECTADY COMMUNITY COLLEGE TRUSTEE; AND THE GOVERNMENT

                    RELATIONS FOR ALL OF THIS, ANDRES PAZMINO.

                                 SO ON BEHALF OF ASSEMBLYMEMBER JACOBSON AND --

                    AND MYSELF, MADAM SPEAKER, IF YOU WOULD GIVE OUR GUESTS CORDIALITIES

                    OF THE HOUSE BECAUSE OF THE WORK THEY DO THROUGHOUT NEW YORK STATE.

                                 THANK YOU.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 ON BEHALF OF MS. HYNDMAN, THE SPEAKER AND ALL

                    MEMBERS, WE WELCOME YOU COMMUNITY COLLEGE PRESIDENTS AND

                    ADMINISTRATORS HERE TODAY.  WE EXTEND THE PRIVILEGES OF THE FLOOR TO

                    YOU.  IT'S ALWAYS WONDERFUL TO SEE OUR COMMUNITY COLLEGES.  TO MY

                    OCC FAMILY BACK THERE, GOOD TO SEE YOU.  MY SON WENT TO CC-3.  SO

                    THIS IS A GREAT DAY FOR COMMUNITY COLLEGES.  EXTEND THE PRIVILEGES OF

                    THE FLOOR TO YOU.  HOPE YOU ENJOY THE PROCEEDINGS TODAY, AS LONG AS

                    YOU CAN STAY.  THANK YOU SO VERY MUCH FOR JOINING US TODAY.

                                 (APPLAUSE)

                                 MR. CARROLL FOR THE PURPOSES OF AN INTRODUCTION.

                                 MR. P. CARROLL:  GOOD MORNING, MADAM

                    SPEAKER.

                                          9



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 ON BEHALF OF ASSEMBLYMAN EACHUS, ASSEMBLYMAN

                    WIEDER AND ASSEMBLYMAN BRABENEC, IT IS MY PLEASURE TO WELCOME TO

                    THE CHAMBER MEMBERS OF THE ROCKLAND COUNTY BUSINESS ASSOCIATION.

                                 SINCE ITS FOUNDING IN 1967, THE ROCKLAND COUNTY

                    BUSINESS ASSOCIATION HAS BEEN A CORNERSTONE OF SUPPORTING BUSINESSES

                    IN THE COMMUNITY OF ROCKLAND COUNTY.  AS A NONPROFIT, THE RBA IS

                    DEDICATED TO EDUCATING, INFORMING AND PROVIDING VALUABLE SERVICES TO

                    ITS MEMBERS WHILE ACTIVELY ADVOCATING FOR THE INTERESTS OF THE BUSINESS

                    COMMUNITY.

                                 OVER THE YEARS, THE RBA HAS PLAYED A PIVOTAL ROLE IN

                    FOSTERING GROWTH AND SUCCESS OF THE COUNTLESS BUSINESSES ACROSS THE

                    REGION, AND SPECIFICALLY IN ROCKLAND COUNTY.

                                 THE RBA'S COMMITMENT GOES BEYOND JUST BUSINESS.

                    ALTHOUGH THE ORGANIZATION IS FOCUSED ON SUPPORTING ITS MEMBERS, IT'S --

                    IT'S ALSO DEDICATED TO THE WELLBEING OF THE GREATER ROCKLAND COMMUNITY

                    THROUGH PARTNERSHIPS OF LOCAL CHARITIES, VOLUNTEER EFFORTS BY MEMBERS,

                    AND COLLABORATION WITH GOVERNMENT AGENCIES.  THE RBA DRIVES -- HELP

                    DRIVES ECONOMIC DEVELOPMENT AND COMMUNITY SERVICE INITIATIVES

                    THROUGHOUT THE COUNTY.

                                 SO IT'S MY PLEASURE, MADAM SPEAKER, TO WELCOME

                    MEMBERS OF THE RBA HERE TODAY, AND I'D WISH YOU OFFER THEM THE

                    CORDIALITIES OF THE HOUSE.  THANK YOU.

                                 ACTING SPEAKER HUNTER:  YES.

                                 ON BEHALF OF MR. CARROLL, THE SPEAKER, THE ROCKLAND

                    COUNTY DELEGATION AND ALL THE MEMBERS, WE WELCOME YOU TO THE

                                         10



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ASSEMBLY CHAMBER, THE ROCKLAND COUNTY BUSINESS ASSOCIATION,

                    EXTEND THE PRIVILEGES OF THE FLOOR TO YOU.  HOPE YOU ARE ABLE TO ENJOY

                    OUR PROCEEDINGS TODAY.  THANK YOU SO VERY MUCH FOR TRAVELING TO JOIN

                    US.

                                 THANK YOU.

                                 (APPLAUSE)

                                 (PAUSE)

                                 MRS. PEOPLES-STOKES.

                                 MRS. PEOPLES-STOKES:  MADAM SPEAKER, WOULD

                    PLEASE CALL THE RULES COMMITTEE TO THE SPEAKER'S CONFERENCE ROOM?

                                 ACTING SPEAKER HUNTER:  RULES COMMITTEE TO

                    THE SPEAKER'S CONFERENCE ROOM.  RULES, SPEAKER'S CONFERENCE ROOM.

                                 RESOLUTIONS, PAGE 3, THE CLERK WILL READ.


                                 THE CLERK:  ASSEMBLY RESOLUTION NO. 379, MR.

                    RAGA.

                                 LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR

                    KATHY HOCHUL TO PROCLAIM APRIL 23, 2025, AS BOOK AND COPYRIGHT DAY

                    IN THE STATE OF NEW YORK.

                                 ACTING SPEAKER HUNTER:  ON THE RESOLUTION,

                    ALL THOSE IN FAVOR SIGNIFY BY SAYING AYE; OPPOSED, NO.

                                 THE RESOLUTION IS ADOPTED.


                                 THE CLERK:  ASSEMBLY RESOLUTION NO. 380, MS.

                    CLARK.

                                 LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR

                    KATHY HOCHUL TO PROCLAIM APRIL 20-26TH, 2025, AS MEDICAL LABORATORY

                                         11



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    PROFESSIONALS WEEK IN THE STATE OF NEW YORK.

                                 ACTING SPEAKER HUNTER:  ON THE RESOLUTION,

                    ALL THOSE IN FAVOR SIGNIFY BY SAYING AYE; OPPOSED, NO.  THE RESOLUTION IS

                    ADOPTED.


                                 THE CLERK:  ASSEMBLY RESOLUTION NO. 381, MS.

                    HUNTER.

                                 LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR

                    KATHY HOCHUL TO PROCLAIM APRIL 2025, AS COMMUNITY COLLEGE MONTH

                    IN THE STATE OF NEW YORK.

                                 ACTING SPEAKER HUNTER:  ON THE RESOLUTION,

                    ALL THOSE IN FAVOR SIGNIFY BY SAYING AYE; OPPOSED, NO.  THE RESOLUTION IS

                    ADOPTED.


                                 THE CLERK:  ASSEMBLY RESOLUTION NO. 382, MR.

                    VANEL.

                                 LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR

                    KATHY HOCHUL TO PROCLAIM APRIL 2025, AS FINANCIAL LITERACY MONTH IN

                    THE STATE OF NEW YORK.

                                 ACTING SPEAKER HUNTER:  MR. VANEL ON THE

                    RESOLUTION.

                                 MR. VANEL:  THANK YOU, MADAM SPEAKER.

                                 APRIL IS FINANCIAL LITERACY MONTH, AND FINANCIAL

                    LITERACY IS ABOUT MAKING SURE THAT WE EMPOWER NEW YORKERS ABOUT

                    ECONOMIC STABILITY AND UPWARD MOBILITY.  FINANCIAL INSECURITY IMPACTS

                    OUR WORKFORCE PRODUCTIVITY, IT IMPACTS PUBLIC HEALTH AND SOCIAL

                    SERVICES.

                                         12



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 NEW YORK STATE IS THE FINANCIAL CAPITAL OF THE WORLD,

                    SO WE MUST MAKE SURE THAT WE ENABLE AND HELP NEW YORKERS NAVIGATE

                    STUDENT LOANS, MORTGAGES AND RETIREMENT.  IT'S REALLY IMPORTANT FOR -- TO

                    MAKE SURE THAT WE PUT NEW YORKERS AHEAD ON MAKING SURE THAT

                    OUR EVERYDAY NEW YORKERS HAVE THE PROPER EDUCATION, BEING -- TO

                    MAKE SURE THAT THEY NAVIGATE THEIR FINANCIAL AND ECONOMIC WORLD

                    PROPERLY.

                                 ALSO, WE, AS LAWMAKERS, ONE OF OUR MOST IMPORTANT

                    JOBS AND WHAT WE'RE DOING NOW IS WORKING ON THE NEW YORK STATE

                    BUDGET.  AND WE HAVE TO MAKE SURE THAT WE ARE ALSO FINANCIALLY

                    LITERATE.  SO THAT'S WHY WE'RE EXCITED TO MAKE SURE THAT WE'RE PROMOTING

                    FINANCIAL LITERACY HERE IN NEW YORK.

                                 THANK YOU, MADAM SPEAKER.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 ON THE RESOLUTION, ALL THOSE IN FAVOR SIGNIFY BY SAYING

                    AYE; OPPOSED, NO.  THE RESOLUTION IS ADOPTED.


                                 THE CLERK:  ASSEMBLY RESOLUTION NO. 338, MS.

                    CRUZ.

                                 LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR

                    KATHY HOCHUL TO PROCLAIM APRIL 2025, AS WORKPLACE VIOLENCE

                    PREVENTION MONTH IN THE STATE OF NEW YORK.

                                 ACTING SPEAKER HUNTER:  MS. CRUZ ON THE

                    RESOLUTION.

                                 MS. CRUZ:  THANK YOU, MADAM SPEAKER.

                                 COLLEAGUES, TODAY I RISE TO INTRODUCE A RESOLUTION

                                         13



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    MEMORIALIZING GOVERNOR KATHY HOCHUL TO PROCLAIM APRIL 2025 AS

                    WORKPLACE VIOLENCE PREVENTION MONTH IN THE STATE OF NEW YORK.

                                 EVERY INDIVIDUAL DESERVES A WORKPLACE FREE FROM THE

                    THREAT OF VIOLENCE; A PLACE WHERE THEY CAN FEEL SAFE, RESPECTED, AND

                    SECURE.  YET WORKPLACE VIOLENCE REMAINS AN URGENT AND GROWING ISSUE

                    ACROSS MANY INDUSTRIES.

                                 ACCORDING TO THE U.S. BUREAU OF LABOR STATISTICS,

                    NEARLY 2 MILLION AMERICANS REPORT BEING VICTIMS OF WORKPLACE

                    VIOLENCE.  HEALTHCARE WORKERS ARE ESPECIALLY VULNERABLE.  THEY ARE FIVE

                    TIMES MORE LIKELY TO EXPERIENCE WORKPLACE VIOLENCE THAN WORKERS IN

                    ANY OTHER FIELD.  IN FACT, NEARLY 75 PERCENT OF ALL WORK -- WORKPLACE

                    ASSAULTS HAPPEN IN HEALTHCARE SETTINGS, AFFECTING NURSES, EMERGENCY

                    ROOM STAFF, AND COUNTLESS OTHERS IN THE FRONT LINES.

                                 APRIL IS FEDERALLY RECOGNIZED AS WORKPLACE VIOLENCE

                    PREVENTION AWARENESS MONTH, AND BY DESIGNATING APRIL 2025 AS

                    WORKPLACE VIOLENCE PREVENTION MONTH IN NEW YORK, WE REINFORCE OUR

                    COMMITMENT TO PROTECTING WORKERS AND RECOGNIZING THE RISKS THAT THEY

                    FACE DAILY.

                                 EVERYONE FROM HEALTHCARE WORKERS TO TEACHERS, FROM

                    TRANSIT EMPLOYEES TO SERVICE INDUSTRY STAFF, DESERVE THE BASIC DIGNITY OF

                    WORKPLACE FREE FROM VIOLENCE.

                                 AND BEFORE I CONCLUDE, I ALSO WANT TO TAKE A MOMENT

                    TO RECOGNIZE SEVERAL DISTINGUISHED GUESTS WHO ARE HERE WITH US TODAY.

                    DR. MARILYN DOLLINGER, R.N. -- OH, I THINK SHE STEPPED OUT.  YES.  SO

                    I -- I'M JUST GONNA SKIP TO DR. KURIEN MATHEWS.  DR. MATHEWS IS AN

                                         14



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    EMERGENCY MEDICINE PHYSICIAN AT THE STATEN ISLAND UNIVERSITY

                    HOSPITAL DESIGNATED THE LEVEL I TRAUMA CENTER WITHIN THE NORTHWELL

                    HEALTH SYSTEM.  DAY IN AND DAY OUT HE PROVIDES LIFESAVING CARE TO THE

                    STATEN ISLAND COMMUNITY, HELPING PATIENTS AND FAMILIES THROUGHOUT

                    SOME OF THE MOST CRITICAL MOMENTS OF THEIR LIVES.

                                 DR. LOUIS CALDERON.  DR. CALDERON IS AN ASSOCIATE

                    DIRECTOR OF NURSING FOR THE EMERGENCY -- MR. CALDERONE, I'M SORRY, IN

                    THE EMERGENCY DEPARTMENT OF STATEN -- MOUNT SINAI, AND BRINGS MORE

                    THAN 25 YEARS OF LEADERSHIP IN EMERGENCY ROOM TRAUMA.  HE BEGAN HIS

                    PUBLIC SERVICE CAREER AT THE NEW YORK CITY EMS, WHERE HE SERVED

                    HEROICALLY DURING SEPTEMBER 11 ATTACKS.  AND HE HAS SINCE DEDICATED

                    HIS CAREER TO IMPROVING THE EMERGENCY SERVICES AND ADVOCATING FOR

                    FRONTLINE WORKERS.

                                 DIANA RODRIGUEZ, A BS AND RN.  AND MS. RODRIGUEZ

                    REPRESENTS THE FUTURE OF OUR HEALTHCARE SYSTEM.  SHE BEGINS HER NURSING

                    CAREER IN -- IN -- SHE BEGAN HER NURSING CAREER IN 2024 AS THE NEW

                    GRADUATE OF THE EMERGENCY DEPARTMENT OF MOUNT SINAI.  EVEN AT THE

                    START OF HER JOURNEY SHE EXEMPLIFIES THE SPIRIT AND RESILIENCY AND

                    DEDICATION WE ARE PROUD TO SEE IN THE NEXT GENERATION OF NURSES.

                                 I URGE MY COLLEAGUES TO JOIN ME IN SUPPORTING THIS

                    RESOLUTION AND SENDING A CLEAR MESSAGE THAT NEW YORK STANDS FIRMLY

                    WITH WORKERS, ESPECIALLY WITH OUR HEALTHCARE WORKERS.

                                 THANK YOU, AND I RESPECTFULLY REQUEST THE SUPPORT OF

                    THIS BODY FOR THIS RESOLUTION.  THANK YOU.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                         15



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 AND WELCOME TO OUR RESPECTED HEALTHCARE LEADERS.

                                 ON THE RESOLUTION, ALL THOSE IN FAVOR SIGNIFY BY SAYING

                    AYE; OPPOSED, NO.  THE RESOLUTION IS ADOPTED.


                                 THE CLERK:  ASSEMBLY RESOLUTION NO. 384, MR.

                    BRABENEC.

                                 LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR

                    KATHY HOCHUL TO PROCLAIM APRIL 2025 AS PET CRUELTY AWARENESS

                    MONTH IN THE STATE OF NEW YORK.

                                 ACTING SPEAKER HUNTER:  ON THE RESOLUTION,

                    ALL THOSE IN FAVOR SIGNIFY BY SAYING AYE; OPPOSED, NO.  THE RESOLUTION IS

                    ADOPTED.


                                 THE CLERK:  ASSEMBLY RESOLUTION NO. 385, MS.

                    BUTTENSCHON.

                                 LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR

                    KATHY HOCHUL TO PROCLAIM MAY 4-10, 2025, AS SMALL BUSINESS WEEK

                    IN THE STATE OF NEW YORK.

                                 ACTING SPEAKER HUNTER:  MS. BUTTENSCHON ON

                    THE RESOLUTION.

                                 MS. BUTTENSCHON:  THANK YOU, MADAM SPEAKER.

                                 I RISE TODAY TO PRESENT THIS RESOLUTION, AND TO

                    ACKNOWLEDGE THE IMPORTANCE OF SMALL BUSINESS IN THE STATE OF NEW

                    YORK.

                                 IT IS ESTIMATED THAT NEARLY 500,000 SMALL BUSINESSES

                    ARE WITHIN THE STATE OF NEW YORK, MAKING UP 98 PERCENT OF NEW YORK

                    BUSINESSES THAT EMPLOY THOSE INDIVIDUALS THAT ARE DEDICATED AND

                                         16



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    COMMITTED TO THE MISSION OF THOSE BUSINESSES.  THIS INCLUDES CLOSE TO 3

                    MILLION NEW YORKERS.  MANY OF THESE BUSINESSES ARE FAMILY-OWNED

                    THAT INCLUDE VETERANS, MINORITIES, WOMEN, AND IMMIGRANTS WHO BELIEVE

                    IN THE AMERICAN DREAM AND KNOW HOW IT COMES TO LIFE IN THE STATE OF

                    NEW YORK.

                                 THIS RESOLUTION REMINDS ALL OF US OF THE HARD WORK,

                    DEDICATION, AND INNOVATION THAT IT TAKES TO RUN A BUSINESS AND HOW IT

                    SUPPORTS THE COMMUNITIES IN WHICH THEY ARE IN.  THANK YOU TO OUR

                    SMALL BUSINESS OWNERS, EMPLOYEES, AND THOSE THAT SUPPORT THEM.

                                 IN CLOSING, I CHALLENGE EVERYONE TO SPEND THAT WEEK

                    WITHIN OUR SMALL BUSINESSES WITHIN YOUR COMMUNITIES OR COMMUNITIES

                    ACROSS THE STATE OF NEW YORK.

                                 THANK YOU, MADAM SPEAKER.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 ON THE RESOLUTION, ALL THOSE IN FAVOR SIGNIFY BY SAYING

                    AYE; OPPOSED, NO.  THE RESOLUTION IS ADOPTED.

                                 MR. PALMESANO FOR THE PURPOSES OF AN INTRODUCTION.

                                 MR. PALMESANO:  YES.  THANK YOU, MADAM

                    SPEAKER, MY COLLEAGUES.

                                 IT IS A GREAT PRIVILEGE FOR ME TO RECOGNIZE AND

                    INTRODUCE IN THE CHAMBER TODAY DR. WILLIAM MULLANEY.  DR. MULLANEY

                    IS CURRENTLY THE PRESIDENT OF CORNING COMMUNITY COLLEGE.  HE CAME TO

                    CORNING IN THE SUMMER OF 2019.  HE IS THE SEVENTH PRESIDENT OF

                    CORNING COMMUNITY COLLEGE.  DURING HIS TENURE HE OVERSAW AND

                    BROUGHT MAJOR PROGRESS AND REVITALIZATION TO THE CORNING COMMUNITY

                                         17



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    COLLEGE FOR THE BETTERMENT OF THE STUDENTS AND FOR THE BUSINESS

                    COMMUNITY.

                                 HE IS LEAVING AT THE END OF THE MONTH, IN MAY, TO --

                    HE'S GOING TO BE LEAVING.  HE'S GOING TO ROCKLAND COMMUNITY COLLEGE.

                    SO CORNING COMMUNITY COLLEGE HAS LOST AS ROCKLAND COMMUNITY

                    COLLEGE HAS GAINED.  BUT I HAVE SAID TO HIM EARLIER, AND HIS IMPACT

                    HERE AT -- HE MADE AT CORNING WILL BE FELT LONG BEYOND HIS YEARS HERE.

                                 SO I'LL -- ALSO, JUST ON BEHALF OF MYSELF, HIS -- DISTRICT --

                    CORNING COMMUNITY COLLEGE COVERS -- COVERS CHEMUNG COUNTY AND

                    STEUBEN COUNTY.  SO -- ALSO, IN ADDITION TO MYSELF, ASSEMBLYMAN

                    CHRIS FRIEND FROM CHEMUNG COUNTY, ASSEMBLYMAN JOE SEMPOLINSKI

                    AND ASSEMBLYWOMAN -- WOMAN ANDREA BAILEY, ON BEHALF OF ALL OF US,

                    IF YOU COULD RECOGNIZE HIM.

                                 BUT I ALSO HAVE SOMEONE HERE WHO'S JOINING HIM;

                    DAVID PINDEL.  HE'S A PROFESSOR OF BIOLOGY AT CORNING COMMUNITY

                    COLLEGE.  BUT DEFINITELY FOR DR. MULLANEY, AND ALL OF YOU, THANK YOU FOR

                    YOUR SERVICE AND WHAT YOU DID -- WHAT YOU'VE CONTRIBUTED TO CORNING.

                    LIKE I SAID, THE IMPACT YOU'VE MADE THERE WILL BE FELT LONG BEYOND

                    YOUR YEARS HERE.  SO WE SALUTE YOU, WE THANK YOU.

                                 AND MADAM -- MADAM SPEAKER, WILL YOU PLEASE PASS

                    THE CORDIALITIES AND THANKS FROM THE HOUSE FROM ALL OF US?

                                 THANK YOU.

                                 ACTING SPEAKER HUNTER:  YES.

                                 ON BEHALF OF MR. PALMESANO, DELEGATIONS FROM THE

                    CORNING COMMUNITY COLLEGE AREA, THE SPEAKER AND ALL MEMBERS,

                                         18



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WELCOME, DR. MULLANEY AND PROFESSOR GOODELL [SIC], TO THE ASSEMBLY

                    CHAMBER.  WE EXTEND THE PRIVILEGES OF THE FLOOR TO YOU.  THANK YOU

                    FOR ALL THE WORK THAT YOU DO FOR OUR YOUNG PEOPLE, AND OLDER ADULTS, IN

                    COMMUNITY COLLEGE.  JUST TRULY AN EXCEPTIONAL EDUCATION PROVIDED.  WE

                    HOPE YOU ENJOY THE PROCEEDINGS TODAY.  THANK YOU SO VERY MUCH FOR

                    JOINING US.

                                 (APPLAUSE)

                                 (PAUSE)

                                 MR. SCHIAVONI FOR THE PURPOSES OF AN INTRODUCTION.

                                 MR. SCHIAVONI:  MADAM SPEAKER, I RISE TODAY TO

                    INTRODUCE A RESIDENT OF EASTERN LONG ISLAND, SUFFOLK COUNTY, DIANE

                    COSTELLO.  DIANE IS A SINCERE, ENGAGING, COMMITTING -- COMMITTED,

                    COMPASSIONATE LEADER AND INDIVIDUAL.  SHE IS A CAREER EDUCATOR,

                    TEACHING OUR NATION'S YOUTH FOR THE BETTER PART OF THREE DECADES.

                                 HERS A NEW YORK STORY.  BORN IN BROOKLYN, RAISED IN

                    NASSAU COUNTY, AND NOW LIVING ON THE EASTERN END OF LONG ISLAND.

                    DIANE IS DEEPLY COMMITTED TO HER COMMUNITY, AND ADVOCATES FOR THEM

                    ON ALL LEVELS OF GOVERNMENT.

                                 SHE IS HERE TODAY WITH A GROUP -- WITH THE GROUP

                    MOMS DEMAND ACTION FOR GUN SENSE IN AMERICA, A GROUP WHICH

                    ENSURES LEGISLATIVE LEADERS -- THAT LEGISLATIVE LEADERS KEEP OUR KIDS SAFE

                    IN SCHOOLS AND ACROSS THE STATE AND NATION.  DIANE VOLUNTEERS AND

                    WORKS ACROSS MANY DISTRICTS.

                                 SO ON BEHALF OF ASSEMBLYMEMBER GIGLIO AND MYSELF,

                    MADAM SPEAKER, I ASK THAT YOU EXTEND THE CORDIALITIES OF THE HOUSE TO

                                         19



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    DIANE AS SHE SETS A FINE EXAMPLE FOR OTHERS AS A LEADER IN OUR

                    COMMUNITY.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 ON BEHALF OF MR. SCHIAVONI, MS. GIGLIO, THE SPEAKER

                    AND ALL MEMBERS, WE WELCOME YOU, MA'AM, MS. COSTELLO, TO THE

                    PEOPLE'S HOUSE.  WE EXTEND TO YOU THE PRIVILEGES OF THE FLOOR.  THANK

                    YOU SO MUCH FOR THE ADVOCACY WORK THAT YOU'VE BEEN DOING TO REDUCE

                    GUN VIOLENCE.  HOPE YOU ENJOY OUR PROCEEDINGS TODAY.  THANK YOU SO

                    VERY MUCH FOR JOINING US.

                                 (APPLAUSE)

                                 MS. SOLAGES.

                                 MS. SOLAGES:  MEMBERS HAVE ON THEIR DESK AN

                    A-CALENDAR.  MADAM SPEAKER, I NOW MOVE TO ADVANCE THE

                    A-CALENDAR.

                                 ACTING SPEAKER HUNTER:  ON A MOTION BY

                    MS. SOLAGES, THE A-CALENDAR IS ADVANCED.

                                 WE JUST WANT TO MAKE SURE WE HAVE QUIET IN THE

                    CHAMBER, PLEASE.  THANK YOU.

                                 MS. SOLAGES:  I NOW DIRECT MEMBERS TO BRING THEIR

                    ATTENTION TO RULES REPORT NO. 155 BY MR. PRETLOW.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 PAGE 3, RULES REPORT NO. 155, THE CLERK WILL READ.


                                 THE CLERK:  ASSEMBLY NO. A08095, RULES REPORT

                    155, PRETLOW.  AN ACT MAKING APPROPRIATIONS FOR THE SUPPORT OF

                    GOVERNMENT; TO AMEND CHAPTER 113 OF THE LAWS OF 2025 MAKING

                                         20



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    APPROPRIATIONS FOR THE SUPPORT OF GOVERNMENT, IN RELATION THERETO; TO

                    AMEND CHAPTER 118 OF THE LAWS OF 2025 MAKING APPROPRIATIONS FOR THE

                    SUPPORT OF GOVERNMENT, IN RELATION THERETO; TO AMEND CHAPTER 119 OF

                    THE LAWS OF 2025 MAKING APPROPRIATIONS FOR THE SUPPORT OF

                    GOVERNMENT, IN RELATION THERETO; AND PROVIDING FOR THE REPEAL OF SUCH

                    PROVISIONS UPON EXPIRATION THEREOF.

                                 ACTING SPEAKER HUNTER:  GOVERNOR'S MESSAGE

                    IS AT THE DESK.  THE CLERK WILL READ.

                                 THE CLERK:  I HEREBY CERTIFICATE TO AN IMMEDIATE

                    VOTE.  KATHY HOCHUL, GOVERNOR.

                                 ACTING SPEAKER HUNTER:  AN EXPLANATION HAS

                    BEEN REQUESTED.

                                 MR. PRETLOW.

                                 MR. PRETLOW:  YES, MADAM SPEAKER.

                                 THIS EXTENDER, OUR NINTH EXTENDER, WOULD ENSURE

                    FUNDING FOR THE STATE OPERATIONS AND OTHER PROGRAMS THROUGH MAY 1,

                    2025.  THE BILL INCLUDES ADDITIONAL FUNDING FOR INSTITUTIONAL PAYROLL,

                    CHILDREN'S HEALTH INSURANCE PROGRAMS, WIC, UNEMPLOYMENT

                    INSURANCE, SUPPORT FOR OPWDD SERVICES, VETERANS' HOMELESS HOUSING,

                    AND GENERAL STATE CHARGES.

                                 ACTING SPEAKER HUNTER:  MR. RA.

                                 MR. RA:  THANK YOU, MADAM SPEAKER.  WOULD

                    CHAIRMAN PRETLOW YIELD?

                                 MR. PRETLOW:  YES, I WILL.

                                 ACTING SPEAKER HUNTER:  THE CHAIR YIELDS.

                                         21



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. RA:  THANK YOU.

                                 SO, THIS IS EXTENDER NUMBER NINE, TO MAY 1ST.  CAN

                    YOU JUST GIVE ME THE APPROPRIATION AMOUNT AND THE ADDITIONAL AMOUNT

                    FROM THE LAST EXTENDER?

                                 MR. PRETLOW:  THE TOTAL APPROPRIATION TO DATE IS

                    $11.9 BILLION, WHICH IS AN ADDITIONAL $520.6 MILLION.

                                 MR. RA:  OKAY.  AND WHAT IS THE TOTAL AMOUNT WE

                    HAVE APPROPRIATED THROUGH THESE NINE EMERGENCY EXTENDERS?

                                 MR. PRETLOW:  $14.7 BILLION.

                                 MR. RA:  THANK YOU.

                                 AND WHAT WOULD WE BE ANTICIPATING AS WE GOT INTO

                    MAY 1ST IN TERMS OF IF A TENTH EXTENDER IS NECESSARY?  PAYROLL COMING

                    DUE OR OTHER CHARGES --

                                 MR. PRETLOW:  WELL, THE TENTH EXTENDER WILL BE

                    NECESSARY NO MATTER WHAT WE DO TODAY OR TOMORROW, AND WE WILL MAKE

                    ARRANGEMENTS FOR THOSE PAYMENTS.

                                 MR. RA:  OKAY.

                                 SO AS WE'RE ALL AWARE AT THIS POINT, THE GOVERNOR MADE

                    AN ANNOUNCEMENT LAST EVENING.  SO DO WE HAVE A DEAL?  IS THAT $254

                    BILLION NUMBER ACCURATE AND SET IN STONE?

                                 MR. PRETLOW:  MR. RA, COULD I ANSWER THAT

                    QUESTION IN THE FORM OF A PARABLE?

                                 MR. RA:  SURE.

                                 MR. PRETLOW:  IN LIFE WE MAKE CERTAIN DECISIONS.

                    AND ONE OF THOSE DECISIONS, FOR MANY OF US, IS TO -- TO MARRY.  AND

                                         22



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WE COURT OUR -- OUR FUTURE SPOUSE FOR A LENGTH OF TIME, AND WE DECIDE

                    TO WED, AND SEND OUT INVITATIONS, AND EVERYBODY'S PLANNING FOR A

                    WEDDING.  AND ONE OF THE TWO DECIDES, I REALLY DON'T WANT TO DO THIS.  I

                    WANT TO CHANGE MY MIND.  AND YOU GO TO YOUR PROSPECTIVE SPOUSE AND

                    SAY, HONEY, I LOVE YOU.  BUT I DON'T THINK WE SHOULD GET MARRIED.  AND

                    YOUR PROSPECTIVE SPOUSE SAYS, BUT THE INVITATIONS ARE OUT.  AND WITH

                    THAT STATEMENT, YOU DECIDE TO GET MARRIED, LIVE MISERABLY FOR THE REST OF

                    YOUR LIFE.  BUT YOU DID IT BECAUSE THE INVITATIONS WERE OUT.

                                 THIS IS THE GOVERNOR GIVING US INVITATIONS, TRYING TO

                    FORCE US INTO SOMETHING THAT WE DON'T NECESSARILY WANT TO DO RIGHT NOW.

                                 (LAUGHTER)

                                 MR. RA:  OKAY.  I -- I DON'T EVEN KNOW WHAT TO DO

                    WITH THAT, BUT WELL -- WELL DONE, MR. PRETLOW.

                                 (APPLAUSE)

                                 SO, MADAM SPEAKER, ON -- ON THE BILL.

                                 ACTING SPEAKER HUNTER:  ON THE BILL, SIR.

                                 MR. RA:  THANK YOU, CHAIR PRETLOW.  I -- I WOULD SAY

                    PERHAPS THAT'S CONFIRMING WHAT -- WHAT MANY OF US FELT MIGHT BE THE

                    SITUATION.

                                 I -- I JUST WANT TO REMIND EVERYBODY, WE HAVE NINE

                    BUDGET BILLS THAT WE STILL NEED TO DO TO PUT A BUDGET IN PLACE FOR THE

                    UPCOMING FISCAL YEAR.  WE STILL HAVE FOUR ARTICLE -- OR, I'M SORRY, FIVE

                    ARTICLE VII BILLS, FOUR APPROPRIATION BILLS.  THE ONLY THING WE HAVE

                    ACTED ON IS DEBT SERVICE.

                                 WE HAVE NOW PASSED THE POINT WHERE OUR SCHOOL

                                         23



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    DISTRICTS HAVE HAD TO PUT OUT BUDGETS.  THEY'RE WAITING.  AND, YOU

                    KNOW, YOU NEED TO LOOK NO FURTHER THAN SOME OF THE COMMUNICATIONS

                    WE'VE GOTTEN FROM THEM, QUOTES THEY'VE HAD IN THE MEDIA.  IT DOES

                    MATTER TO THEM THAT WE ARE -- WE ARE AT THIS POINT WITH THIS BUDGET.

                                 I -- I THINK IT'S UNFORTUNATE THAT THE EXECUTIVE WOULD

                    COME OUT PREMATURELY WITH REGARD TO -- TO AN ANNOUNCEMENT IF WE ARE

                    NOT QUITE THERE.  BUT TAKING THAT NUMBER FOR WHAT IT IS, $254 BILLION,

                    WHICH WOULD BE 2 BILLION ABOVE THE ORIGINAL PROPOSAL, ABOUT $11

                    BILLION ABOVE WHAT LAST YEAR WILL BE, ALL SAID AND DONE, THAT'S A LOT OF

                    MONEY.  AND AT SOME POINT, WE HOPE LATER THIS WEEK, MAYBE NEXT

                    WEEK, WE'LL PUT THE FINAL TOUCHES ON PASSING THOSE BILLS THAT ACTUALLY

                    APPROPRIATE THAT OVER QUARTER-OF-A-TRILLION DOLLARS.  AND WE'LL FIGURE OUT

                    WHAT IS ACTUALLY GOING TO HELP MIDDLE-CLASS FAMILIES WITH AFFORDABILITY,

                    CHILDCARE, THE REBATE CHECKS, TAX CUTS.  BUT THERE IS ANY NUMBER OF

                    THINGS STILL OUT THERE AND STILL REALLY GOING ON BEHIND CLOSED DOORS ON --

                    ON THE POLICY SIDE.  WE'RE TALKING ABOUT CHANGES TO THE PUBLIC FINANCE

                    SYSTEM THAT -- THAT NEW YORK STATE UTILIZED FOR THE FIRST TIME IN LAST

                    FALL'S ELECTIONS.  WE'RE TALKING, OBVIOUSLY, ABOUT THE POLICY ISSUES THAT

                    HAVE BEEN AT THE FOREFRONT FOR MONTHS; DISCOVERY AND MASKING,

                    INVOLUNTARY COMMITMENT.  THERE IS WORD REGARDING WHAT WE'RE DOING

                    WITH THE MTA AND A POTENTIAL ANOTHER INCREASE IN THE MTA PAYROLL

                    MOBILITY TAX, WHICH IS -- I WOULD REMIND EVERYBODY, QUITE FRANKLY, A

                    TAX ON JOBS.

                                 SO WE AWAIT THOSE DETAILS WITH HOPE THAT WE'LL BE

                    DISCUSSING THEM IN THIS CHAMBER, IN THE LIGHT OF DAY, AT SOME POINT;

                                         24



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    AGAIN, MAYBE THIS WEEK, MAYBE NEXT WEEK.  BUT, YOU KNOW, I -- I THINK

                    IT IS EMBLEMATIC OF THIS PROCESS THAT WE PROBABLY HAVE ALL HEARD FROM

                    PEOPLE BACK HOME SAYING, GREAT, THERE'S A DEAL.  WHAT'S THE STATUS OF --

                    OF THIS ISSUE OR THAT ISSUE?  AND YOU HAVE TO SAY, WELL, YEAH.  THAT'S

                    OUT THERE.  THERE'S A DEAL.  BUT I DON'T KNOW.  WE DON'T HAVE ANY ACTUAL

                    TEXT TO LOOK AT TO SHARE WITH OUR CONSTITUENTS, TO SHARE WITH

                    STAKEHOLDERS SO THEY UNDERSTAND WHAT WILL BE WITH REGARD TO ANY

                    NUMBER OF ISSUES THEY'RE CONCERNED WITH.

                                 WITH THAT, YOU KNOW, I'LL BE SUPPORTING THIS BILL.  I -- I

                    HAVE A FEELING EVERYBODY WILL, TO CONTINUE TO MAKE SURE THE STATE IS

                    MEETING OUR OBLIGATIONS AS WE WORK TOWARDS A -- A FULL BUDGET.  BUT

                    IT -- IT IS SAD THAT THE LEADERSHIP OF -- OF -- OF THIS STATE, IN PARTICULAR,

                    THE EXECUTIVE, WANTS TO GO OUT THERE, MAKE AN ANNOUNCEMENT, PERHAPS,

                    PREMATURELY, AND ACTUALLY SAY THINGS LIKE, WHEN PEOPLE ASK WHAT IS

                    GOING ON WITH X, Y?  OH, YEAH.  WE HAVE A DEAL ON THAT.  I'M NOT

                    GONNA -- I DON'T WANT THAT OUT -- OUT IN THE PUBLIC BECAUSE I GUESS THE

                    FEELING IS, THE BEST WAY TO DO THINGS IS BEHIND CLOSED DOORS WITH ZERO

                    TRANSPARENCY.

                                 THIS IS MY 15TH BUDGET.  IT GETS WORSE EVERY SINGLE

                    TIME.  AND WE'RE GOING TO PIECEMEAL A QUARTER-OF-A-TRILLION-PLUS DOLLARS

                    BEING APPROPRIATED, AND WE'RE GONNA START APPROPRIATING THOSE DOLLARS

                    IN ONE BILL AND WE'RE NOT GONNA KNOW WHAT THE -- WHAT THE END RESULT

                    IS, WHAT THE OUT-YEAR BUDGET GAPS ARE THAT WE'RE GONNA BE DEALING WITH.

                    AND IT'S JUST NO WAY TO -- TO RUN A GOVERNMENT.  IT'S NOT TRANSPARENT.

                    AND IT'S NOT IN THE BEST INTEREST IN THE LONG-TERM FISCAL HEALTH OF THIS

                                         25



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    STATE.

                                 THANK YOU.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MR. TAGUE.

                                 MR. TAGUE:  THANK YOU, MADAM SPEAKER.  WOULD

                    CHAIRMAN PRETLOW YIELD FOR A QUESTION?

                                 ACTING SPEAKER HUNTER:  WOULD THE CHAIR

                    YIELD?

                                 MR. PRETLOW:  ONE QUESTION?  YES.

                                 ACTING SPEAKER HUNTER:  THE CHAIR YIELDS.

                                 MR. TAGUE:  WELL, MR. CHAIRMAN, I GUESS THE

                    ANTICIPATION OF THERE BEING WHITE SMOKE OUT OF THE CAPITOL TODAY,

                    TOMORROW OR THE NEXT DAY MAY BE A LITTLE PREMATURE; IS THAT CORRECT?

                                 MR. PRETLOW:  YES.

                                 MR. TAGUE:  OKAY.  THANK YOU VERY MUCH.  I

                    APPRECIATE IT.

                                 THERE'S NOT MUCH MORE I CAN SAY THAT MY COLLEAGUE,

                    MR. RA, HAS ALREADY BROUGHT UP.  TO ME THIS IS DISAPPOINTING,

                    DISINGENUOUS TO THE PEOPLE OF THE STATE OF NEW YORK.  NINE EXTENDERS,

                    29 DAYS LATE ON A BUDGET.  PEOPLE IN NEW YORK STATE HOPING THAT

                    AGENCIES AND THEIR STATE GOVERNMENT WOULD WORK FOR THEM, BUT

                    NOTHING, AGAIN.  AND --

                                 ACTING SPEAKER HUNTER:  ARE YOU ON THE BILL,

                    SIR?

                                 MR. TAGUE:  I AM ON THE BILL.

                                         26



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MR. TAGUE:  THANK YOU.

                                 I ALREADY EXCUSED HIM.  HE DIDN'T -- HE DIDN'T WANT TO

                    ANSWER ANYMORE QUESTIONS.

                                 BUT ANYWAYS [SIC], HE EVEN -- YOU MADE ME LOSE MY

                    SPOT.  NOW I'M GONNA HAVE TO START ALL OVER AGAIN, MADAM SPEAKER.

                                 ANYWAYS [SIC], AS MY COLLEAGUE, MR. RA, SAID, THE

                    PEOPLE OF THE STATE NEW YORK, THEY DO CARE ABOUT HAVING A BUDGET ON

                    TIME.  HERE WE ARE.  THE EXECUTIVE, THE GOVERNOR, COME OUT AND SAYS

                    THERE'S A DEAL.  BUT THERE'S NO DETAILS.  NOBODY'S AGREEING WHETHER THERE

                    IS AN AGREEMENT OR NOT.  AND HERE WE ARE NO DIFFERENT TODAY THAN WE

                    WERE YESTERDAY, LAST WEEK, THE WEEK BEFORE.  IT'S JUST RIDICULOUS.

                    RIDICULOUS.  WE NEED TO COME HERE, DO OUR JOBS -- DO OUR JOBS FOR THE

                    PEOPLE OF THE STATE OF NEW YORK.

                                 I WILL BE VOTING IN FAVOR OF THIS, AS I HAVE IN THE PAST.

                                 THANK YOU.

                                 ACTING SPEAKER HUNTER:  THANK YOU, MR.

                    TAGUE.

                                 (PAUSE)

                                 ON A MOTION BY MR. PRETLOW, THE SENATE BILL IS BEFORE

                    THE HOUSE.  THE SENATE BILL IS ADVANCED.

                                 READ THE LAST SECTION.

                                 THE CLERK:  THIS ACT SHALL TAKE EFFECT IMMEDIATELY.

                                 ACTING SPEAKER HUNTER:  THE CLERK WILL

                    RECORD THE VOTE.

                                         27



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 (THE CLERK RECORDED THE VOTE.)

                                 ARE THERE ANY OTHER VOTES?  ANNOUNCE THE RESULTS.

                                 (THE CLERK ANNOUNCED THE RESULT.)

                                 THE BILL IS PASSED.

                                 MS. SOLAGES.

                                 MS. SOLAGES:  THANK YOU, MADAM SPEAKER.

                                 CAN YOU PLEASE CALL THE MEMBERS OF THE CHILDRENS AND

                    FAMILIES COMMITTEE TO THE SPEAKER'S CONFERENCE ROOM IMMEDIATELY?

                                 ACTING SPEAKER HUNTER:  CHILDREN AND

                    FAMILIES COMMITTEE, PLEASE SEE MR. HEVESI IN THE SPEAKER'S

                    CONFERENCE ROOM.  CHILDREN AND FAMILIES COMMITTEE, SPEAKER'S

                    CONFERENCE ROOM.

                                 MS. SOLAGES.

                                 MS. SOLAGES:  AND WE'RE KEEPING ON ROLLING.

                                 I DRAW THE MEMBERS' ATTENTION TO RULES REPORT NO.

                    153 BY MS. PAULIN.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 WILL THE SERGEANT-AT-ARMS PLEASE GET THE FOLKS IN

                    ORDER?  WE'RE GONNA BE ON DEBATE.

                                 (PAUSE)

                                 PAGE 3, REAL -- RULES REPORT NO. 153, THE CLERK WILL

                    READ.


                                 THE CLERK:  ASSEMBLY NO. A00136, RULES REPORT

                    153, PAULIN, ROSENTHAL, DINOWITZ, HEVESI, STECK, LUPARDO, RIVERA,

                    EPSTEIN, SEAWRIGHT, WOERNER, REYES, CRUZ, SAYEGH, DAVILA, STERN,

                                         28



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    BURDICK, GALLAGHER, KELLES, GONZÁLEZ-ROJAS, MITAYNES, MAMDANI,

                    CLARK, ANDERSON, JACKSON, SEPTIMO, GLICK, GIBBS, TAPIA, LUNSFORD,

                    CUNNINGHAM, LEVENBERG, SIMONE, BORES, FORREST, SHRESTHA, SHIMSKY,

                    RAGA, RAJKUMAR, KIM, HUNTER, STIRPE, CHANDLER-WATERMAN, LEE,

                    TAYLOR, MEEKS, OTIS, ALVAREZ, LAVINE, DAIS, JACOBSON, KAY, P. CARROLL,

                    LASHER, SCHIAVONI, ROMERO, VALDEZ, BURROUGHS, HOOKS, O'PHARROW,

                    DILAN, TORRES, DE LOS SANTOS.  AN ACT TO AMEND THE PUBLIC HEALTH

                    LAW, IN RELATION TO A TERMINALLY ILL PATIENT'S REQUEST FOR AND USE OF

                    MEDICATION FOR MEDICAL AID IN DYING.

                                 ACTING SPEAKER HUNTER:  AN EXPLANATION HAS

                    BEEN REQUESTED.

                                 MS. PAULIN.

                                 MS. PAULIN:  YES.  OF COURSE.  THANK YOU.

                                 THE BILL WOULD ALLOW A TERMINALLY ILL, MENTALLY

                    CAPABLE ADULT WITH A PROGNOSIS OF SIX MONTHS OR LESS TO LIVE, TO HAVE

                    THE OPTION TO REQUEST, OBTAIN, AND DECIDE TO INGEST MEDICATION FOR

                    MEDICAL AID IN DYING.

                                 ACTING SPEAKER HUNTER:  MR. JENSEN.

                                 MR. JENSEN:  THANK YOU, MADAM SPEAKER.  WILL

                    THE SPONSOR YIELD FOR SOME QUESTIONS?

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MR. JENSEN:  I WANT TO THANK CHAIR PAULIN FOR -- FOR

                                         29



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    YIELDING.  AND -- AND BEFORE WE START TODAY'S DEBATE, CERTAINLY, AS WE

                    TALKED ABOUT IN THE HEALTH COMMITTEE YESTERDAY, THAT THIS IS A TOPIC

                    THAT -- THAT THERE'S A LOT OF EMOTIONS ON.  AND, CERTAINLY, IT'S A QUESTION

                    OF LIFE AND DEATH, A QUESTION OF MORALITY.  SO I'M SURE TODAY'S DEBATE

                    WILL BE PASSIONATE FROM -- FROM BOTH SUPPORTERS AND DETRACTORS.

                                 AND I DO WANT TO RECOGNIZE -- EVEN THOUGH I MAY NOT

                    BE A SUPPORTER OF THE LEGISLATION -- THE WORK AND THE EFFORT THAT YOU'VE

                    PUT IN AND THE PASSION THAT YOU'VE SHOWN THROUGHOUT THE TIME THAT

                    WE'VE SERVED TOGETHER AND THROUGH YOUR CAREER ON THIS BILL.

                                 MY QUESTIONS LEADING OFF TODAY'S DEBATE ARE GONNA

                    FOCUS ON SOME AREAS OF THE LEGISLATION THAT I BELIEVE WE HAVE NOT BUILT

                    IN ENOUGH SAFEGUARDS IN THIS LEGISLATION TO ENSURE THAT VULNERABLE NEW

                    YORKERS WILL HAVE THE PROTECTIONS THAT THEY NEED SHOULD MEDICAL AID

                    IN DYING BECOME LAW.  REALLY -- REALLY FOCUSING ON THE ISSUES OF

                    COERCION, THE PROCESS SURROUND PHYSICIANS, MENTAL COMPETENCY, AND

                    THE TERMINAL DIAGNOSIS.

                                 SO I WANT TO LEAD OFF WITH QUESTIONS AROUND COERCION.

                    WHAT SAFEGUARDS EXIST IN THE LEGISLATION TO ENSURE THAT THERE IS NO

                    COERCION THROUGHOUT THE DECISION-MAKING PROCESS SHOULD AN INDIVIDUAL

                    WANT TO UTILIZE MEDICAL AID IN DYING?

                                 MS. PAULIN:  SO, FIRSTLY, THE PENAL STATUTE'S VERY

                    CLEAR THAT -- THAT IF SOMEBODY IS COERCIVELY ATTEMPTING TO HURT

                    SOMEONE, LIKE THEY WOULD BE HERE, THAT IT WOULD BE -- IT WOULD RANGE

                    DEPENDING ON WHAT THAT COERCIVE NATURE IS, FROM A CLASS A

                    MISDEMEANOR TO A CLASS D FELONY.

                                         30



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 WE ALSO KNOW THAT SINCE 1997 WHEN OREGON BEGAN

                    AND WAS THE FIRST STATE TO DO SO.  SO FOR NEARLY 30 YEARS THERE'S NEVER

                    BEEN A SINGLE CASE OF COERCION IN ANY OF THOSE OTHER JURISDICTIONS.  AND

                    WE ALSO KNOW THAT FAMILY MEMBERS TYPICALLY COERCE IN THE OPPOSITE

                    DIRECTION.  THEY WANT THEIR FAMILY MEMBERS TO LIVE.  AND SO IF THERE'S A

                    TREATMENT OUT THERE, AN EXPERIMENTAL TRIAL OR ANYTHING OF THE SORT, IT'S

                    USUALLY THE CASE THAT THEY WILL TRY TO PROLONG THAT FAMILY MEMBER'S LIFE

                    AND WORK TOWARD THAT AND NOT WORK TOWARD MEDICAL AID IN DYING.

                                 YOU KNOW, MOST PEOPLE WHO OPT FOR MEDICAL AID IN

                    DYING DO SO WITH WANTING TO PRESERVE THEIR BODILY AUTONOMY.  AND SO

                    IT'S VERY, VERY UNLIKELY THAT THEY'RE GOING TO BE COERCED INTO THIS KIND OF

                    SITUATION.

                                 MR. JENSEN:  WELL, AND I -- AND I THINK, CERTAINLY,

                    TO YOUR POINT, WHEN MOST PEOPLE BRING UP THE IDEA OF COERCION, IT IS

                    THINKING ABOUT CLOSE, PERSONAL FAMILY COERCION ABOUT TRYING TO -- TO

                    POTENTIALLY FORCE AN INDIVIDUAL WHO HAS A TERMINAL DIAGNOSE TO, FOR

                    WHATEVER REASON, POTENTIALLY NOT WANT TO PURSUE END-OF-LIFE

                    DECISIONMAKING.  BUT COERCION ISN'T JUST ABOUT WHAT YOU SAY, IT'S ALSO

                    WHAT YOU DON'T SAY.  AND OTHER TYPES OF COERCION DON'T JUST INCLUDE

                    FAMILIAR COERCION, BUT IT COULD BE PRACTITIONER COERCION, LARGER FAMILY

                    COERCION, SELF COERCION.  AND I THINK ONE OF THE THINGS THAT -- THAT

                    HAS ME -- CONCERNED A LOT PEOPLE, IS THAT THERE COULD BE SOCIETAL OR

                    SYSTEMIC CONCERNS WHERE BECAUSE OF THE NATURE OF SOMEBODY'S

                    PERCEIVED BURDEN ON THEIR FAMILY, ON THEIR SYSTEM, ACCESS TO CERTAIN

                    THINGS, THAT THEY COULD SAY, WELL, I DON'T WANT TO BE A BURDEN TO STAY IN

                                         31



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    A NURSING HOME LONG FOR LONGER.  I DON'T WANT TO HAVE TO MAKE MY

                    CHILDREN SUFFER BY HAVING TO CARE FOR ME AN ADDITIONAL AMOUNT OF TIME.

                    AND THAT UNSPOKEN COERCION THAT MAY NOT BE THE INDIVIDUAL'S WISHES,

                    BUT IT COULD BE SAYING THEY DON'T WANT TO DO IT FOR THEMSELVES, THEY

                    WANT TO DO IT FOR OTHER PEOPLE.

                                 AND SO I GUESS MY QUESTION IS, YOU KNOW,

                    UNDERSTANDING THE BILL, YOU HAVE TO HAVE AN ATTENDING PHYSICIAN AS WELL

                    AS A CONSULTING PHYSICIAN.  HOW WOULD THEY DECIDE WHETHER ALL FORMS

                    OF COERCION HAD OCCURRED NOT JUST AT THE INITIAL DECISION-MAKING

                    PROCESS, BUT THROUGHOUT THE PROCESS?

                                 MS. PAULIN:  SO, THERE'S NO SAFEGUARDS LIKE THE

                    SAFEGUARDS THAT WE HAVE IN THIS BILL FOR ANY OTHER MEDICAL PROCESS,

                    INCLUDING WHETHER OR NOT THERE'S COERCION TO COME OFF OF DIALYSIS

                    OR WHETHER THERE'S COERCION TO STOP EATING AND DRINKING AT THE END OF

                    YOUR LIFE BECAUSE THERE'S NO OTHER WAY TO -- TO END IT IF YOU'RE IN SUCH

                    PAIN.  WE DON'T HAVE THE KIND OF SAFE -- THOSE SAFEGUARDS.  HERE WE

                    HAVE ENORMOUS SAFEGUARDS.  TWO DOCTORS HAVE TO ATTEST TO THE FACT THAT

                    THERE'S NO COERCION.  THERE IS A MENTAL HEALTH EVALUATION IF NECESSARY

                    WHO HAS TO, AGAIN, ATTEST TO THE FACT THAT THERE'S NO COERCION.  IF THERE'S

                    ANY SUSPICION OF COERCION IT'S PROSECUTED.  AND, AGAIN, WE'VE SEEN NO

                    DATA.  WE'VE SEEN NO PROSECUTIONS.  WE'VE SEEN ONE REFERRAL TO A

                    DISTRICT ATTORNEY IN ONE STATE WHERE IT WAS DECIDED THERE WAS NO

                    COERCION.

                                 SO I DON'T -- I THINK HERE WE HAD -- CAN BE VERY SURE

                    THAT WHEN SOMEONE'S OPTING TO END THEIR LIFE THROUGH THIS, THEY'RE DOING

                                         32



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    IT FROM THEIR OWN SELF.  THEY HAVE TO SELF-INGEST.  THEY HAVE TO MAKE

                    THAT DECISION FOR THEMSELVES.  THOSE ARE VERY POWERFUL.

                                 MR. JENSEN:  YEAH.  AND -- AND -- AND FOR ME, I --

                    IT'S NOT SURPRISING TO HEAR THAT IN -- IN OTHER STATES, THE 11 JURISDICTIONS

                    OF -- OF THE U.S. WHERE -- WHERE THIS IS A LEGAL MEANS OF ENDING ONE'S

                    OWN LIFE, THAT THERE ISN'T COERCION BECAUSE I -- MY BELIEF WOULD BE THAT

                    MOST PEOPLE WHO ARE COERCING SOMEONE AREN'T PUTTING IT IN WRITING OR

                    DOING SOMETHING THAT CAN BE DEMONSTRATED AS EVIDENCE IN A COURT OF

                    LAW.  IT'S GOING TO BE THROUGH THEIR ACTIONS.  AND ONCE SOMEBODY ENDS

                    THEIR LIFE THROUGH GOVERNMENT-ASSISTED DEATH, IT'S TOUGH FOR THEM TO

                    ALLEGE COERCION.

                                 AND SO I THINK THAT'S WHY WE HAVE TO HAVE LARGER

                    SAFEGUARDS AT THE BEGINNING OF THE PROCESS AND THROUGHOUT THE PROCESS

                    TO ENSURE THAT IF THIS BECOMES LAW, IT IS THE INDIVIDUAL AND THE

                    INDIVIDUAL ALONE CHOOSING TO BE THE ONE TO MAKE THE DECISION TO END

                    THEIR LIFE, AND NOT DOING IT BECAUSE OF ULTERIOR BELIEF THAT IT MAY BENEFIT

                    SOMEONE ELSE OR LESSON THE HARM TO OTHER PEOPLE RATHER THAN, THROUGH

                    YOUR INTENT OF THE LEGISLATION, TO END THE PAIN AND SUFFERING SOMEBODY

                    MAY HAVE THROUGH THAT TERMINAL ILLNESS OR DISEASE.

                                 SO IT WOULD BE THE ATTENDING AND THE CONSULTING

                    PHYSICIAN TO DETERMINE WHETHER OR NOT COERCION IS TAKING PLACE BEFORE

                    THE MEDICATION HAS BEEN PRESCRIBED OR THROUGHOUT THE PROCESS?

                                 MS. PAULIN:  SO, CERTAINLY, THE ATTENDING PHYSICIAN

                    HAS A RELATIONSHIP THROUGHOUT THE PROCESS AS YOU'RE DESCRIBING.  SO,

                    YES, I WOULD SAY THAT THEY HAVE A RELATIONSHIP, AND -- YOU KNOW, WITH

                                         33



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THAT PATIENT.  AND, YOU KNOW, AGAIN, IF SOMEBODY WAS TRYING TO COERCE

                    THEM TO ACTUALLY TAKE THE MEDICATION AFTER THEY GOT A PRESCRIPTION, THAT

                    DOCTOR COULD -- WOULD BE ABLE TO REPORT THAT TO THE AUTHORITIES.

                                 MR. JENSEN:  SO THE MECHANISM WOULD BE -- SO IF

                    SOMEBODY BELIEVED, WHETHER IT WAS THE DOCTOR, ANOTHER FAMILY

                    MEMBER, THAT THERE MAY HAVE BEEN COERCIVE BEHAVIOR IN SOMEBODY

                    EITHER REQUESTING MEDICAL AID IN DYING OR, IN FACT, FOLLOWING THROUGH

                    WITH THEIR OWN DEATH, THE PROCESS WOULD BE THAT ANYBODY CAN MAKE A

                    REFERRAL.  WOULD IT BE TO THE LOCAL DISTRICT ATTORNEY?

                                 MS. PAULIN:  ABSOLUTELY.

                                 MR. JENSEN:  OKAY.  SO THAT WOULD BE JUDGED IN A

                    COURT OF LAW.  THERE WOULDN'T BE -- I GUESS, WHAT WOULD HAPPEN IF THERE

                    IS SOMEBODY WHO MAKES THAT -- THAT ALLEGATION BEFORE THE INDIVIDUAL

                    WOULD -- THEY'VE BEEN PRESCRIBED THE MEDICATION, YOU HAVE TWO

                    SIBLINGS.  ONE SIBLING ALLEGES THE OTHER SIBLING IS COERCING THEIR PARENT

                    INTO AN END-OF-LIFE DECISION THROUGH MEDICAL AID IN DYING.  THE

                    INDIVIDUAL HAS BEEN PRESCRIBED THE -- THE END-OF-LIFE MEDICATION BUT

                    HAS NOT TAKEN IT YET.  SIBLING B ALLEGES THAT THE -- SIBLING A IS COERCING

                    THE PARENT.  WOULD THERE BE A MECHANISM TO DELAY OR STOP THE

                    INDIVIDUAL FROM TAKING THE MEDICATION UNTIL THE LEGITIMACY OF THAT

                    COERCION IS DETERMINED OR THAT THE INDIVIDUAL SEES A MENTAL HEATH

                    PROVIDER TO DETERMINE WHETHER OR NOT THEY'RE OF SOUND MIND AND

                    INDEPENDENT DECISION-MAKING?

                                 MS. PAULIN:  YOU KNOW, THESE ARE PEOPLE OF SOUND

                    MIND AND DECISION-MAKING.  THESE ARE NOT -- YOU KNOW, THAT'S ONE OF

                                         34



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THE THINGS THAT BOTH DOCTORS HAVE TO ATTEST TO.  AND IF THEY THINK THERE'S

                    A DIFFERENT -- IF THEY THINK THERE'S ANY SUSPICION OF -- OF NOT BEING ABLE

                    TO MAKE A DECISION REGARDING GETTING A PRESCRIPTION OR USING THE

                    PRESCRIPTION, THEN THEY HAVE TO MAKE A REFERRAL TO THE MENTAL HEALTH

                    PROVIDER.

                                 SO -- SO I THINK THAT WHAT WE'VE SEEN, YOU KNOW, OVER

                    THE COURSE OF THE NEARLY 30 YEARS, AS THERE IS NO COERCION.  AND PEOPLE

                    GET THIS MEDICATION TO FEAR -- OR IN THE -- IN THE -- IN THE POSSIBILITY THAT

                    THEY'RE GOING TO HAVE EXCESSIVE PAIN AT THE END OF THEIR LIFE.  IT GIVES

                    THEM GREAT COMFORT TO BE ABLE TO KNOW THAT.  AND -- AND, HOPEFULLY --

                    YOU KNOW, WE ALSO KNOW THAT NEARLY 40 PERCENT OF PEOPLE NEVER USE

                    THE MEDICATION WHO GET A PRESCRIPTION.  SO IT JUST GIVES THEM THAT

                    ENORMOUS COMFORT TO -- TO KNOW THAT THEY HAVE THAT JUST IN CASE.

                                 MR. JENSEN:  OKAY.  SO I DO WANT -- YOU TALKED A

                    LITTLE BIT ABOUT THE RELATIONSHIP BETWEEN THE DOCTOR AND THE PATIENT.  I

                    WANT TO DIG A LITTLE BIT DEEPER INTO THAT.

                                 WOULD THE ATTENDING PHYSICIAN HAVE TO HAVE A

                    PREEXISTING MEDICAL RELATIONSHIP WITH THE PATIENT?

                                 MS. PAULIN:  WELL, THEY WOULD HAVE TO HAVE SOME

                    RELATIONSHIP WITH THE -- YOU KNOW, WITH THE PATIENT, CERTAINLY, IN ORDER

                    TO BE THE ATTENDING PHYSICIAN, TO WHATEVER THE DISEASE IS THAT THEY'RE --

                    THAT THEY HAVE.  I MEAN, THEY WOULD -- WHAT WE KNOW IS THAT THE

                    ATTENDING PHYSICIAN HAS TO BE ABLE, HAS TO BE COMPETENT TO BE ABLE TO

                    ASSESS TERMINAL ILLNESS.

                                 MR. JENSEN:  SO THE REASON I ASK THAT QUESTION IS,

                                         35



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    TRYING TO FIGURE OUT IF SOMEBODY IS -- IS SEEING THE PHYSICIAN THEY'VE

                    BEEN SEEING FOR THAT ILLNESS, FOR THAT DISEASE, AND THEY DO NOT GRANT

                    THEM THAT TERMINAL DIAGNOSIS.  COULD AN INDIVIDUAL WHO -- WHO

                    BELIEVES THAT THEIR OWN PAIN AND SUFFERING IS UNIMAGINABLE, THAT THEY

                    CANNOT CARRY ON, THAT THEY WANT TO UTILIZE, BUT THEIR DOCTOR WHO'S BEEN

                    TREATED THEM FOR A SET AMOUNT OF TIME DISAGREES WITH GIVING THEM THAT

                    SIX MONTH OR LESS DIAGNOSIS, COULD AN INDIVIDUAL ESSENTIALLY DOCTOR

                    SHOP TO FIND A PROVIDER WITH THE EXPERTISE FOR THAT DISEASE OR ILLNESS,

                    BUT A WILLINGNESS TO GIVE THEM A DIAGNOSIS DESPITE THEIR PRIMARY

                    PROVIDER, WHO THEY HAVE A RELATIONSHIP WITH, DISAGREEING WITH THAT

                    DIAGNOSIS?

                                 MS. PAULIN:  I WOULD SAY IT'S LESS ABOUT THE

                    DIAGNOSIS, BECAUSE DOCTORS WHO ARE SIMILAR IN SPECIALTY -- I KNOW IN

                    NEW YORK, I HAVE A GOOD FRIEND RIGHT NOW THAT HAS CANCER.  AND SHE

                    SAYS ALL THE DOCTORS IN NEW YORK SEEM TO TALK TO EACH OTHER.  SHE HAS A

                    UNIQUE CANCER.  SO I -- I THINK IT'S LESS ABOUT THE DIAGNOSIS THAN IT IS

                    ABOUT A DOCTOR'S WILLINGNESS TO PARTICIPATE IN THIS PROGRAM.  ESPECIALLY

                    AT THE OUTSET OF PASSING A BILL LIKE THIS, WE MAY SEE SOME DOCTORS

                    WILLING AND OTHER DOCTORS NOT.  SO IF THE PATIENT DESIRES TO GET THIS

                    PRESCRIPTION, I COULD OBVIOUSLY SEE A DOCTOR SAYING, LOOK, I'M NOT

                    COMFORTABLE YET IN PRESCRIBING THIS, BUT AT MOUNT SINAI OR AT SLOAN

                    THEY ARE.  SO I'M GOING TO GIVE YOU A REFERRAL TO ANOTHER PHYSICIAN THAT

                    HAS THE SAME EXPERTISE.  THAT WE HAVE SEEN.

                                 MR. JENSEN:  SO -- OKAY.  SO IS THERE ANYTHING --

                    KNOWING THAT WE COULD HAVE DOCTORS REFERRING THEIR PATIENTS TO OTHER

                                         36



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    DOCTORS WHO BE -- MAY BE MORE LIKELY TO ASSIST WITH PRESCRIBING

                    END-OF-LIFE MEDICATION, ARE WE CONCERNED ABOUT THE DEVELOPMENT OF A

                    NEW SUBSET OF PROVIDERS WHO MAY EXCLUSIVELY TREAT OR SEE PATIENTS WHO

                    WISH TO END THEIR LIVES AND DEVELOP THAT EXPERTISE IN THESE TYPES OF

                    ILLNESSES TO CATER ONLY TO INDIVIDUALS WHO ARE IN THE END-OF-LIFE

                    TERMINAL STAGE, AND HIT -- ESSENTIALLY, CREATE A COTTAGE INDUSTRY OF

                    DOCTORS WHO ARE ESSENTIALLY HELPING TO UTILIZE END-OF-LIFE SUICIDE?

                                 MS. PAULIN:  I DO THINK WE WILL SEE SOME DOCTORS

                    WILLING TO PRESCRIBE AND OTHER DOCTORS NOT YET WILLING, AS WE'VE SEEN

                    WITH OTHER STATES.  BUT TO CREATE A COTTAGE INDUSTRY I THINK IS -- IS AN

                    EXTREME.

                                 MR. JENSEN:  OKAY.  WOULD DOCTORS BE PROHIBITED

                    FROM BEING THE ONE TO RAISE THE POSSIBILITY WITH A PATIENT ABOUT

                    UTILIZING MEDICAL AID IN DYING UPON A TERMINAL DIAGNOSIS WITH LESS THAN

                    SIX MONTHS TO LIVE?  WOULD THE DOCTOR BE PROHIBITED FROM SAYING, HEY,

                    HAVE YOU THOUGHT ABOUT THIS?

                                 MS. PAULIN:  NO.  I THINK THAT THAT WOULD -- JUST LIKE

                    ANY OPTION, I THINK THAT IT WOULD BE A DOCTOR'S OBLIGATION TO -- TO SHARE

                    ANY AND ALL --

                                 ACTING SPEAKER HUNTER:  THANK YOU, MR.

                    JENSEN.

                                 MR. JENSEN:  THANK YOU, MADAM SPEAKER.  THANK

                    YOU, MADAM SPONSOR.

                                 ACTING SPEAKER HUNTER:  MS. SOLAGES.

                                 MS. SOLAGES:  MADAM SPEAKER, WILL YOU PLEASE

                                         37



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    CALL THE EDUCATION COMMITTEE IMMEDIATELY TO THE SPEAKER'S

                    CONFERENCE ROOM?

                                 ACTING SPEAKER HUNTER:  EDUCATION

                    COMMITTEE TO THE SPEAKER'S CONFERENCE ROOM.  EDUCATION TO THE

                    SPEAKER'S CONFERENCE ROOM.

                                 MS. SEPTIMO.

                                 MS. SEPTIMO:  WILL THE SPONSOR YIELD FOR --

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MS. SEPTIMO:  SO, WHO IS ELIGIBLE FOR THIS

                    MEDICATION?

                                 MS. PAULIN:  YOU HAVE TO BE TERMINALLY ILL,

                    DIAGNOSED BY TWO INDEPENDENT PHYSICIANS, THE ATTENDING AND THE

                    CONSULTING, TO BE -- AND YOU HAVE TO BE 18 TO BE ELIGIBLE.

                                 MS. SEPTIMO:  AND WHO DETERMINES THE SIX MONTH

                    OR LESS DIAGNOSES?

                                 MS. PAULIN:  THE -- THE DOCTOR WHO'S AN EXPERT IN

                    THE -- IN THE -- IN THE -- IN THE ILLNESS.

                                 MS. SEPTIMO:  OKAY.  SO SOMEONE WHO HAD GAINED

                    ACCESS TO THIS MEDICATION BY VISITING WITH A DOCTOR WHO IS SPECIALIZED

                    IN THE ILLNESS THAT THEY ARE SUFFERING FROM, AND THAT DOCTOR WOULD HAVE

                    TO DETERMINE THAT THAT PERSON HAS SIX MONTHS OR LESS LEFT TO LIVE; IS THAT

                    CORRECT?

                                         38



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. PAULIN:  YES.

                                 MS. SEPTIMO:  AND MY UNDERSTANDING IS THAT

                    ANOTHER DOCTOR WOULD ALSO HAVE TO AGREE, SEPARATE FROM THAT DOCTOR,

                    THAT THAT PERSON ONLY HAS SIX MONTHS OR LESS LEFT TO LIVE?

                                 MS. PAULIN:  YES.

                                 MS. SEPTIMO:  TWO SEPARATE DOCTORS WHO HAVE

                    TAKEN TWO SEPARATE OATHS, CORRECT?

                                 MS. PAULIN:  YES.

                                 MS. SEPTIMO:  OKAY.  AND WHO WOULD BE ABLE TO

                    ADMINISTER THIS MEDICATION?

                                 MS. PAULIN:  IT HAS TO BE SELF-ADMINISTERED.

                                 MS. SEPTIMO:  OKAY.  SO WHAT IF YOU WERE UNABLE

                    TO COMMUNICATE THAT YOU WOULD LIKE TO TAKE THIS MEDICATION, BUT YOUR

                    FAMILY MEMBERS OR YOUR CAREGIVERS ARE ABSOLUTELY CERTAIN THAT YOU

                    WOULD WANT TO TAKE THIS MEDICATION?

                                 MS. PAULIN:  YOU WOULD NOT BE ELIGIBLE.

                                 MS. SEPTIMO:  OKAY.  SO YOU ARE THE ONLY PERSON

                    WHO IS ABLE TO SAY THAT YOU WOULD LIKE TO ACCESS THIS MEDICATION.

                                 MS. PAULIN:  YES.

                                 MS. SEPTIMO:  AND LET'S SAY THAT YOU ARE ABLE TO

                    COMMUNICATE THAT YOU WANT TO TAKE THIS MEDICATION, THAT YOU FIND TWO

                    DOCTORS WHO AGREE THAT YOU HAVE SIX MONTHS OR LESS LEFT TO LIVE.  YOU

                    GET THE MEDICATION, BUT YOU ARE TOO ILL TO TAKE IT YOURSELF.  WHAT WOULD

                    HAPPEN IN THAT CASE?

                                 MS. PAULIN:  IF YOU CAN'T SELF-ADMINISTER -- AND

                                         39



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THERE'S LOTS OF WAYS YOU CAN SELF-ADMINISTER, SO THAT WOULD LIKELY NOT

                    BE A PROBLEM -- BUT IF YOU CAN'T SELF-ADMINISTER, THEN YOU CANNOT TAKE

                    THE MEDICATION.

                                 MS. SEPTIMO:  OKAY.  SO YOU'D MENTIONED AN

                    EVALUATION OF SOMEONE'S MENTAL STATE BEFORE THEY'RE ABLE TO TAKE THIS

                    MEDICATION.  WHO IS ABLE TO DECIDE THAT YOU ARE OF SOUND MIND?

                                 MS. PAULIN:  THE TWO -- THE TWO DOCTORS; THE INITIAL

                    DOCTOR, THE ATTENDING, AND THEN THE CONSULTING DOCTOR.

                                 MS. SEPTIMO:  IS THERE ANY SPACE IN THAT PROCESS

                    FOR, AGAIN, YOUR FAMILY MEMBER, YOUR CAREGIVER, YOUR HOME ATTENDANT,

                    FOR ANYONE TO WEIGH IN ON YOUR STATE OF MIND OR HOW YOU FEEL ABOUT

                    YOUR ILLNESS IN THE PROCESS OF THE EVALUATION OF YOUR MENTAL HEALTH?

                                 MS. PAULIN:  THEY CAN CERTAINLY TALK ABOUT IT, BUT

                    THEY HAVE NO IMPACT.

                                 MS. SEPTIMO:  OKAY.  AND HOW CAN WE KNOW --

                    GOING BACK TO THE SELF-ADMINISTERING, HOW CAN WE KNOW THAT THE

                    SELF-ADMINISTRATION, WHEN SOMEONE IS TAKING THE MEDICATION, HOW CAN

                    WE KNOW THAT THAT IS HOW IT WILL ACTUALLY HAPPEN?  IS THERE A

                    MECHANISM IN PLACE TO MAKE SURE THAT WHEN IT IS HAPPENING THERE IS

                    SOMEONE THERE TO SEE IT?

                                 MS. PAULIN:  THERE'S ALWAYS -- YOU KNOW, WHEN THE

                    DOCTOR PRESCRIBES, THERE'S A LIST OF THINGS THAT WE ADVISE THE DOCTOR TO

                    ADVISE THE PATIENT, AND ONE OF THEM IS THAT THEY SHOULDN'T DO THIS ALONE.

                    THEY SHOULD HAVE OTHER PEOPLE THERE.

                                 MS. SEPTIMO:  AND WITH RESPECT TO THOSE OTHER

                                         40



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    PEOPLE, ARE THERE ANY SAFEGUARDS IN TERMS OF WHO THOSE OTHER PEOPLE

                    MUST OR MAY OR MAY NOT BE?

                                 MS. PAULIN:  NO.  IT'S UP TO THE PATIENT TO HAVE -- TO

                    CHOOSE.

                                 MS. SEPTIMO:  ARE THERE ANY WITNESSES THAT ARE

                    ABLE TO BE THERE THAT HAVE AN INTEREST IN SEEING THIS PERSON END THEIR

                    LIFE?

                                 MS. PAULIN:  CERTAINLY, ANYBODY BY THE CHOICE OF

                    THE PATIENT COULD BE IN THE ROOM.

                                 MS. SEPTIMO:  GREAT.

                                 MS. PAULIN:  WHAT THEY CAN'T DO IS, THEY CAN'T

                    WITNESS THE REQUEST IF THEY HAVE ANY FINANCIAL INTEREST.

                                 MS. SEPTIMO:  OKAY.  SO JUST TO MAKE SURE THAT I

                    HAVE IT STRAIGHT.  IF SOMEONE HAS A FINANCIAL INTEREST IN SOMEONE DYING,

                    LET'S SAY TURNING TO THE EXAMPLE OF A CHILD AND A PARENT, THE CHILD IS NOT

                    ABLE TO BE THE LEGAL WITNESS WITH RESPECT TO THEIR PARENT REQUESTING

                    THE -- THE MEDICATION --

                                 MS. PAULIN:  RIGHT --

                                 MS. SEPTIMO:  -- CORRECT?

                                 MS. PAULIN:  THERE COULD BE NO FAMILIAL PERSON

                    SIGNING THAT WITNESS STATEMENT.

                                 MS. SEPTIMO:  OKAY.  AND SO THEY WOULD NOT BE

                    ABLE TO COERCE IN THAT MOMENT TO SAY, SIGN THIS PAPER, BECAUSE THEY

                    WOULD NOT BE ABLE TO BE THE WITNESS --

                                 MS. PAULIN:  RIGHT.

                                         41



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. SEPTIMO:  -- IN THAT MOMENT?  OKAY.

                                 NOW TURNING TO DISPARITIES FOR A MOMENT.  DO YOU

                    KNOW WHAT THE RACIAL BREAKDOWN IS WITH RESPECT TO ACCESS TO THIS

                    MEDICATION ACROSS THE COUNTRY AND OTHER PLACES WHERE IT EXISTS?

                                 MS. PAULIN:  WE KNOW THAT 92 PERCENT ACROSS THE

                    11 JURISDICTIONS ARE WHITE.  I THINK IT WAS 5 PERCENT WERE BLACK, AND

                    THEN WITH ALL THE OTHER MINORITIES FILLING IN THE GAPS.  MY -- I THINK IT'S

                    ACTUALLY LESS BLACK THAN 5 PERCENT.  I THINK ACTUALLY HISPANIC WERE

                    HIGHER.  YOU KNOW, I THINK 3.9, IF I'M REMEMBERING RIGHT.  SO IT -- IT --

                    THERE'S A RANGE FOR THE REMAINING.  AND IT DEPENDS ON THE STATE, TOO.

                                 MS. SEPTIMO:  UH-HUH.

                                 MS. PAULIN:  YOU KNOW, CALIFORNIA ONLY HAS 87

                    PERCENT WHITE.  SO YOU HAVE A MORE DIVERSE STATE, YOU HAVE MORE

                    DIVERSITY FOR THE REMAINDER.

                                 MS. SEPTIMO:  OKAY.  THANK YOU.

                                 AND HAS THERE BEEN ANY EFFECT ON ADDITIONAL ACCESS TO

                    END-OF-LIFE CARE IN OTHER STATES WHERE THIS MEDICATION IS AVAILABLE?

                                 MS. PAULIN:  SO, THEY HAVE FOUND IN OTHER STATES

                    THAT HOSPICE CARE GOES UP.  YOU KNOW, WE ARE ONE STATE THAT DOES NOT

                    HAVE -- THERE ISN'T A HIGH UTILIZATION COMPARED TO OTHER STATES.  AND THAT

                    UTILIZATION HAS REALLY TAKEN OFF IN STATES WHERE THEY HAVE THIS.

                                 MS. SEPTIMO:  OKAY.  SO IT WOULD BE SAFE TO SAY

                    IN -- IN EFFECT OF PASSING THIS MEDICATION, IS THAT MORE PEOPLE HAVE

                    ACCESS TO END-OF-LIFE CARE OPTIONS LIKE HOSPICE CARE?

                                 MS. PAULIN:  YEAH.  AND LET'S REMEMBER WHAT

                                         42



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    HOSPICE CARE IS, TOO.  IT -- IT ALLOWS SOMEONE TO GET PALLIATIVE CARE, PAIN

                    RELIEF.  SO, YES, IT'S A VERY GOOD OPTION FOR PEOPLE IN AN END-OF-LIFE

                    SITUATION.  AND -- AND IT'S GREAT THAT, YOU KNOW, THIS BILL MAY PROVIDE

                    AN AVENUE TO DO THAT.  WE HAVE A PROVISION IN THE -- IN THE BILL THAT

                    REQUIRES THE ATTENDING PHYSICIAN TO -- TO SAY EXACTLY WHAT THE HOSPICE

                    OPTIONS ARE, AND PALLIATIVE OPTIONS ARE, AS WELL AS ALL TREATMENT OPTIONS.

                                 MS. SEPTIMO:  SO, TO THE EARLIER POINT THAT WAS

                    RAISED, WHEN -- WHEN A PHYSICIAN IS COMMUNICATING ABOUT THIS

                    MEDICATION, THEY WILL ALSO BE COMMUNICATING ABOUT EVERY OTHER

                    END-OF-LIFE CARE OPTION THAT EXISTS HERE IN THE STATE?

                                 MS. PAULIN:  YES.

                                 MS. SEPTIMO:  OKAY.  AND WE KNOW THAT HEALTHCARE

                    IS A BUSINESS IN THIS COUNTRY, AND CERTAINLY IN THE STATE.  ARE INSURANCE

                    COMPANIES ABLE TO MAKE MONEY OFF OF THE PRESCRIPTION OF THIS

                    MEDICATION OR THE ADMINISTRATION OF THIS MEDICATION IN ANY WAY?

                                 MS. PAULIN:  NO.  THEY'RE PROHIBITED FROM EVEN

                    LETTING ALL THEIR -- THEIR -- YOU KNOW, WE ALL HAVE HEALTH INSURANCE.

                    YOU KNOW, YOU GET THAT BOOK, YOU KNOW, IN THE BEGINNING, THAT NONE

                    OF US REALLY LOOK AT THE DETAIL, MAYBE SOME, I DIDN'T.  YOU -- THEY CAN

                    HAVE THE INFORMATION IN THAT KIND OF BOOK, BUT THEY CAN'T JUST MAIL

                    OUT -- YOU KNOW, FOR EXAMPLE, YOU -- WITH -- TYPICALLY WITH THESE

                    SEVERE ILLNESSES LIKE CANCER, YOU GET A LOT OF DENIALS, UNFORTUNATELY.

                    AND SO IN THAT DENIAL YOU CAN'T SAY WHAT ELSE IS AVAILABLE.  LIKE THIS

                    ONE.  WE SPECIFICALLY PROHIBIT THE ABILITY FOR SOMEONE TO DO -- FOR AN

                    INSURANCE COMPANY TO DO THAT.  BUT IF A PATIENT ASKED THE INSURANCE

                                         43



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    COMPANY OR THE ATTENDING PHYSICIAN ASKED ON BEHALF OF A PATIENT, THEN

                    THE INSURANCE COMPANY COULD PROVIDE THAT INFORMATION.

                                 MS. SEPTIMO:  OKAY.  JUST SO I HAVE IT STRAIGHT.  THE

                    INSURANCE COMPANY CAN'T BE IN A POSITION WHERE SOMEONE IS DENIED

                    CARE FOR A TERMINAL ILLNESS, AND THEN TURN TO THAT PATIENT AND SAY, BUT

                    HERE IS THIS MEDICATION THAT WILL END YOUR LIFE AND END YOUR SUFFERING?

                                 MS. PAULIN:  NO.  AND AS A MATTER OF FACT, MOST

                    PATIENTS AT THAT STAGE ARE ON MEDICAID AND MEDICARE, AND THEY DON'T

                    OFFER THIS.  SO WE'RE TALKING ABOUT VERY FEW PATIENTS THAT WOULD EVEN

                    HAVE THE COMMERCIAL INSURANCE TO BE ABLE TO ASK.  BUT, YOU KNOW, IN

                    NEW YORK, WHERE, YOU KNOW, WE KNOW THAT VERY FEW PEOPLE WILL BE

                    ABLE TO EVEN HAVE THE INSURANCE TO COVER IT.  BUT IF THEY DID, THOSE

                    INSURANCE COMPANIES WOULD BE PROHIBITED FROM GIVING THAT

                    INFORMATION.

                                 MS. SEPTIMO:  GREAT.  AND I JUST WANT TO MAKE SURE

                    THERE'S NO FINANCIAL INCENTIVE FOR AN INSURANCE COMPANY TO SUGGEST,

                    RECOMMEND, SHARE INFORMATION ABOUT THIS MEDICATION WITH A PATIENT.

                                 MS. PAULIN:  ABSOLUTELY NONE.

                                 MS. SEPTIMO:  OKAY.  GREAT.  AND LAST COUPLE OF

                    QUESTIONS.

                                 THIS MEDICATION, TO BE CLEAR, IS RESERVED EXCLUSIVELY

                    FOR SOMEONE WITH A TERMINAL ILLNESS; IS THAT RIGHT?

                                 MS. PAULIN:  YES.

                                 MS. SEPTIMO:  IS THERE ANY TYPE OF ILLNESS THAT IS

                    NOT TERMINAL UNDER WHICH SOMEONE COULD GAIN ACCESS TO THIS

                                         44



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    MEDICATION?

                                 MS. PAULIN:  NO.

                                 MS. SEPTIMO:  OKAY.  SO TO BORROW FROM THE EARLIER

                    EXAMPLE AGAIN, IF SOMEONE IS LIVING IN A NURSING HOME, WITH A CHRONIC

                    ILLNESS, WAS GOING THROUGH A MOMENT WHERE THEY FELT LIKE THEY NO

                    LONGER WANTED TO BE A BURDEN TO THEMSELVES, TO THEIR FAMILY, TO THEIR

                    COMMUNITY, TO THE NURSING HOME, DID NOT HAVE A TERMINAL ILLNESS,

                    WOULD THAT PERSON BE ABLE TO OPT IN TO THIS MEDICATION?

                                 MS. PAULIN:  NO.

                                 MS. SEPTIMO:  OKAY.  THANK YOU.

                                 ACTING SPEAKER HUNTER:  MR. DURSO.

                                 MR. DURSO:  (INAUDIBLE) -- SPEAKER.  WOULD THE

                    SPONSOR YIELD FOR SOME QUESTIONS?

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MR. DURSO:  THANK YOU, MS. PAULIN.

                                 SO I WANT TO GET INTO THE DEFINITION WHEN IT COMES TO

                    THIS BILL IN REGARDS TO "TERMINALLY ILL".  YOU'RE SAYING SOMEONE HAS TO

                    BE -- SAID TO BE TERMINALLY ILL WITH LESS THAN SIX MONTHS OR LESS TO LIVE,

                    CORRECT?

                                 MS. PAULIN:  YES.

                                 MR. DURSO:  NOW WOULD THAT TERMINALLY ILL

                    DIAGNOSIS INCLUDE IF THERE WAS MEDICATION TO EXTEND YOUR LIFE?  SO, IN

                                         45



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    OTHER WORDS -- I KNOW, OBVIOUSLY, WHEN IT COMES TO THIS BILL WE TALK A

                    LOT ABOUT CANCERS.  IF YOU HAVE CANCER AND YOU'RE SAYING, IF YOU DON'T

                    TREAT IT YOU HAVE SIX MONTHS TO LIVE.  BUT IF YOU DO RECEIVE SOME TYPES

                    OF TREATMENTS YOU CAN LIVE UP TO TEN YEARS.  WOULD THAT INCLUDE

                    SOMETHING LIKE THIS?

                                 MS. PAULIN:  NO.  IF THERE'S A TREATABLE -- JUST LIKE

                    DIALYSIS, RIGHT?  YOU USE DIALYSIS, YOU -- IT'S A TREATABLE ILLNESS.  IF IT'S

                    TREATABLE THEN YOU'RE NOT ELIGIBLE.

                                 MR. DURSO:  SO WHERE DOES IT SAY IN THE BILL THAT IF

                    IT'S A TREATABLE -- I'M JUST CURIOUS --

                                 MS. PAULIN:  A CHALLENGE.  OKAY.  OKAY.  SO I'LL

                    JUST READ UNTIL I FIND IT HERE.

                                 MR. DURSO:  SURE.

                                 MS. PAULIN:  "TERMINAL ILLNESS OR CONDITION" -- IT'S

                    IN THE DEFINITIONS ON PAGE 3 -- MEANS AN INCURABLE AND IRREVERSIBLE

                    ILLNESS OR CONDITION THAT HAS BEEN MEDICALLY CONFIRMED, AND WILL WITHIN

                    A REASONABLE -- WITHIN REASONABLE MEDICAL JUDGMENT PRODUCE DEATH

                    WITHIN SIX MONTHS.

                                 SO, WE CAN GO BACK TO "MEDICAL CONDITION" BECAUSE I

                    KNOW THAT'S ALSO A DEFINITION IN HERE.  AND --

                                 MR. DURSO:  WE'RE GONNA GET TO THAT PART OF IT.

                                 MS. PAULIN:  OKAY.

                                 MR. DURSO:  BUT -- BUT MY -- MY QUESTION IS, IT --

                    IT'S SAYING IF IT'S IRREVERSIBLE, RIGHT.  BUT --

                                 MS. PAULIN:  RIGHT.

                                         46



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. DURSO:  -- IF YOU HAVE A DIAGNOSIS OF WHATEVER

                    THE -- THE TERMINAL ILLNESS IS, AND YOU'RE ABLE TO TAKE MEDICATIONS OR

                    HAVE A PROCEDURE DONE THAT EXTENDS YOUR LIFE, IT DOESN'T REVERSE THE

                    ILLNESS, WHAT IT DOES IS PRO -- REALLY PROLONG YOUR LIFE.

                                 SO COULDN'T YOU ARGUE TO SAY THAT IF I HAD SOME TYPE OF

                    FROM OF CANCER OR ANYTHING ELSE, OR EVEN DIALYSIS, WHICH THE DIALYSIS IS

                    WHAT IS KEEPING ME ALIVE BECAUSE MY KIDNEYS NO LONGER WORK, RIGHT?

                    IF I DON'T DO DIALYSIS, IF I DECIDE THAT I DON'T WANT THAT TREATMENT, DO I

                    THEN FALL UNDER THIS AND SAY, YOU KNOW WHAT?  I KNOW THERE'S A

                    TREATMENT IN PLACE, BUT I DON'T WANT IT.  AND WITHOUT THAT TREATMENT I

                    HAVE SIX MONTHS OR LESS TO LIVE, I WOULD TECHNICALLY QUALIFY.

                                 MS. PAULIN:  IF THERE'S A TREATMENT IN PLACE THEN,

                    NO, YOU WOULD NOT QUALIFY.

                                 MR. DURSO:  BUT IT -- BUT IT DOESN'T SPECIFICALLY SAY

                    THAT.  IT SAYS "IRREVERSIBLE".  BUT IT'S NOT REVERSING IT, WHAT IT'S DOING IS

                    PROLONGING IT.

                                 SO, I'M NOT AN ATTORNEY --

                                 MS. PAULIN:  YOU KNOW WHAT?  THAT'S THE TERM

                    WE'RE USING TO MEAN THAT, THOUGH.

                                 MR. DURSO:  I UNDERSTAND WE'RE NOT USING IT TO

                    MEAN THAT --

                                 MS. PAULIN:  BUT WE'RE CREATING LEGISLATIVE INTENT

                    RIGHT NOW.

                                 MR. DURSO:  BUT -- BUT WE'RE -- I UNDERSTAND THE

                    LEGISLATIVE INTENT, BUT WE'VE BEEN WORKING ON THIS BILL FOR TWO DECADES

                                         47



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    AND IT'S NOT IN THE BILL.  SO MY CONCERN WOULD BE, WHY WOULDN'T THAT

                    LANGUAGE BE IN THERE SAYING IF THERE IS MEDICATION OR PROCEDURES

                    AVAILABLE TO EXTEND YOUR LIFE, YOU DO NOT QUALIFY FOR THIS?

                                 MS. PAULIN:  YOU KNOW, WE HAVE A LOT OF

                    PROVISIONS IN THE BILL THAT ONE MIGHT ARGUE WERE DUPLICATIVE BECAUSE

                    WE DIDN'T HAVE THE WORDING THAT, YOU KNOW, A MEMBER THOUGHT WAS

                    CLEAR OR STRONG ENOUGH.  SO FOR MEMBERS WHO BROUGHT THOSE TO MY

                    ATTENTION PRIOR, MOSTLY, THEY WERE SAYING, IF YOU DO THIS, THEN FEELING

                    COMFORTABLE WITH THE BILL, I WAS OPEN TO MAKING THAT CHANGE.

                    UNFORTUNATELY, YOU DIDN'T COME.  I RAISE THAT --

                                 MR. DURSO:  I WASN'T INVITED --

                                 MS. PAULIN:  NOPE.  HONESTLY, A LOT OF MEMBERS

                    CAME UNINVITED AND SAID, I WANT YOU TO ADD A PROVISION TO MAKE SURE

                    THAT THE INSURANCE PROVISION IS STRONG ENOUGH.  I WANT YOU TO ADD A

                    PROVISION TO MAKE SURE THAT THERE WAS A NO LIABILITY ON A HEALTH

                    PRACTITIONER IF THEY DID OR DID NOT USE THIS -- MAKE -- YOU KNOW, USE THE

                    OPTION OF THE BILL TO PROVIDE FOR THEIR PATIENTS.

                                 SO I'M GONNA SAY RIGHT NOW THAT THAT WAY WE HAD

                    TERMED IT WAS INTENDED TO MEAN THAT IF THERE WAS A TREATMENT

                    AVAILABLE -- AND I WILL ADD, WE'VE HAD NEARLY 30 YEARS OF USING THAT

                    SAME WORD ACROSS THE 11 JURISDICTIONS, AND THAT WORD HAS MEANT THAT

                    AND HAS HELD UP TO MEAN THAT.  SO WE -- THAT'S WE DID IN NEW YORK.

                                 IF YOU THINK THAT YOU -- IF YOU TELL ME NOW YOU'RE

                    PREPARED TO VOTE FOR IT, I'LL OFFER YOU AN AMENDMENT TO THE BILL DOWN

                    THE LINE.

                                         48



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. DURSO:  HOW ABOUT WE JUST AMEND IT NOW?

                                 MS. PAULIN:  OBVIOUSLY, THAT'S NOT IN THE CARDS.

                                 MR. DURSO:  OH.  WELL, THEN, NEITHER IS MY VOTE.

                                 MS. PAULIN:  BUT IT'S STRONG ENOUGH.  I CAN ASSURE

                    YOU THAT THAT'S THE LANGUAGE THAT'S USED ACROSS THE --

                                 MR. DURSO:  AND I UNDERSTAND WHAT THE INTENTION

                    OF IT IS, BUT THE FACT OF THE MATTER IS --

                                 MS. PAULIN:  AND THE PRACTICE OF IT --

                                 MR. DURSO:  WELL, I UNDERSTAND.  BUT WE'RE PUTTING

                    INTO LAW THAT FACT THAT SOMEONE'S ALLOWED TO CHOOSE THE -- TO END THEIR

                    LIFE, ESSENTIALLY.  AND I UNDERSTAND THE ANGST WITH IT AND I UNDERSTAND

                    THE PAIN THAT PEOPLE GO THROUGH.  I'VE WITNESSED IT MYSELF WITH MY OWN

                    MOTHER.  I UNDERSTAND IT PERSONALLY.  BUT MY CONCERN WOULD BE THAT THIS

                    IS OBVIOUSLY A VERY IMPORTANT PIECE OF LEGISLATION, WHICH A LOT OF US,

                    YOU KNOW, WRESTLE BACK AND FORTH WITH.  I MEAN, THERE'S -- THERE'S

                    ADVOCATES IN THE ROOM.  THERE'S -- THERE'S PEOPLE HERE THAT HAVE BEEN

                    PUSHING THIS FOR A LONG TIME.  AND THE FACT OF THE MATTER IS, IS THAT THAT'S

                    JUST A SIMPLE PIECE OF LANGUAGE THAT COULD HAVE WENT INTO THIS BILL TO

                    SAY, IF THERE IS A TREATMENT, IF THERE'S A WAY TO PROLONG YOUR LIFE, RIGHT --

                    SOMEONE COULD ACTUALLY COME IN AN ARGUE SAY, I DON'T WANT DIALYSIS.

                    BECAUSE, LISTEN, IT -- IT'S TIRING.  IT'S PAINFUL.  IT'S -- IT'S UNCOMFORTABLE,

                    RIGHT, AND I WANT -- AND NOW, IF I DON'T DO DIALYSIS IT'LL BE LESS THAN SIX

                    MONTHS THAT I WON'T LIVE.  SO, THEREFORE, THEY COULD FIGHT IN A COURT OF

                    LAW AND SAY, I DESERVE THIS OPTION TO END MY LIFE.  AND I UNDERSTAND IT.

                    BUT THE FACT OF THE MATTER IS THE LANGUAGE ISN'T IN THE BILL.

                                         49



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. PAULIN:  IT IS IN BILL.

                                 MR. DURSO:  NO, NO, NO.  IT -- IT'S -- YOU JUST SAID IT

                    ISN'T --

                                 MS. PAULIN:  MAYBE NOT THAT WORD --

                                 MR. DURSO:  YOU SAID YOU WOULD ACTUALLY OFFER AN

                    AMENDMENT.

                                 MS. PAULIN:  WELL, TO ADD, TO YOUR SATISFACTION, AS I

                    DID WITH OTHER MEMBERS, THINGS THAT WE KNEW THAT WE COVERED, BUT

                    THEY WANTED IT -- A WORD CHANGED.  THEY WANTED TO --

                                 MR. DURSO:  SO I'M THE FIRST ONE TO BRING THIS UP?

                                 MS. PAULIN:  WHAT?

                                 MR. DURSO:  I'M THE FIRST ONE THAT BRINGS THIS UP?

                                 MS. PAULIN:  YES, YOU ARE.  BECAUSE EVERYBODY

                    KNOWS THAT ACROSS ALL OF THESE JURISDICTIONS THOSE WORDS HAVE MEANT

                    THAT, AND IN PRACTICE THAT'S WHAT HAPPENS.

                                 MR. DURSO:  I -- I COMPLETELY UNDERSTAND THE -- MY

                    CONCERN IS IT'S NOT IN THE LEGISLATION, WHICH MAKES ME CONCERNED.  BUT

                    I'LL MOVE ON TO THE NEXT PORTION OF IT --

                                 MS. PAULIN:  SURE.

                                 MR. DURSO:  -- WHICH IS ATTENDING PHYSICIAN.  SO

                    YOU HAD SAID THAT IF YOU WERE DIAGNOSED WITH AN INCURABLE DISEASE, THAT

                    YOU HAVE LESS THAN SIX MONTHS TO LIVE, BY YOUR ATTENDING PHYSICIAN,

                    WOULD THAT MEAN THAT IT'S THE PHYSICIAN THAT FINDS WHAT THE DISEASE OR

                    INCURABLE DISEASE THAT YOU ARE -- ARE SADDLED WITH, IS THAT WHAT

                    "ATTENDING PHYSICIAN" MEANS?  OR, SO, IF YOU'RE MY DOCTOR AND YOU SAY,

                                         50



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    MIKE, YOU HAVE BRAIN CANCER.  YOU HAVE LESS THAN SIX MONTHS TO LIVE.

                    AND I SAY, I DON'T LIKE YOUR DIAGNOSIS.  I'M GONNA GO TO THIS DOCTOR.  IS

                    THAT NOW MY ATTENDING PHYSICIAN, OR IS IT THE PERSON THAT FIRST DISCOVERS

                    IT?

                                 MS. PAULIN:  SO IT'S THE PERSON WHO IS RESPONSIBLE

                    FOR THE CARE OF THE PATIENT, AND THE TREATMENT OF THE PATIENT'S TERMINAL

                    ILLNESS OR CONDITION.

                                 MR. DURSO:  SO IN OTHER WORDS --

                                 MS. PAULIN:  IF YOU CHANGE DOCTORS TO DO THAT, THEN

                    THAT WOULD BE YOUR ATTENDING PHYSICIAN.

                                 MR. DURSO:  SO IF MY ATTENDING PHYSICIAN WHO

                    FINDS MY TERMINALLY ILL --

                                 MS. PAULIN:  THEY MAY NOT BE THE ONE THAT TREATS

                    YOU OR CARES FOR YOU, THOUGH.

                                 MR. DURSO:  RIGHT.  BUT THEY ALSO MIGHT SAY, YOU

                    HAVE TWO YEARS TO LIVE.  AND I CAN GO TO ANOTHER DOCTOR AND THEY CAN

                    SAY I HAVE SIX MONTHS.  IS THAT NOW MY ATTENDING PHYSICIAN?

                                 MS. PAULIN:  YOU KNOW, WE DO KNOW THAT DOCTORS,

                    FOR THE MOST PART, STUDIES HAVE SHOWN, TEND TO OVERESTIMATE HOW LONG

                    SOMEONE'S GONNA LIVE.  SO WE KNOW THAT'S ABOUT 85 PERCENT OF DOCTORS

                    WHO MAKE INCORRECT BECAUSE THEY ERR ON THE SIDE OF TRYING TO GIVE THE

                    PERSON A LONGER LIFE, FRANKLY.  AND SO IT'S UNLIKELY THAT A -- THAT TWO

                    DOCTORS IN THE SAME FIELD, DIAGNOSING THE SAME KIND OF CANCER, WHO ARE

                    SPECIALISTS, THEY USUALLY DO CONFER WITH EACH OTHER IF THEY HAVE ANY --

                                 MR. DURSO:  WELL, WHAT IF IT'S A DIFFERENT PRACTICE?

                                         51



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    I MEAN, IF IT'S A DIFFERENT DOCTOR -- IF I'M ON LONG ISLAND AND ONE DOCTOR

                    SAYS YES AND I COME TO ALBANY AND ANOTHER DOCTOR SAYS, NO, YOU HAVE

                    MORE TIME TO LIVE.  OR LESS TIME.

                                 MS. PAULIN:  THE DOCTORS IN THESE FIELDS, AGAIN --

                                 MR. DURSO:  I UNDERSTAND --

                                 MS. PAULIN:  -- I KNOW FROM FIRSTHAND EXPERIENCE,

                    THEY TALK TO EACH OTHER --

                                 MR. DURSO:  I UNDERSTAND (INAUDIBLE/CROSSTALK) --

                                 MS. PAULIN:  -- AND THEY'RE GONNA MAKE A JOINT

                    DECISION.

                                 MR. DURSO:  AND I DON'T MEAN TO SPEAK OVER YOU,

                    MA'AM.  I APOLOGIZE.  BUT OBVIOUSLY WE'RE LIMITED ON TIME.

                                 REALLY, MY QUESTION IS, IT'S NOT THE INITIAL DOCTOR, RIGHT,

                    IT'S JUST WHO YOU DECIDE IS YOUR ATTENDING PHYSICIAN, CORRECT?

                                 MS. PAULIN:  TO TREAT YOUR TERMINAL ILLNESS.

                                 MR. DURSO:  YES.

                                 MS. PAULIN:  YES.

                                 MR. DURSO:  RIGHT.  SO, AGAIN -- SO, ESSENTIALLY, YOU

                    COULD DOCTOR SHOP.  BECAUSE IF I DON'T LIKE ONE DOCTOR'S DIAGNOSIS --

                    JUST LIKE YOU ALWAYS GO TO GET A SECOND OPINION.  IF ONE DOCTOR TELLS ME

                    IT'S TWO YEARS, ONE DOCTOR SAYS IT'S SIX MONTHS, I NOW CHOOSE THAT TO BE

                    MY DOCTOR, THAT'S MY ATTENDING PHYSICIAN, CORRECT?

                                 MS. PAULIN:  YES.  BECAUSE --

                                 MR. DURSO:  THAT'S A -- YEAH --

                                 MS. PAULIN:  YEAH.  OKAY.

                                         52



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. DURSO:  -- SO IT'S DOCTOR SHOPPING.

                                 MS. PAULIN:  YES.

                                 MR. DURSO:  SO, WITH THAT BEING SAID, YOU SAID TWO

                    DOCTORS HAVE TO DECIDE THAT YOU HAVE SIX MONTHS LEFT TO LIVE OR --

                    (INDISCERNIBLE) -- CORRECT?

                                 MS. PAULIN:  YES.

                                 MR. DURSO:  CAN THEY BE TWO DOCTORS IN THE SAME

                    PRACTICE?

                                 MS. PAULIN:  IF IN THAT PRACTICE THERE WERE TWO

                    DOCTORS THAT HAD THAT SAME SPECIALTY, WHICH IS VERY UNUSUAL, BUT

                    POSSIBLE, YES.

                                 MR. DURSO:  OKAY.  SO -- SO, AS MY COLLEAGUE HAD

                    SAID, YOU COULD HAVE DOCTORS THAT BASICALLY START A COTTAGE INDUSTRY TO

                    SAY, OKAY, WE ARE THE ONE-STOP SHOP; THAT WE'RE GONNA HAVE TWO

                    ONCOLOGISTS IN THIS OFFICE THAT ARE BOTH GONNA SAY THE SAME THING,

                    CORRECT?  SO IT DOESN'T HAVE TO BE SEPARATE PRACTICES, IT DOESN'T HAVE TO

                    BE SEPARATE HOSPITALS, IT DOESN'T HAVE TO BE ANYTHING.  IT'S JUST TWO

                    DOCTORS?

                                 MS. PAULIN:  IT'S TWO DOCTORS.  BUT I WOULD ARGUE

                    THAT --

                                 MR. DURSO:  I'M JUST -- I UNDERSTAND WE COULD

                    ARGUE IT --

                                 MS. PAULIN:  OKAY.

                                 MR. DURSO:  -- BUT IT'S JUST -- IT'S TWO DOCTORS --

                                 MS. PAULIN:  IT'S TWO DOCTORS.

                                         53



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. DURSO:  OKAY.  AND THEN YOU HAD SAID ALSO

                    MENTAL HEALTH CHECK IF NECESSARY.  WHO MAKES THAT DECISION, IF IT'S

                    NECESSARY?

                                 MS. PAULIN:  THE DOCTOR AND THE CONSULTING DOCTOR

                    INDEPENDENTLY.

                                 MR. DURSO:  SO THE SAME TWO PEOPLE THAT I SHOPPED

                    FOR WILL DECIDE WHETHER OR NOT I'M MENTALLY COMPETENT.

                                 MS. PAULIN:  WHY, IF YOU WANT TO LIVE, WOULD YOU

                    SHOP FOR A DOCTOR WHO'S GONNA --

                                 MR. DURSO:  BUT IF YOU WANT TO DIE YOU WILL.

                                 MS. PAULIN:  YES.  IF YOU WANT TO DIE YOU CAN

                    OVERDOSE ON ASPIRIN.

                                 MR. DURSO:  YEAH.  YOU -- WELL, THAT WOULD TAKE A

                    LOT OF ASPIRIN.  BUT -- BUT I'M JUST -- I'M JUST TRYING TO UNDERSTAND THE

                    LEGISLATIVE INTENT THAT'S ACTUALLY NOT IN THE BILL.

                                 SO, ALSO, MY OTHER COLLEAGUE HAD STATED THAT YOU HAVE

                    TAKE THIS MEDICATION YOURSELF, CORRECT?

                                 MS. PAULIN:  YES.

                                 MR. DURSO:  OKAY.  NOW, YOU HAVE TO PHYSICALLY

                    BE ABLE TO TAKE IT.

                                 MS. PAULIN:  YES.

                                 MR. DURSO:  SO, NOW, I GET DIAGNOSED WITH AN

                    INCURABLE DISEASE, MY DOCTOR THEN SAYS, YOU QUALIFY FOR THIS.  I SEE THE

                    TWO DOCTORS.  I DON'T NEED TO SEE A MENTAL HEALTH PROFESSIONAL.  THEY

                    GIVE ME THE MEDICATION.  YOU BRING IT HOME, CORRECT?

                                         54



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. PAULIN:  RIGHT.

                                 MR. DURSO:  I DON'T HAVE TO TAKE IT IN FRONT OF

                    ANYBODY, CORRECT?

                                 MS. PAULIN:  YOU DON'T HAVE TO.

                                 MR. DURSO:  BUT YOU NEED TO BE MENTALLY

                    COMPETENT TO TAKE IT.

                                 MS. PAULIN:  YES.

                                 MR. DURSO:  PHYSICALLY COMPETENT TO TAKE IT.

                                 MS. PAULIN:  YES.

                                 MR. DURSO:  SO, NOW, OBVIOUSLY -- AND I'M JUST

                    GOING BY MY OWN PERSONAL STORY, WHICH MANY PEOPLE DO.  MY MOTHER

                    HAD BRAIN CANCER, RIGHT.  OVER A FIVE-MONTH PERIOD SHE LOST THE ABILITY

                    TO WALK, TO USE HER ARMS, TO SWALLOW ON HER OWN.  NOW, IF THAT

                    MEDICATION IS SITTING AT HOME, RIGHT, AND I KNOW MY MOTHER WANTED TO

                    END HER LIFE THAT WAY, OBVIOUSLY, I CANNOT GIVE HER THE MEDICATION,

                    CORRECT?

                                 MS. PAULIN:  THAT'S CORRECT.

                                 MR. DURSO:  BUT SHE ALSO CAN'T TAKE IT HERSELF.

                                 MS. PAULIN:  SHE COULD.

                                 MR. DURSO:  HOW?  SHE CAN'T MOVE HER ARMS --

                                 MS. PAULIN:  THERE ARE OTHER WAYS TO INGEST --

                                 MR. DURSO:  HOW IS THAT?

                                 MS. PAULIN:  SO, FOR EXAMPLE, THERE'S FOUR WAYS TO

                    INGEST.  THEY ARE -- I'M GONNA --

                                 MR. DURSO:  WELL, SHE CAN'T USE HER ARMS.

                                         55



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. PAULIN:  WELL, THERE'S A -- THERE'S RECTAL

                    INGESTION AS WELL.

                                 MR. DURSO:  HOW IS SHE GONNA DO THAT?

                                 MS. PAULIN:  YOU CAN PUSH A BUTTON.

                                 MR. DURSO:  YOU CAN -- OH.  OH.  SO -- BUT IT WOULD

                    HAVE TO BE SET UP PRIOR TO THAT, CORRECT?

                                 MS. PAULIN:  SOMEONE ELSE COULD HELP SET IT UP AS

                    LONG AS SHE WAS ACTUALLY --

                                 MR. DURSO:  WHO IS THAT PERSON THAT'S ALLOWED TO

                    SET IT UP?

                                 MS. PAULIN:  ANYBODY COULD SET IT UP IF SHE ASKED

                    THEM.

                                 MR. DURSO:  OH, OKAY.  SO IT'S NOT JUST A PILL FORM,

                    CORRECT?

                                 MS. PAULIN:  NO, IT'S NOT JUST A PILL FORM --

                                 MR. DURSO:  OH, OKAY.

                                 MS. PAULIN:  IN FACT, IT'S MOSTLY --

                                 (CROSSTALK)

                                 MR. DURSO:  WHO WOULD PUSH THAT BUTTON?

                                 MS. PAULIN:  SHE WOULD HAVE TO.

                                 MR. DURSO:  WHAT IF SHE CAN'T?

                                 MS. PAULIN:  THEN SHE WOULDN'T BE ELIGIBLE.

                                 MR. DURSO:  OKAY.  SO WHAT IS THE MECHANISM IN

                    PLACE TO -- TO PROTECT THOSE PEOPLE OR MAKE SURE THAT DOESN'T HAPPEN?

                    ESSENTIALLY, YOU'RE -- YOU'RE SENDING SOMEONE HOME WITH A LIFE-ENDING

                                         56



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    DRUG, BUT THERE'S NO MECHANISM IN PLACE TO MAKE SURE THAT THAT PERSON

                    ADMINISTERS IT TO THEMSELVES WILLINGLY, CORRECT, IF, AT THAT POINT, AFTER

                    TWO MONTHS?

                                 MS. PAULIN:  IF -- SO YOU'RE SAYING THAT -- YOU

                    KNOW, BECAUSE REMEMBER IF THERE'S COERCION OR SOMEONE IS ACTUALLY

                    MURDERING SOMEONE --

                                 MR. DURSO:  ABSOLUTELY.

                                 MS. PAULIN:  -- RIGHT?  THAT YOU BELIEVE THAT THIS

                    COULD HAPPEN, WHEN WE KNOW THERE'S BEEN NEVER A CASE THAT THIS HAS

                    HAPPENED --

                                 MR. DURSO:  HOW DO WE KNOW IT'S NEVER

                    HAPPENED?  THIS -- THERE'S NO -- YOU DON'T SEND THEM HOME WITH A

                    CAMERA AND A PILL.

                                 MS. PAULIN:  YOU KNOW, IN 82 PERCENT OF THE CASES

                    THERE'S A MEDICAL PROVIDER THERE.  SO WE KNOW IN 82 PERCENT OF THE

                    CASES THERE'S SOME OTHER PERSON THERE, RIGHT, THAT IS OUTSIDE THE FAMILY

                    UNIT.  I'M THINKING YOU'RE SUGGESTING THAT SOME FAMILY MEMBER IS

                    GONNA KILL SOMEONE --

                                 MR. DURSO:  NO.  THAT'S NOT WHAT I'M SUGGESTING --

                                 MS. PAULIN:  WELL, THEN -- THEN WHAT ARE YOU

                    SUGGESTING?

                                 MR. DURSO:  I'M NOT SUGGESTING THAT THEY'RE GONNA

                    KILL SOMEONE.  WHAT I'M SUGGESTING IS, YOU'RE SENDING THEM HOME WITH

                    A -- WITH A LIFE-ENDING PILL, RIGHT.  SOMEONE COULD --

                                 MS. PAULIN:  WELL, A SERIES OF MEDICATIONS --

                                         57



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. DURSO:  A SERIES OF MEDICATIONS --

                                 MS. PAULIN:  -- YES.

                                 MR. DURSO:  -- HOWEVER YOU WANT TO CALL IT.  BUT

                    ONCE THEY'RE HOME WITH IT, THERE IS NO GUARANTEE AND NO MECHANISM IN

                    PLACE TO MAKE SURE THAT THEY'RE THE ONES TAKING IT, THEY'RE THE ONES

                    GIVING IT TO THEMSELVES, THAT THEY'RE MENTALLY COMPETENT AT THAT POINT,

                    BECAUSE, AGAIN, PERSONAL STORY --

                                 MS. PAULIN:  THEY HAVE TO SELF-INGEST, RIGHT?  SO IF

                    THEY'RE SELF-INGESTING, YOU KNOW, THEN --

                                 MR. DURSO:  WHY COULDN'T THEY DO IT AT THE DOCTOR'S

                    OFFICE?

                                 MS. PAULIN:  THEY -- THEY COULD IF THEY WANTED TO.

                                 MR. DURSO:  WHY -- WHY SHOULDN'T THAT BE PART OF

                    THE LEGISLATION TO SAY THAT IT HAS TO --

                                 MS. PAULIN:  BECAUSE PEOPLE WANT TO DIE AT HOME.

                                 MR. DURSO:  I -- I UNDERSTAND THAT.  BELIEVE ME.

                    BUT MY CONCERN IS THAT IF MY MOTHER'S WISHES WERE TO TAKE THIS, AND

                    THEN AT THAT POINT SHE'S NOT MENTALLY COMPETENT AND CAN'T USE HER ARMS

                    AND LEGS, HOW IS SHE GETTING IT?  YOU SAID YOU COULD TAKE IT RECTALLY.  I

                    DON'T KNOW HOW SHE'S DOING THAT WITHOUT HER ARMS OR LEGS.  OR YOU

                    COULD PUSH A BUTTON.  YOU CAN'T DO THAT WITHOUT YOUR HANDS.

                                 MS. PAULIN:  SO, THERE ARE TECHNOLOGY ADVANCES

                    NOW.  SO, FOR EXAMPLE, WITH A BLINK OF THE EYE YOU CAN -- YOU CAN

                    TRIGGER SOMETHING.  YOU KNOW, IF -- IF YOU HELD THE CUP WITH A STRAW

                    AND SHE COULD SIP, THE SIPPING WOULD BE --

                                         58



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. DURSO:  IF YOU HELD A CUP WITH A STRAW AND YOU

                    [SIC] SIPPED IT, AREN'T YOU HELPING THEM?  YOU CANNOT AID --

                                 MS. PAULIN:  SHE HAS TO BE THE ONE TO DO THE

                    SIPPING --

                                 MR. DURSO:  -- BUT YOU CANNOT AID THEM IN DOING

                    IT --

                                 MS. PAULIN:  YOU CAN -- YOU CAN HOLD THE CUP --

                                 MR. DURSO:  -- BUT IT'S SPECIFIC -- IT SAYS THAT?

                    BECAUSE AS FAR AS I'M CONCERNED THAT -- THAT'S -- THAT'S HELPING

                    SOMEONE --

                                 MS. PAULIN:  WELL, WE HAVE 30 YEARS OF EXPERIENCE

                    TO SHOW THAT THIS HAS BEEN --

                                 (CROSSTALK)

                                 MR. DURSO:  WITH 30 YEARS OF EXPERIENCE AND WE

                    STILL DON'T HAVE THE LANGUAGE IN THE BILL, MS. PAULIN.

                                 MS. PAULIN:  WHY DOES THE LANGUAGE HAVE TO BE

                    SIPPING A STRAW?

                                 MR. DURSO:  BECAUSE YOU'RE -- BECAUSE YOU'RE

                    ALLOWING SOMEONE TO END THEIR LIFE --

                                 (CROSSTALK)

                                 ACTING SPEAKER HUNTER:  THANK YOU,

                    MR. DURSO.

                                 MS. SOLAGES.

                                 MS. SOLAGES:  MADAM SPEAKER, CAN YOU PLEASE

                    CALL THE SOCIAL SERVICES COMMITTEE TO THE SPEAKER'S CONFERENCE

                                         59



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ROOM?

                                 ACTING SPEAKER HUNTER:  SOCIAL SERVICES

                    COMMITTEE TO THE SPEAKER'S CONFERENCE ROOM.  PLEASE GO SEE MEMBER

                    DAVILA IN THE SPEAKER'S CONFERENCE ROOM FOR SOCIAL SERVICES.

                                 MS. WALSH.

                                 MS. WALSH:  THANK YOU, MADAM SPEAKER.

                                 ON THE BILL.

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MS. WALSH:  AT THE OUTSET, I WANT TO SAY THAT I HAVE

                    LISTENED TO INDIVIDUALS AND GROUPS WHO BOTH SUPPORT AND OPPOSE THIS

                    BILL, AND THESE HAVE BEEN AMONG THE DEEPEST AND MOST MEANINGFUL

                    DECISIONS THAT I HAVE HAD AS A LEGISLATOR.

                                 IT'S CLEAR FROM THE DEBATE THAT WE HAVE HAD SO FAR

                    TODAY THAT ALL OF US SHARE A DEEP CONCERN FOR PEOPLE AND THEIR ANXIETY,

                    THEIR PAIN, AND THEIR SUFFERING.  I'VE EXPERIENCED PERSONAL FAMILY LOSSES

                    THAT COME TO MIND WHENEVER THIS TOPIC IS DISCUSSED, WHICH I CAN'T SHARE

                    NOW FOR FEAR THAT I WOULD NOT BE ABLE TO GET THROUGH IT.  RATHER THAN

                    USING -- OR -- OR TALKING ABOUT MY OWN PERSONAL STORIES, I WANT TO FIRST

                    HIGHLIGHT SPECIFIC PORTIONS OF THE BILL THAT I FIND PROBLEMATICAL.

                                 THE BILL PROVIDES THAT YOU MUST HAVE A TERMINAL

                    ILLNESS OR CONDITION; MEANING AN INCURABLE AND IRREVERSIBLE ILLNESS OR

                    CONDITION THAT HAS BEEN MEDICALLY CONFIRMED AND WILL, WITHIN A

                    REASONABLE DEGREE OF MEDICAL CERTAINTY, PRODUCE DEATH WITHIN SIX

                    MONTHS.

                                 THE ADVOCATES FOR THIS BILL CITE TERMINAL CANCER, MOST

                                         60



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    OFTEN.  BUT IN NEW JERSEY'S MEDICAL AID IN DYING STATUTE, WHICH THE

                    NEW YORK LEGISLATION PARALLELS, THERE ARE OTHER TERMINAL ILLNESSES OR

                    CONDITION BESIDES CANCER; NEURODEGENERATIVE DISORDERS, WHICH COULD

                    INCLUDE ALZHEIMER'S, MS, ALS, OR LOU GEHRIG'S DISEASE, PARKINSON'S,

                    HUNTINGTON'S DISEASE, JUST TO NAME A FEW.  THERE IS CONCERN IN THE

                    LITERATURE THAT SOMETHING LIKE ANOREXIA NERVOSA COULD BE CLASSIFIED AS

                    TERMINAL ANOREXIA, AND DOES QUALIFY FOR MEDICAL AID IN DYING.

                                 IN NEW JERSEY AROUND 25 PERCENT OF MEDICAL AID IN

                    DYING (INAUDIBLE) WERE FOR NEURODEGENERATIVE DISORDERS, BUT WHEN I

                    HAD MET WITH ADVOCATES FOR THIS LEGISLATION I WAS ASSURED THAT

                    NEURODEGENERATIVE DISORDERS WOULD NOT QUALIFY BECAUSE YOU COULDN'T

                    CERTIFY DEATH WITHIN SIX MONTHS.  WHICH IS IT?

                                 THE WHOLE IDEA OF THE SIX MONTHS IS A FICTION.

                    SOMETIMES YOU COULD TELL ROUGHLY WHEN SOMEONE IS ABOUT TO DIE, BUT

                    FOR MOST OF THE TIME YOU'RE MAKING AN EDUCATED GUESS.  SOME PATIENTS

                    LIVE FAR, FAR LONGER THAN THAT.  IF A PATIENT REALLY, REALLY WANTS TO DIE, I

                    COULD SEE DOCTORS ADJUSTING THE SIX-MONTH ESTIMATE TO ACCOMMODATE.

                    OR IF THEY WON'T, FINDING A DOCTOR THAT THE PATIENT FINDS WHO WILL.

                                 THERE'S NO REQUIREMENT THAT THE PATIENT IS A NEW YORK

                    STATE RESIDENT.  THE BILL SAYS THAT THE ATTENDING PHYSICIAN MUST

                    EXAMINE THE PATIENT, BUT DOESN'T SPECIFY WHETHER IT COULD OCCUR OVER

                    TELEHEALTH OR WHETHER IT HAS TO BE IN PERSON.  THERE IS NO EXPLICIT

                    PROHIBITION REGARDING SENDING THE PRESCRIPTION FOR LETHAL MEDS OUT OF

                    STATE, AS IS ALLOWED WITH ABORTION DRUGS.

                                 THERE IS NO REQUIREMENT THAT THE DEATH BE ATTENDED.  IF

                                         61



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    IT IS UNATTENDED AND UNWITNESSED, YOU HAVE THE POTENTIAL TRAUMA TO THE

                    FAMILY MEMBERS OR PEOPLE WHO DISCOVER THE BODY.  YOU DON'T KNOW IF

                    THE PERSON DIED NATURALLY OR FROM THE LETHAL DOSE.  IF THERE IS NO

                    MEDICATION PRESENT, AND YOU KNOW THAT A PRESCRIPTION WAS ISSUED TO THE

                    PATIENT, YOU DON'T KNOW WHAT HAS HAPPENED TO IT.  WAS IT GIVEN TO

                    SOMEONE ELSE?  WOULD THAT SOMEONE ELSE HAVE QUALIFIED FOR MEDICAL

                    AID IN DYING?  WHO HAS IT?  THAT MEDICATION IS AS DANGEROUS AS A

                    LOADED GUN, BUT PRECAUTIONS FOR ITS SAFEKEEPING ARE ABSENT IN THIS

                    LEGISLATION.

                                 THE CHECKS IN PLACE TO LOOK FOR INFORMED CONSENT,

                    CAPACITY, AND ABSENCE OF COERCION ALL PRECEDE THE ISSUANCE OF THE

                    PRESCRIPTION.  AFTER THAT THERE ARE NO FURTHER CHECKS.  THIS IS A HUGE

                    PROBLEM FOR ME.  IN OTHER COUNTRIES THERE ARE REPEATED FURTHER CHECKS

                    ON THE PATIENT TO MAKE SURE THAT THE PATIENT STILL HAS CAPACITY, STILL

                    CONSENTS, AND STILL IS NOT BEING COERCED.  IN -- I THINK IT WAS CANADA --

                    THERE ARE NO FEWER THAN EIGHT CHECK-IN POINTS WITH THE PATIENTS DURING

                    THE PROCESS.  THAT ADDITIONAL SCRUTINY IS NECESSARY, IN MY OPINION, AND

                    IS ABSENT FROM THIS LEGISLATION.

                                 FOR EXAMPLE, WHAT DO YOU DO WITH A PATIENT WHO HAS

                    ALZHEIMER'S AND HAS CAPACITY AT THE TIME A PRESCRIPTION IS WRITTEN, BUT

                    WHO DOESN'T TAKE IT UNTIL FAR LATER WHEN CAPACITY HAS BEEN LOST?  THERE

                    IS NO REQUIREMENT THAT THE DEATH IS ATTENDED BY ANYONE.  THERE IS

                    NOTHING THAT SAYS, HEY, THIS PRESCRIPTION WAS WRITTEN SIX MONTHS AGO

                    AND THE PERSON IS STILL ALIVE.  WE SHOULD TAKE BACK THAT LETHAL

                    PRESCRIPTION OR WE SHOULD REEVALUATE FOR CAPACITY.  OR, THIS PERSON

                                         62



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    DIED UNATTENDED AND WE DON'T KNOW WHETHER OR NOT THEY USED THE

                    PRESCRIPTION AND NOW WE CAN'T FIND IT.  THE ENTIRE CHAIN OF CUSTODY FOR

                    WHAT IS BY ITS VERY NATURE A LETHAL DOSE IS VERY CONCERNING TO ME,

                    PARTICULARLY SINCE THE SPONSOR HAS INDICATED THAT 40 PERCENT OF THE TIME

                    THE PATIENT NEVER USES THE MEDICATION.

                                 THE BILL LAYS OUT GROUND RULES AND PROTECTIONS FROM

                    OUTSIDE COERCION.  THAT IS GOOD, AS FAR AS DIRECT PRESSURE FROM

                    INTERESTED PARTIES OR FAMILY MEMBERS, BUT I DON'T THINK THAT THAT'S AS BIG

                    OF A PROBLEM COMPARED TO YOU PRESSURING YOURSELF AS THE PATIENT.  YOU

                    DON'T WANT TO SEE YOUR SAVINGS DEPLETED TAKING CARE OF YOU IN YOUR FINAL

                    DAYS, GIVE THE MONEY TO THE GRANDKIDS.  YOU DON'T WANT TO BE A MESS IN

                    THE END FOR YOUR LOVED ONES TO SEE.  THE LEGISLATION DOESN'T ADDRESS THAT

                    KIND OF INTERNAL COERCION OR SOCIETAL PRESSURE, NOR CAN IT, REALLY.

                                 THE BILL DOESN'T REQUIRE ANY REAL COUNSELING.  A

                    MENTAL HEATH PROFESSIONAL ONLY NEEDS TO BE BROUGHT IN IF EITHER THE

                    ATTENDING OR THE CONSULTING PHYSICIAN FEEL THAT CAPACITY IS A QUESTION.

                    OTHERWISE, TWO PHYSICIANS WITHOUT MENTAL HEALTH CREDENTIALS CAN MAKE

                    THE CALL.  THESE TWO PHYSICIANS DO HAVE TO ISSUE CERTAIN WARNINGS AND

                    CAUTIONS, BUT HOW HARD ARE THEY GOING TO TRY TO REDIRECT THE PATIENT TO

                    HOSPICE OR PALLIATIVE CARE INSTEAD OF SUICIDE?  THERE IS NO REQUIREMENT

                    THAT A PATIENT TRY PALLIATIVE OR HOSPICE CARE FIRST.

                                 THEN THERE IS THE PART OF THE BILL THAT PROHIBITS CALLING

                    THE PATIENT SUICIDAL AND SELF-ADMINISTERING MEDICATION UNDER THIS

                    ARTICLE SHALL NOT BE DEEMED TO BE SUICIDE.  WELL, THEN, WHAT IS IT?

                    SUICIDE IS DEFINED AS THE ACT OF INTENTIONALLY CAUSING ONE'S OWN DEATH.

                                         63



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ISN'T THAT EXACTLY WHAT WE'RE TALKING ABOUT?  IF THIS IS SUCH A DIGNIFIED,

                    AUTONOMOUS DECISION, THEN WHY ARE TAKING SUCH PAINS IN THE BILL TO

                    CONCEAL IT?  IT REMINDS ME OF THE WAY ABORTION OF A FETUS IS DESCRIBED

                    AS A CLUMP OF TISSUE OR FETAL TISSUE.  LIKE IT'S NOTHING.  LIKE IT DOESN'T

                    MATTER.  I DON'T FIND THAT PARTICULARLY DIGNIFIED OR RESPECTFUL.

                                 I'M AWARE THAT THE REASON WE DON'T WANT TO CALL IT

                    SUICIDE IS BECAUSE WE WANT TO MAKE SURE THAT INSURANCE COMPANIES

                    WILL STILL HAVE TO PAY OUT TO BENEFICIARIES ON LIFE INSURANCE POLICIES.

                    BUT WE SHOULD CALL THIS WHAT IT IS, IT IS GOVERNMENT-SANCTIONED SUICIDE.

                                 THIS BILL EVEN SAYS THAT ON THE DEATH CERTIFICATE

                    SUICIDE WON'T BE LISTED AS THE CAUSE OF DEATH, BUT RATHER THE UNDERLYING

                    TERMINAL ILLNESS OR CONDITION.  ARGUABLY, THAT'S BEEN DISCUSSED AS

                    PERJURY TO COMMIT A FRAUD ON THE INSURANCE COMPANY.

                                 THE LAST THING I'LL SAY ABOUT THE BILL LANGUAGE ITSELF IS

                    THAT THE EFFECTIVE DATE IS IMMEDIATELY.  AND I WAS SURPRISED BY THAT.

                    EVEN IN NEW JERSEY THERE WAS A FOUR-MONTH DELAY BEFORE IT BECAME

                    EFFECTIVE.  I CAN APPRECIATE THE DESIRE TO HELP SOME OF THE ADVOCATES,

                    SOME OF WHOM MAY HAVE LESS THAN SIX MONTHS ALREADY TO LIVE.

                    HOWEVER, THERE WILL ALMOST CERTAINLY BE COURT CHALLENGES TO THIS.  I

                    THINK IT WOULD BE A BETTER COURSE TO ACKNOWLEDGE THAT AND BUILD IN

                    SOME TIME FOR THAT TO BE RESOLVED.  BETTER STILL WOULD BE TO PULL THIS BILL

                    NOW AND HOLD SOME HEARINGS.  THERE HAVEN'T BEEN HEARINGS ON THIS

                    SINCE 2018.  I FIND IT IMPOSSIBLE TO BELIEVE THAT THERE IS NOTHING NEW TO

                    BE LEARNED IN THE LAST SEVEN YEARS, ESPECIALLY AFTER A COVID PANDEMIC,

                    WHEN ALL WE SEEM TO THINK OR TALK ABOUT WAS DISEASE, DEATH, AND DYING.

                                         64



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 YES, WE ARE VOTING ON THE SPECIFICS OF THIS BILL, BUT WE

                    ARE ALSO VOTING ON A PRINCIPLE.  AND WE ARE NOT JUST RESPONDING TO THE

                    IMPASSIONED PLEAS OF ADVOCATES WITH DEEPLY PERSONAL, INDIVIDUAL

                    STORIES, WE ARE LEGISLATING FOR ALL NEW YORKERS.

                                 I DON'T BELIEVE -- THIS IS ME TALKING NOW -- I DON'T

                    BELIEVE THAT THIS STATE SHOULD BE A PART OF TAKING A LIFE.  WE HAVEN'T HAD

                    CAPITAL PUNISHMENT IN NEW YORK SINCE 2004 WHEN THE COURT OF

                    APPEALS SAID THAT IT WAS UNCONSTITUTIONAL.  I DO THINK THAT THE STATE HAS

                    AN OBLIGATION TO PROTECT OUR MOST VULNERABLE NEW YORKERS FROM

                    PREDATORY RELATIVES, FROM THE STATE ITSELF, AND FROM THEMSELVES.

                                 I THINK THAT INSTEAD OF MEDICAL AID IN DYING, WE IN THE

                    LEGISLATURE SHOULD BE DOING A FAR BETTER JOB OF SHOWING THAT WE CAN

                    PROVIDE FOR ASSISTED LIVING BEFORE LEGISLATING ASSISTED DYING.  WHAT

                    DOES THAT MEAN?  WELL, NEW YORK CURRENTLY RANKS LAST NATIONALLY IN

                    TERMS OF HOSPICE AND PALLIATIVE CARE.  AND, MY COLLEAGUES, THAT IS

                    ABSOLUTE DISGRACE.  IT IS UNDER-SOURCED, UNDERSTAFFED, AND

                    UNDERUTILIZED.

                                 BEFORE I VOTED ON THIS LEGISLATION, I WOULD WANT NEW

                    YORK TO BE NUMBER ONE IN HOSPICE AND PALLIATIVE CARE.  IF WE APPROVE

                    THIS TODAY AND THIS BECOMES LAW, I BELIEVE WE CAN ALL FORGET ABOUT

                    MAKING HOSPICE AND PALLIATIVE CARE NUMBER ONE.  IT WILL LIKELY FALL BY

                    THE WAYSIDE.  WE WILL SKIP RIGHT PAST IT.  THIS BILL DOESN'T REQUIRE THAT

                    ALL REASONABLE MEANS OF TREATMENT HAVE BEEN MADE, NOR DOES IT REQUIRE

                    THAT PEOPLE TRY HIGH-QUALITY HOSPICE CARE FIRST.

                                 ONE PERSON TOLD ME, OH, BUT WE SHOULD NOT HOLD

                                         65



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    PEOPLE HOSTAGE BECAUSE OUR MEDICAL SYSTEM HAS FAILED.  WHAT A SAD

                    COMMENTARY.  I DON'T WANT DESPERATE PEOPLE TO CHOOSE TO KILL

                    THEMSELVES BECAUSE WE AS A STATE OFFERED A POOR EXCUSE FOR HOSPICE

                    CARE.

                                 I WANT TO CONFINE MY COMMENTS TO THE BILL THAT WE'RE

                    TALKING ABOUT TODAY, BUT I'M NOT NAIVE.  THE LEGISLATIVE PROCESS, AS WE

                    KNOW, IS INCREMENTAL AND EXTREMELY IMPERFECT.  SO RIGHT NOW THIS BILL

                    IS SPECIFICALLY CONFINED TO ADULTS WITH A TERMINAL ILLNESS OR CONDITION

                    WITH SIX MONTHS OR LESS TO LIVE, WHO CAN GET INFORMED CONSENT AND WHO

                    CAN SELF-ADMINISTER THE LETHAL DOSE -- DOSE OF MEDICATION.

                                 FOLKS WHO ADVOCATE FOR PEOPLE WITH INTELLECTUAL AND

                    DEVELOPMENTAL DISABILITIES HAVE SHOWN CONCERN WITH THIS BILL AND, I

                    BELIEVE, WITH THE ENTIRE CONCEPT OF ASSISTED SUICIDE BECAUSE JUST SIMPLY

                    HAVING IT DEVALUES THEM IN A SOCIETY WHERE THEY FIGHT TO LIVE.  LOOK AT

                    OUR CDPAP SYSTEM AND THE UNHOLY MESS THAT'S BEEN CAUSED BY

                    SWITCHING TO A SINGLE FISCAL INTERMEDIARY.  LOOK AT THE WAY WE PAY OUR

                    DIRECT CARE WORKERS, GIVING THEM INCREASES THAT THEY NEVER ACTUALLY GET,

                    FORCING THEM TO LOAD UP THEIR FOLKS AND GO TO THE WAR ROOM EACH

                    BUDGET CYCLE AND BEG TO BE TREATED WITH DIGNITY AND RESPECT.  AND LOOK

                    AT HOW THIS STATE FAILS THEM EVERY SINGLE TIME.

                                 COULD ANY OF US BE SURPRISED IF THIS ASSISTED SUICIDE

                    BILL BECOMES LAW, THAT PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL

                    DISABILITIES ARE COERCED BY OTHERS OR BY THEMSELVES TO JUST GIVE UP AND

                    DIE?  FOR GOD'S SAKE, WE HEARD THE NEW HEALTH SECRETARY SAY

                    SOMETHING DURING AUTISM AWARENESS MONTH, FOR GOD'S SAKE, NO LESS,

                                         66



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THAT PEOPLE WITH AUTISM CAN'T CONTRIBUTE MEANINGFULLY TO OUR SOCIETY,

                    CAN'T HOLD JOBS AND WILL BE A BURDEN.  I REGRET THAT HE SAID THOSE THINGS

                    BECAUSE I KNOW THAT THEY ARE NOT TRUE.

                                 EACH AND EVERY LIFE HAS VALUE.  PROGRESS MAY NOT BE

                    ON A STRAIGHT LINE.  IT WILL LOOK DIFFERENT TO EACH OF US.  BUT THIS IDEA OF

                    GIVING UP AND DYING IS NOT EXCELSIOR, EVER UPWARD.  IT'S INCREDIBLY SAD.

                                 AS POPE FRANCIS SAID IN 2019, EUTHANASIA AND ASSISTED

                    SUICIDE ARE A DEFEAT FOR US ALL.  WE ARE CALLED TO NEVER ABANDON THOSE

                    WHO ARE SUFFERING, NEVER GIVING UP, BUT CARING AND LOVING TO RESTORE

                    HOPE.

                                 WE NEED ONLY LOOK AT THE EXAMPLE OF OUR NEIGHBOR TO

                    THE NORTH, CANADA, TO UNDERSTAND THE RISK.  THAT COUNTRY PASSED A

                    SIMILAR LAW TO NEW YORK'S BILL IN 2016.  WITHIN A FEW SHORT YEARS IT

                    WAS EXPANDED TO ALLOW NOT ONLY THOSE WITH TERMINAL ILLNESS, BUT ALSO

                    THOSE WITH CHRONIC ILLNESSES SUCH AS ARTHRITIS TO END THEIR LIVES.  IN

                    2027, THE LAW IS SET TO EXPAND FURTHER TO THOSE WHOSE ONLY UNDERLYING

                    CONDITION IS MENTAL ILLNESS SUCH AS DEPRESSION, ANXIETY OR ANOREXIA

                    NERVOSA.  IT IS THAT SO-CALLED "SLIPPERY SLOPE" THAT IS REAL.  WE AS

                    LEGISLATORS KNOW THAT THIS IS TRUE.  WE HAVE WITNESSED TIME AND TIME

                    AGAIN IN OUR LEGISLATIVE WORK THE GRADUAL, CONTINUED MODIFICATION,

                    SOME WOULD SAY EROSION, OF OUR LAW.  ANY MAJOR ISSUE FROM GUNS TO

                    ABORTION TO VOTING HAVE ALL SEEN CONTINUED CHANGES MADE.  IN OUR STATE

                    NOW YOU CAN GET AN ABORTION ON DEMAND, LEGALLY BUY AND CONSUME

                    MARIHUANA, ENGAGE IN ONLINE SPORTS BETTING, AND NOW APPLY FOR THE

                    STATE'S SUICIDE SERVICE.

                                         67



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 IS THIS THE STATE THAT WE WISH TO BECOME?  THAT IS IN

                    PART WHAT THIS VOTE IS ABOUT TODAY.  YES, NINE OTHER STATES HAVE DONE IT,

                    BUT 41 HAVE NOT.  THERE IS A REASON FOR THAT.  DON'T DISCOUNT THOSE

                    REASONS, NO MATTER HOW HEART-WRENCHING THE PERSONAL STORIES.

                    CONSIDER NOT ONLY WHAT THIS BILL DOES, BUT THAT BY PASSING IT WE ARE

                    OPENING THE DOOR TO THE NEXT THING AND THE NEXT.

                                 WE ARE BEING ASKED TO REQUIRE THE STATE TO SANCTION

                    SUICIDE AT THE SAME TIME, MY FRIENDS, THAT THE STATE CALLS SUICIDE A

                    MAJOR PUBLIC HEALTH PROBLEM.  EVIDENCE SHOWS THAT CONTRARY TO

                    EXPECTATIONS AND JURISDICTIONS WHERE MEDICAL AID IN DYING HAS BEEN

                    LEGALIZED, RATES OF GENERAL SUICIDE HAVE INCREASED.  THE EPIDEMIC OF

                    DEPRESSION AND OTHER NEGATIVE IDEATIONS, PARTICULARLY AMONG OUR YOUNG

                    PEOPLE, MAKES THIS PERHAPS THE WORST POSSIBLE TIME FOR LAWMAKERS TO

                    LEGITIMIZE AND SANCTION SUICIDE.

                                 I SAY THIS:  LET'S TAKE ALL OF OUR ENERGY, OUR LOVE, AND

                    OUR COMPASSION AND SAY NO TO THIS BILL TODAY.  LET'S INSTEAD WORK

                    STEADFASTLY TO MAKE OUR HOSPICE AND PALLIATIVE CARE SYSTEM THE BEST IN

                    THE NATION.  LET US FIND THE RESOURCES TO DO SO.  I TRULY BELIEVE IN MY

                    HEART THAT ONCE WE DO THAT, THE NEED FOR MEDICAL AID IN DYING WOULD GO

                    AWAY FOR THE VAST MAJORITY OF PATIENTS.

                                 TO PARA -- TO PARAPHRASE H. L. MENCKEN:  FOR EVERY

                    COMPLEX PROBLEM THERE IS A SIMPLE, EASY ANSWER.  AND IT'S WRONG.

                                 WE CAN DO BETTER, MY COLLEAGUES, THAN THIS BILL.  AND I

                    WILL VOTE NO.

                                 THANK YOU, MADAM SPEAKER.

                                         68



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 (APPLAUSE)

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MS. SOLAGES.

                                 MS. SOLAGES:  MADAM SPEAKER, CAN YOU PLEASE

                    CALL THE MENTAL HEALTH COMMITTEE TO THE SPEAKER'S CONFERENCE ROOM?

                                 ACTING SPEAKER HUNTER:  MENTAL HEALTH

                    COMMITTEE TO THE SPEAKER'S CONFERENCE ROOM.  IMMEDIATE

                    COMMITTEE, MENTAL HEALTH, THE SPEAKER'S CONFERENCE ROOM.

                                 MR. EPSTEIN.

                                 MR. EPSTEIN:  WILL THE SPONSOR YIELD?

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MR. EPSTEIN:  THANK YOU, SPONSOR.

                                 YOU MENTIONED 82 PERCENT OF THE TIME THERE ARE

                    MEDICAL PROFESSIONALS ON SITE FOR THE MEDICAL AID IN DYING.  HOW --

                    WHERE DO YOU GET THAT STATISTIC FROM?

                                 MS. PAULIN:  IN SOME STATES, NOT ALL, BUT IN MOST,

                    THEY ACTUALLY HAVE DATA THAT'S REQUIRED, AS WE DO IN OUR BILL FOR NEW

                    YORK, TO MONITOR AND RECORD EXACTLY WHAT HAS TAKEN PLACE.  AND

                    THAT'S -- THAT 82 PERCENT IS FROM OREGON, WHICH HAS THE LONGEST STANDING

                    EXPERIENCE.

                                 MR. EPSTEIN:  YEAH.  AND BESIDES THE 82 PERCENT IN

                    THOSE OREGON CASES OF MEDICAL PROFESSIONALS, THERE ARE OTHER PEOPLE

                                         69



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WHO ARE IN THE ROOM AT THAT TIME AS WELL?  DOES THAT STUDY --

                                 MS. PAULIN:  IT'S -- YES, IN ALMOST ALL CASES.  I

                    IMAGINE THERE'S BEEN A FEW, BUT HONESTY, WE HAVEN'T HEARD OF ANY

                    WHERE THERE HAS BEEN NO WITNESSES PRESENT.

                                 MR. EPSTEIN:  SO BEYOND MEDICAL PROFESSIONALS,

                    THERE MAY BE LOVED ONES AND FAMILY MEMBERS WHO MIGHT BE PRESENT IN

                    THAT MOMENT?

                                 MS. PAULIN:  MOSTLY, YES.  BECAUSE WHAT THE

                    MEDICATION DOES IS IT GIVES THAT OPPORTUNITY FOR A PATIENT NOT TO DIE

                    ALONE.

                                 MR. EPSTEIN:  AND SO YOU -- YOU MENTIONED TWO

                    DOCTORS, A REQUIREMENT TO HAVE TWO DOCTORS.  I KNOW WE HEARD EARLIER

                    ABOUT THE TWO DOCTORS IN PRACTICES.  WHY DO YOU -- WHY IS IT SUCH A

                    REALLY COMPELLING REQUIREMENT TO HAVE TWO DOCTORS WHO HAVE MEDICAL

                    LICENSES TO MAKE THAT DETERMINATION?

                                 MS. PAULIN:  BECAUSE WE UNDERSTAND THE

                    SERIOUSNESS OF MAKING A DECISION LIKE THIS.  AND WE WANT TO BE SURE

                    THAT THE PERSON WHO IS GETTING THAT PRESCRIPTION IS AS COMFORTABLE IN

                    MAKING THE DECISION AS POSSIBLE.

                                 MR. EPSTEIN:  AND WHAT'S AT RISK FOR THE DOCTOR

                    WHO MAKES THE DECISION -- YOU KNOW, LIKE, WE'VE HEARD ABOUT

                    (INAUDIBLE).  IS THERE ANYTHING AT RISK FOR THAT MEDICAL PROFESSIONAL WHO

                    MIGHT GO DOWN THAT ALLEGED PATH?

                                 MS. PAULIN:  NO, THERE'S NO LIABILITY.  WE SAY SO IN

                    THE BILL.

                                         70



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. EPSTEIN:  AND -- SO YOU MAY -- YOU TALKED

                    ABOUT POTENTIAL REFERRALS FOR MENTAL HEALTH PROFESSIONALS.  WHY -- WHY

                    IS THAT IN THE BILL?  WHY DO -- WHY DO WE OUTLINE THAT?

                                 MS. PAULIN:  BECAUSE WE WANT TO MAKE SURE THE

                    PERSON HAS THE DECISIONMAKING CAPABILITY OF MAKING THIS KIND OF

                    DECISION.

                                 MR. EPSTEIN:  AND SO THERE'S BEEN SOME CLAIMS

                    AROUND COERCION FROM FAMILY MEMBERS TO -- DOWN THIS PATH.  AND WHY

                    DO YOU THINK THIS BILL PROTECTS AGAINST THAT LEVEL OF COERCION?

                                 MS. PAULIN:  BECAUSE THE PATIENT HAS TO, FIRSTLY,

                    ORALLY ASK, AND THEN THE WRITTEN ASK IS -- HAS TO BE WITNESSED BY TWO

                    PEOPLE WHO HAVE -- WHO ARE NOT IN RELATION AT ALL WITH THE PATIENT AND

                    WOULD ALSO HAVE NO FINANCIAL GAIN FROM THAT PATIENT.  SO THEY CANNOT BE

                    KNOWN TO BE IN THE ESTATE OR WILL.  SO THOSE WITNESSES ARE INDEPENDENT,

                    AND HAVE TO ATTEST THERE'S NO COERCION.  SO YOU HAVE MULTI-LEVELS AND

                    MULTI PEOPLE ATTESTING TO THE FACT THAT THERE'S NO COERCION.

                                 MR. EPSTEIN:  AND YOU MENTIONED WITNESSES.

                    WHAT'S THE -- WHAT'S -- WHY DO YOU THINK THAT ROLE OF WITNESSES PLAYS AN

                    IMPORTANT ROLE IN THIS?

                                 MS. PAULIN:  YOU KNOW, WE REQUIRE WITNESSES

                    THROUGH THE LAW TO -- YOU KNOW, ON DOCUMENTS.  AND THIS IS ONE SUCH

                    IMPORTANT DOCUMENT.

                                 MR. EPSTEIN:  AND -- SO THE DOCTORS WHO ARE

                    INVOLVED IN THIS KIND OF CARE --

                                 MS. PAULIN:  I'VE TALKED TO MANY PEOPLE INVOLVED

                                         71



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WITH THIS ISSUE, YES.

                                 MR. EPSTEIN:  AND WHAT HAVE YOU HEARD FROM THE

                    MEDICAL PROFESSIONALS?

                                 MS. PAULIN:  WE'VE HEARD THAT, AS WAS STATED BY THE

                    PRIOR SPEAKER, THE ASSEMBLYMEMBER, THAT MOST PEOPLE WILL NOT AVAIL

                    THEMSELVES OF THIS.  MOST PEOPLE ARE -- ARE VERY -- THAT ONLY 1 PERCENT

                    OF THE PEOPLE WHO ARE GONNA DIE IN ANY ONE STATE ARE GOING TO GET OR

                    WANT THIS PRESCRIPTION.  SO IT'S VERY SMALL NUMBERS.  AND THE REASON IT'S

                    SMALL IS BECAUSE HOSPICE AND PALLIATIVE CARE DO A GOOD JOB FOR MOST

                    PATIENTS, BUT THEY DON'T DO A GOOD JOB FOR ALL PATIENTS, EVEN ADMITTED BY

                    MY COLLEAGUE.  SO THOSE -- BUT THOSE PEOPLE WHO ARE IN SUCH AGONY,

                    WHO ARE IN SUCH PAIN, THIS IS THE WAY THEY CAN RELIEVE THEMSELVES OF

                    THAT DISTRESS.  AND SO WE KNOW MOST PEOPLE ARE NOT GONNA AVAIL

                    THEMSELVES.  MOST PEOPLE WHO GET IT ARE GOING TO DIE THEIR NATURAL

                    COURSE.  BUT FOR THE FEW, FOR THAT 1 PERCENT OF NEW YORKERS, THIS

                    BECOMES PARAMOUNT FOR THEM TO DIE PEACEFULLY.

                                 MR. EPSTEIN:  THANK YOU.

                                 ON THE BILL.

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MR. EPSTEIN:  I WANT TO THANK THE SPONSOR FOR HER

                    LEADERSHIP ON THIS ISSUE.  I THINK A LOT -- I THOUGHT A LOT ABOUT THIS BILL

                    OVER THE YEARS.  I REMEMBER A FEW YEARS AGO WHEN MY MOTHER-IN-LAW

                    PASSED AWAY AND THE MONTHS OF PAIN AND AGONY THAT SHE WENT THROUGH

                    AND TALKING TO MY WIFE EVERY DAY ABOUT HER ONLY GOAL REALLY WAS TO DIE.

                    SHE WAS IN PAIN AND SUFFERING.  AND EVEN OVER THE LAST TWO WEEKS OF

                                         72



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    HER LIFE, EVERY BREATH SEEMED LIKE IT WAS GONNA BE THE LAST AND IT WAS --

                    IT WAS HORRIFIC AND HORRIBLE TO WATCH.  AND THEN YOU NEVER KNEW WHEN

                    THE END WAS IN SIGHT, AND ALL SHE WAS IN THE END WAS IN PAIN.  ALL SHE

                    WAS IN THE END WAS LOOKING TO END HER LIFE.  AND IF THIS WAS MADE

                    AVAILABLE TO HER, KNOWING WHO SHE WAS SHE WOULD HAVE LOVED TO HAVE

                    DIED WITH HER FAMILY MEMBERS AROUND HER, IN THAT LOVING EMBRACE IN

                    THE MOMENT WHERE SHE WAS READY TO GO.  BUT INSTEAD, HER END AND HER

                    LAST BREATH WAS THAT OF PAIN AND TRAGEDY AND HORROR.  AND FOR THOSE

                    WHO WANT TO CHOOSE THIS, FOR THOSE WHOSE FAMILIES -- INDIVIDUALS WANT

                    TO MAKE THAT DECISION WHO CAN AT THAT LAST MOMENT KNOW THAT THEIR

                    FAMILY MEMBERS CAN BE WITH THEM, SURROUNDING THEM AND GO IN PEACE -

                    WHICH IS ALL OUR ENDS, WE'RE ALL AT SOME POINT GONNA PASS - IT IS

                    SOMETHING REALLY LOVING TO BE ABLE TO GIVE THAT TO SOMEONE WHO IS

                    DYING, TO LET THEM CHOOSE THEIR OWN PATH OUT AND TO ALLOW THAT

                    SUFFERING THAT THEY'RE GOING THROUGH TO BE OVER.

                                 DEATH IS NOT SOMETHING WE ALL LOOK FORWARD TO, IT'S NOT

                    JOYFUL.  BUT IT IS SOME PEOPLE WHO ARE AT THE END OF THEIR LIVES WITH

                    TERMINAL ILLNESS WHO WANT TO MAKE THAT DECISION, AND WE SHOULD

                    RESPECT THOSE CHOICES.  LIKE THE SPONSOR SAID, THE VAST MAJORITY OF NEW

                    YORKERS ARE NOT GONNA USE THIS.  THE VAST MAJORITY OF NEW YORKERS

                    DON'T WANT THIS.  BUT FOR THOSE WHO BELIEVE THIS IS WHAT'S BEST FOR THEM,

                    FOR THOSE WHO BELIEVE WHILE AT THE END OF THEIR LIVES, UNDER THE

                    SUPERVISION OF DOCTORS, PROBABLY SEEING A MENTAL HEALTH PROFESSIONAL IN

                    CONSULTATION WITH THEIR LOVED ONES AND FAMILY MEMBERS, WE HAVE TO BE

                    THOUGHTFUL AND RESPONSIVE TO THEIR CONCERNS.

                                         73



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 I HAVE A CONSTITUENT UP HERE TODAY WHO IS A PROMINENT

                    DOCTOR IN HIS FIELD, RAN A LARGE HOSPITAL SYSTEM IN NEW YORK CITY AND,

                    UNFORTUNATELY, HAS ALS.  AND HE SPOKE JUST A LITTLE WHILE AGO ABOUT HIS

                    STRUGGLES ABOUT WHETHER -- HE'S NOT SURE WHETHER HE WOULD USE IT OR

                    NOT, BUT FELT SO HEART-WARMED BY THE MOMENT THAT WERE -- WE ARE AT

                    TODAY THAT HE WOULD HAVE THIS AS AN OPTION FOR HIM.  AND FOR HIM AND

                    THE THOUSANDS OF OTHER NEW YORKERS, THIS IS AN OPTION THAT WE SHOULD

                    NOT TAKE LIGHTLY, BUT HONOR THEIR REQUEST.  THIS IS AN OPTION THAT SHOULD

                    BE AVAILABLE FOR PEOPLE WHO WANT TO MAKE THEIR LIFE DECISION ALONG

                    WITH THEIR FAMILY AND LOVED ONES ABOUT WHAT'S BEST FOR THEM.

                                 AND I WANT TO THANK THE SPONSOR FOR HER DEDICATION

                    AND LEADERSHIP ON THIS ISSUE; THIS WAS NO EASY TASK.  BUT THIS IS A BILL

                    WORTHWHILE FOR THE NEW YORKERS THAT DESERVE IT.

                                 THANK YOU.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MR. GANDOLFO.

                                 MR. GANDOLFO:  THANK YOU, MADAM SPEAKER.

                    WOULD THE SPONSOR PLEASE YIELD FOR SOME MORE QUESTIONS?

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  ABSOLUTELY.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MR. GANDOLFO:  THANK YOU, CHAIR PAULIN.

                                 SO, FIRST I WANT TO GO BACK AND KIND OF TOUCH ON THE

                    TWO-DOCTOR REQUIREMENT HERE.  SO YOU HAVE THE ATTENDING AND THE

                                         74



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    CONSULTING PHYSICIAN, AND IN -- IN MY READING OF THE BILL IT LOOKS LIKE

                    THE ATTENDING PHYSICIAN WOULD REFER THE PATIENT TO A SPECIFIC CONSULTING

                    PHYSICIAN; IS THAT CORRECT?

                                 MS. PAULIN:  YES.

                                 MR. GANDOLFO:  SO THAT -- THAT IS THE SOLE PROCESS

                    FOR IT?  IT COULD BE SOMEONE THAT THEY MIGHT HAVE A SOMEWHAT WORKING

                    RELATIONSHIP WITH, THEY MIGHT REFER ALL THEIR PATIENTS OVER TO THIS

                    CONSULTING PHYSICIAN?

                                 MS. PAULIN:  I -- I THINK THAT, YOU KNOW, SINCE WE

                    KNOW MOST OF THE PEOPLE WHO ARE OPTING TO GET THIS MEDICATION ARE --

                    ALMOST 70 PERCENT ARE CANCER.  EACH CANCER IS VERY UNIQUE.  SO USUALLY

                    THOSE PHYSICIANS HAVE A RELATIONSHIP WITH ONE ANOTHER AND KNOW WHO

                    THEY ARE AND KNOW WHO TO REFER SOMEONE TO.

                                 MR. GANDOLFO:  OKAY.  ARE THERE ANY SAFEGUARDS

                    IN PLACE FROM PREVENTING THIS -- TO JUST USE A TERM ONE OF MY COLLEAGUES

                    USED -- FROM BECOMING A COTTAGE INDUSTRY?  I'M ALMOST LOOKING AT IT

                    LIKE EVERYONE KNOWS A PERSONAL INJURY ATTORNEY WHO YOU CALL HIM UP

                    AND HE SAYS, HEY, GO SEE MY DOCTOR AND HE'LL EVALUATE YOU.  IS THERE

                    ANYTHING PREVENTING THAT SECOND DOCTOR FROM ALMOST BECOMING A

                    RUBBER STAMP FOR THE ATTENDING PHYSICIAN?  I KNOW PEOPLE KEEP

                    BRINGING UP THE FACT THAT TWO DOCTORS HAVE TO CONFIRM, BUT IF YOU'RE AN

                    ATTENDING DOCTOR AND YOU BELIEVE YOU -- YOU HAVE A PATIENT WHO WANTS

                    TO GO THROUGH WITH THIS, YOU'RE GOING TO SEND THEM TO THE CONSULTING

                    PHYSICIAN YOU WORK WITH WHO IS PROBABLY GOING TO BACK UP YOUR

                    DIAGNOSIS, NO?

                                         75



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. PAULIN:  I WOULD THINK IF YOU'RE A MEDICAL

                    PROFESSIONAL OF ANY WORTH THAT -- AND YOU TAKE A MEDICAL OATH, THAT YOU

                    ARE GOING TO BE LOOKING AT THOSE SAME X-RAYS AND CHARTS AND -- AND

                    MAKING YOUR OWN INDEPENDENT DECISION.  SO I'M NOT REALLY CONCERNED

                    THAT, YOU KNOW, WE'RE GONNA SEE A LOT OF DOCTORS OUT THERE THAT ARE JUST

                    GOING TO RUBBER STAMP.  THAT'S NOT WHAT DOCTORS DO.

                                 MR. GANDOLFO:  OKAY.  SO THERE'S -- SO THEY COULD

                    USE THE SAME CONSULTING PHYSICIAN EVERY SINGLE TIME IF THEY SO PLEASE

                    THE ATTENDANT?

                                 MS. PAULIN:  I WOULD SAY THAT EACH OF THEIR PATIENTS

                    IS GONNA BE UNIQUE AND MAYBE THOSE CONSULTING PHYSICIANS WOULD HAVE

                    TO VARY BY THE TYPE OF ILLNESS THAT THEY'RE PRESENTED WITH.

                                 MR. GANDOLFO:  OKAY.

                                 IS THERE ANY REQUIREMENT -- I KNOW WE WERE TALKING

                    ABOUT TREATMENT AND REFUSAL OF TREATMENT.  IS THERE ANY REQUIREMENT TO

                    EXHAUST MULTIPLE TREATMENT OPTIONS BEFORE BEING ELIGIBLE FOR ASSISTED

                    SUICIDE?

                                 MS. PAULIN:  SO I WOULD SAY THAT THE PEOPLE WHO

                    AVAIL THEMSELVES OF THIS, THEY WANT TO LIVE.  SO IF THERE'S A TREATMENT

                    OPTION AND YOU'RE TOLD, YOU KNOW, YOU'LL HAVE SIX MONTHS IF YOU DO

                    THIS, THEY'RE GONNA TAKE ADVANTAGE OF THAT.  IF THEY'RE TOLD THAT SAME

                    TREATMENT IS GOING TO DETERIORATE YOUR -- YOUR QUALITY OF LIFE, THEN

                    MAYBE THEY'RE NOT GONNA TAKE ADVANTAGE OF IT.  BUT THESE ARE PEOPLE

                    WHO WANT TO LIVE.  THEY'RE NOT LOOKING TO DIE.  THEY'RE LOOKING TO LIVE

                    AS LONG AS THEY CAN WITH A STRONG QUALITY OF LIFE.  SO I'M NOT CONCERNED

                                         76



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THAT -- THAT SOMEONE ISN'T GONNA LOOK FOR THOSE TREATMENTS.  THEY ARE,

                    THEY'RE DOING IT NOW.  THEY ONLY TAKE THIS AND WANT THIS AND HAVE THIS

                    PRESCRIPTION IF THEY'RE DESPERATE, IF THEY KNOW IT'S THE END.  YOU KNOW

                    -- AND THEY KNOW THAT THEY'RE IN SUFFERING PAIN.

                                 MR. GANDOLFO:  RIGHT.  BUT LIKE WAS MENTIONED

                    BEFORE, THERE'S NOTHING PRECLUDING A PHYSICIAN FROM LETTING THE PATIENT

                    KNOW THAT THEY HAVE THIS OPTION.  SO IF YOU'RE -- IF YOU'RE -- YOU'VE BEEN

                    BATTLING AN ILLNESS, A CANCER FOR SUCH A LONG PERIOD OF TIME -- AND I

                    UNDERSTAND IT'S EMOTIONAL, IT'S EXHAUSTING -- AND YOU'RE -- YOU'RE FACED

                    WITH A CHOICE, YOU COULD GO FOR ANOTHER TREATMENT AND IT'S GOING TO BE

                    DIFFICULT BUT IT MIGHT GET YOU MORE TIME OR, YOU KNOW, IF YOU'RE TIRED OF

                    FIGHTING YOU CAN GO THE ASSISTED SUICIDE ROUTE.  I COULD SEE HOW THE

                    ASSISTED SUICIDE ROUTE MIGHT BE ATTRACTIVE FOR SOMEONE WHO'S BEEN

                    FIGHTING A -- A -- A DIAGNOSIS FOR SO LONG.  BUT IT -- IT'S A LITTLE TROUBLING

                    THAT THERE'S NO REQUIREMENT TO EXHAUST ANY OF THESE POTENTIAL OPTIONS

                    THAT COULD PROLONG THE LIFE LONGER THAN THE SIX MONTHS.  AND -- BUT I

                    GUESS WE HAVE SOME DIFFERENT OPINIONS ON THAT.

                                 MS. PAULIN:  SO I -- I WOULD -- IN NEW YORK, YOU

                    KNOW, WE ARE -- WE'RE NOT FIRST HERE.  YOU KNOW, WE'RE 12TH.  AND THE

                    11 OTHER PLACES ALREADY HAVE A 30-YEAR EXPERIENCE IN SOME CASES, SO

                    THAT WE ALREADY KNOW THAT THOSE WHO ARE OPTING TO TAKE THE

                    MEDICATION, NOT THOSE OPTIONS TO GET THE PRESCRIPTION, THAT'S OFTEN

                    PEOPLE WHO JUST WANT TO HAVE THAT PEACE OF MIND.  PEOPLE WHO ARE

                    OPTING TO TAKE IT ARE AT THE VERY, VERY END.  THEY ARE AT THE TIME WHEN

                    THEY'RE IN SUCH GREAT PAIN.  THEY ARE -- THEY ARE AT A TIME WHERE THEY

                                         77



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    KNOW THAT THEY ONLY HAVE NOT MONTHS TO LIVE, BUT WEEKS OR DAYS TO LIVE.

                    SO IF THEY THINK THAT THEY CAN EXTEND THEIR LIFE WITH A TREATMENT OR IF

                    THERE IS AN EXPERIMENTAL TREATMENT OR IF THERE IS A TRIAL THAT THEY CAN

                    USE, THEY'RE GOING TO USE IT BECAUSE THEY WANT TO LIVE.

                                 MR. GANDOLFO:  BUT THEY DON'T HAVE TO USE IT,

                    THEY COULD GO RIGHT FOR THE ASSISTED SUICIDE OPTION?

                                 MS. PAULIN:  THEY COULD, BUT THEY'RE NOT.

                                 MR. GANDOLFO:  OKAY.  OKAY.

                                 NOW, WHY ISN'T THERE -- I KNOW THERE'S THE REQUIREMENT

                    OF A MENTAL HEALTH EVALUATION IN THE EVENT THAT COMPETENCY IS IN

                    QUESTION.  WHY ISN'T THERE GENERALLY A REQUIREMENT OF SEEING A MENTAL

                    HEALTH PROFESSIONAL WHEN YOU DECIDE TO PURSUE THIS OPTION?

                                 MS. PAULIN:  WE DON'T REQUIRE THAT FOR ANYTHING

                    ELSE.  WE DON'T REQUIRE IT FOR ANY OTHER END-OF-LIFE OPTION, AND THERE ARE

                    END-OF-LIFE OPTIONS NOW.  FOR EXAMPLE, AT THE END OF MY SISTER'S LIFE SHE

                    CHOSE NOT TO EAT OR DRINK ANYMORE.  WE DON'T SAY AT THAT POINT, OH, IS

                    SHE EQUIPPED TO MAKE THAT DECISION AND WE HAVE TO SEND HER TO A

                    PSYCHIATRIST IN ORDER FOR HER TO MAKE THAT DECISION.  WE DON'T.  SO WHY

                    WOULD WE REQUIRE IT HERE?  YOU KNOW, WE REQUIRE IT MORE SO THAN

                    ANYTHING ELSE BECAUSE WE WANT TO -- BECAUSE PEOPLE ARE DOING IT IN

                    ADVANCE OF MAKING THAT FINAL DECISION BUT THERE ARE OTHER END-OF-LIFE

                    OPTIONS AND WE DON'T REQUIRE IT FOR THOSE SO WE'RE NOT REQUIRING IT FOR

                    HERE.

                                 MR. GANDOLFO:  OKAY.  IT JUST SEEMS LIKE THIS

                    ONE'S A LITTLE MORE UNIQUE, WHICH IS WHY IT'S CURRENTLY NOT LEGAL HERE IN

                                         78



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THAT YOU'RE ASKING A DOCTOR TO PRESCRIBE A MEDICATION THAT WILL -- THAT IS

                    INTENDED TO LEAD THE PERSON TO DEATH.

                                 AND I'M ALMOST CURIOUS AS TO -- WE HAD THE DISCUSSION

                    EARLIER ABOUT COERCION.  WHAT ABOUT MAYBE NOT COERCION, BUT ARE THERE

                    ANY SAFEGUARDS TO ENSURE THAT SOMEONE -- WELL, THEY MIGHT NOT BEING --

                    THEY MIGHT NOT BE COERCED, THAT THEY'RE NOT BEING JUST INFLUENCED WITH

                    COMMENTS FROM MAYBE SOME OF THEIR FAMILY WHO ARE TIRED OF HAVING TO

                    CARE FOR A SICK LOVED ONE, UNFORTUNATELY, OR WHO MIGHT HAVE A FINANCIAL

                    INCENTIVE?  THEY MIGHT NOT BE COERCING THAT PERSON, BUT CERTAINLY THEY

                    COULD MAKE COMMENTS AND HAVE CONVERSATIONS THAT'S INFLUENCED

                    SOMEONE TOWARD A CERTAIN PATH.  ARE THERE ANY SAFEGUARDS?

                                 MS. PAULIN:  I -- EVERYONE IS INFLUENCED BY THEIR

                    FAMILY.  EVERYONE IS INFLUENCED BY THEIR LOVED ONES, AND MOST LOVED

                    ONES, IN FACT, THE VAST MAJORITY OF LOVED ONES WANT TO SEE SOMEONE'S

                    LIFE PROLONGED.  THAT'S THE EXPERIENCE.  AND I THINK IF WE SEARCH IN OUR

                    HEARTS WE KNOW THAT'S TRUE.

                                 YOU KNOW, I TOOK CARE OF MY MOM AT THE END OF HER

                    LIFE, FOR THE LAST TEN YEARS OF HER LIFE, AND WHEN THEY TOLD ME IT WAS -- IT

                    WAS OVER AND THAT -- I -- I REMEMBER THEY TOOK AWAY THE MEDS THAT THEY

                    WE'RE PUTTING IN HER BODY AND THEY SAID, YOU KNOW WHAT?  SHE'S DYING.

                    IT'S THE END.  AND I REMEMBER THINKING AND SAYING, NO, I JUST WANT HER

                    TO KEEP THE MEDS, YOU KNOW, BECAUSE I WANTED TO EVEN PROLONG THE --

                    THE -- THIS WOMAN WHO WAS MY MOM.  SO THAT'S NOT THE EXPERIENCE THAT

                    DYING PEOPLE FACE.  THEIR EXPERIENCE FROM THEIR LOVED ONES IS THAT THEY

                    WANT THEM TO LIVE.

                                         79



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. GANDOLFO:  I UNDERSTAND THAT, AND I THINK THE

                    VAST MAJORITY OF PEOPLE ARE GOOD PEOPLE WHO LOVE THEIR FAMILY.  BUT

                    THERE ARE OUTLIERS AND PEOPLE WHO HAVE NEFARIOUS ACTIONS.  IF THERE

                    WEREN'T, WE WOULDN'T HAVE A CRIMINAL COURT SYSTEM AND WE WOULDN'T

                    HAVE PEOPLE COMMITTING MATRICIDE AND PATRICIDE AND, YOU KNOW,

                    TAKING ADVANTAGE OF ELDERLY FAMILY MEMBERS, WHICH WE DO SEE HAPPEN.

                    SO I THINK IT WOULD STAND TO BENEFIT IF THERE WERE -- TO HAVE SOME MORE

                    GUARDRAILS HERE TO MAKE SURE THAT THIS PERSON MIGHT NOT BE BEING

                    COERCED, BUT THEY'RE NOT HAVING PEOPLE LEAD THEM TO A -- A PLACE WHERE

                    THEY MIGHT NOT HAVE GOTTEN OTHERWISE.  BUT WE CAN MOVE ON FROM THAT

                    TOPIC.

                                 ANOTHER QUESTION I DID HAVE WAS ABOUT THE POTENTIAL

                    FOR TELEHEALTH.  IN THE -- THE ATTENDING PHYSICIAN RESPONSIBILITIES, THE

                    ATTENDING -- THE ATTENDING PHYSICAL SHALL EXAMINE THE PATIENT AND THE

                    PATIENT'S RELEVANT MEDICAL RECORDS.  THERE'S NO SPECIFICITY THAT IT HAS TO

                    BE AN IN-PERSON EXAMINATION.  IS THERE ANY PROHIBITION IN THE LANGUAGE

                    THAT WOULD PROHIBIT TELEHEALTH SERVICES FROM DIAGNOSING SOMEONE FROM

                    AN ATTENDING AND THEN A CONSULTING PHYSICIAN?

                                 MS. PAULIN:  WELL, THE ATTENDING PHYSICIAN IS

                    SOMEONE WHO IS GONNA BE, YOU KNOW, SEEING THE PERSON IN PERSON.

                    THE CONSULTING PHYSICIAN MAY BE SOMEONE IN OHIO THAT HAS THE

                    EXPERTISE IN THIS PARTICULAR DISEASE.  SO NO, THERE'S NO -- THERE'S NO

                    PROVISION THAT PRECLUDES TELEHEALTH AND, IN FACT, TELEHEALTH IS USED

                    WIDELY IN THE OTHER JURISDICTIONS FOR THE CONSULTING PHYSICIAN.

                                 MR. GANDOLFO:  FOR ASSISTED SUICIDE?

                                         80



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. PAULIN:  FOR MEDICAL AID IN DYING.  SUICIDE IS

                    ILLEGAL -- OR ASSISTING SUICIDE IS ILLEGAL IN NEW YORK AND WILL REMAIN SO.

                                 MR. GANDOLFO:  OKAY.  SO YOU COULD HAVE

                    PATIENTS FROM OUT-OF-STATE, THEN?  IS THAT POSSIBLE, A PATIENT FROM

                    OUT-OF-STATE UTILIZING A MEDICAL AID IN DYING TELEHEALTH SERVICE AND

                    BEING PRESCRIBED THE MEDICATION?

                                 MS. PAULIN:  YOU COULD HAVE SOMEONE WHO IF THE

                    PRESIDING DOCTOR IS -- THE -- THE PRESIDING DOCTOR WOULD REQUIRE THAT

                    PATIENT TO ACTUALLY BE PHYSICALLY IN -- IN OUR STATE BECAUSE IT'S, YOU

                    KNOW, THAT'S WHAT A PRESIDING DOCTOR IS, RIGHT?

                                 MR. GANDOLFO:  BUT THERE'S NO REQUIREMENT IN THE

                    BILL.

                                 MS. PAULIN:  THE PRESIDING DOCTOR COULD BE

                    SOMEONE THAT IS SOMEWHERE ELSE BECAUSE BASED ON THEIR EXPERTISE THAT'S

                    WHO THE -- THE DOCTOR WHO IS REFERRING THEM TO AND THE PATIENT BELIEVES

                    IS GONNA GIVE THEM THE BEST DIAGNOSIS.

                                 MR. GANDOLFO:  IS THERE A RESIDENCY REQUIREMENT

                    OUTLINED IN THE BILL THAT THE PATIENT WOULD HAVE TO LIVE IN NEW YORK

                    STATE?

                                 MS. PAULIN:  NO.

                                 MR. GANDOLFO:  OKAY.  SO OUT-OF-STATE PATIENTS,

                    THEN, COULD SEE NEW YORK DOCTORS VIA TELEHEALTH FOR MEDICAL AID IN

                    DYING PURPOSES?

                                 MS. PAULIN:  NO.  HOW COULD THEY BE A PRESIDING

                    DOCTOR IF THEY ARE LIVING OUT-OF-STATE?  WOULDN'T THEY HAVE TO --

                                         81



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. GANDOLFO:  THE -- THE ATTENDING PHYSICIAN --

                    IT JUST SAYS THE ATTENDING PHYSICIAN SHALL EXAMINE THE PATIENT.  IT

                    DOESN'T SAY --

                                 MS. PAULIN:  AND BE TREATING THEM.

                                 MR. GANDOLFO:  I'M SORRY?

                                 MS. PAULIN:  AND BE TREATING THEM FOR THEIR CANCER

                    OR FOR THEIR OTHER TERMINAL ILLNESS.

                                 MR. GANDOLFO:  WELL, WE ESTABLISHED EARLIER YOU

                    CAN KIND OF DOCTOR SHOP AND LEAVE YOUR CURRENT PHYSICIAN THAT MIGHT

                    HAVE BEEN TREATING YOU TO FIND A PHYSICIAN WHO WOULD BE MORE APT TO

                    RECOMMEND YOU FOR --

                                 MS. PAULIN:  I DON'T THINK THAT -- PEOPLE ARE GOING

                    TO BE LOOKING FOR THE BEST DOCTOR FOR THEIR ILLNESS.  THEY'RE NOT GONNA BE

                    LOOKING FOR THE BEST DOCTOR TO PRESCRIBE MEDICAL AID IN DYING.  IF YOU

                    HAVE A CONDITION THAT IS SO SEVERE AND YOU GET DIAGNOSED, THE FIRST THING

                    YOU'RE GONNA THINK ABOUT IS FINDING THE BEST DOCTOR TO HELP YOU LIVE THE

                    LONGEST LIFE POSSIBLE.  SO COULD THAT BE A DOCTOR IN NEW YORK FROM A

                    RESIDENT COMING FROM OHIO OR OTHER PLACES?  YEAH, BECAUSE WE HAVE

                    SOME OF THE BEST DOCTORS IN NEW YORK, THANK GOODNESS.  BUT MOST

                    OFTEN, THEN THEY'RE GOING TO BE MOVING HERE.  OR, YOU KNOW, WE'VE HAD,

                    YOU KNOW, ONE COLLEAGUE, FOR EXAMPLE, THAT LIVED UP IN THIS AREA WHO

                    -- WHOSE FAMILY MEMBER WENT DOWN TO -- TO GET TREATED IN SLOAN.  YOU

                    MIGHT SEE SOMEONE FROM NEW JERSEY COMING TO NEW YORK TO DO THAT.

                    BUT IT'S NOT GONNA BE THE NORM.

                                 MR. GANDOLFO:  IS THERE ANY CONCERN THAT IF YOU

                                         82



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    HAVE AN OUT-OF-STATE PATIENT COME TO NEW YORK, GET PRESCRIBED THE

                    MEDICATION AND TAKE IT BACK TO THEIR HOME STATE WHERE IT MIGHT NOT BE

                    LEGAL, ARE THERE ANY LEGAL RAMIFICATIONS FOR THAT PATIENT BRINGING THIS

                    MEDICATION BACK HOME, TAKING IT AND DYING IN A STATE WHERE THIS IS NOT

                    LEGAL FROM THAT MEDICATION?

                                 MS. PAULIN:  NO, NOR SHOULD THERE BE.

                                 MR. GANDOLFO:  SO SOMEONE COULD COME FROM A

                    STATE WHERE THIS IS PROHIBITED, GET PRESCRIBED THE MEDICAL AID IN DYING

                    PRESCRIPTION, GO BACK TO LET'S SAY, YOU KNOW, CONNECTICUT -- I DON'T

                    KNOW, I'M JUST USING THAT OFF THE TOP --

                                 MS. PAULIN:  THAT'S UP TO THE LAWS THERE --

                                 MR. GANDOLFO:  OKAY.

                                 MS. PAULIN:  -- YOU KNOW, RIGHT, TO -- TO -- NOT UP TO

                    OUR LAWS.

                                 MR. GANDOLFO:  COULD THAT PUT THE DOCTORS AT RISK

                    WHO MAKE THIS PRESCRIPTION THINKING THAT THEY WERE GOING TO TAKE THE

                    MEDICATION IN NEW YORK STATE --

                                 MS. PAULIN:  WE HOLD THEM HARMLESS.  THEY'RE NOT

                    LIABLE, WE HOLD THEM HARMLESS IN THE BILL.

                                 MR. GANDOLFO:  IS THERE ANY -- HARMLESS FROM

                    WHO?  FROM --

                                 MS. PAULIN:  FROM OUR LAWS.  THEY'RE NOT

                    CRIMINALLY LIABLE, NOT CIVILLY LIABLE, THEY'RE NOT PROFESSIONALLY LIABLE.

                                 MR. GANDOLFO:  BUT THEY COULD -- OKAY, SO THEY'RE

                    NOT CIVILLY LIABLE AT ALL, WHICH ACTUALLY BRINGS ME TO ANOTHER QUESTION.

                                         83



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    IS THERE ANY PROCESS FOR A THIRD-PARTY TO CONTEST THE DIAGNOSIS OF THE

                    ATTENDING OR THE CONSULTING PHYSICIAN?

                                 MS. PAULIN:  WAIT, SAY THAT AGAIN.

                                 MR. GANDOLFO:  IS THERE ANY PROCESS FOR A

                    THIRD-PARTY, LET'S SAY A CHILD, TO CONTEST THE DIAGNOSIS OF AN ATTENDING OR

                    CONSULTING PHYSICIAN?

                                 MS. PAULIN:  THERE'S ALWAYS -- IF A FAMILY MEMBER

                    QUESTIONS A DIAGNOSIS, YOU KNOW -- YOU KNOW, IN MOST CASES YOU HAVE

                    YOUR FAMILY MEMBERS THERE MOSTLY BECAUSE YOU WANT SOMEONE ELSE

                    WHEN YOU'RE FOGGY AND HEARING THAT YOUR -- YOUR LIFE IS AT RISK BECAUSE

                    YOU HAVE A TERMINAL ILLNESS, YOUR FAMILY MEMBERS ARE THERE TAKING

                    NOTES, RECORDING THE INFORMATION --

                                 MR. GANDOLFO:  RIGHT, BUT COULD THEY FORMALLY

                    CONTEST IT?

                                 MS. PAULIN:  -- THAT THEY LEARNED.

                                 THEY WOULD ARGUE WITH THE -- WITH THE DOCTORS RIGHT --

                    RIGHT THERE OR THEY GO TO --

                                 MR. GANDOLFO:  OKAY, AND --

                                 (CROSSTALK)

                                 MS. PAULIN:  -- THEY -- PEOPLE HAVE THE OPTION IF

                    THEY FEEL THAT THEY'VE BEEN MISDIAGNOSED TO GO TO ANOTHER DOCTOR.

                    THEY DO THAT ALL THE TIME.

                                 MR. GANDOLFO:  BUT I'M -- I'M LOOKING FOR

                    SAFEGUARDS IN THE EVENT THAT YOU MIGHT HAVE SOMEONE WHO IS LOOKING

                    FOR A WAY TO END THEIR LIFE AND USING THIS AS A VEHICLE TO DO IT.

                                         84



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. PAULIN:  THEY HAVE TO BE TERMINALLY ILL AND --

                                 MR. GANDOLFO:  I KNOW --

                                 MS. PAULIN:  -- THAT HAS TO BE DIAGNOSED --

                                 MR. GANDOLFO:  I SEE THAT.

                                 MS. PAULIN:  -- BY TWO INDEPENDENT COMPETENT

                    DOCTORS.

                                 MR. GANDOLFO:  INDEPENDENT FROM WHO?

                    BECAUSE THE DOCTORS COULD BE WORKING TOGETHER ALL THE --

                                 MS. PAULIN:  INDEPENDENT FROM THE -- FROM THE

                    PATIENT.

                                 MR. GANDOLFO:  INDEPENDENT FROM THE PATIENT,

                    OKAY.

                                 I -- I BELIEVE I'M ABOUT OUT OF TIME, BUT I APPRECIATE

                    YOU ANSWERING MY QUESTIONS.

                                 MS. PAULIN:  SURE.

                                 MR. GANDOLFO:  THANK YOU, MR. SPEAKER.

                                 ACTING SPEAKER TAYLOR:  MS. SOLAGES.

                                 MS. SOLAGES:  MR. SPEAKER, CAN YOU PLEASE CALL

                    THE CORPORATIONS COMMITTEE TO THE SPEAKER'S CONFERENCE ROOM?

                                 ACTING SPEAKER TAYLOR:  CORPORATIONS TO THE

                    SPEAKER'S CONFERENCE ROOM.  CORPORATIONS TO THE SPEAKER'S

                    CONFERENCE ROOM.

                                 MR. RA.

                                 MR. RA:  THANK YOU, MR. SPEAKER.  WILL THE SPONSOR

                    YIELD?

                                         85



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER TAYLOR:  THE SPONSOR YIELDS.

                                 MR. RA:  THANK YOU.

                                 SO I HAVE SOME QUESTIONS THAT I JUST WANT TO FOLLOW UP

                    ON WHAT MY PREVIOUS COLLEAGUE WAS TALKING ABOUT.  JUST IN TERMS OF IF

                    THERE IS A TELEHEALTH SITUATION, THE PERSON'S IN ANOTHER STATE.  THAT -- I

                    MEAN, IT WOULD HAVE TO BE A STATE WHERE IT DOESN'T VIOLATE THAT STATE'S

                    MEDICAL LAWS FOR -- FOR THAT DOCTOR TO PARTICIPATE IN THAT DECISION,

                    WOULD IT NOT, OR HOW WOULD THAT WORK?

                                 MS. PAULIN:  YES.  YES, IF THERE WERE LAWS IN

                    ANOTHER STATE THAT SAID DON'T PARTICIPATE, I WOULD IMAGINE THAT DOCTOR

                    WOULD NOT PARTICIPATE.

                                 MR. RA:  OKAY.  AND DOES THE BILL ADDRESS IN ANY

                    WAY, YOU KNOW, THAT TYPE OF SITUATION?

                                 MS. PAULIN:  NO.  BECAUSE WE WANT PATIENTS TO BE

                    ABLE TO GET ADVICE AND TREATMENT FROM PATIENT -- FROM DOCTORS ACROSS

                    THE COUNTRY IF THEY HAD TO, TO HELP THEM IF THERE ARE TREATMENT OPTIONS.

                                 MR. RA:  AND THIS -- THIS BILL, THE ENTIRETY OF THE TEXT

                    AMENDS THE PUBLIC HEALTH LAW, CORRECT?  THERE'S NO PROVISIONS THAT ARE

                    AMENDING THE PENAL LAW IN ANY WAY?

                                 MS. PAULIN:  I'M SORRY?

                                 MR. RA:  ARE -- ARE -- DOES THIS BILL AMEND THE PENAL

                    LAW IN ANY WAY OR IT JUST IS --

                                 MS. PAULIN:  IT -- IT CREATES SOME ADDITIONAL -- WELL,

                    I GUESS AMEND IS A - IT -- IT'LL -- THERE'S -- THERE ARE PENAL PENALTIES.  YOU

                                         86



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    KNOW, I'M USING STATUTES IN THE PENAL CODE, SO COERCION, CERTAINLY IF

                    YOU -- IF YOU ATTEMPTED TO MURDER SOMEONE BY -- AS WAS -- HAS BEEN

                    SUGGESTED, THEY -- YOU KNOW, SOME FAMILY MEMBER GOES ROGUE AND

                    DECIDES THAT THEY WANT THE INHERITANCE AND THEY, YOU KNOW, MIX THE

                    COCKTAIL AND GIVE IT TO THEM, THEY WOULD BE SUBJECT TO THE CRIMINAL

                    CODES, YES.  THEY'D BE -- YOU KNOW, FOR MURDERING SOMEONE.  SO THERE

                    ARE PENAL CODE PENALTIES BUT I -- WE DON'T HAVE ADDITIONAL ADDS TO THE

                    PENAL CODE.

                                 MR. RA:  OKAY.  SO --

                                 MS. PAULIN:  -- WE'RE USING THE PENAL CODE AS IT

                    STANDS.

                                 MR. RA:  SO ON I BELIEVE IT'S EITHER PAGE 5 OR 6,

                    SOMETIMES I -- I HAVE TROUBLE FIGURING OUT WHERE THE NUMBERS ARE WHEN

                    I'M LOOKING AT IT ON THE TABLET.  BUT WHERE IT TALKS ABOUT THAT THE

                    PHYSICIAN OR ANOTHER INDIVIDUAL CAN'T ADMINISTER THE MEDICATION TO -- TO

                    THE INDIVIDUAL WHO HAS -- WHO HAS CHOSEN --

                                 MS. PAULIN:  YEAH.

                                 MR. RA:  -- THIS PATH.  SO, RIGHT, PRESUMABLY IF A

                    PHYSICIAN WERE TO TAKE THAT ACTION THEY ARE NOW REALLY, I WOULD SAY,

                    WOULD YOU SAY, VIOLATING THEIR SCOPE OF PRACTICE BECAUSE THEY'RE NOT

                    PERMITTED TO DO THAT?

                                 MS. PAULIN:  THEY'D BE VIOLATING THE PENAL CODE,

                    ACTUALLY.  THEY'D BE VIOLATE -- THEY'D BE COMMITTING A CRIME.

                                 MR. RA:  OKAY.  SO YOU'RE -- SO THAT WOULD BE A

                    CRIMINAL -- BECAUSE THAT -- THAT WAS MY QUESTION, AS OPPOSED TO SOME

                                         87



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    OTHER INDIVIDUAL WHO DID IT --

                                 MS. PAULIN:  SAME PENALTY.

                                 MR. RA:  -- OBVIOUSLY, THEY'RE NOT CONCERNED WITH --

                    THEY'RE -- THEY DON'T HAVE A MEDICAL LICENSE.  THEY DON'T HAVE A MEDICAL

                    LICENSE THAT'S AT RISK IF THEY WERE TO VIOLATE, SAY, THE PUBLIC HEALTH

                    LAW.

                                 MS. PAULIN:  WELL, THEY'RE ALL VIOLATING THE

                    CRIMINAL CODE AND THEY WOULD ALL BE -- I THINK IT'S -- IT WAS SAID

                    YESTERDAY AT THE COMMITTEE MEETING, THERE'S ONE STATUTE, PENAL CODE --

                    WAIT, I'LL FIND IT.  I HAVE -- I HAVE IT SOMEWHERE.  IT'S --  IT'S 120.30,

                    WHICH IS PROMOTING A SUICIDE ATTEMPT.  AND IT'S UP TO -- IT'S A CLASS E

                    FELONY AND UP TO FOUR YEARS IN JAIL.  THAT'S WOULD THEY WOULD BE SUBJECT

                    TO.

                                 MR. RA:  OKAY.  THANK YOU.

                                 SO I WANT TO TAKE A STEP BACK NOW.  SOME -- SOME OF

                    THAT JUST CAME INTO MY HEAD AS I WAS LISTENING TO THE PREVIOUS SPEAKER.

                    BUT I JUST HAVE SOME -- SOME QUESTIONS, AND A LOT OF IT STEMS FROM THE

                    FACT -- I MEAN, YOU'VE TALKED ABOUT OTHER JURISDICTIONS.  I THINK THE ONE

                    THAT WE HAVE THE LARGEST, YOU KNOW, TRACK RECORD OF -- OF EVIDENCE

                    WOULD BE, OBVIOUSLY, OREGON BECAUSE IT'S BEEN THE LAW THERE FOR MANY

                    YEARS, AND I JUST HAVE SOME QUESTIONS AS TO HOW THIS BILL MAYBE DIFFERS.

                    BECAUSE MY UNDERSTANDING IS THAT SOME OF THE THINGS THAT WE'RE TALKING

                    ABOUT AS NOT ALLOWABLE OR THINGS WE'RE TRYING TO PREVENT HAVE REALLY

                    OCCURRED IN OREGON.  SO, LIKE, FOR INSTANCE, MY UNDERSTANDING IS THAT

                    PATIENTS IN --  IN OREGON HAVE SELF-REPORTED FINANCIAL IMPLICATIONS OF

                                         88



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    TREATMENT AS A REASON THEY REQUEST LETHAL DRUGS.

                                 MS. PAULIN:  WAIT, SAY -- SAY THAT LAST THING AGAIN.

                                 MR. RA:  THAT PEOPLE IN OREGON HAVE -- HAVE LISTED

                    FINANCIAL IMPLICATIONS OF TREATMENT AS A REASON THEY REQUEST THE OPTION

                    OF -- OF ASSISTED SUICIDE.

                                 MS. PAULIN:  I THINK THAT IT WAS 5 PERCENT OF THE

                    CASES.  SOMETHING LIKE THAT.

                                 MR. RA:  OKAY.  SO WOULD -- WOULD THAT POTENTIALLY

                    BE SOMETHING PEOPLE WOULD BE CONSIDERING IN NEW YORK AS WELL?

                                 MS. PAULIN:  I -- IT'S POSSIBLE THAT THERE MIGHT BE

                    SOME PEOPLE WHO, YOU KNOW, ARE WEIGHING THAT VERY EXPENSIVE

                    TREATMENT AGAINST THIS AT THE VERY END OF THEIR LIFE.  I -- I PRESUME THAT

                    THERE MIGHT BE SOME PEOPLE LIKE THAT, BUT IT WAS FOUND THAT VERY, VERY

                    SMALL NUMBERS OF PEOPLE HAD THAT CONCERN.

                                 MR. RA:  OKAY.  AND THERE -- THERE IS SOME

                    INTERESTING STUDIES THAT HAVE BEEN DONE WITH REGARD TO THIS, AND A LOT OF

                    THOSE TYPES OF THINGS HAVE INCREASED EXPONENTIALLY OVER -- OVER TIME.

                    THERE WAS A STUDY THAT WAS -- WAS PUT OUT A COUPLE YEARS AGO THAT I HAD

                    FOUND.

                                 NOW, ANOTHER THING IN OREGON THAT -- IS THAT CHRONIC

                    CONDITIONS ARE ALLOWED UNDER WHAT I UNDERSTAND TO BE SIMILAR LANGUAGE

                    TO THIS BILL.  YOUR INTENTION IS THAT CHRONIC CONDITIONS ARE NOT AN

                    ALLOWABLE REASON FOR REQUESTING THESE DRUGS.

                                 MS. PAULIN:  THEY'RE NOT ALLOWED IN OREGON, EITHER.

                    ANYWHERE THAT YOU GOT THAT FROM IS JUST NOT CORRECT.  BUT THERE -- ALL OF

                                         89



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THE 11 JURISDICTIONS, THEY HAVE EXACTLY THE SAME LANGUAGE ON REQUIRING

                    SOMEONE TO BE TERMINALLY ILL WITHIN SIX MONTHS TO GET THAT DIAGNOSIS.

                                 MR. RA:  OKAY.  AND I KNOW YOU SPOKE WITH ONE OF

                    MY COLLEAGUES ABOUT TREATMENT, RIGHT, AND I KNOW TREATMENT ISN'T

                    REQUIRED BUT THERE ARE MANY TREATABLE CONDITIONS THAT WOULD PRODUCE

                    DEATH WITHIN SIX MONTHS, PERHAPS, AND OTHER STATES HAVE LISTED

                    CONDITIONS LIKE DIABETES, HIGH BLOOD PRESSURE.  THOSE ARE NOT ALLOWABLE

                    UNDER THIS LEGISLATION?

                                 MS. PAULIN:  IT DEPENDS ON THE STAGE.  FOR EXAMPLE,

                    YOU KNOW, SO DIALYSIS, RIGHT?  YOU KNOW IF YOU GET OFF IT YOU'RE GONNA

                    DIE.  SO IF YOU DECIDE YOU'RE NO LONGER GONNA BE ON DIALYSIS, YEAH, YOU

                    WOULD BE ELIGIBLE.  BUT, BY THE TIME YOU'VE GOT YOUR CONSULTING DOCTOR,

                    YOU WOULD BE DEAD.  SO THAT'S NOT A -- A POSSIBILITY.  WITH DIABETES, IT'S

                    NOT A TERMINAL ILLNESS, BUT IT DOES LEAD MOST OFTEN TO END-STAGE RENAL

                    DISEASE.  IF YOU HAVE END-STAGE RENAL DISEASE YOU WOULD BE ELIGIBLE, SO

                    COULD YOU SAY IT CAME FROM DIABETES INITIALLY?  YES.  BUT WHAT WOULD

                    BE LISTED ON YOUR DEATH CERTIFICATE WOULD BE RENAL DISEASE.  I KNOW IT

                    WAS REFERENCED, ANOREXIA NEROSA -- NERVOSA BEFORE; THAT WOULD NOT BE

                    ELIGIBLE.

                                 MR. RA:  OKAY.

                                 SO WITH REGARD TO THE PHYSICIAN, THE -- THE ATTENDING

                    PHYSICIAN, ONE OF THE THINGS THAT A STUDY ON OREGON LISTED WAS THAT

                    WHEN THIS LAW FIRST TOOK EFFECT THERE HAD BEEN OFTEN A VERY LENGTHY

                    RELATIONSHIP BETWEEN THAT ATTENDING PHYSICIAN AND THE PATIENT.  NOW

                    THE MEDIAN LENGTH OF TIME IS ONLY FIVE WEEKS.  ARE WE ENVISIONING THAT

                                         90



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THIS MAY BE SOMEBODY THAT -- THAT HAS A VERY SHORT-TERM RELATIONSHIP TO

                    THE PATIENT AS OPPOSED TO SOMEBODY WHO MAYBE IS A DOCTOR THAT THEY

                    HAVE BEEN SEEING FOR MANY YEARS AND HAVE A LONG-TERM RELATIONSHIP

                    WITH WHO MIGHT HAVE A BETTER ABILITY TO KNOW THAT PATIENT, KNOW THEIR

                    HISTORY, KNOW THAT THEY'RE OF SOUND MIND WHEN THEY'RE COMING AND

                    MAKING THIS TYPE OF REQUEST?

                                 MS. PAULIN:  I HAVEN'T SEEN THAT DATA ON FIVE WEEKS.

                    I AM -- I DON'T KNOW WHERE IT'S COME FROM EXACTLY.  BUT I CAN TELL YOU

                    THAT, YOU KNOW, AS MEDICAL SCIENCE GETS BETTER, YOU KNOW, WE SEE

                    TREATMENTS THAT PROLONG SOMEONE'S LIFE LONGER, EVEN FOR THESE VERY

                    SEVERE ILLNESSES.  SO FIVE WEEKS SEEMS A LITTLE STRANGE TO ME.  BUT WE

                    ALSO KNOW THAT SOME PEOPLE DO GET DIAGNOSED AND THEN DIE RELATIVELY

                    QUICKLY, SO IT COULD BE BECAUSE OF THAT.  BUT I JUST FIND THE FIVE WEEKS A

                    LITTLE SUSPECT.

                                 MR. RA:  OKAY.

                                 SO WHAT I ALSO WANT TO UNDERSTAND NOW IS WHEN YOU

                    GET THE PRESCRIPTION.  SO THERE'S AN ATTENDING PHYSICIAN, THERE'S A

                    CONSULTING PHYSICIAN.  NOW, COULD THERE BE ANOTHER PHYSICIAN THAT

                    ACTUALLY WRITES THE PRESCRIPTION OR DOES THE PRESCRIPTION HAVE TO BE

                    WRITTEN BY EITHER THE ATTENDING OR CONSULTING PHYSICIAN?

                                 MS. PAULIN:  IT HAS TO BE WRITTEN BY THE ATTENDING OR

                    CONSULTING.

                                 MR. RA:  OKAY.  AND --

                                 MS. PAULIN:  AND JUST THE -- THE -- GOOD QUESTION.  I

                    THINK THE -- IT HAS TO BE WRITTEN BY THE ATTENDING, NOT THE CONSULTING.

                                         91



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THE CONSULTING IS CONSULTING TO THE ATTENDING.

                                 MR. RA:  OKAY.  NOW, THEN THE INDIVIDUAL, RIGHT, GETS

                    THIS, FILLS THE PRESCRIPTION.  IS THERE ANY CONTINUING PART OF THIS PROCESS

                    ONCE THAT -- THAT PRESCRIPTION HAS BEEN FILLED AND GIVEN TO THE

                    INDIVIDUAL WHO HAS REQUESTED IT?

                                 MS. PAULIN:  THE PROCESS IS ONGOING CARE, YOU

                    KNOW, ON THE PART OF THE ATTENDING PHYSICIAN AND THE -- AND THE PATIENT.

                    THAT'S THE PROCESS THAT YOU -- THAT'S USED FOR ANY TREATMENT OPTION.

                                 MR. RA:  BUT -- WELL, MY UNDERSTANDING IS, YOU

                    KNOW, IN STATES THAT HAVE DONE THIS LIKE OREGON, SOME PATIENTS HAVE

                    HELD ON TO THESE DRUGS FOR -- FOR YEARS.  IF, YOU KNOW, THE PERSON TAKES

                    THE DRUG -- TAKES THE DRUGS HOME AND HOLDS ONTO THEM, IS THERE ANY

                    SPECIFIC REQUIREMENT THAT THERE BE SOME TYPE OF FOLLOW-UP IN THE FUTURE

                    ON -- ON AN INDIVIDUAL TO --TO ASSESS WHETHER THEY'RE STILL IN THE RIGHT

                    MENTAL, YOU KNOW, FRAME OF MIND AND -- AND THINGS OF THAT NATURE?

                    BECAUSE THEY NOW HAVE THAT SITTING IN A CUPBOARD AND -- AND MAYBE

                    HAVE A ROUGH DAY IN -- IN TREATMENT OR -- OR FROM -- AS A RESULT OF THEIR

                    ILLNESS.  IS THERE ANY FOLLOW-UP THAT'S REQUIRED?

                                 MS. PAULIN:  AGAIN, THE FOLLOW-UP IS THE ONGOING

                    RELATIONSHIP OF THE ATTENDING PHYSICIAN WITH THAT PATIENT.  AND IF YOU

                    HAVE AN ILLNESS LIKE CANCER OR ALS OR HUNTINGTON'S DISEASE, YOU HAVE

                    THAT ONGOING RELATIONSHIP.  AND THAT RELATIONSHIP IS NOT JUST ASSESSING

                    YOUR PHYSICAL CONDITION, IT'S OFTEN SOMEONE WHO YOU'RE TALKING TO

                    ABOUT YOUR FEARS, ABOUT YOUR CONCERNS.  I MEAN, THESE DOCTORS ARE

                    REMARKABLE, AND THEY ARE -- BECOME PART OF THE FAMILY IN A LOT OF WAYS.

                                         92



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    AN EXTENSION OF -- OF THE FAMILY.  AND THEY ARE INVOLVED IN A LOT OF

                    DECISION-MAKING, AND THEY OBVIOUSLY WOULD BE ABLE TO TALK TO THAT

                    PATIENT WITH THE -- WITH THE -- THE HEART AND THE SENSITIVITY AND THE

                    KNOWLEDGE THAT WOULD BE REQUIRED, KNOWING THAT THAT PATIENT HAS THAT

                    MEDICATION IN THEIR CUPBOARD, WHICH IS GIVING THEM COMFORT.

                                 MR. RA:  OKAY.  THANK YOU, MS. PAULIN.

                                 MADAM SPEAKER, ON THE BILL.

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MR. RA:  YOU KNOW, AS MANY COLLEAGUES HAVE

                    ALREADY SAID, THIS IS A VERY PERSONAL, EMOTIONAL ISSUE FOR SO MANY OF US.

                    BUT I -- BUT I WANT TO BE VERY CLEAR ABOUT -- ABOUT SOMETHING.  THERE

                    ARE PLENTY OF US WHO WILL BE VOTING AGAINST THIS BILL WHO HAVE HAD

                    THOSE EXPERIENCES AS WELL WITH -- WITH LOVED ONES AND DEALING WITH

                    LONG-TERM ILLNESSES.  SO I DON'T THINK THAT ANYBODY SHOULD BE UNDER THE

                    IMPRESSION THAT -- THAT OUR OBJECTIONS TO THIS BILL COME FROM A LACK OF

                    COMPASSION FOR ANY INDIVIDUAL OR -- OR A LACK OF UNDERSTANDING, EVEN,

                    WHY SOMEBODY MIGHT WANT TO AVAIL THEMSELVES OF THIS OPTION.  BUT

                    WE'VE SEEN OTHER THINGS WE -- WE'VE DONE IN THIS CHAMBER, AND JUST I

                    GUESS SOCIETY AS A WHOLE CONTINUES TO REALLY IN A LOT OF WAYS DEVALUE

                    LIFE.  AND THERE ARE OPPORTUNITIES WITH REGARD TO THIS LEGISLATION AND

                    THAT WE'VE SEEN IN OTHER STATES WHERE IT OPENED UP PANDORA'S BOX AND

                    PEOPLE WITH CHRONIC CONDITIONS, PEOPLE WITH DISABILITIES, ENDED UP

                    BEING IN A POSITION TO DECIDE, MAYBE I'M A BURDEN ON MY FAMILY.  I'M

                    GONNA TAKE ADVANTAGE OF THIS.  MAYBE IT'S BETTER FOR MY FINANCIAL

                    CIRCUMSTANCES OR THAT OF MY FAMILY TO -- TO JUST END MY LIFE.  AND THERE

                                         93



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ARE A NUMBER OF ORGANIZATIONS THAT WORK ON BEHALF OF OUR DISABLED

                    COMMUNITY AND THEY ARE VERY, VERY SCARED OF WHAT THIS LEGISLATION IS

                    GONNA MEAN FOR THOSE INDIVIDUALS THAT -- THAT THEY SERVE.

                                 MANY YEARS AGO WHEN WE HAD A HEARING WITH REGARD

                    TO THIS, I WAS A MEMBER OF THE HEALTH COMMITTEE AND I PARTICIPATED IN

                    IT ALL DAY.  WE HEARD LOTS OF STORIES FROM INDIVIDUALS ON BOTH SIDE [SIC]

                    OF IT, BUT I -- I JUST THINK THIS TAKES THE IDEA OF A DOCTOR WHO -- WE THINK

                    OF DOCTORS AS PEOPLE WHOSE JOB IS TO MAKE YOU BETTER, AT THE VERY LEAST

                    MAKE YOU COMFORTABLE, AND I THINK WE'RE JUMPING OVER TO A PLACE

                    WHERE THEY'RE NOW FACILITATING DEATH.  SO I'LL BE VOTING IN THE NEGATIVE.

                                 ACTING SPEAKER HUNTER:  THANK YOU, MR. RA.

                                 MS. CRUZ.

                                 MS. CRUZ:  THANK YOU, MADAM SPEAKER.  WILL THE

                    SPONSOR YIELD FOR A COUPLE OF QUESTIONS?

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MS. CRUZ:  MADAM SPONSOR, I WANT TO HAMMER ON

                    THE PROCESS A LITTLE BIT.  LET'S SAY I'M DIAGNOSED WITH CANCER, I GO

                    THROUGH THE TREATMENT AND EVENTUALLY I'M TOLD THAT I NO LONGER HAVE ANY

                    OTHER TREATMENT CHOICES.  I MAKE THE DECISION IN CONSULTATION WITH MY

                    DOCTOR THAT I NO LONGER WANT TO LIVE.  WHAT HAPPENS NEXT?

                                 MS. PAULIN:  SO YOU WOULD -- YOU MADE THAT -- FIRST

                    YOU WOULD HAVE TO MAKE AN ORAL REQUEST FOR THE MEDICAID [SIC] IN

                                         94



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    DYING DRUGS.  THEN YOUR -- YOU COULD EITHER GET YOUR CONSULTING

                    PHYSICIAN IN LINE OR YOU COULD GO STRAIGHT TO YOUR WRITTEN REQUEST.  BUT

                    YOU HAVE TO DO BOTH, NOT NECESSARILY IN A CERTAIN ORDER.  SO LET'S -- THE

                    CONSULTING PHYSICIAN REFERRAL BY THE RESIDING OR THE ATTENDING OR MAYBE

                    YOU FIND YOUR OWN, YOU SUGGEST IT, YOU GIVE ME A REFERRAL.  SO YOU GET

                    A REFERRAL, YOU GO TO THE CONSULTING PHYSICIAN AND THEN THEY DECIDE,

                    YES, YOU ONLY HAVE THE SAME SIX MONTHS OR LESS TO LIVE.  THEN AS FAR AS

                    THE WRITTEN, WE HAVE ACTUALLY IN THE STATUTE THE WRITTEN FORM THAT YOU

                    WOULD NEED TO ATTEST TO, AND THEN THAT WRITTEN FORM WOULD HAVE TO BE

                    WITNESSED BY TWO PEOPLE WHO ARE NOT FAMILY MEMBERS AND HAVE NO

                    FINANCIAL INTEREST IN YOUR ESTATE, AND THEY WITNESS YOUR STATEMENT THAT

                    YOU WERE NOT COERCED, YOU SAY YOU'RE NOT COERCED IN YOUR STATEMENT.

                    AND IT'S PENALTY OF PERJURY IF EITHER OF THE WITNESSES ARE DOING THIS

                    INCORRECTLY.  AND -- AND THEN YOU SUBMIT THAT TO YOUR ATTENDING

                    PHYSICIAN AND THEN YOU'RE ELIGIBLE TO GET THE MEDS.  YOU GET THE

                    PRESCRIPTION, THEN YOU DECIDE WHEN YOU WANT TO SELF-INGEST THEM.

                                 MS. CRUZ:  LET'S SAY ONCE PRESCRIBED, AM I REQUIRED

                    TO TAKE IT WITHIN A CERTAIN AMOUNT OF TIME?

                                 MS. PAULIN:  NO.  AND MOST -- UNLESS -- PEOPLE --

                    YOU KNOW, WE KNOW FROM EXPERIENCE A LOT OF PEOPLE ARE

                    PROCRASTINATORS, SO WE ALSO KNOW THAT A LOT OF PATIENTS REQUEST THEM

                    KIND OF LATE.  SO COULD THEY TAKE THEM RIGHT AWAY?  YES.  AND IN FACT,

                    STATES THAT HAVE HAD WAITING PERIODS HAVE HAD TO WAIVE THEM TO ALLOW

                    FOR THAT.  BUT MANY, MANY PEOPLE JUST WANT TO HAVE THE COMFORT AND

                    KNOWLEDGE.  YOU KNOW, IN HAVING MET SO MANY ADVOCATES AND MEETING

                                         95



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    PEOPLE WHO ARE -- HAVE A DISEASE, MEETING ONE WOMAN AND HAVING HER

                    SAY, I JUST WORRY ABOUT THE PAIN AT THE END.  I WORRY ABOUT THE PAIN,

                    THAT I'M NOT GONNA TO BE ABLE TO TAKE IT, YOU KNOW?  AND SO HAVING

                    THOSE MEDS GIVES THAT PATIENT COMFORT.

                                 MS. CRUZ:  AND LET'S SAY I DECIDE NOT TO TAKE IT AND

                    THE MEDICATION IS THERE.  ARE THERE SAFEGUARDS AROUND WHAT TO DO WITH

                    THIS MEDICATION IF I DECIDE NOT TO TAKE IT?

                                 MS. PAULIN:  YES, JUST LIKE ANY OF THE OTHER

                    MEDICATIONS THAT WE HAVE OUT THERE THAT ARE ADDICTIVE AND DANGEROUS

                    LIKE, YOU KNOW, MORPHINE, OTHER CONTROLLED SUBSTANCES.  THERE ARE

                    GUIDELINES THAT -- FEDERAL GUIDELINES THAT THEY HAVE TO FOLLOW.  WE ALSO

                    OFFER IN THE BILL AN OPTION FOR THE COMMISSIONER TO ESTABLISH

                    REGULATIONS SPECIFIC TO THIS, BUT OTHERWISE, THEY WOULD FOLLOW THE SAME

                    OPTIONS.  AND AS MY COLLEAGUE WHO IS A PHARMACIST MENTIONED TO ME

                    EARLIER, WE PASSED A BILL THAT -- ALMOST UNANIMOUS, IF NOT UNANIMOUS --

                    THAT ALLOWS YOU TO BRING THOSE MEDS BACK TO THE PHARMACIST AND WOULD

                    REQUIRE A FAMILY MEMBER TO DO THAT.

                                 MS. CRUZ:  AND LET'S SAY IT'S NOT CANCER.  LET'S SAY

                    WHAT I HAVE IS DEMENTIA.  WHAT HAPPENS THEN?

                                 MS. PAULIN:  DEMENTIA IS NOT CONSIDERED ELIGIBLE

                    FOR THIS BECAUSE YOU CAN'T TELL WHEN SOMEONE IS ACTUALLY GONNA DIE.

                                 MS. CRUZ:  AND WE HEARD SOME OF OUR COLLEAGUES

                    EARLIER MENTION THE CONCEPT OF FEELING LIKE YOU'RE A BURDEN ON THE

                    FAMILY.  LET'S SAY INSTEAD OF CANCER OR A TERMINAL ILLNESS WHAT YOU HAVE

                    IS SOME SORT OF DISABILITY BECAUSE OF AN ACCIDENT, BECAUSE OF SOME

                                         96



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    OTHER REASON, LET'S SAY.  IN A SITUATION LIKE THAT, WHAT THEN?

                                 MS. PAULIN:  SO, IF YOU HAVE A DISABILITY YOU'RE

                    ACTUALLY NOT -- WE SAY IN THE STATUTE THAT YOU'RE NOT ELIGIBLE SOLELY

                    BECAUSE YOU HAVE A DISABILITY OR BECAUSE OF AGE.  THAT'S ACTUALLY

                    EXPLICIT IN THE BILL.  SO YOU WOULD NOT BE ELIGIBLE UNLESS YOU ALSO HAD A

                    TERMINAL ILLNESS.

                                 MS. CRUZ:  THANK YOU.

                                 ON THE BILL, MADAM SPEAKER.

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MS. CRUZ:  I WANT TO THANK THE SPONSOR OF THIS

                    LEGISLATION.  THE EXPERIENCE OF WATCHING A LOVED ONE DIE I THINK HAS

                    COLORED OUR DECISION-MAKING PROCESS FOR MANY OF US.  AND I WANT TO

                    SAY THAT I RESPECT AND HONOR WHATEVER SIDE OF THE VOTE YOU END UP ON

                    TODAY BECAUSE THIS IS A VERY PERSONAL DECISION FOR MANY OF US.  FOR ME,

                    IT WAS COLORED BY HAVING TO BE AT THE BEDSIDE, ACTUALLY BY GETTING THE

                    HONOR TO BE AT THE BEDSIDE BY MY FATHER WHEN HE PASSED AWAY.  FOR

                    ME, THIS WAS COLORED BY THE IDEA THAT ANYONE WHO IS IN THAT PROCESS

                    SHOULD HAVE A CHOICE ABOUT WHEN THEIR LIFE AND HOW THEIR LIFE ENDS.

                                 ABOUT 15 YEARS AGO I TOOK AN EMERGENCY TRIP TO

                    COLUMBIA AFTER ALMOST SEVEN YEARS OF MY FATHER HAVING BATTLED CANCER.

                    HE REACHED THE END.  I DIDN'T KNOW IT THEN, BUT IT HAD -- IT WAS THE END.

                    HE HAD BEEN AN AVID SOCCER PLAYER, HE NEVER DRANK, HE NEVER SMOKED.

                    AND WHEN HE WAS JUST 46 YEARS OLD HE WAS DIAGNOSED WITH AN

                    EXTREMELY RARE FORM OF OSTEOSARCOMA AND HAD TAKEN OVER HIS LIFE

                    COMPLETELY.  IT CHANGED WHO HE WAS AND THE LIFE THAT OUR FAMILY LIVED.

                                         97



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    FROM THE BEGINNING OF THE DIAGNOSIS, ALL OF THE DECISIONS REGARDING HIS

                    TREATMENT WERE MADE AS A FAMILY WITH HIS MEDICAL DOC -- WITH HIS

                    MEDICAL TEAM; FROM WHEN TO HAVE CHEMO, TO WHEN TO STOP CHEMO, TO

                    WHEN TO TRY HOMEOPATHIC MEDICATIONS, TO WHEN TO HAVE HIS LEG

                    AMPUTATED, ACTUALLY, SO THAT HE COULD WALK ME DOWN THE AISLE.

                                 AFTER HIS INITIAL TREATMENT HE WENT INTO REMISSION AND

                    HE WAS CANCER-FREE FOR A COUPLE OF YEARS.  BUT THEN IN DECEMBER OF

                    2020 THE CANCER CAME BACK AND IT CAME BACK WITH A VENGEANCE.  IT

                    CAME BACK AS LUNG CANCER.  REMEMBER THAT I SAID THIS MAN HAD NEVER

                    SMOKED A CIGARETTE IN HIS LIFE.  SO I MADE THE EMERGENCY TRIP IN HOPES

                    THAT ONCE AGAIN AS A FAMILY WE COULD CHOOSE TREATMENT, THAT WE COULD

                    HAVE SOME SORT OF MIRACLE HAPPEN AND HAVE AN INFORMED DECISION WITH

                    HIS DOCTORS THAT COULD SAVE HIS LIFE.  BUT A FEW DAYS AFTER I ARRIVED, HE

                    BECAME SO ILL THAT WE HAD TO PUT HIM IN THE HOSPITAL AND LESS THAN 24

                    HOURS LATER MY FATHER WAS GONE.  WHEN WE WERE AT THE HOSPITAL, THE

                    DOCTOR INFORMED ME THAT MY FATHER WAS BASICALLY ALIVE BY A PURE

                    MIRACLE.  ALL HE HAD LEFT WAS 25 PERCENT OF ONE LUNG, AND IT WOULD BE A

                    MATTER OF DAYS OR PERHAPS HOURS.  MY FATHER WANTED TO LIVE.  HE WENT

                    THROUGH YEARS OF TREATMENT BECAUSE HE LOVED MY SISTER, MY BROTHER, MY

                    STEP-MOM, BECAUSE HE LOVED ME, AND HE WANTED IT TO WORK.  BUT HE

                    ALSO DID NOT WANT TO LIVE OR DIE AS A VEGETABLE.  HE DID NOT WANT TO

                    SUFFER.  NOW THIS FORMER UNION ORGANIZER-TURNED PROFIT -- NON-PROFIT

                    BANKER WAS A SHELL OF A MAN.  HE COULD NO LONGER WALK, HE COULD NO

                    LONGER EAT.  HE BARELY SPOKE.  HE WAS THE VEGETABLE HE ALWAYS SAID HE

                    NEVER WANTED TO BE.

                                         98



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 A DAY AFTER WE ENTERED THE HOSPITAL HE DIED, BUT HE

                    WAS BROUGHT BACK TO LIFE.  AND AGAIN, AS A FAMILY WE MADE THE DECISION

                    THAT IF IT HAPPENED AGAIN, WE WOULD LET HIM GO.  THAT IF HIS HEART

                    STOPPED, WE WOULD LET HIM BE FREE.  MY FATHER DID NOT HAVE A CHOICE.

                    IN COLUMBIA, MEDICAL AID IN DYING, OTHERWISE KNOWN THERE AS

                    "DIGNIFIED END OF LIFE", DID NOT BECOME A NATIONALLY, CONSTITUTIONALLY-

                    PROTECTED RIGHT UNTIL 2022.  I SAW MY FATHER DROWN ALIVE.  WHEN HE

                    COULD NO LONGER BREATHE, WHEN LIQUID GOT INTO HIS LUNGS.  WHEN HIS

                    EYES TURNED COMPLETELY BLACK AND HIS FINGERS BLUE.

                                 I'VE SPOKEN TO MY STEP-MOM ACTUALLY RIGHT BEFORE I

                    CAME IN HERE, AND I TOLD HER WE WERE TAKING THIS DEBATE UP AND THIS

                    VOTE.  AND SHE SAID TO ME, I AM SO GLAD YOU'RE DOING THIS BECAUSE NO

                    ONE SHOULD DIE LIKE YOUR FATHER DID.  PEOPLE SHOULD HAVE A CHOICE.

                    AND WE SUSPECT THAT HAD HE HAD THAT CHOICE HE WOULD HAVE TAKEN IT.

                                 SOMETIMES THE MOST LOVING CHOICE YOU CAN MAKE FOR

                    SOMEONE WHO IS DYING IS TO LET THEM GO WITH DIGNITY.  THIS BILL HAS

                    PLACED PROTECTIONS TO ENSURE THAT PEOPLE CHOOSING TO END THEIR LIVES ARE

                    NOT PRESSURED INTO IT, THAT INSURANCE COMPANIES AREN'T MAKING BANK

                    FROM IT, AND THAT EVERY DAY WE ALLOW PEOPLE TO MAKE THAT CHOICE.  MY

                    VOTE TODAY IS FOR THAT SO THAT PEOPLE CAN MAKE THAT CHOICE.  I

                    UNDERSTAND THAT IT'S ONLY COVERED BY PRIVATE INSURANCE RIGHT NOW AND

                    I'M HOPING THAT ONCE WE CHANGE FEDERAL LEADERSHIP IT COULD BECOME

                    SOMETHING THAT EVERYONE HAS ACCESS TO.  MANY TREATMENT CHOICES RIGHT

                    NOW ARE NOT COVERED BY INSURANCE BECAUSE THAT'S THE WAY THAT IT IS.

                                 THE CONCEPT OF INTERNAL COERCION AS WE HEARD EARLIER,

                                         99



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    TO ME I LOOK AT IT AS SIMPLY THAT CHOICE-MAKING PROCESS THAT YOU GO

                    THROUGH WHERE YOU'RE THINKING ABOUT, WHAT'S BEST FOR ME?  WHAT'S BEST

                    FOR MY FAMILY?  WHAT'S BEST FOR ME, WHETHER TO LIVE OR TO DIE WITH

                    DIGNITY?  THAT CHOICE, AS ELECTED OFFICIALS WE OFTEN THINK OF IN TERMS OF

                    WHAT DO OUR VOTERS SUPPORT.  AND 74 PERCENT OF AMERICANS, THAT'S

                    REPUBLICANS AND DEMOCRATS, ARE ACTUALLY IN SUPPORT OF MEDICAL AID IN

                    DYING.  THAT'S FROM A 2020 POLL.

                                 TO ME, AGAIN, THIS IS ABOUT CHOICE.  AS A LEGISLATOR, A

                    KEY PART OF MY JOB IS TO OPEN UP THE DOORS SO THAT PEOPLE CAN MAKE

                    DECISIONS FOR THEMSELVES, AND THAT'S WHAT WE'RE GONNA DO TODAY.  AND

                    THANK YOU AGAIN, MADAM SPONSOR, AND I'LL BE VOTING LATER IN THE

                    AFFIRMATIVE.

                                 THANK YOU.

                                 ACTING SPEAKER HUNTER:  MRS. PEOPLES-

                    STOKES.

                                 MRS. PEOPLES-STOKES:  MADAM SPEAKER, IF YOU

                    WOULD PLEASE CALL THE WAYS AND MEANS COMMITTEE TO THE SPEAKER'S

                    CONFERENCE ROOM.

                                 ACTING SPEAKER HUNTER:  WAYS AND MEANS TO

                    THE SPEAKER'S CONFERENCE ROOM.  WAYS AND MEANS COMMITTEE

                    MEMBERS TO THE SPEAKER'S CONFERENCE ROOM.

                                 MR. SEMPOLINSKI.

                                 MR. SEMPOLINSKI:  THANK YOU, MADAM SPEAKER.

                    WILL THE SPONSOR YIELD FOR A COUPLE OF QUESTIONS?

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                                         100



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MR. SEMPOLINSKI:  THANK YOU, MADAM SPONSOR,

                    FOR YIELDING.

                                 WOULD YOU CONCUR THAT THIS LAW IS GIVING NEW POWERS

                    TO DOCTORS AND THOSE THAT ARE IN THIS CHAIN OF PROCESS?  THEY HAVE

                    THINGS THEY'RE ALLOWED TO DO THEY WERE NEVER ALLOWED TO DO BEFORE.

                                 MS. PAULIN:  I WOULD SAY THEY'RE BEING GIVEN MORE

                    TREATMENT OPTIONS.

                                 MR. SEMPOLINSKI:  BUT THERE ARE THINGS THAT THEY

                    CAN NOW DO THEY WERE NOT ALLOWED TO DO BEFORE SHOULD THIS PASS.

                                 MS. PAULIN:  THEY CAN WRITE THIS PRESCRIPTION, YES.

                                 MR. SEMPOLINSKI:  OKAY.  AND AS YOU MENTIONED

                    TO MR. RA, THERE'S NO CHANGE WHATSOEVER TO THE PENAL LAW ANYWHERE IN

                    THIS TEXT.

                                 MS. PAULIN:  THERE'S -- I DON'T -- SO WE DON'T AMEND

                    THE PENAL CODE, BUT WE DO SAY THAT SOME THINGS IN HERE ARE CRIMES,

                    YES.

                                 MR. SEMPOLINSKI:  OKAY.  SO THERE -- BUT THERE'S

                    NO CHANGE IN THE PENAL CODE.

                                 AND IN SECTION L, WHICH IS ON PAGE 9, THERE'S AN

                    EXTENSIVE LIST OF PROTECTIONS AND IMMUNITIES.  SO, WHAT PHYSICIANS

                    CANNOT BE HELD LIABLE FOR IS -- IS ENUMERATED IN THAT SECTION.  IN SECTION

                    R ON PAGE 12, WHICH IS THE PENALTY SECTION, THERE'S NO SUCH

                                         101



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ENUMERATION.  IT JUST SAYS, AS YOU JUST SORT OF IMPLIED, THAT THE EXISTING

                    CIVIL AND CRIMINAL PENALTIES FOR ANY PARTICULAR OFFENSE COULD APPLY.

                    THERE IS -- THE PENALTY SECTION OF THE BILL DOES NOT PRODUCE ANYMORE

                    PENALTIES.  IT MERELY SAYS THAT WE'RE NOT GOING TO REDUCE THE PENALTIES

                    THAT ALREADY EXIST IN STATUTE.  AM I INTERPRETING THOSE TWO SECTIONS

                    CORRECTLY?

                                 MS. PAULIN:  I'M NOT EXACTLY SURE WHAT YOU'RE

                    SAYING.  HOWEVER, I WILL -- IF SOMEONE IS GUILTY OF COERCION OR THEY'RE

                    GUILTY OF ATTEMPTED MURDER OR THEY'RE GUILTY OF PERJURY, WE ALREADY

                    HAVE STATUTES ON THOSE.  WE DON'T NEED TO WRITE A NEW ONE.

                                 MR. SEMPOLINSKI:  WELL, THAT'S WHERE SORT OF I'M

                    GOING, BECAUSE YOU'VE MENTIONED OVER THE COURSE OF THE DEBATE A

                    COUPLE DIFFERENT CRIMES, PERJURY AND COERCION, WHICH ARE CLASS D

                    FELONIES, WHICH IS TWO TO SEVEN YEARS.  YOU MENTIONED PROMOTION OF

                    SUICIDE, WHICH WOULD REMAIN IN LAW FOR OTHER CIRCUMSTANCES.  THAT'S A

                    CLASS E FELONY, THAT'S UP TO FOUR YEARS.

                                 SO WE CREATE NEW CRIMES ALL THE TIME, THINGS THAT YOU

                    CAN'T DO.  WE'RE CREATING NEW THINGS YOU CAN DO, AND IF YOU WERE TO

                    ABUSE THAT POWER THERE'S NO ENHANCED PENALTY THAT'S NOT WORSE TO

                    PERJURE YOURSELF TO LEAD TO SOMEONE'S DEATH.  IT'S NOT WORSE TO COERCE

                    SOMEONE THAT LEADS TO THEIR DEATH.  IT'S NOT A WORSE TYPE OF PROMOTING

                    SUICIDE, YOU'RE JUST GONNA DUMP IT BACK INTO THE CURRENT PENAL CODE.

                    WHY DIDN'T WE ENHANCE PENALTIES OR PRODUCE A CRIME HERE SINCE WE'RE

                    NOW DEALING WITH A FAR MORE SERIOUS TOPIC, LIFE OR DEATH?  WHY ARE

                    THERE NO ENHANCED PENALTIES IN ANY WAY, SHAPE OR FORM IN THIS LAW?

                                         102



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. PAULIN:  I THINK -- I THINK IF YOU LOOKED AT THE

                    STATUTE, YOU KNOW, PARTICULARLY THE ONE ON SUICIDE, RIGHT, THERE IS

                    ALREADY AN ENHANCED PENALTY.  IT'S 120.35, PROMOTING SUICIDE ATTEMPT;

                    WHEN PUNISHABLE AS ATTEMPT TO COMMIT MURDER.  SO WE ALREADY HAVE

                    TWO STATUTES ON THE BOOKS THAT WOULD COVER IT, AND THE SECOND ONE IS A

                    CLASS B VIOLENT FELONY, WHICH IS PRETTY SERIOUS.

                                 MR. SEMPOLINSKI:  SO -- SO -- WHAT -- BUT AM I

                    CORRECT THAT WE ARE GIVING NEW POWERS TO PEOPLE OVER LIFE AND DEATH

                    AND NOT CREATING ANY NEW CRIMES OR ENHANCED PENALTIES IF THAT IS

                    ABUSE?

                                 MS. PAULIN:  SO, I'VE BEEN IN THIS CHAMBER FOR

                    NEARLY 25 YEARS, AND I HAVE SEEN BILL AFTER BILL, STATUTE AFTER STATUTE

                    WHERE WE SIMPLY SAY IT'S A CLASS A FELONY.  IT -- OR WE REFER IT BACK TO A

                    --

                                 MR. SEMPOLINSKI:  BUT YOU DON'T -- YOU DON'T SAY

                    ANYTHING IS A CLASS A FELONY.

                                 MS. PAULIN:  WELL, BECAUSE WE DON'T HAVE TO

                    BECAUSE THESE ARE --

                                 MR. SEMPOLINSKI:  ARE -- ARE YOU -- WHY ARE YOU

                    HESITANT TO CHANGE TO LAW TO INCREASE PENALTIES?

                                 MS. PAULIN:  I MEAN, DO YOU WANT US TO SAY THAT IT'S

                    -- THAT 120.30 WOULD APPLY IF YOU'RE -- YOU KNOW, IF IT WAS PROMOTING A

                    SUICIDE ATTEMPT?  I MEAN, HONESTLY --

                                 MR. SEMPOLINSKI:  I THINK THE PENALTY SHOULD BE

                    ENHANCED.  I THINK THEY SHOULD BE INCREASED.  I THINK THERE SHOULD BE

                                         103



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    NEW CRIMES.  IF YOU'RE A DOCTOR THAT ABUSES THE POWERS OF LIFE AND DEATH

                    THAT WE'RE ABOUT TO GIVE YOU, I THINK THAT SHOULD BE A NEW CRIME IN THE

                    STATE OF NEW YORK.  IT PROBABLY SHOULD BE MURDER 1, FRANKLY, BECAUSE

                    WE'RE GIVING PEOPLE A MASSIVE AMOUNT OF POWER AND NOT PUTTING ANY

                    TEETH ON IT.  AND -- AND I --

                                 (CROSSTALK)

                                 MS. PAULIN:  IF THE --

                                 MR. SEMPOLINSKI:  I WILL REPHRASE THE QUESTION BY

                    WAY--

                                 MS. PAULIN:  MURDER 1 IS VERY CLEAR.  AND IF THE --

                                 ACTING SPEAKER HUNTER:  COLLEAGUES, CAN WE

                    PLEASE ASK AND ANSWER?

                                 MR. SEMPOLINSKI:  I WILL REPHRASE THE QUESTION BY

                    WAY OF A CASE STUDY.  AND THE REASON I'M CONCERNED ABOUT THIS, I HAVE A

                    DAUGHTER WITH PROFOUND DISABILITY, PROFOUND DEVELOPMENTAL DISABILITY.

                    SHE HAS MULTIPLE CONGENTIAL HEART DEFECTS.  I'M 42 YEARS OLD.  I THINK

                    I'M IN PRETTY GOOD SHAPE, I HOPE I'M AROUND FOR AT LEAST ANOTHER 42.

                    WHO KNOWS?  SHE'S SIX.  WHETHER I LIVE A LONG LIFE OR NOT, SHE'S GONNA

                    REACH A POINT IN HER LIFE WHERE I'M NOT GONNA BE THERE TO PROTECT HER.

                    WHAT'S GONNA PROTECT HER FROM BEING ABUSED, AS FAR AS THIS STATUTE IS

                    CONCERNED OF BEING COERCED, ARE YOUR WORDS.  AND IF YOUR WORDS DON'T

                    HAVE ANY TEETH BEHIND THEM, HOW AM I SUPPOSED TO FEEL CONFIDENT

                    WHEN I'M IN THE HEREAFTER THAT NO ONE WILL TRICK OR INDUCE OR COERCE OR

                    PUSH MY DAUGHTER, WHO'S IN A VERY VULNERABLE SITUATION, INTO KILLING

                    HERSELF?  HOW AM I SUPPOSED TO FEEL CONFIDENT OF THAT IF YOU WON'T PUT

                                         104



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ANY PENALTIES IN THE LAW, THEY'RE JUST WORDS ON PAPER?

                                 MS. PAULIN:  WELL, UNFORTUNATELY, PENALTIES COME

                    AFTER THE FACT.  WHAT WE'VE PUT IN THE LAW, THOUGH, IS PREVENTIVE.  AND

                    WHAT WE HAVE IN THE LAW IS THAT A DISABILITY IS NOT -- CANNOT BE THE SOLE

                    REASON FOR THIS.  THAT -- I DON'T KNOW THE CONDITION OF YOUR DAUGHTER,

                    BUT IF SHE DOESN'T HAVE DECISION-MAKING CAPABILITY, SHE COULDN'T GET IT.

                    SO THOSE ARE PREVENTIVE.  IF SOMEONE, GOD FORBID, MURDERS YOUR

                    DAUGHTER, THEN THEY WOULD BE SUBJECT TO VERY HIGH PENALTIES IN THE

                    PENAL CODE ALREADY.

                                 MR. SEMPOLINSKI:  SO -- BUT I'M TALKING -- I'M NOT

                    TALKING ABOUT MURDER, I'M TALKING ABOUT COERCING HER INTO THIS.  BUT

                    THERE ARE NO ENHANCED PENALTIES.  SHE SIMPLY HAS TO LIVE UNDER THE

                    CIRCUMSTANCE THAT THESE WORDS WILL PROTECT HER.

                                 MS. PAULIN:  COERCION -- COERCION RISES TO A FELONY

                    D.  THAT'S PRETTY SERIOUS.

                                 MR. SEMPOLINSKI:  COERCION TO KILL SOMEBODY

                    WOULD BE 2 TO 7.  SO IN THEORY, IF YOU COERCE SOMEBODY INTO KILLING

                    THEMSELVES, TWO YEARS POTENTIALLY.

                                 MS. PAULIN:  NO.  IF YOU COERCE SOMEONE INTO

                    KILLING THEMSELVES YOU WOULD BE GUILTY OF -- YOU'D PROBABLY BE GUILTY

                    OF PROMOTING A SUICIDE ATTEMPT THAT'S -- THAT WOULD BE A CLASS B VIOLENT

                    FELONY, WHICH IS 25 YEARS.

                                 MR. SEMPOLINSKI:  I HAVE ONE FINAL QUESTION.  I --

                    I DO APPRECIATE YOU ANSWERING MY QUESTIONS.

                                 MY FINAL QUESTION IS, THERE IS NO -- AM I CORRECT THAT

                                         105



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THERE IS NO EXPLICIT BAN ON THOSE WITH DEVELOPMENTAL DISABILITIES FROM

                    USING THIS?  IT JUST SAYS SOLELY IT CANNOT BE -- BE -- YOU CANNOT BE PUT

                    INTO THIS PROGRAM BECAUSE OF A DISABILITY AND YOU HAVE TO MAKE SURE

                    SOMEBODY HAS CAPACITY.  BUT SIMPLY BY HAVING A DEVELOPMENTAL

                    DISABILITY, THAT DOES NOT PREVENT YOU IF, SAY THAT PERSON HAD A TERMINAL

                    DIAGNOSIS AND TWO DOCTORS SAID THEY WERE CAPABLE.

                                 MS. PAULIN:  THAT'S CORRECT.  AND IN FACT, THE

                    DISABILITY COMMUNITY IN NEW YORK HAS SPOKEN LOUD AND CLEAR.

                    SEVENTY -- 73 PERCENT OF NEW YORKERS THAT IDENTIFY WITH A DISABILITY

                    SUPPORT MEDICAL AID IN DYING.  THAT'S A HIGHER NUMBER THAN THE REST OF

                    NEW YORK STATE, WHICH IS AT 72 PERCENT IN THE LAST STUDY THAT WAS DONE

                    JUST LAST YEAR.  SO WE KNOW THAT PEOPLE WITH DISABILITIES WANT TO BE

                    ABLE TO HAVE THE SAME OPTIONS AS EVERYBODY ELSE.

                                 MR. SEMPOLINSKI:  I'M GONNA GO ON THE BILL.  AND

                    I APPRECIATE THE --

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MR. SEMPOLINSKI:  -- SPONSOR BEING WILLING TO

                    ANSWER MY QUESTIONS.

                                 I THINK PART OF THE REASON, AND -- AND MR. RA ELUDED TO

                    THIS -- WHY THERE'S SO MANY LOOPHOLES AND PROBLEMS AND CONCERNS IS

                    FOR THE ENTIRETY OF CIVILIZATION, DOCTORS' SOLE ROLE HAS BEEN TO PROMOTE,

                    EXTEND LIFE, TO PROVIDE HEALTH.  AND NOW WE ARE TAKING THAT PROFESSION

                    AND ASKING IT TO DO THE EXACT OPPOSITE OF THE REASON THAT IT EXISTS.  AND

                    SO WHEN YOU TRY AND PERVERT THAT AND REVERSE THAT, IT SIMPLY DOESN'T

                    WORK AND YOU RUN INTO ALL THESE REASONS WHY YOU'RE GONNA HAVE PEOPLE

                                         106



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    FALL THROUGH THE CRACKS, ALL THESE PROBLEMS THAT MY FRIENDS KEEP

                    BRINGING UP.  ALL THESE LOOPHOLES.  SO WE'RE TRYING TO TAKE AN ENTIRE

                    BODY OF LAW AND THOUSANDS OF YEARS OF HISTORY AND FLIP IT.

                                 AND I MENTIONED MY MOST PRESSING CONCERN, WHICH IS

                    WHAT HAPPENS TO MY DAUGHTER WHEN I'M NOT HERE TO PROTECT HER AND

                    WHAT HAPPENS TO THOUSANDS OF PEOPLE LIKE HER.  IF HISTORY SHOWS

                    ANYTHING, WHEN WE OPEN A DOOR LIKE THIS WE KNOW WHO GETS SHOVED

                    THROUGH FIRST, AND IT'S THOSE THAT CANNOT DEFEND THEMSELVES.  AND MY

                    CONCERNS ARE NOT MERELY SIMPLY A SLIPPERY-SLOPE ARGUMENT, THOUGH I

                    THINK IT IS VERY APT.  AND WE SEE WHAT HAPPENS IN CANADA, A

                    JURISDICTION THAT'S CLOSER TO MY DISTRICT THAN THIS BUILDING IS.  BUT IT'S MY

                    CONCERNS WITH THE BILL ITSELF WITHOUT HAVING ANY ENHANCED PENALTIES.

                    WE'RE GIVING THE POWER OF LIFE AND DEATH TO PEOPLE AND NOT INCREASING

                    THE PENALTIES AND NOT CREATING NEW CRIMES.  THAT MAKES NO SENSE.

                                 THE REASON THIS BILL HAS NOT PASSED UP TO THIS POINT IS

                    BECAUSE OF MAJORITY MEMBERS OF CONSCIENCE HAVE NOT WANTED IT TO

                    COME TO THE FLOOR.  WE HAVEN'T VOTED YET.  I ASK THOSE SAME MAJORITY

                    MEMBERS OF CONSCIENCE TO VOTE NO.  THANK YOU VERY MUCH.

                                 ACTING SPEAKER HUNTER:  MR. MANKTELOW.

                                 (BRIEF PAUSE)

                                 MS. GLICK.

                                 (BRIEF PAUSE)

                                 MR. SLATER.

                                 MR. SLATER:  THANK YOU, MADAM SPEAKER.  WILL

                    THE SPONSOR YIELD FOR SOME QUESTIONS?

                                         107



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MR. SLATER:  THANK YOU VERY, VERY MUCH.  I

                    APPRECIATE IT.  AND THANK YOU FOR TAKING THE TIME FOR ANSWERING SO

                    MANY QUESTIONS TODAY.

                                 I JUST WANTED TO SEE IF WE CAN JUST FOCUS IN A BIT MORE

                    ON THE MENTAL HEALTH ASPECTS OF SOME OF THE THINGS THAT HAVE BEEN SAID

                    TODAY.  SO JUST TO MAKE SURE I'M CLEAR, THE INDIVIDUALS WHO DETERMINE

                    WHETHER A PATIENT HAS THE MENTAL COMPETENCY TO RECEIVE THE

                    MEDICATION OR TO, I GUESS, ASK FOR THE MEDICATION AND THEN RECEIVE THE

                    MEDICATION WOULD BE THE ATTENDING AND CONSULTING DOCTORS, CORRECT?

                                 MS. PAULIN:  (NODDED IN THE AFFIRMATIVE)

                                 MR. SLATER:  GREAT.  AND IS IT POSSIBLE FOR AN

                    INDIVIDUAL'S MENTAL COMPETENCY TO CHANGE BASED ON THEIR DIAGNOSIS

                    AND THE PROGRESSION OF THEIR DISEASE?

                                 MS. PAULIN:  (INAUDIBLE/MIC OFF) -- THEY'RE ALL

                    DIFFERENT.  SO I DON'T KNOW WHETHER SOMEONE'S COMPETENCY

                    DETERIORATES BECAUSE OF THEIR ILLNESS.  I JUST CAN'T SPEAK TO THAT.

                                 MR. SLATER:  BUT THE ATTENDING AND CONSULTING

                    PHYSICIANS ARE EXPECTED TO BE ABLE TO, CORRECT?

                                 MS. PAULIN:  YES.

                                 MR. SLATER:  NOW, DO THE -- DOES THE LEGISLATION

                    REQUIRE THE ATTENDING OR CONSULTING PHYSICIANS, PRESUMABLY BOTH, ARE

                                         108



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THEY REQUIRED TO RECEIVE SOME TYPE OF MENTAL HEALTH TRAINING?  ARE THEY

                    -- BECAUSE THEY ARE NOT MENTAL HEALTH EXPERTS, CORRECT?

                                 MS. PAULIN:  RIGHT.

                                 MR. SLATER:  SO ARE THEY REQUIRED TO RECEIVE SOME

                    FORM OF TRAINING TO DEAL WITH THE QUESTION I PREVIOUSLY POSED ABOUT

                    ONE'S COMPETENCY?

                                 MS. PAULIN:  SO, DOCTORS ALL THE TIME ARE REQUIRED

                    TO ASSESS SOMEONE'S DECISION-MAKING CAPABILITIES FOR EVERY SINGLE

                    TREATMENT THAT -- THAT SOMEONE HAS.  FOR EXAMPLE, YOU KNOW, WHEN WE

                    HAVE TREATMENTS WE HAVE TO SIGN A FORM, YOU KNOW, RIGHT?  EVERYBODY

                    SIGNS THE CONSENT FORM FOR WHATEVER THE TREATMENT IS.  MINOR ONES.

                    AND DOCTORS HAVE TO ASSESS WHETHER OUR SIGNATURE IS VALID BASED ON OUR

                    COMPETENCY TO HAVE SIGNED THAT.  SO EVERY DAY, DOCTORS HAVE TO MAKE

                    THESE DECISIONS.

                                 I DON'T UNDERSTAND WHY THIS DECISION IS DIFFERENT, YOU

                    KNOW THAN -- THAN A DECISION TO GO ON DIALYSIS, TO GET AN EXPERIMENTAL

                    TREATMENT.  WE EXPECT DOCTORS TO BE ABLE TO DETERMINE, AND IF THEY HAVE

                    ANY DOUBT, ANY DOUBT, THEY CAN MAKE THAT REFERRAL.

                                 MR. SLATER:  BUT TO MAKE SURE I'M CLEAR, THERE IS

                    NO REQUIREMENT STATED WITHIN THE LEGISLATION THAT THE -- THAT THE

                    ATTENDING OR CONSULTING DOCTOR MUST TAKE SOME FORM OF MENTAL HEALTH

                    TRAINING IN ORDER TO BE THE ATTENDING OR CONSULTING DOCTOR?

                                 MS. PAULIN:  I'M NOT SURE, BUT I WOULD -- I BELIEVE

                    THAT, YOU KNOW, WHEN DOCTORS GO INTO MEDICINE THAT THEY'RE REQUIRED TO

                    DO ROTATIONS IN ALMOST EVERYTHING, AND PROBABLY THIS AS WELL.

                                         109



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. SLATER:  WELL, I JUST -- JUST TO DIG DOWN DEEPER

                    INTO IT, BECAUSE I WAS LOOKING TO SEE WHAT TYPE OF REQUIREMENTS WERE

                    THERE AND I DIDN'T SEE ANY IN THE LEGISLATION.  THAT'S WHY I'M CONTINUING

                    TO ASK THE QUESTION.  SO I UNDERSTAND FROM -- WHAT YOU'RE SAYING, BUT

                    WITHIN THE TEXT ITSELF, IN ORDER TO BE EITHER THE ATTENDING OR CONSULTING,

                    MAKING A VERY IMPORTANT DECISION, THERE IS NO REQUIREMENT STATED ABOUT

                    A MENTAL HEALTH TRAINING FOR THOSE INDIVIDUALS?

                                 MS. PAULIN:  NO, THERE'S NO REQUIREMENT.

                                 MR. SLATER:  OKAY.  THANK YOU.  I -- I APPRECIATE

                    THAT.

                                 SO IF -- IF AN INDIVIDUAL'S COMPETENCY OCCURS AFTER

                    THEY'VE BEEN PRESCRIBED, IF THEIR COMPETENCY DETERIORATES BASED ON

                    THEIR DIAGNOSIS AFTER THEY'VE BEEN DESCRIBED [SIC] END-OF-LIFE

                    MEDICATION, WHAT HAPPENS?

                                 MS. PAULIN:  YOU KNOW, THESE ARE PEOPLE WHO ARE

                    DYING WITHIN SIX MONTHS.  THE -- THE ODDS OF THEIR MENTAL CAPACITY

                    CHANGING SO SEVERELY ARE PROBABLY VERY REMOTE.  I WOULD THINK THAT IF A

                    DOCTOR SAW THE ONE INDIVIDUAL IN -- IN THE NUMBERS THAT THEY WERE

                    DOCTORS OF, YOU KNOW, THAT THEY WERE -- THAT THEY HAD PATIENTS, THAT THEY

                    WOULD MAYBE, YOU KNOW, SUGGEST TO THAT PATIENT THAT THEY SHOULDN'T BE

                    USING THIS TREATMENT OPTION.  BUT IT'S JUST NOT BEEN THE EXPERIENCE OF --

                    OF THE NEARLY 30 YEARS.  WE JUST HAVEN'T HEARD OF ONE CASE, NOT EVEN

                    ONE OF THE 10,211 CASES WHERE PEOPLE USED THIS MEDICATION OR AVAILED

                    THEMSELVES OF IT THAT -- WHERE WE'VE SEEN THAT HAPPEN.  SO WE'RE REALLY

                    WORRYING ABOUT NOTHING.

                                         110



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. SLATER:  ARE THERE -- ARE THERE ANY STATISTICS

                    RELATED TO THE NUMBER OF CASES THAT YOU JUST CITED THAT THOSE INDIVIDUALS

                    WERE REFERRED TO MENTAL HEALTH EXPERTS BY THEIR CONSULTING OR END -- OR

                    THEIR ATTENDING PHYSICIAN?

                                 MS. PAULIN:  SINCE EVERY STATE IS A LITTLE DIFFERENT IN

                    TERMS OF HOW THEY STRUCTURE THAT AND EACH STATE IS A LITTLE DIFFERENT IN

                    TERMS OF THE DATA THEY COLLECT, IT WOULD REALLY BE NEARLY IMPOSSIBLE TO

                    FIGURE THAT OUT.

                                 MR. SLATER:  I MEAN, THERE -- I -- I WAS SEEING

                    SOME STATISTIC THAT SHOWED LESS THAN 5 PERCENT OF INDIVIDUALS WHO WENT

                    TO A DOCTOR FOR END-OF-LIFE MEDICATION WERE ULTIMATELY REFERRED FOR A

                    MENTAL HEALTH EVALUATION.

                                 MS. PAULIN:  THAT -- I -- I VAGUELY REMEMBER THAT

                    STATISTIC AS WELL, SO THAT COULD BE THE CASE.  AND THAT JUST SHOWS YOU

                    THAT THESE ILLNESSES THAT ARE END-OF-LIFE TYPE ILLNESSES LIKE CANCER, LIKE

                    ALS, ARE ONES WHERE YOU KEEP YOUR MEDICAL FACULTIES.

                                 MR. SLATER:  BUT DOESN'T IT ALSO RAISE A CONCERN

                    THAT THOSE WHO ARE BEING EMPOWERED TO BE THE ATTENDING OR CONSULTING

                    PHYSICIANS ARE JUST NOT PROPERLY TRAINED AND ABLE TO REFER AN INDIVIDUAL

                    TO A MENTAL HEALTH PROFESSIONAL?  ARE THEY NOT PROPERLY ABLE TO IDENTIFY

                    THE DIFFERENCE BETWEEN END-OF-LIFE AND AN EMOTIONAL OR MENTAL

                    DISTRESS?

                                 MS. PAULIN:  I WOULD ARGUE THAT THEY ABSOLUTELY

                    HAVE THAT -- THAT ABILITY.  THESE DOCTORS ARE HIGHLY TRAINED AND HIGHLY

                    SENSITIVE TO PATIENTS' NEEDS.  THEY ARE TREATING THE MOST VULNERABLE

                                         111



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    PATIENTS AND PEOPLE THAT -- THAT ARE IN OUR -- IN OUR STATE, IN OUR -- IN

                    OUR WORLD AND OUR COUNTRY AND OUR LIFE, AND THEY HAVE THOSE EXPERTISE.

                    I -- I AM NOT CONCERNED IN THE LEAST BIT.

                                 MR. SLATER:  BUT AGAIN, JUST TO MAKE SURE WE'RE

                    CLEAR, ACCORDING TO YOUR LEGISLATION THERE IS NO REQUIREMENT FOR MENTAL

                    HEALTH TRAINING IN ORDER TO BE AN ATTENDING OR CONSULTING PHYSICIAN.

                    PATIENTS ARE OFTEN PROVIDED OR SEEK MENTAL HEALTH HELP AND ASSISTANCE

                    WHEN THEY ARE DIAGNOSED WITH A CANCER -- CANCER DIAGNOSIS; IS THAT

                    CORRECT?

                                 MS. PAULIN:  THEY CAN BE.  IF THEY'RE DEPRESSED AND

                    THEY WANT TO SEEK SOMEONE, ABSOLUTELY THEY COULD -- THEY COULD DO

                    THAT.

                                 MR. SLATER:  BUT CANCER PATIENTS ARE ALSO

                    ENCOURAGED TO SEEK MENTAL PROFESSIONALS TO HELP THEM THROUGH THAT --

                    THROUGH THAT PROCESS OF BATTLING CANCER.  IS THAT -- IS THAT A FAIR

                    STATEMENT?

                                 MS. PAULIN:  PERHAPS.  I DON'T KNOW.  YOU KNOW

                    WHAT?  AGAIN --

                                 MR. SLATER:  WELL, I KNOW SOMEONE SPECIFICALLY

                    WHO WAS -- SEVERAL PEOPLE WHO WERE DIAGNOSED WITH CANCER AND THEY

                    WERE ALL PROVIDED WITH MENTAL HEALTH OPTIONS TO GO THROUGH THAT

                    PROCESS.

                                 MS. PAULIN:  I THINK THAT THERE'S SUPPORT GROUPS AND

                    OTHER SITUATIONS WHERE SOMEONE CAN --

                                 MR. SLATER:  MY QUESTION IS IF SOMEONE IS

                                         112



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    PROVIDED WITH OR SEEKS A MENTAL HEALTH THERAPIST TO HELP THEM THROUGH

                    THEIR TREATMENTS, IS THAT PERSON BROUGHT INTO THE DISCUSSION OF END-OF-

                    LIFE MEDICATION AT ANY POINT IN TIME?

                                 MS. PAULIN:  WAIT, SAY THAT ONE MORE TIME.

                                 MR. SLATER:  IF A CANCER PATIENT SEEKS A MENTAL

                    HEALTH ADVISOR OR EXPERT TO HELP THEM AS THEY'RE GETTING TREATMENTS, AS

                    THEY ARE BATTLING THROUGH THEIR DIAGNOSIS, BUT ULTIMATELY THEIR CONDITION

                    DETERIORATES TO THE POINT WHERE THEY'RE WITHIN THAT SIX-MONTH WINDOW.

                    DOES THAT THERAPIST THAT THAT INDIVIDUAL HAS BEEN SEEING WHILE THEY'RE

                    RECEIVING TREATMENT, ARE THEY BROUGHT INTO THE DISCUSSION AT ANY POINT

                    IN TIME IF THAT INDIVIDUAL SEEKS END-OF-LIFE MEDICATION?

                                 MS. PAULIN:  THEY ARE IF IT'S DETERMINED BY EITHER

                    THE PRESIDE -- THE ATTENDING PHYSICIAN OR CONSULTING PHYSICIAN THAT IT'S

                    NECESSARY TO ASSESS SOMEONE'S DECISION-MAKING CAPABILITY.

                                 MR. SLATER:  BUT THAT -- BUT THOSE -- AGAIN, THOSE

                    ATTENDING AND CONSULTING PHYSICIANS MAY NOT BE AWARE THAT THE

                    INDIVIDUAL HAS BEEN SEEKING MENTAL HEALTH ASSISTANCE DURING THAT

                    PROCESS, NOR IS THE INDIVIDUAL REQUIRED, I'M GUESSING, TO DIVULGE THAT

                    FACT.  IS THAT AN ACCURATE ASSUMPTION?

                                 MS. PAULIN:  THAT IS, EXCEPT THAT BY YOUR OWN

                    ADMISSION EARLIER YOU SAID THAT THEY ARE USUALLY ENCOURAGED BY THEIR

                    ATTENDING PHYSICIAN TO SEEK THAT MENTAL HEALTH EVALUATION, AND THEY

                    USUALLY HAVE A VERY OPEN, HONEST RELATIONSHIP WITH THEIR ATTENDING

                    PHYSICIAN.  SO IT'S LIKELY THEY WOULD KNOW, BUT EVEN IF THEY KNEW OR

                    THEY DIDN'T KNOW, THE EVALUATION THAT THE ATTENDING PHYSICIAN IS MAKING

                                         113



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    IS ON THEIR DECISION-MAKING CAPACITY ON MEDICATION THAT THEY WOULD BE

                    GIVING THEM.  THEY ARE MAKING A DECISION ON WHETHER THEY WERE FIT IN

                    TERMS OF THEIR DECISION-MAKING CAPABILITY TO ASSESS MEDICAL ISSUES, NOT

                    ON ANY OTHER -- ANY OTHER CIRCUMSTANCE.

                                 MR. SLATER:  I -- I UNDERSTAND THAT AND I APPRECIATE

                    YOUR ANSWER.  I GUESS IT JUST BOILS DOWN TO WHY ARE WE NOT MAKING IT

                    MANDATORY FOR ALL INDIVIDUALS?  AND SINCE, AGAIN, THE ATTENDING AND

                    CONSULTING DOCTORS DON'T NEED MENTAL HEALTH TRAINING, WHY ARE WE NOT

                    MAKING IT MANDATORY FOR ALL INDIVIDUALS WHO ARE SEEKING END-OF-LIFE

                    MEDICATION TO BE SEEN BY A MENTAL HEALTH PROFESSIONAL BEFORE THEY'RE

                    PRESCRIBED ANY LIFE-ENDING MEDICATION?

                                 MS. PAULIN:  BECAUSE VERY SIMPLY, WE DON'T WANT

                    TO DISTINGUISH THIS FROM OTHER MEDICAL OPTIONS THAT SOMEONE WOULD

                    HAVE.  SO YOU DON'T MAKE THOSE DETERMINATIONS.

                                 MR. SLATER:  IS THERE -- IS THERE ANY -- IS THERE ANY

                    RIGHT OF -- OF AN APPEAL IF AN INDIVIDUAL'S FAMILY BELIEVES THAT THEY DO

                    NOT HAVE OR NO LONGER HAVE THE MENTAL COMPETENCY TO MAKE THIS

                    DECISION?

                                 MS. PAULIN:  I WOULD ARGUE THAT THEY -- THEY COULD

                    TELL THE -- THE ATTENDING DOCTOR OF THEIR BELIEF.

                                 MR. SLATER:  THE FAMILY CAN TELL THE ATTENDING

                    DOCTOR --

                                 MS. PAULIN:  YEAH.  OR THE CONSULTING DOCTOR --

                                 MR. SLATER:  OR THEIR CONSULTING DOCTOR --

                                 MS. PAULIN:  -- THAT THEY DON'T BELIEVE THAT SOMEONE

                                         114



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    HAS THE ABILITY TO HAVE DECISION-MAKING POWER OVER THEIR HEALTH

                    DECISIONS.  THEY COULD GO TO COURT.

                                 MR. SLATER:  WHAT HAPPENS IF THEY'VE ALREADY BEEN

                    PRESCRIBED THE MEDICATION AND IT HASN'T BEEN TAKEN AND THE FAMILY DOES

                    NOT BELIEVE THAT THE INDIVIDUAL OBTAINED IT IN THE RIGHT MINDSET?

                                 MS. PAULIN:  THAT -- IT'S SELF-DETERMINATION.  IT'S UP

                    TO THAT PERSON.  YOU KNOW, I DON'T KNOW THAT I WANT MY CHILDREN TO

                    DECIDE WHETHER I'M ABLE OR CAPABLE OF DOING ANYTHING.  I WANT TO BE

                    ABLE TO MAKE THOSE DECISIONS FOR MYSELF.  AND THIS IS THE MOST

                    IMPORTANT DECISION THAT YOU'RE GONNA MAKE.  SO I WANT THAT DECISION.  I

                    DON'T -- I DON'T WANT OTHERS TO DECIDE THAT FOR ME.  AND IF A DOCTOR

                    BELIEVES THAT I CAN'T MAKE THE DECISION, THEN HE OR SHE IS GONNA REFER

                    ME TO A MENTAL HEALTH PROFESSIONAL.  BUT I -- I DON'T KNOW THAT I WANT

                    MY CHILDREN OR MY HUSBAND TO MAKE THAT DETERMINATION FOR ME.  I WANT

                    TO -- I WANT TO BE INVOLVED.  I AM A COMPETENT HUMAN BEING, AS ARE THE

                    PATIENTS AND ALL OF THE PEOPLE WHO WORE YELLOW SHIRTS IN THIS CHAMBER

                    FOR SO MANY YEARS.

                                 MR. SLATER:  I APPRECIATE THAT.

                                 MY OTHER QUESTION IS REGARDING SINCE WE DON'T HAVE

                    THE DOCTORS BEING MANDATED TO SEEK MENTAL HEALTH TRAINING, WOULD THE

                    DOCTORS WHO WISH TO PARTICIPATE IN PRESCRIBING END-OF-LIFE MEDICATION

                    HAVE TO TAKE ANY CONTINUING EDUCATION OR PROFESSIONAL DEVELOPMENT TO

                    ENSURE THAT THEY ARE PREPARED FOR ALL EVENTUALITIES WITH ASSISTING THEIR

                    PATIENT WITH -- WITH ENDING THEIR LIFE?

                                 MS. PAULIN:  AGAIN, THEY'RE NOT ASSISTING.  THEY'RE

                                         115



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    PROVIDING A PRESCRIPTION.

                                 MR. SLATER:  IS THERE ANY CONTINUING EDUCATION

                    REQUIREMENTS FOR THEM TO PRESCRIBE --

                                 MS. PAULIN:  NO.

                                 MR. SLATER:  -- THOSE PRESCRIPTIONS?

                                 MS. PAULIN:  NO.  JUST, YOU KNOW, DOCTORS HAVE THE

                    PRESCRIPTION ABILITY AND THIS IS JUST ANOTHER PRESCRIPTION THAT THEY --

                    (INAUDIBLE/CROSSTALK).

                                 MR. SLATER:  SO NO MENTAL HEALTH TRAINING AND NO

                    CONTINUING EDUCATION REQUIREMENTS --

                                 MS. PAULIN:  NO.

                                 MR. SLATER:  -- TO -- TO PRESCRIBE.

                                 IS THERE ANY REVIEW PROCESS TO ENSURE THAT DOCTORS

                    HAVE FOLLOWED THE LAW FOR A PATIENT WHO UTILIZED MEDICAL AID IN

                    DYING?

                                 MS. PAULIN:  THE PROCESS BY WHICH SOMEONE

                    WOULD REVIEW ARE THAT THERE WOULD BE MEDICAL RECORDS THAT THEY HAVE

                    TO KEEP, DETAILED MEDICAL RECORDS, AND THE HEALTH DEPARTMENT HAS THE

                    AUTHORITY TO REVIEW THOSE RECORDS.  SO THAT'S THE REVIEW.

                                 MR. SLATER:  UNDERSTOOD.  WELL, THANK YOU VERY

                    MUCH FOR ANSWERING MY QUESTIONS.  I APPRECIATE IT.

                                 MADAM SPEAKER, ON -- ON THE BILL IF I MAY, QUICKLY.

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MR. SLATER:  YOU KNOW, I THINK BASED ON THE

                    ANSWERS THAT I JUST RECEIVED, I HAVE SIGNIFICANT CONCERNS REGARDING THE

                                         116



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WAY THAT THIS LEGISLATION'S WRITTEN, SPECIFICALLY AS IT RELATES TO MENTAL

                    HEALTH.  WE CONTINUALLY SAY THAT THERE'S A MENTAL HEALTH CRISIS, BUT YET

                    HERE WE ARE, ENABLING DOCTORS TO PRESCRIBE END-OF-LIFE MEDICATION

                    WITHOUT ANY MENTAL HEALTH TRAINING AND I THINK THAT'S VERY CONCERNING.

                    I'M ALSO CONCERNED OVER THE FACT THAT WE JUST HEARD THAT THERE IS NO

                    REQUIREMENT FOR CONTINUING EDUCATION IN ORDER TO BE A PRESCRIBER.  AND

                    SO THIS IS A VERY SERIOUS ISSUE THAT REQUIRES THAT LEVEL OF SCRUTINY AND

                    THAT LEVEL OF TRAINING.

                                 I DO RECOGNIZE THE FACT THAT WE HAVE GREAT DOCTORS ALL

                    OVER THIS STATE, DOCTORS WHO I BELIEVE DO HAVE THEIR PATIENTS' BEST

                    INTERESTS IN HEART.  BUT WHEN WE'RE TALKING ABOUT SOMETHING AS SERIOUS

                    AS END-OF-LIFE MEDICATION, MAKING SURE THAT WE CONTINUE TO HOLD UP A

                    HIGH BAR I DON'T THINK IS TOO MUCH TO ASK FOR.

                                 AND SO AGAIN, I WANT TO THANK THE SPONSOR FOR

                    ANSWERING MY QUESTIONS.  I'LL BE VOTING IN THE NEGATIVE BECAUSE OF THE

                    CONCERNS THAT I HAVE ARTICULATED.  THANK YOU VERY MUCH.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MS. GLICK.

                                 MS. GLICK:  WILL THE SPONSOR YIELD TO A COUPLE OF

                    QUESTIONS?

                                 ACTING SPEAKER HUNTER:  DOES THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MS. GLICK:  THANK YOU VERY MUCH.

                                         117



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 IF SOMEONE GOES INTO THE HOSPITAL, THEIR CARDIOLOGIST

                    SUGGESTS TO THEM THAT THEY, YOU KNOW, NEED OPEN HEART SURGERY; IS IT

                    REASONABLE PRACTICE THAT PEOPLE MIGHT BE ASKED TO EITHER HAVE A

                    HEALTHCARE PROXY OR A DNR BEFORE THEY UNDERGO SERIOUS SURGERY?

                                 MS. PAULIN:  ABSOLUTELY.

                                 MS. GLICK:  AND SO IN THE EVENT -- AND DOES ANY --

                    WHEN THEY'RE AT THE HOSPITAL AND THEY'VE TALKED TO A CARDIOLOGIST WHO

                    MAY NOT HAVE ANY MENTAL HEALTH TRAINING, DOES ANYBODY SUGGEST THAT

                    BEFORE THEY WRITE A DNR, A DO NOT RESUSCITATE, THAT THEY SEE A MENTAL

                    HEALTH PROFESSIONAL?

                                 MS. PAULIN:  NO, THEY DO NOT.

                                 MS. GLICK:  WHEN SOMEBODY HAS BEEN IN THE

                    HOSPITAL OR IN A NURSING HOME FOR A LONG PERIOD OF TIME, CAN THEY AT

                    SOME POINT WHEN THEY FEEL THEY'RE FAILING, CAN THEY REFUSE HYDRATION?

                                 MS. PAULIN:  ABSOLUTELY.

                                 MS. GLICK:  DOES ANYBODY REQUIRE THEM TO SEE A

                    MENTAL HEALTH PROFESSIONAL BEFORE THEY MAKE THAT DECISION?

                                 MS. PAULIN:  NO.

                                 MS. GLICK:  NOW, IT'S MY UNDERSTANDING THAT IT'S

                    ACTUALLY QUITE -- THAT IT'S ESSENTIALLY, YOU KNOW, STARVING YOURSELF TO

                    DEATH AND THAT'S PRETTY UNCOMFORTABLE.  BUT NOBODY REQUIRES ANYTHING.

                    NOWHERE IN THE LAW, NOWHERE IN MEDICAL -- THAT WE HAVE THAT

                    REQUIREMENT, RIGHT?

                                 MS. PAULIN:  ABSOLUTELY CORRECT.

                                 MS. GLICK:  OKAY.

                                         118



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 IF YOU HAVE A LOVED ONE WHO HAS A -- YOU'VE GIVEN A

                    HEALTHCARE PROXY TO SOMEBODY ELSE.  THEY CAN MAKE A DECISION TO

                    DETERMINE THAT YOU NOT BE RESUSCITATED IF YOU ARE ON -- IF THERE'S A

                    PROBLEM IN THE COURSE OF SURGERY AND YOU ARE IN A COMA, SOMEBODY

                    ELSE CAN MAKE THAT DECISION ONCE YOU'VE ASSIGNED THEM THE -- AS YOUR

                    HEALTHCARE PROXY; IS THAT --

                                 MS. PAULIN:  CORRECT.

                                 MS. GLICK:  OKAY.  THANK YOU VERY MUCH.

                                 ON THE BILL.

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MS. GLICK:  YOU KNOW, IF I COULD JUST ASK YOU ONE

                    MORE QUESTION.  I'M SORRY, IF YOU WOULD YIELD TO ONE MORE QUESTION.

                                 ACTING SPEAKER HUNTER:  DOES THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MS. GLICK:  WE TALKED ABOUT THE OTHER POSSIBILITIES

                    IN END-OF-LIFE CARE, WHICH INCLUDES PALLIATIVE CARE.  WHAT IS INVOLVED IN

                    PALLIATIVE CARE?  IS THAT, LIKE, PAIN RELIEVERS AND --  TO WHAT EXTENT CAN

                    SOMEBODY BE PROVIDED PAIN RELIEF?

                                 MS. PAULIN:  TO THE EXTENT -- MAXIMUM EXTENT

                    BASED ON WHAT WE HAVE AVAILABLE.  YOU KNOW, TYPICALLY MORPHINE

                    WHEN SOMEONE IS IN SEVERE PAIN, WHICH YOU CAN TAKE UNTIL YOU'RE

                    COMATOSE, WHICH MANY PATIENTS DON'T WANT TO DO BECAUSE THEY ACTUALLY

                    WANT TO CONVERSE WITH THE PEOPLE IN THE ROOM.  BUT THEY -- THEY COULD

                                         119



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    DO THAT.

                                 MS. GLICK:  SO IF THEY SAID, I -- I'M -- I REALLY -- I'VE

                    SAID MY GOODBYES AND I MAY OR MAY NOT, BUT I CAN ASK YOU TO REALLY

                    SNOW ME UNDER AND AT SOME POINT I WILL SUCCUMB AND THAT'S FINE, THEY

                    CAN DO THAT?  THEY DON'T HAVE TO HAVE THE MENTAL HEALTH PEOPLE COME

                    IN AND CHECK?

                                 MS. PAULIN:  I THINK IT'S VERY COMMON.

                                 MS. GLICK:  OKAY.  THANK YOU.

                                 ON THE BILL.

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MS. GLICK:  MOST PEOPLE WANT TO TAKE WHATEVER

                    POSSIBLE TREATMENTS AVAILABLE TO THEM.  ALTHOUGH A LOT OF PEOPLE DON'T

                    HAVE A LOT OF OPTIONS BECAUSE, YOU KNOW, THE HEALTHCARE SYSTEM ISN'T

                    FREE AND WE'VE HAD RESTRICTIONS.  AND SO NOT EVERYBODY CAN AVAIL

                    THEMSELVES OF EVERY CLINICAL TRIAL.  IN FACT, I THINK RECENTLY SOME

                    CLINICAL TRIALS FOR CANCER AND OTHER MED -- HAVE JUST BEEN CUT OFF.  SO

                    PEOPLE, BY EXECUTIVE ORDER, WERE DENIED ACCESS TO CLINICAL TRIALS THAT

                    MIGHT HAVE EXTENDED THEIR LIVES AND MIGHT BE FACING THEIR DEMISE

                    UNEXPECTEDLY BECAUSE THEY WERE TRYING DESPERATELY TO FIND A WAY TO

                    STAY ALIVE.  SO I -- I FIND IT A LITTLE BIT IRONIC, SOME OF THE CONVERSATION

                    TODAY.  BUT, YOU KNOW, NOBODY WANTS TO FACE THEIR OWN MORTALITY, AND

                    IT'S A DIFFICULT THING.  AND THOSE OF US WHO HAVE HAD ANY RELIGIOUS

                    UPBRINGING MAY FEEL THAT EVERYTHING SHOULD BE FOCUSED ON EXTENDING

                    LIFE, WHETHER THAT LIFE IS THE QUALITY OF LIFE THAT WE REALLY WOULD WANT

                    FOR OURSELVES.  BUT THAT'S OUR IMPULSE AS PEOPLE TO TRY TO STAY ALIVE.  BUT

                                         120



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WHEN THE DOCTORS HAVE TOLD YOU, THERE IS NOTHING ELSE WE CAN DO FOR

                    YOU AND YOU ARE FACING A SITUATION WHERE EITHER YOU WILL EXPERIENCE

                    SUFFERING OR YOU OPT FOR THE PALLIATIVE CARE THAT SLOWLY SNOWS YOU

                    UNDER SO THAT YOU'RE NOT REALLY LIVING A LIFE, PEOPLE DESERVE DIGNITY AND

                    OPTIONS.  AND THEY DESERVE TO MAKE A DECISION ABOUT THEMSELVES.

                    THEY MAY DECIDE, IN THE CONSULTATION WITH THE DOCTOR, AND THIS REQUIRES

                    THEM TO DO THAT.  AND IF -- THIS ACTUALLY REQUIRES THEM TO SEE A COUPLE

                    OF DOCTORS, EVEN THOUGH THEY MAY KNOW IN THEIR HEART THAT THERE'S

                    NOTHING ELSE THAT CAN BE DONE.

                                 SO IT WAS VERY UNCOMFORTABLE TO SIT WITH A FRIEND WHO

                    WAS SITTING IN THEIR APARTMENT IN A WHAT I WOULD REFER TO AS SORT OF A

                    BEACH LOUNGER BECAUSE THAT WAS THE ONLY COMFORTABLE CHAIR AVAILABLE

                    TO THEM, AND JUST SORT OF SAID, I'M SITTING HERE WAITING TO DIE.  I THINK --

                    I THINK ELLEN DESERVED ANOTHER OPTION.  I THINK ELLEN WAS COMPASSED.  I

                    THINK SHE KNEW WHAT WAS HAPPENING TO HER.  I THINK SHE KNEW

                    ABSOLUTELY THAT THERE WAS NO TURNING BACK, NO MIRACLE THAT WAS GOING TO

                    SHOW UP ON THE INTERNET THAT WAS GOING TO PULL HER BACK TO FULL HEALTH

                    AND FULL LIFE.  AND SHE DESERVED TO MAKE A DECISION NOT TO JUST SIT IN HER

                    LIVING ROOM IN A BEACH LOUNGER, WAITING TO DIE.

                                 AND OF COURSE, YOU KNOW, MANY PEOPLE, THEY HAD

                    FAMILY MEMBERS, AS I HAVE, WHO -- YOU KNOW, THERE WAS A GENTLEMAN

                    WHO HAD A SIGN ABOUT, YOU KNOW, NOW THEY WANT TO KILL OLD PEOPLE.

                    WELL, YOU KNOW, NOT EVERYBODY IS OLD WHEN THEY FACE A TERMINAL

                    DIAGNOSIS, AND THEY WISH THAT THEY COULD GET TO BE OLD BUT NOW THEY'VE

                    BEEN TOLD THERE ARE NO MORE OPTIONS.  AND THEY DECIDE, AND THEY ARE

                                         121



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    FREE TO DECIDE, THAT THEY'RE NOT GONNA TAKE ANYMORE CHEMOTHERAPY

                    THAT'S MAKING THEM SICK EVERY DAY.  THEY'VE BEEN THROUGH THE HAIR

                    FALLING OUT.  THEY'VE BEEN THROUGH THE PAIN.  THEY'VE BEEN THROUGH NOT

                    BEING ABLE TO GET UP.  THEY'VE BEEN THROUGH HAVING TO HAVE THE

                    INDIGNITY OF BODILY FUNCTIONS IN THEIR BED.  THEY -- THEY DESERVE

                    COMPASSION AND EMPATHY AND DIGNITY.

                                 AND I WANT TO THANK THE SPONSOR FOR THE YEARS OF

                    WORK, AND I WANT TO THANK THE ADVOCATES WHO HAVE SPOKEN FOR THEIR

                    FRIENDS AND THEIR FAMILY MEMBERS WHO DESERVE THE DIGNITY AND THE

                    GRACE TO LEAVE THIS LIFE BY THEIR OWN DECISION.  NOW, THERE ARE PROBABLY

                    PEOPLE WHO HAVE MADE THAT DECISION AHEAD OF TIME AND THEY DON'T

                    REALLY NEED THE NEW YORK STATE LEGISLATURE TO SAY TO THEM IT'S OKAY.

                    BECAUSE THEY HAVE -- THEY KNEW WHAT WAS COMING AND THEY STOCKPILED

                    MEDICATION AHEAD OF TIME AND TOOK A CHANCE THAT NOBODY IN THEIR

                    FAMILY WOULD BE ARRESTED FOR HELPING THEM.

                                 I RESPECT THAT THERE ARE PEOPLE WHOSE RELIGIOUS BELIEFS

                    BAR THEM FROM SUPPORTING THIS.  BUT I OBJECT TO HAVING OTHER PEOPLE'S

                    RELIGIOUS BELIEFS FORCE PEOPLE WITHOUT THOSE BELIEFS TO LIVE THAT WAY

                    AND DIE THAT WAY.

                                 SO I WANT TO THANK THE SPONSOR.  I WANT TO THANK THE

                    ADVOCATES.  AND I WANT TO SAY THAT FINALLY WE ARE DOING THE RIGHT THING

                    FOR THE PEOPLE OF NEW YORK WHO HAVE FACED PAINFUL LINGERING AND ARE

                    BEING GIVEN AN OPPORTUNITY TO SAY GOODBYE TO THEIR FAMILIES WITH THE

                    KNOWLEDGE THAT THEY CAN END THEIR LIVES WITH DIGNITY.

                                 THANK YOU.  I VOTE IN THE AFFIRMATIVE.

                                         122



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MR. MANKTELOW.

                                 MR. MANKTELOW:  THANK YOU, MADAM SPEAKER.

                    WOULD THE SPONSOR YIELD FOR A COUPLE OF QUESTIONS?

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MR. MANKTELOW:  THANK YOU, MS. PAULIN.

                                 AS I WAS READING THE BILL TEXT, I DO HAVE A COUPLE OF

                    QUESTIONS.  THE PART WITH THE DECLARATION OF THE WITNESS ON LINE 38, 39

                    AND 40 IT SAYS, "I FURTHER DECLARE UNDER PENALTY OF PERJURY THAT THE

                    STATEMENTS MADE HEREIN ARE TRUE AND CORRECT AND FALSE STATEMENTS MADE

                    HEREIN ARE PUNISHABLE."  WHY IS THAT IN THERE?

                                 MS. PAULIN:  BECAUSE WE WANT TO BE SURE THAT THE

                    WITNESSES ARE ASKING THE RIGHT QUESTIONS, THAT THEY'RE -- THAT THEY'RE

                    INFORMED ON, YOU KNOW, ALL THE ELEMENTS THAT THE WITNESS OR THAT THE

                    PATIENT IS SIGNING, AND -- AND TO BE SURE THAT THEY ARE APPROPRIATELY

                    SIGNING THAT DOCUMENT AND NOT JUST MAKING ASSUMPTIONS, ESSENTIALLY.

                                 MR. MANKTELOW:  OKAY.  SO I'M ASSUMING IT'S

                    REALLY TO COVER THE WHOLE PROCESS, MAKING SURE THINGS ARE DONE RIGHT.

                                 MS. PAULIN:  LEGITIMATE, YES.

                                 MR. MANKTELOW:  SO ALSO ON PAGE 12, LINES 9

                    THROUGH 14, IT TALKS ABOUT THE DEATH CERTIFICATE.  IT SAYS, THE CAUSE OF

                    DEATH LISTED ON A QUALIFIED INDIVIDUAL -- OR INDIVIDUAL'S DEATH

                                         123



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    CERTIFICATE WHO DIES AFTER SELF-ADMINISTERING MEDICATION UNDER THIS

                    ARTICLE WILL BE THE UNDERLYING TERMINAL ILLNESS OR CONDITION.  WHAT DOES

                    THAT MEAN?

                                 MS. PAULIN:  SO JUST LIKE WITH ANY PROCEDURE, RIGHT,

                    FOR EXAMPLE, MY COLLEAGUE SPOKE ABOUT, YOU KNOW, PERHAPS TAKING OR

                    HAVING A -- YOU KNOW, HAVE A DO NOT RESUSCITATE ORDER IF YOU HAVE

                    HEART SURGERY AND THEN YOU GO INTO A COMA AND YOU HAVE TO BE PUT ON A

                    RES -- YOU KNOW, ANY KIND OF GIZMOS, RIGHT?  THE UNDERLYING FACT IS THAT

                    YOU HAD A CARDIAC CONDITION.

                                 MR. MANKTELOW:  OKAY.

                                 SO WE TALK -- WE TALK ABOUT CANCER A LOT HERE.  SO IF I

                    HAD CANCER AND I DECIDED TO DO THIS, THE UNDERLYING ISSUE WOULD BE THE

                    CANCER --

                                 MS. PAULIN:  YES.

                                 MR. MANKTELOW:  -- WHICH WOULD GO ON MY

                    DEATH CERTIFICATE.

                                 MS. PAULIN:  YES.

                                 MR. MANKTELOW:  OKAY.

                                 SO WHEN THE INDIVIDUAL TAKES THE PILL, WHEN THE

                    INDIVIDUAL TAKES THE VERY LAST PILL, WHAT -- WHAT HAPPENS TO THEIR BODY?

                    HOW DO THEY END UP DYING?

                                 MS. PAULIN:  THEY DIE IN THEIR SLEEP OF WHAT --

                                 MR. MANKTELOW:  BUT WHAT -- WHAT CAUSES THEM

                    TO DIE?

                                 MS. PAULIN:  THERE'S MEDICATION -- FIRST THEY'RE --

                                         124



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THEY'RE GIVEN AN ANTI-NAUSEA AND ABSORPTION MEDICATION.  ABOUT 45

                    MINUTES LATER THEY'RE GIVING --

                                 MR. MANKTELOW:  I'M FAMILIAR WITH THE PROCESS.

                                 MS. PAULIN:  OKAY.

                                 MR. MANKTELOW:  I JUST WANNA KNOW WHAT'S

                    GOING TO KILL MY BODY?

                                 MS. PAULIN:  WHAT'S GONNA TO KILL YOUR BODY?

                                 MR. MANKTELOW:  YEAH.  WHEN I TAKE --

                                 MS. PAULIN:  YOU KNOW, I -- I WOULD SAY THAT I

                    WOULD ASK SOME OF MY COLLEAGUES WHO ARE EITHER A PHARMACIST OR A

                    NURSE TO TALK ABOUT THE SPECIFIC DRUG.  BUT I CAN GIVE YOU THE NAMES OF

                    THE DRUGS, AND AMONG THEM, ONE OF THEM IS -- IS GOING TO PUT YOU TO

                    SLEEP AND THEN OTHERS ARE GOING TO SLOWLY STOP THE REST OF YOUR ORGANS

                    FROM FUNCTIONING.

                                 MR. MANKTELOW:  OKAY.  SO IT'S PROBABLY LIKE A

                    BARBITURATE OR SOMETHING THEY'RE GONNA GIVE YOU (INAUDIBLE/CROSSTALK)?

                                 MS. PAULIN:  BARBITURATE IS DEFINITELY PART OF IT.

                                 MR. MANKTELOW:  ALL RIGHT.  PERFECT.

                                 SO MY NEXT QUESTION IS, AS I WAS READING ABOUT THE

                    DEATH CERTIFICATE AND WHAT THEY WERE GOING TO PUT ON THERE, I -- I TOOK A

                    LOOK AT THE NEW YORK STATE DEATH CERTIFICATE AND IT'S QUITE, QUITE

                    LENGTHY.  A LOT -- A LOT OF THINGS TO PUT IN THERE.  AND I WAS READING

                    ABOUT THE CERTIFIER, THE ONE THAT'S ACTUALLY GONNA CERTIFY THE DEATH, AND

                    UNDER 25(A) OF THAT BOX IT SAYS TO THE -- TO THE CERTIFIER'S NAME, TO THE

                    BEST OF MY KNOWLEDGE DEATH OCCURRED AT THE TIME, DATE AND PLACE AND

                                         125



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    DUE TO THE CAUSE(S) STATED.

                                 MS. PAULIN:  AND DUE TO THE WHAT?

                                 MR. MANKTELOW:  DUE TO THE CAUSE(S) STATED.

                    WHY -- WHY I DIED.

                                 MS. PAULIN:  MM-HMM.

                                 MR. MANKTELOW:  UNDERNEATH THAT, IN BOX 27

                    THERE ARE SIX OPTIONS THERE.  OPTION NUMBER ONE IS NATURAL CAUSE.

                    OPTION NUMBER TWO IS ACCIDENT.  OPTION NUMBER THREE IS A HOMICIDE.

                    OPTION NUMBER FOUR IS A SUICIDE.  OPTION NUMBER FIVE IS AN

                    UNDETERMINED CIRCUMSTANCES.  AND THE LAST ONE IS OPTION SIX, PENDING

                    INVESTIGATION.  SO IN THIS SITUATION, WHAT BOX DO THEY CHECK?

                                 MS. PAULIN:  I DON'T HAVE THE FORM IN FRONT OF ME,

                    BUT I DO KNOW THAT DEATH CERTIFICATES ARE USED TO ESSENTIALLY TRACK AND

                    UNDERSTAND TRENDS IN DISEASES.  SO WHATEVER THE BOX IS THAT YOU WOULD

                    THEN PUT HEART ATTACK OR YOU WOULD PUT -- WHAT ARE SOME OTHER CAUSES

                    OF DEATH?  UM --

                                 MR. MANKTELOW:  BUT -- WELL, LET'S -- LET'S RULE

                    THEM OUT.  SO IT'S DEFINITELY NOT NATURAL CAUSE BECAUSE THEY JUST TOOK A

                    PILL TO END THEIR LIFE.  IT'S NOT AN ACCIDENT.  WE'VE ALL HEARD THAT TODAY,

                    THEY HAVE TO MAKE THE DECISION TO DO THAT.  IT'S NOT A HOMICIDE.  IT'S NOT

                    FROM UNDETERMINED CIRCUMSTANCES BECAUSE WE KNOW EXACTLY HOW THEY

                    DIED.  AND PENDING INVESTIGATION IS PROBABLY FOR A MURDER TRIAL OR

                    SOMETHING LIKE THAT.  BUT THE OTHER BOX THAT'S THERE IS SUICIDE.  THIS IS

                    SUICIDE.  THIS IS ASSISTED SUICIDE.  SO WHY WOULD THAT BOX NOT BE

                    CHECKED?

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. PAULIN:  IT'S NOT ASSISTED SUICIDE.  ASSISTED

                    SUICIDE IS AGAINST THE LAW IN NEW YORK AND WILL REMAIN SO.

                                 MR. MANKTELOW:  SO THAT'S WHY WE WORD IT

                    "MEDICAL AID IN DYING?"

                                 MS. PAULIN:  AS DID ALL THE OTHER STATES THAT HAVE

                    ALREADY DONE THIS, YES.

                                 MR. MANKTELOW:  SO -- OKAY.  SO IT'S NOT A

                    SUICIDE.

                                 MS. PAULIN:  NO.

                                 MR. MANKTELOW:  OKAY.

                                 SO IF I DROP DOWN TO THE NEXT BOX, CAUSE OF DEATH,

                    THERE'S THREE -- THERE ARE THREE RESPONSES.  PART ONE, WHAT WOULD BE THE

                    IMMEDIATE CAUSE OF DEATH?

                                 MS. PAULIN:  IT WOULD BE THE UNDERLYING CANCER,

                    ALS OR ANY OF THE OTHER DISEASES OR THAT THAT PERSON MIGHT HAVE.

                                 MR. MANKTELOW:  SO WHAT WOULD -- WHAT WOULD

                    BE THE CONSEQUENCE OF THE DEATH?

                                 MS. PAULIN:  THE -- THE SAME THING.  THAT'S THE --

                    IT'S -- THE UNDERLYING CAUSE OF DEATH IS WHATEVER -- LIKE, FOR EXAMPLE, IF,

                    YOU KNOW, IN THE CASE OF MY SISTER WHO HAD CANCER AT THE END SHE

                    DIDN'T EAT OR DRINK.  THE UNDERLYING CAUSE OF HER CAN -- OF HER DEATH

                    WAS OVARIAN CANCER AND THAT'S WHAT WAS LISTED ON THE DEATH CERTIFICATE.

                                 MR. MANKTELOW:  OKAY.  SO UNDER THOSE TWO

                    BOXES WE JUST TALKED ABOUT, WE'RE ASKING EITHER A DOCTOR OR A CORONER TO

                    SIGN OFF ON THIS THAT IT'S AN UNDERLYING ISSUE THAT ACTUALLY CAUSED THEM

                                         127



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    TO DIE.

                                 MS. PAULIN:  JUST LIKE WE DO FOR ALL OF THE, YOU

                    KNOW, DO NOT RESUSCITATE ORDERS.  FOR THE -- FOR ALL THE TIMES IF

                    SOMEONE DOESN'T EAT OR DRINK TO, YOU KNOW, TO -- TO EXPEDITE THEIR

                    DEATH.  THE -- THE MORPHINE, THE OVERDOSE OF MORPHINE, YOU KNOW, BUT

                    IT'S NOT THE MAIN CAUSE.  THOSE ARE ALL THE EXACT SAME CIRCUMSTANCES AS

                    THIS.

                                 MR. MANKTELOW:  OKAY.  SO WE CAN'T USE THE

                    WORD "SUICIDE."  SO, YOU KNOW, I TALKED TO A YOUNG PERSON THIS

                    MORNING ABOUT THE BILL AND THEY USED THE WORD, YOU KNOW, "IT'S

                    SUICIDE."  AND THIS WAS A JUNIOR IN HIGH SCHOOL.  IT -- IT IS SUICIDE.

                    THERE -- THERE'S -- ANYWAYS [SIC], WE'LL -- YOU CAN CALL IT WHAT YOU WANT.

                    IT'S LIKE PUTTING LIPSTICK ON A PIG.  I DON'T CARE HOW MUCH LIPSTICK YOU

                    PUT ON THAT PIG, IT'S STILL A PIG.  BUT I'M JUST SAYING.

                                 SO MY NEXT QUESTION IS, IF THERE'S AN AUTOPSY REPORT

                    THAT -- THAT'S ASKED TO BE DONE.  IF IT'S -- IF IT'S AN INDIVIDUAL THAT TAKES

                    THAT AT THEIR HOUSE, YOU SAID EARLIER THAT THE INDIVIDUAL COULD GO HOME

                    AND TAKE IT AT ANY TIME.  HOW -- HOW WOULD YOU ANSWER AN AUTOPSY

                    REPORT AT THAT POINT?  WHAT -- WHAT WOULD BE THE CAUSE OF DEATH FOR AN

                    AUTOPSY REPORT?

                                 MS. PAULIN:  IT'S THE SAME THING.  YOU KNOW, IF THE

                    UNDERLYING CAUSE OF DEATH IS CANCER OR ALS OR --

                                 MR. MANKTELOW:  BUT -- BUT --

                                 MS. PAULIN:  -- ANOTHER TERMINAL ILLNESS --

                                 MR. MANKTELOW:  THOSE THREE TERMINAL ILLNESSES

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THAT YOU JUST SAID, WITHOUT TAKING THIS MEDICATION THEY DON'T DIE.  IF -- IF

                    THE CAUSE IS CANCER, IF THE CAUSE IS DIABETES, IF THE CAUSE IS HEART ATTACK,

                    WHATEVER, THEN WHY DO WE NEED THE PILL?

                                 MS. PAULIN:  IT'S THE SAME THING AS IF SOMEONE TOOK

                    MORPHINE.  YOU KNOW, ARE YOU GONNA SUGGEST THAT IF YOU'RE IN DIRE PAIN

                    YOU DON'T TAKE MORPHINE BECAUSE MORPHINE OVERDOSE IS GONNA BE PUT

                    ON THE DEATH CERTIFICATE?  NO.  DEATH CERTIFICATES ARE USED FOR CERTAIN

                    PURPOSES.  THEY'RE USED TO TRACK DISEASES.  THEY'RE USED FOR INSURANCE

                    PURPOSES.  THEY'RE USED -- THEY'RE -- THEY'RE USED TO PROTECT PATIENTS'

                    CONFIDENTIALITY ON ISSUES LIKE THIS, AND MORPHINE AND NOT EATING OR

                    DRINKING.

                                 MR. MANKTELOW:  SO -- SO LIKE WITH THE

                    MORPHINE, I -- I DON'T KNOW OF ANY DOCTOR OR ANYONE ELSE THAT

                    PRESCRIBES MORPHINE TO TAKE SOMEONE'S LIFE.  THEY PRESCRIBE MORPHINE

                    TO EASE THE PAIN.  THIS IS -- THIS IS NOT THE SAME.

                                 MS. PAULIN:  IF YOU'VE EVER SEEN ANYONE DYING --

                                 MR. MANKTELOW:  I HAVE.

                                 MS. PAULIN:  -- LIKE I HAVE, AND ON MORPHINE, YOU

                    KNOW THAT IT CAN BE THE -- THE -- IT COULD BE THE LEAD CAUSE OF SOMEONE

                    ACTUALLY DYING.  IT IS JUST A VERY, VERY TOXIC DRUG THAT ABSOLUTELY LEADS

                    OR EXPEDITES SOMEONE'S DEATH, ABSOLUTELY.

                                 MR. MANKTELOW:  SO WITH THIS -- WITH THIS

                    CERTIFICATE OF DEATH, IF WE PUT ON THERE THAT THE DEATH WAS CAUSED BY

                    CANCER AND WE'RE ASKING SOMEONE TO SIGN OFF ON THAT, A LICENSED

                    PHYSICIAN OR A LICENSED CORONER, HOW IS THAT NOT -- HOW IS THAT NOT

                                         129



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    SKIRTING THE TRUTH?  IT'S BLATANTLY SAYING DOES -- HE OR SHE DOESN'T KNOW

                    THAT CANCER ACTUALLY CAUSED IT.  THAT MAY BE THE UNDERLYING ISSUE, BUT

                    HOW DO THEY KNOW?

                                 MS. PAULIN:  YOU HAVE TO REMEMBER WHAT A DEATH

                    CERTIFICATE IS USED FOR.  WE ARE ALREADY GOING TO KNOW AND TRACK THESE

                    CASES OF -- OF THIS -- OF THE USE OF MEDICAL AID IN DYING, SO WE ALREADY

                    HAVE THAT INFORMATION.  DEATH CERTIFICATES WOULD BE -- WE WOULD BE

                    DOING A DISSERVICE TO -- TO THE REST OF THE POPULATION IF WE DIDN'T PUT

                    THAT UNDERLYING DISEASE BECAUSE WE WANT TO KNOW, ARE THERE MORE

                    BREAST CANCER IN NEW YORK.  YOU KNOW, IS THERE MORE BREAST CANCER IN

                    MANHATTAN COMPARED TO BROOKLYN.  YOU KNOW, WE WANT TO LOOK AT

                    ENVIRONMENTAL FACTORS, WE WANT TO LOOK AT --

                                 MR. MANKTELOW:  SURE.

                                 MS. PAULIN:  -- FAMILY FACTORS.  SO DEATH

                    CERTIFICATES HAVE A PURPOSE, AND WE WOULD BE NOT CONFORMING TO THAT

                    PURPOSE IF WE DIDN'T PUT THE UNDERLYING DISEASE.

                                 MR. MANKTELOW:  ALL RIGHT.  I -- I THINK WE'RE

                    GONNA DIFFER ON THAT.  I THINK THAT'S A QUESTION THAT REALLY NEEDS TO BE

                    ANSWERED.  LIKE MY COLLEAGUE TALKED ABOUT EARLIER, THERE ARE A LOT OF --

                    A LOT OF QUESTIONS THAT ARE VERY GRAY AND WE DON'T REALLY KNOW HOW THAT

                    ALL WORKS OUT.  ALL I KNOW IS IF I WAS A CORONER AND I KNEW THAT THE

                    INDIVIDUAL TOOK THE DRUGS TO END THEIR LIFE, THERE'S NO WAY IN GOOD

                    CONSCIENCE I COULD PUT ON THAT CERTIFICATE THAT THEY DIED FROM NATURAL

                    CAUSES SUCH AS CANCER.

                                 I -- I APPRECIATE THE -- THE TIME TO -- TO ANSWER MY

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    QUESTIONS, MADAM.

                                 MADAM SPEAKER, ON THE BILL.

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MR. MANKTELOW:  SO I GOT A CHANCE TO ASK A FEW

                    QUESTIONS AND MUCH LIKE WE'VE TALKED ABOUT HERE IN THIS CHAMBER, WE

                    ARE CONSTANTLY IN CHAMBER ABOUT LIFE.  AND WE HAVE PROFESSIONALS THAT

                    CAN PROBABLY GUESS HOW LONG WE MAY LIVE, EVEN WITH A TERMINAL

                    ILLNESS.  BUT IT'S JUST A GUESS.  THERE'S ONLY ONE PERSON THAT ACTUALLY

                    KNOWS WHEN OUR TIME IS UP AND WE ALL KNOW WHO THAT IS.  SO ARE WE

                    GOING TO BE A CHAMBER OF LIFE OR ARE WE GONNA CONTINUE TO BE A

                    CHAMBER OF DEATH?  WHAT IS -- WHAT ARE OUR CHOICES?  WHERE ARE WE

                    GOING TO GO?  WE TALK ABOUT GUN SUICIDE.  WE TALKED ABOUT INDIVIDUALS

                    THAT OD.  WE TALK ABOUT WHAT OUR YOUNG PEOPLE ARE DOING.  WHAT DO

                    YOU THINK A YOUNG PERSON'S GONNA THINK ABOUT WHEN THIS CHAMBER GOES

                    AHEAD AND OKAYS, THEY'RE GONNA SEE IT AS SUICIDE.  WE CAN CALL IT WHAT

                    YOU WANT, MEDICAL AID IN DYING.  IT IS WHAT IT IS.  WHAT MESSAGE ARE

                    WE SENDING TO OUR YOUNG PEOPLE?

                                 AND AS YOU SAID EARLIER ON THE BILL, MADAM CHAIR, THAT

                    YOU SAT THERE WITH SOMEBODY.  I HAVE, TOO.  I SAT THERE WITH MY DAD

                    WHOSE LUNGS FILLED UP WITH FLUID EVERY OTHER DAY.  BUT EVERY SINGLE

                    TIME, HE WANTED US TO DRAIN HIS LUNGS SO HE COULD LIVE LONGER.  WAS HE

                    IN PAIN?  ABSOLUTELY.

                                 I JUST FEEL THAT ONCE WE PASS THIS, IF IT PASSES AND IS

                    SIGNED INTO LAW, WHAT'S NEXT?  WHAT AMENDMENT'S GONNA COME OUT?

                    WHAT'S THE NEXT STEP WE'RE GOING TO DO HERE AS LEGISLATORS?  THAT'S NOT

                                         131



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    OUR JOB.  OUR JOB IS TO SAVE THE LIVES, WHETHER IT'S PAINFUL OR NOT.  WE

                    TRIED TO SAVE THOSE LIVES.  AND AS A VETERAN, TALKING WITH MEN AND

                    WOMEN IN SERVICE THAT HAVE LOST THEIR LIMBS, LAYING ON THE GROUND,

                    WANTING TO MAKE SURE THAT THEY LIVE AND GET TO SEE THEIR FAMILY AGAIN.

                    YOU WANT TO TALK ABOUT PAIN?  THOSE INDIVIDUALS ARE IN PAIN EVERY

                    SINGLE DAY.

                                 SO LET'S THINK ABOUT LIFE INSTEAD OF DEATH.  LET'S BE

                    POSITIVE INSTEAD OF NEGATIVE.  AS MY -- MY -- MY FELLOW

                    ASSEMBLYMEMBER SAID EARLIER, LET'S GIVE THEM THE PROPER CARE TO

                    EXTEND THAT LIFE.  LET'S DO EVERYTHING WE CAN TO COMFORT THEM AND THAT

                    FAMILY.  I THINK THAT'S THE THING WE NEED TO DO.

                                 SO MADAM SPEAKER, THANK YOU FOR ALLOWING ME TO SAY

                    A FEW WORDS ON THIS, AND I -- I HOPE AND PRAY THAT WE VOTE THIS DOWN.

                    THANK YOU.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MR. MOLITOR.

                                 MR. MOLITOR:  THANK YOU, MADAM SPEAKER.

                    WOULD THE SPONSOR YIELD?

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MR. MOLITOR:  THANK YOU.  I KNOW YOU'VE BEEN

                    DOING THIS A LONG TIME WITHOUT A BREAK.  I'VE GONE TO THE BATHROOM

                    TWICE, SO I APPRECIATE IT.

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 I JUST WANT TO START, IF I COULD, ON PAGE 3 OF THE BILL,

                    LINES 20 THROUGH 22.  AND IT'S MY UNDERSTANDING THAT THE DOCTOR, THE

                    ATTENDING PHYSICIAN OR THAT A PHYSICIAN HAS TO DIAGNOSE THE PERSON, THE

                    PATIENT, WITH AN INCURABLE AND IRREVERSIBLE ILLNESS OR CONDITION.  THAT'S

                    STEP ONE, RIGHT?

                                 MS. PAULIN:  MM-HMM.

                                 MR. MOLITOR:  AND THEN STEP 2 THEY HAVE TO,

                    WITHIN REASONABLE MEDICAL JUDGMENT, DETERMINE THAT THAT ILLNESS OR

                    CONDITION WILL PRODUCE DEATH WITHIN SIX MONTHS; IS THAT CORRECT?

                                 MS. PAULIN:  YES.

                                 MR. MOLITOR:  AND SO MY FIRST -- OR MY THIRD

                    QUESTION, I GUESS, TO YOU IS WHAT DOES "WITHIN REASONABLE MEDICAL

                    JUDGMENT" MEAN?

                                 MS. PAULIN:  I THINK DOCTORS IN THIS SITUATION DO THIS

                    ALL THE TIME.  YOU KNOW, THEY KNOW AND HAVE THE EXPERIENCE THAT, YOU

                    KNOW, THEY'RE BEING PRESENTED WITH A PATIENT WITH ONE OR -- YOU KNOW,

                    WITH ONE TYPE OF, YOU KNOW, WHAT -- LET'S USE CANCER, RIGHT, WHAT TYPE

                    OF LUNG CANCER -- AS ONE OF MY COLLEAGUES SAID, HER -- HER FATHER HAD --

                    VERSUS ANOTHER TYPE OF LUNG CANCER VERSUS A TYPE OF BREAST CANCER.

                    AND, YOU KNOW, WE ALL HEAR, YOU KNOW, STAGE 1, STAGE 2, STAGE 3,

                    STAGE 4.  YOU KNOW, I'M NOT A MEDICAL PROFESSIONAL, BUT WE'VE ALL

                    HEARD THAT TERMINOLOGY.  SO WE KNOW WHEN WE HEAR STAGE 4 WE KNOW

                    IT'S MUCH MORE SERIOUS.  AND SO, THEREFORE, THAT DOCTOR IS ASSESSING THAT

                    STAGE BY LOOKING AT THE RECORDS AND EXAMINING THAT PATIENT.  AND THEN

                    THEY'RE MAKING A FURTHER DETERMINATION THAT THAT PERSON IS GOING TO LIVE

                                         133



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    A CERTAIN AMOUNT OF TIME.  I KNOW RECENTLY A GOOD FRIEND OF MINE WAS

                    DIAGNOSED WITH LUNG CANCER, AND -- AND SHE WAS DIAGNOSED WITH 4TH

                    STAGE LUNG CANCER.  AND THEY SAID TO HER, YOU KNOW, YOU COULD LIVE FOR

                    FIVE YEARS.  YOU KNOW, YOU'RE -- YOU'RE TREATABLE, YOU KNOW, FOR FIVE

                    YEARS.  AND THEY'RE MAKING A DETERMINATION THEN AND THEY'RE TELLING HER

                    THAT INFORMATION.

                                 MR. MOLITOR:  SO -- WELL, I'M SORRY.

                                 MS. PAULIN:  NO, GO AHEAD.

                                 MR. MOLITOR:  SO WOULDN'T YOU AGREE WITH ME,

                    THOUGH, THAT THAT DETERMINATION IS MADE BASED UPON THE DOCTOR'S, YOU

                    KNOW, EVALUATION OF MEDICAL RECORDS AND -- AND EXPERIENCE, RIGHT?

                                 MS. PAULIN:  YES.

                                 MR. MOLITOR:  BUT EVEN THEN -- AND, YOU KNOW,

                    I'VE HEARD THIS FROM DOCTORS.  THEY'LL USUALLY SAY, THAT'S MY BEST GUESS,

                    RIGHT?

                                 MS. PAULIN:  RIGHT.

                                 MR. MOLITOR:  BECAUSE -- BECAUSE SCIENTIFICALLY,

                    DOCTORS DO NOT HAVE A CRYSTAL BALL, RIGHT?

                                 MS. PAULIN:  ABSOLUTELY.

                                 MR. MOLITOR:  AND, YOU KNOW, WOULDN'T YOU AGREE

                    WITH ME THAT IF SOMEONE WAS TOLD BY A DOCTOR THAT THEY ONLY HAD SIX

                    MONTHS TO LIVE AND THEY -- AND THIS OPTION WAS LEGAL TO THEM AND THEY

                    TOOK IT, THAT IT WOULD BE A TRAGEDY IF, IN FACT, THAT DOCTOR WAS WRONG?

                                 MS. PAULIN:  THAT'S NOT THE EXPERIENCE OF -- OF THE

                    11 JURISDICTIONS AND 30 YEARS.

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. MOLITOR:  I UNDERSTAND, BUT IT COULD HAPPEN,

                    COULDN'T IT?

                                 MS. PAULIN:  A HYPOTHETICAL, IT COULD HAPPEN.  BUT

                    IF YOU'RE TOLD YOU HAVE SIX MONTHS TO LIVE, YOU WANT TO LIVE FOR AS LONG

                    AS POSSIBLE.  YOU'RE GONNA ASK THE QUESTION, WHAT CAN I DO TO MAKE

                    THAT LONGER?  ARE THERE TREATMENTS?  ARE THERE EXPERIMENTS?  ARE THERE

                    CLINICAL TRIALS?  YOU'RE GONNA ASK THOSE QUESTIONS.  AND IF YOU'RE TOLD

                    THERE ARE NONE AND YOU'RE TOLD THAT NO, THERE IS NOTHING OUT THERE THAT'S

                    GONNA MAKE YOU LIVE LONGER, YOU MIGHT GET A PRESCRIPTION.  BUT I BET

                    YOU'RE NOT GONNA TAKE IT UNTIL YOU ARE FACED WITH DISTRESS AND PAIN LIKE

                    YOU HAVE NEVER ENCOUNTERED.  YOU'RE NOT GONNA TAKE IT UNTIL THEY SAY,

                    YOU HAVE A WEEK TO LIVE.  YOU HAVE TWO DAYS TO LIVE.  YOU'RE NOT GONNA

                    TAKE IT UNTIL THE END.  THAT'S THE EXPERIENCE THAT WE'VE SEEN OVER 30

                    YEARS.  PEOPLE JUST DON'T, OH, I AM -- I'VE BEEN DIAGNOSED.  YOU KNOW,

                    I'VE GOT SIX MONTHS TO LIVE, BUT I FEEL GREAT, AND THEN DECIDE THEY'RE

                    GONNA TAKE THAT MEDICATION.  THAT JUST DOESN'T HAPPEN.

                                 MR. MOLITOR:  BUT EVEN SAYING ALL OF THAT, RIGHT,

                    LET'S SAY THEY GET TO THAT POINT WHERE THEY FIND THAT IT'S NECESSARY FOR

                    THEM TO TAKE THAT MEDICATION.  THE DAY AFTER THEY TAKE IT, RIGHT, THEY'RE

                    GONE.  OR THAT THE MOMENT THEY TAKE IT THEY'RE GONE, RIGHT?

                                 MS. PAULIN:  WITHIN A FEW HOURS.

                                 MR. MOLITOR:  WITHIN A FEW HOURS.  AND SO IF THAT

                    DOCTOR WAS WRONG, IT WOULD BE A TRAGEDY, WOULDN'T IT?

                                 MS. PAULIN:  AGAIN --

                                 MR. MOLITOR:  WOULDN'T IT BE A TRAGEDY?

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. PAULIN:  -- YOU KNOW, WE'RE -- WE'RE SAYING

                    THAT THE PERSON WOULD LIKELY GET A PRESCRIPTION EARLIER, BUT UNTIL THEY'RE

                    FACED WITH THE PAIN AND THE PROGNOSIS THAT THEIR DEATH IS MORE

                    IMMINENT, THEY DON'T TAKE THE MEDS.

                                 MR. MOLITOR:  I UNDERSTAND.

                                 MS. PAULIN:  SO YES, IT'S A TRAGEDY WHEN YOU LOSE

                    SOMEONE IN THAT CIRCUMSTANCE.  IT'S A TRAGEDY.  BUT WHAT YOU'RE

                    SUGGESTING IS NEVER GONNA HAPPEN, IT DOESN'T HAPPEN.

                                 MR. MOLITOR:  WELL, I WOULD HOPE THAT IT WOULDN'T

                    BECAUSE NONE OF US HAVE A CRYSTAL BALL, RIGHT?

                                 MS. PAULIN:  CORRECT.

                                 MR. MOLITOR:  SURELY, YOU DON'T.

                                 I WOULD LIKE TO GO -- I'D LIKE TO STAY ON PAGE 3 AND GO

                    DOWN TO LINE 30.  THIS IS THE REQUEST PROCESS.

                                 MS. PAULIN:  MM-HMM.

                                 MR. MOLITOR:  SO AS I UNDERSTAND THIS, A PATIENT

                    HAS TO FIRST REQUEST ORALLY THAT THEY WISH FOR THAT MEDICATION; IS THAT

                    CORRECT?

                                 MS. PAULIN:  THAT'S CORRECT.

                                 MR. MOLITOR:  AND THEN THEY HAVE TO SUBMIT A

                    WRITTEN REQUEST, BUT THAT WRITTEN REQUEST CAN COME SOMETIME AFTER THE

                    CONFIRMING DOCTOR MAKES THEIR DETERMINATION; IS THAT CORRECT?

                                 MS. PAULIN:  IT COULD COME BEFORE THE CONFIRMING

                    DOCTOR OR AFTER.

                                 MR. MOLITOR:  BUT IT -- BUT THE WRITTEN REQUEST HAS

                                         136



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    -- HAS TO BE DONE BEFORE THE MEDICATION CAN BE PRESCRIBED; IS THAT

                    CORRECT?

                                 MS. PAULIN:  THAT'S CORRECT.

                                 MR. MOLITOR:  OKAY.  AND THE -- THE TWO ADULTS,

                    THE TWO ADULTS THAT HAVE TO WITNESS THE -- THE APPLICATION OR THE -- THE --

                    THEY HAVE TO WITNESS THE -- THE REQUEST, THOSE CAN BE ANY TWO -- ANY

                    TWO ADULTS IN THE WORLD EXCEPT FOR THE PEOPLE THAT ARE LISTED IN THE

                    STATUTE; IS THAT CORRECT?

                                 MS. PAULIN:  THAT'S CORRECT.

                                 MR. MOLITOR:  AND I -- I NOTICED THROUGH THE

                    COURSE OF THE DEBATE THAT YOU STATED THAT THOSE TWO INDIVIDUALS CAN

                    HAVE NO FINANCIAL GAIN; IS THAT RIGHT?

                                 MS. PAULIN:  THE EXACT WORDS IS "ENTITLED TO ANY

                    PORTION OF THE ESTATE OF THE PATIENT UPON DEATH."

                                 MR. MOLITOR:  SO AS A PATIENT, I COULD PAY A

                    COUPLE OF MY FRIENDS TO SIGN THAT DOCUMENT, COULDN'T I?

                                 MS. PAULIN:  YOU COULD, I GUESS.  YEAH, YOU COULD

                    -- YOU COULD -- I DON'T KNOW WHAT POINT THAT MAKES, BUT YEAH, YOU

                    COULD GET A COUPLE OF YOUR FRIENDS.  IN FACT, THAT'S USUALLY WHO WOULD

                    SIGN THIS.

                                 MR. MOLITOR:  OR I COULD PAY A COUPLE OF

                    STRANGERS, COULDN'T I?

                                 MS. PAULIN:  YOU COULD.

                                 MR. MOLITOR:  OR THE SECRETARY OF THE ATTENDING

                    PHYSICIAN COULD SIGN -- COULD BE ONE OF THE PEOPLE THAT SIGNS IT,

                                         137



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    COULDN'T IT?

                                 MS. PAULIN:  WELL, WE ACTUALLY PRECLUDE ANYONE IN

                    THAT, YOU KNOW -- WELL, YOU KNOW, ANYONE THAT'S PART OF THAT HEALTHCARE

                    FACILITY.  YOU KNOW, THAT WE DON'T ALLOW.

                                 MR. MOLITOR:  WHERE IS THAT IN THE STATUTE?

                                 MS. PAULIN:  THAT'S ON PAGE 4, LINES 1 AND 2 AND 3.

                    AN EMPLOYEE.

                                 MR. MOLITOR:  OKAY.  THANK YOU FOR CLARIFYING

                    THAT.

                                 LOOKING NOW AT PAGE 5, LINE 3 -- OH WAIT, I'M SORRY.

                    JUST GOING BACK TO THE WRITTEN REQUEST.  NOW, THE TWO PEOPLE THAT SIGN

                    THE WRITTEN REQUEST, THEIR SIGNATURES DO NOT HAVE TO BE NOTARIZED; IS THAT

                    CORRECT?

                                 MS. PAULIN:  RIGHT.  THEY DON'T HAVE TO BE

                    NOTARIZED, BUT THEY -- THEY'RE SIGNING IT UNDER PENALTY OF PERJURY.

                                 MR. MOLITOR:  OKAY.  AND WHO THEN WILL CONFIRM

                    THAT THE -- THAT THE SIGNATURES ON THAT DOCUMENT ARE ACTUALLY THE PEOPLE

                    SIGNING THEM, SIGNING THE DOCUMENTS?

                                 MS. PAULIN:  IF THEY WEREN'T AND IT WAS FOUND OUT,

                    THEY WOULD BE COMMITTING FORGERY, WHICH IS SUBJECT TO A CRIMINAL

                    PENALTY.

                                 MR. MOLITOR:  WHAT IF THIS PERSON COMMITTING

                    FORGERY WAS ALREADY DEAD?  IN OTHER WORDS, WHAT IF THE PATIENT SAID, I'M

                    GONNA GO HOME AND FILL OUT THIS WRITTEN REQUEST AND MAKE UP A COUPLE

                    SIGNATURES AND THEN GIVE IT TO MY DOCTOR?

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. PAULIN:  SO IN OTHER WORDS, THE PATIENT

                    THEMSELVES WAS COMMITTING FORGERY?

                                 MR. MOLITOR:  SURE.  COULDN'T THAT BE POSSIBLE?

                                 MS. PAULIN:  I -- I PRESUME, AND THEY WOULD BE

                    SUBJECT TO THE SAME CRIMINAL PENALTIES.

                                 MR. MOLITOR:  OH.  OKAY.  BUT THEY'D BE DEAD,

                    WOULDN'T THEY, AFTER THEY TAKE THE MEDICATION?

                                 MS. PAULIN:  IF -- IF THEY TOOK IT AND WASN'T FOUND

                    OUT BEFOREHAND, YES, THEY -- THEY WOULD BE DEAD.

                                 MR. MOLITOR:  OKAY.

                                 OKAY, LOOKING AT PAGE 5, LINE 3... I THINK IT'S LINE 3...

                    I'M SORRY.  LINE 10 THROUGH LINE 13 --

                                 MS. PAULIN:  ON PAGE 5?

                                 MR. MOLITOR:  PAGE 5, I'M SORRY, YES.  THE

                    ATTENDING PHYSICIAN HAS TO INFORM THE PATIENT'S FAMILY OF THE PATIENT'S

                    DECISION TO REQUEST AND TAKE MEDICATION THAT WILL END THE PATIENT'S LIFE;

                    IS THAT CORRECT?

                                 MS. PAULIN:  WHAT -- CAN YOU JUST POINT IT OUT AGAIN

                    WHAT LINE IT WAS?  I MISSED WHAT YOU SAID.

                                 MR. MOLITOR:  YEAH, I'M SORRY.  IT'S LINES 10

                    THROUGH 13.

                                 MS. PAULIN:  AH, OKAY.  INFORMED -- YES, MM-HMM.

                                 MR. MOLITOR:  AND THEN AFTER THAT, AFTER THE

                    SEMICOLON IT SAYS A PATIENT WHO DECLINES OR IS UNABLE TO NOTIFY FAMILY

                    SHALL HAVE -- SHALL NOT HAVE SUCH PATIENT -- PATIENT'S REQUEST FOR

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    MEDICATION DENIED FOR THAT REASON.  DOES THAT MEAN THAT THE PATIENT CAN

                    BASICALLY SAY TO THE ATTENDING PHYSICIAN, I DON'T WANT MY FAMILY TO

                    KNOW?

                                 MS. PAULIN:  SO IF YOU LOOK AT PAGE 7 WHICH IS THE,

                    YOU KNOW, THE -- THE WRITTEN REQUEST AND YOU LOOK AT LINES 7 THROUGH

                    11, YOU SEE A CHECK BOX, YOU KNOW, AND YES, YOU CAN SAY, I HAVE

                    INFORMED OR INTEND TO INFORM ONE OR MORE MEMBERS OF MY FAMILY, I

                    HAVE DECIDED NOT TO INFORM ANY MEMBER OF MY FAMILY, OR I HAVE NO

                    FAMILY TO INFORM.  SO YOU CAN CHECK THAT.

                                 MR. MOLITOR:  OKAY, THANK YOU.

                                 NOW, ONCE THE -- ONCE THE PHYSICIAN PRESCRIBES THE

                    MEDICATION -- I -- I THINK WE'VE BEEN OVER THIS MORE THAN ONCE, BUT

                    THERE'S -- THERE'S NO WAY FOR -- OR -- OR -- I MEAN, IT'S POSSIBLE, I GUESS,

                    FOR THE DOCTOR TO DO THIS, BUT IT'S NOT NECESSARY THAT ANYONE MAKE SURE

                    THAT THIS MEDICATION IS SECURED IN ANY WAY, SHAPE OR FORM; IS THAT

                    CORRECT?

                                 MS. PAULIN:  WELL, THERE'S OBLIGATIONS TO -- LIKE

                    THERE ARE ANY OBLIGATIONS WITH MEDICATION.

                                 MR. MOLITOR:  RIGHT.  BUT THIS IS A LETHAL DOSE OF

                    MEDICATION, RIGHT, AND THERE ISN'T -- THERE ISN'T ANY -- ANY PROVISIONS

                    UNDER THE LAW THAT WOULD MAKE SURE THAT THESE MEDICATIONS, IF TAKEN,

                    WERE TAKEN IN A WAY THAT WAS SAFE?

                                 MS. PAULIN:  THERE'S LOTS OF VERY TOXIC MEDICATIONS

                    THAT ARE GIVEN.  FOR EXAMPLE, HOSPICE MEDICATIONS ARE TOXIC AND MOST

                    HOSPICES AT HOME.  SO YOU WOULD -- YOU'D HAVE THAT CIRCUMSTANCE

                                         140



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ALREADY.

                                 MR. MOLITOR:  BUT HOSPICE DOESN'T -- DOESN'T

                    HOSPICE COME INTO THE HOME TO TAKE CARE OF THE PERSON?

                                 MS. PAULIN:  BUT THE MEDICATION IS THERE.  MY MOM

                    WAS ON HOSPICE TWICE IN MY -- IN HER -- YOU KNOW, IN OUR HOUSE AND --

                    AND THE MEDICATION WAS LEFT THERE.

                                 MR. MOLITOR:  OKAY, THANK YOU.

                                 LOOKING AT PAGE 10, LINE 21 -- IT'S LINES 21 THROUGH 24.

                    AND IT SPECIFICALLY STATES THAT NOTHING IN THIS SECTION SHALL LIMIT CIVIL,

                    ADMINISTRATIVE OR CRIMINAL LIABILITY OR PENALTY FOR ANY PROFESSIONAL --

                    PROFESSIONAL DISCIPLINARY ACTION OR EMPLOYMENT, CREDENTIALING OR

                    CONTRACTUAL LIABILITY OR PENALTY FOR NEGLIGENCE, RECKLESSNESS OR

                    INTENTIONAL MISCONDUCT.  IF AN ATTENDING PHYSICIAN MISDIAGNOSES

                    SOMEBODY, A PATIENT WHO THEN ULTIMATELY TAKES THIS MEDICATION, WOULD

                    THIS SECTION PERMIT THE FAMILY TO FILE A LAWSUIT AGAINST THAT ATTENDING

                    PHYSICIAN FOR MEDICAL MALPRACTICE?

                                 MS. PAULIN:  WELL, THAT'S WHY WE HAVE THE

                    CONSULTING PHYSICIAN SO THAT DOESN'T HAPPEN.

                                 MR. MOLITOR:  BUT WHAT IF BOTH OF THEM COMMIT

                    MALPRACTICE?

                                 MS. PAULIN:  IF THEY BOTH COMMITTED MALPRACTICE,

                    YES, OF COURSE.  MALPRACTICE IS STILL AGAINST THE LAW.

                                 MR. MOLITOR:  OKAY.  AND YOU DON'T FORESEE

                    NECESSARILY ANY INTERVENING ARGUMENT THAT SAY THAT THE DEFENSE ATTORNEY

                    FOR THE -- FOR THE DOCTORS MIGHT SAY, WELL, BUT I DIDN'T CAUSE THEIR

                                         141



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    DEATH.  OR, YOU KNOW, THEY TOOK THIS MEDICATION.

                                 MS. PAULIN:  YOU KNOW, EVERYONE WILL ARGUE

                    WHATEVER THEY WANT IN COURT, BUT IF THEY COMMITTED MALPRACTICE, THAT'LL

                    BE SUBJECT TO A COURT DECISION.

                                 ACTING SPEAKER HUNTER:  THANK YOU, MR.

                    MOLITOR.

                                 MR. TAYLOR.

                                 MR. TAYLOR:  THANK YOU, MADAM SPEAKER.  WILL

                    THE SPONSOR YIELD?

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MR. TAYLOR:  THANK YOU.  I JUST HAVE A COUPLE OF

                    QUESTIONS FOR YOU, IF I COULD.

                                 CURRENTLY, OUR THERE DOCTORS, TO YOUR UNDERSTANDING,

                    THAT CURRENTLY AUTHORIZE MEDICINES THAT POTENTIALLY COULD BE LETHAL?

                                 MS. PAULIN:  YES.

                                 MR. TAYLOR:  THANK YOU.

                                 WITH RESPECT TO HEALTH PROXIES.  THE PERSON THAT SIGNS

                    A HEALTH PROXY, DO THEY NEED TO HAVE A MEDICAL EXAMINATION OR A

                    MENTAL HEALTH BEFORE THEY CAN SIGN A PROXY?

                                 MS. PAULIN:  NO.

                                 MR. TAYLOR:  THANK YOU.

                                 ARE THERE ANY PRIOR LEGAL ACTION REQUIRED BY FAMILIES

                                         142



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THAT WISH TO HAVE THEIR PERSON OR THEIR LOVED ONE REMOVED FROM LIFE

                    SUPPORT SYSTEM?

                                 MS. PAULIN:  NO.

                                 MR. TAYLOR:  SO, IN -- IN -- AND IN THAT CASE,

                    DEPENDING ON WHAT THE ILLNESS IS THAT BROUGHT THAT INDIVIDUAL TO THAT

                    SPACE, WHAT WOULD MOST LIKELY THEIR DEATH CERTIFICATE BE?  THE DRUGS

                    THAT KEPT THEM ALIVE TO THAT POINT OR WOULD IT INDICATE WHAT IT WAS, WHY

                    THEY EXPIRED?

                                 ACTING SPEAKER HUNTER:  WHY THEY EXPIRED.

                                 MR. TAYLOR:  OKAY.  THANK YOU.

                                 AND WITH RESPECT TO ONE -- ONE MORE PIECE.  DOES THIS

                    LEGISLATION REQUIRE PATIENTS TO POTENTIALLY NEGATE THEIR RIGHTS IN ANY

                    OTHER TYPE OF INFORMATION THAT THEY NEED TO SECURE IN TURNS OF MAKING

                    GOOD DECISIONS?

                                 MS. PAULIN:  WAIT.  SAY THAT ONE MORE TIME.

                                 MR. TAYLOR:  DOES THIS LEGISLATION REQUIRE PATIENTS

                    TO WAIVE THEIR RIGHTS TO GET ALL THE UNDERSTANDING THAT THEY NEED WITH

                    RESPECT TO THEIR MEDICAL CONDITION?

                                 MS. PAULIN:  NO.  THEY HAVE TO -- THEY DON'T WAIVE

                    THEIR RIGHTS EVER.

                                 MR. TAYLOR:  SO THAT MEANS THEY CAN GET MORE

                    THAN ONE OPINION --

                                 MS. PAULIN:  YES.

                                 MR. TAYLOR:  -- RIGHT?  OKAY.  THANK YOU.

                                 AND I JUST HAVE A COUPLE OF MORE QUESTIONS.

                                         143



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 ONLY TERMINALLY ILL -- TERMINALLY ILL ADULTS WITH SIX

                    MONTHS OR LEFT QUALIFY FOR THIS?

                                 MS. PAULIN:  YES.

                                 MR. TAYLOR:  THANK YOU.

                                 DO THEY HAVE TO HAVE A MENTAL CAPACITY OR CAPABILITY

                    CHECK?  DO THEY HAVE TO HAVE SOMEONE CHECK THEM OUT MEDICALLY TO

                    MAKE --

                                 (INAUDIBLE/CROSSTALK)

                                 MS. PAULIN:  IF -- IF THEY -- THEY -- THEY DON'T UNLESS

                    THE CONSULTING OR THE ATTENDING BELIEVE THAT THEY NEED TO.

                                 MR. TAYLOR:  AND TWO DOCTORS ARE REQUIRED TO SIGN

                    OFF IF --

                                 MS. PAULIN:  YES.

                                 MR. TAYLOR:  OKAY.  NOW THESE DOCTORS ARE NOT

                    COMING FROM SOME FOREIGN COUNTRY?  THEY'RE HERE.  THEY'RE LICENSED.

                    THEY ARE BONDED TO DO THIS TYPE OF SERVICE IN THE STATE OF NEW YORK --

                                 MS. PAULIN:  YES.

                                 MR. TAYLOR:  -- CORRECT?  OKAY.

                                 MS. PAULIN:  YES.

                                 MR. TAYLOR:  THANK YOU.

                                 CAN ANYONE ELSE TAKE THE MEDICATION THAT'S BEEN GIVEN

                    TO THAT PATIENT OTHER THAN THE PATIENT?

                                 MS. PAULIN:  NO.

                                 MR. TAYLOR:  THANK YOU.

                                 IN THE LAST 25, 30 YEARS OF THIS BEING APPROVED IN

                                         144



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    DIFFERENT STATES, EVEN IN CANADA, HAS THERE BEEN A SINGLE SUBSTANTIAL

                    CASE OF ABUSE UNDER THOSE LAWS --

                                 MS. PAULIN:  NO --

                                 MR. TAYLOR:  -- TO YOUR KNOWLEDGE?

                                 MS. PAULIN:  NOT ONE CASE OF COERCION OR ABUSE.

                                 MR. TAYLOR:  OKAY.  THANK YOU VERY MUCH.

                                 MADAM SPEAKER, ON THE BILL.

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MR. TAYLOR:  THANK YOU.

                                 AS -- AS -- AS I SAT HERE, AND THIS IS NOT EASY UNDER ANY

                    CIRCUMSTANCES, WHATEVER SIDE YOU FIND YOURSELF ON, IT'S A DIFFICULT PLACE

                    TO BE.  AND I STAND HERE AND I WANT TO SHARE A COUPLE OF THINGS.  AND IN

                    ONE THAT -- THAT -- THAT REALLY GLARED AT ME WAS AT THE AGE OF 25, MY

                    NEIGHBOR INFORMED US -- MY FAMILY AND I, LIVING IN -- IN THE HEIGHTS,

                    THAT SHE HAD SIX MONTHS TO LIVE BECAUSE SHE'D BEEN DIAGNOSED WITH

                    CANCER.  WE WERE WRECKED.  I MEAN, TEARS AND WATER EVERYWHERE.  MY

                    SISTER, HER GREATEST FRIEND, WAS JUST INCONSOLABLE.  IN THREE MONTHS MY

                    SISTER WAS DEAD FROM A CAR ACCIDENT, AND THE WOMAN LIVED SIX MONTHS,

                    YOU KNOW WHAT I'M SAYING.  WE DON'T KNOW AROUND WHAT CORNER LIFE IS

                    GOING TO END.  AND WE WANT THE BEST.  WE WANT TO BE ABLE TO DO THOSE

                    THINGS THAT MAKE SENSE.

                                 SO I -- I -- I GUESS -- LET ME JUST SHARE A FEW THINGS IN

                    HOW I GOT HERE.  I -- I CAME TO THIS DECISION NOT BECAUSE IT WAS EASY.

                    TRUST ME, WHEN I SAW THE YELLOW SHIRTS IN THE HALLWAY, I WAS LIKE, I

                    KNOW YOU'RE NOT EVEN THINKING ABOUT TALKING TO ME.  DON'T EVEN LOOK IN

                                         145



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    MY DIRECTION.  WHY?  BECAUSE I'M A CLERGY.  I HAVE MY OWN FOR --

                    FORMAT AND FORMATION OF WHAT I BELIEVE.  AND I STILL HAVE THOSE BELIEFS.

                    AND I'M STANDING HERE TODAY FOR MYSELF AFTER SPENDING TWO-AND-A-HALF

                    YEARS OF CRUCIAL TIME WITH MY DAD WHOSE LIFE WAS DETERIORATING.  AND

                    WHEN I SAY SPEND TIME, I'M NOT AT THE DOCTOR AND PEOPLE SAYING -- I'M

                    TALKING ABOUT CHANGING BANDAGES AND DOING ALL OF THOSE INDIVIDUALLY

                    YOURSELF.  AND HAVING TO DEAL WITH SOILED SHEETS, WASHING CLOTHES, AND

                    ALL OF THAT.  AND YOU'RE DOING THAT 14 HOURS A DAY AT ANY GIVEN TIME.

                    AND MY FATHER SAID THIS TO ME, HE SAID, I CAN'T TAKE THIS.  AND THE FIRST

                    TIME I HEARD IT I KNEW WHAT IT WAS BUT I DIDN'T WANT TO OWN IT.  I DIDN'T

                    WANT TO OWN THE IDEA THAT MY DAD IS TELLING ME HE WANTS TO CASH OUT.

                    AND I TRIED NOT TO OWN IT.  AND I TRIED TO DENY IT.  BUT AT THE END OF THE

                    DAY THAT'S EXACTLY WHAT -- AND THEN IT GOT TO THE POINT HE WAS -- HE WAS

                    BEGGING.

                                 I'M NOT HERE TO CHANGE ANYBODY'S MIND.  I'M JUST

                    SHARING MY TRAVEL TO THIS SPACE WHERE I NOW CAN STAND UP HERE AND SAY,

                    YOU KNOW WHAT, I'M ALL RIGHT WITH THIS.  AND FOR THE PEOPLE THAT HAVE

                    THE DECISIONS, AND THEY HAVE THIS IDEA OF WHAT THEY THINK THEIR CREATOR

                    WANTS US TO DO, GOD BLESS YOU, BECAUSE I HAD MY OWN STRUGGLES WITH

                    THAT.  BUT I LANDED ON THIS SPACE RIGHT HERE.

                                 MEDICAL AID IN DYING IS -- IS NOT A BOGEYMAN.  IT'S NOT

                    INEVITABLE -- IT'S -- IT'S -- DEATH'S INEVITABLE.  IT'S GOING TO HAPPEN.  THE

                    QUESTION IS, ARE WE PREPARED FOR IT?

                                 AND I CAN'T TELL YOU AS A PASTOR AND A CLERGY HOW

                    MANY TIMES I'VE BEEN IN THAT ROOM WHEN PEOPLE ARE TRYING TO DECIDE,

                                         146



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THE -- THE DOCTOR JUST GAVE US THIS NEWS.  WHATEVER THAT NEWS IS, AND

                    THE PERSON IS LYING THERE, AND THEY'RE NOT GONNA GET UP, AND THEN YOU

                    HAVE SOMEONE THAT SAYS, DO NOT RESUSCITATE, BECAUSE THAT'S WHAT THEY

                    WANTED.  WE'RE NOT TAKING ANYTHING FROM ANYBODY.  WE'RE SAYING LET'S

                    LET THEM HAVE THAT DECISION, AND THEY'LL DO IT IN A SPACE WHERE THEY'RE

                    COMPETENT AND ABLE TO HAVE THAT DISCUSSION.  BECAUSE ONE OF THE THINGS

                    THAT WE DON'T WANT TO TALK ABOUT IS THE IDEA THAT ME AND MY SPECIAL

                    LOVED ONE, WE NEVER TALK ABOUT, BUT IT'S INEVITABLE, AND IT'S HAPPENED.

                    AND WHAT DOES THAT MEAN?  THAT PERSON IS GOING TO DIE.  BUT WHY DON'T

                    WE DO IT WITH SOME DIGNITY?  BECAUSE TRUTH BE KNOWN, THEY COULD JUMP

                    OFF A BRIDGE, IN FRONT OF A TRAIN, IN FRONT OF A CAR, ALL OF THESE THINGS, AND

                    THEY'RE SAYING, WILL YOU RESPECT WHAT I HAVE TO DO?  AND IT'S A DIFFICULT

                    ONE.  AND IT'S GONNA TAKE A WHOLE LOT OF EVERYTHING TO GET YOUR MIND

                    AROUND IT.  BUT WILL YOU RESPECT THAT?  AND IT'S -- IT'S EVERYBODY'S

                    INDIVIDUAL CHOICE.  WE'RE NOT MANDATING ANYBODY DOES ANYTHING.

                                 IN THIS STATE THAT WE'VE DONE SO MUCH, WE'RE SAYING

                    YOU HAVE AN OPPORTUNITY TO SELECT THIS IF YOU CHOSE -- CHOOSE TO.  AND

                    IF YOU DON'T WANT IT, IT'S OKAY.  BUT IF YOU DO FIND YOU THAT YOU NEED IT,

                    WE WANT YOU TO HAVE IT.  AND NOT FEEL ANY KIND OF WAY.

                                 NOW I THINK THERE'S SOMETHING CALLED A HIPAA LAW.

                    AND THE HIPAA SAYS THAT YOU CAN'T TELL MY BUSINESS TO ANYBODY.  AND

                    IF I STILL DON'T WANT MY DOCTORS TO TELL MY CHILDREN OR MY SPOUSE WHAT'S

                    GOING ON, THEN DOGGONE IT THEY CAN'T.  BUT IT DOESN'T STOP THAT TRAIN FROM

                    LEAVING THE STATION IF THAT PERSON HAVE REACHED THAT CONCLUSION.

                                 I JUST WANT US TO ENCOURAGE US TO APPROACH THIS WITH

                                         147



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    AN OPEN MIND.  AND, LISTEN, IF I AM WRONG, I HAVE A GOD THAT WILL JUDGE

                    ME, BUT I'M ALL RIGHT WITH THIS JOURNEY BECAUSE I SPENT TIME WITH MY

                    FATHER.  AND LISTENED TO HIM BEG ABOUT HOW HE DID NOT WANT TO LIVE IN

                    THIS CONDITION.  AND THERE WAS NOTHING I COULD DO.  AND ULTIMATELY HE

                    DIED FROM CANCER, RIGHT THERE IN THAT ROOM.  THE QUALITY OF LIFE

                    CHANGED.  AND FOR ME IT -- IT MEANT A LOT.  AND I DIDN'T START OUT

                    WANTING TO SUPPORT THIS.  BUT AS I SPEND THAT TIME -- I'M NOT TALKING

                    ABOUT YOU GOING BY THE NURSING HOME AND SEE THEM, THEY LOOK

                    CLEAN AND EVERY -- BUT WHEN YOU'RE IN THE TRENCHES, AND YOU'RE THE ONLY

                    PERSON -- OR MY WIFE, SPEAKING -- IT CHANGES THE NARRATIVE.  AND -- AND

                    IF YOU'VE BEEN THERE?  GOD HELP YOU COME THROUGH.  AND IF YOU NEVER

                    BEEN THERE, I PRAY YOU NEVER HAVE TO HAVE THAT EXPERIENCE.  AND MY

                    DECISION IS MY DECISION ALONE.  I'M NOT HERE TO GET ANYBODY TO CHANGE

                    IT, BUT I STAND BEHIND WHAT I SAID.

                                 AND I WANT TO COMMEND THE SPONSOR FOR HAVING THE

                    ABILITY TO BRING THIS HERE, AND THE SPEAKER FOR HAVING IT COME TO THE

                    FLOOR, BECAUSE WE'RE IN CHANGING TIMES.  IT'S GOING TO HAPPEN.  IT'S

                    INEVITABLE.  BECAUSE WE ALL KNOW WHAT A DEATH CERTIFICATE LOOKS LIKE.

                    BUT MORE IMPORTANTLY, WE HAVE A BIRTH CERTIFICATE, BUT WE DON'T KNOW

                    THE DAY AND THE HOUR, AND WHAT'S GONNA BE IN THE BOX FOR US.

                                 BUT I THINK THAT THE PEOPLE IN THE STATE OF NEW YORK,

                    IF THEY WANT TO DO THIS, THEY SHOULD HAVE THAT OPTION TO DO IT.  WE DONE

                    A WHOLE LOT OF OTHER FOOLISHNESS.  AND I'M JUST SAYING, GIVE PEOPLE AN

                    OPPORTUNITY.

                                 THANK YOU, MADAM SPEAKER.  I'LL BE VOTING IN THE -- IN

                                         148



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THE POSITIVE.

                                 (APPLAUSE.)

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MR. MAHER.

                                 MR. MAHER:  THANK YOU, MADAM SPEAKER.  WILL

                    THE SPONSOR YIELD FOR SOME QUESTIONS?

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MR. MAHER:  OKAY.  THANK YOU.  SO I JUST WANT TO

                    QUALIFY AND TRY TO CORRECT A STATEMENT THAT WAS JUST MADE.

                                 SO CAN ANYONE TAKE THE MEDICATION EVEN IT'S NOT

                    PRESCRIBED TO THEM UNDER THE LAW?  NO.  BUT ANYONE COULD TAKE THAT

                    MEDICATION IF IT'S PHYSICALLY THERE.  THAT'S JUST A MATTER OF FACT, WOULD

                    YOU AGREE?

                                 MS. PAULIN:  YES.  THEY CAN TAKE ANY MEDICATION

                    IN ANY MEDICINE CABINET OR -- THAT THEY COULD FIND.  THIS ISN'T --

                                 MR. MAHER:  OKAY.

                                 MS. PAULIN: -- SOMETHING THAT THEY COULD GET

                    PRESCRIBED.

                                 MR. MAHER:  OKAY.  I JUST WANTED TO MAKE THAT

                    CLARIFICATION --

                                 MS. PAULIN:  YEAH.

                                 MR. MAHER:  -- WHICH WE ALL KNOW, BUT DEFINITELY

                                         149



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WANTED THAT ON THE RECORD.

                                 NOW, I WANT TO GO FURTHER INTO THAT.  BECAUSE A

                    STATEMENT THAT YOU MAKE EARLIER, CORRECT ME IF I'M WRONG, IS THAT IN

                    THESE CASES WHERE THE MEDICATION IS PRESCRIBED, 40 PERCENT DO NOT USE

                    IT.

                                 MS. PAULIN:  THIRTY-EIGHT PERCENT.

                                 MR. MAHER:  THIRTY-EIGHT PERCENT.  THANK YOU.

                    NEARLY 40 PERCENT.

                                 SO WOULDN'T YOU AGREE THAT IT IS POSSIBLE THAT SOMEONE

                    HAS USED THIS MEDICATION, EVEN THOUGH IT WAS NOT PRESCRIBED TO THEM,

                    WITH THAT MUCH OF A PERCENTAGE OUT THERE?

                                 MS. PAULIN:  SO YOU'RE SAYING AMONG THE 38

                    PERCENT, YOU THINK SOMEBODY MIGHT HAVE FOUND IT AND USED IT?  OR --

                                 MR. MAHER:  YES.

                                 MS. PAULIN:  I SEE.  SO WE KNOW WHO HAS TAKEN OR

                    GOTTEN THE MEDICATION.  AND WE KNOW THAT IT'S BEEN RETURNED.  THOSE

                    ARE TRACKED AND THOSE ARE AVAILABLE.  SO WE KNOW THAT IT'S NOT AMONG

                    THE 38 PERCENT, IT -- YOU KNOW, THAT YOU'RE WORRIED ABOUT.

                                 MR. MAHER:  SO YOU'RE SAYING, ON THE RECORD, THAT

                    THE 38 PERCENT NUMBER, WHICH IS -- COMES OUT TO THOUSANDS OF -- OF

                    FOLKS THAT DO NOT USE THIS MEDICATION, ALL OF THAT HAS BEEN -- WAS

                    RETURNED, AND THERE'S A RECORD OF THAT?

                                 MS. PAULIN:  WE ACTUALLY HAVE A REQUIREMENT IN

                    OUR BILL THAT IT IS RETURNED.  YES.

                                 MR. MAHER:  I UNDERSTAND THE BILL THAT WE'RE

                                         150



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    CURRENTLY DISCUSSING, BUT OUT OF THE 11 IN THE UNITED STATES AND TWO

                    DIFFERENT TERRITORIES IN THE -- IN THIS COUNTRY, I ASSUME THAT'S WHERE THAT

                    38 PERCENT NUMBER COMES FROM, CORRECT?

                                 MS. PAULIN:  YES.

                                 MR. MAHER:  SO YOU'RE SAYING IN ALL THOSE STATES

                    AND JURISDICTIONS, THAT THERE IS A RECORD AND A PROCESS, AND THAT WE

                    KNOW FOR SURE THAT MEDICATION WAS RETURNED?

                                 MS. PAULIN:  SO I -- I DON'T KNOW EACH INDIVIDUAL

                    ONES.  I'M NOT GOING TO ATTEST TO THAT.  I -- I DO KNOW THAT THEY'RE

                    TRACKED.  I DO KNOW THAT WE WORRY AS WE DO WITH ANY CONTROLLED

                    SUBSTANCE THAT -- THAT WE KNOW WHO HAS GOTTEN IT.  WE KNOW THAT, YOU

                    KNOW, THEY HAVE TO SIGN OFF THAT THEY'VE RECEIVED IT.  AND THEY'RE TOLD,

                    WHEN THEY DO RECEIVE IT, YOU KNOW, WHAT THE PROCESS IS FOR RETURNING IT.

                                 MR. MAHER:  OKAY.  JUST -- THAT IS VERY CONCERNING

                    TO ME.  BUT THAT'S -- THAT'S JUST ONE OF THE QUESTIONS THAT I HAD.

                                 I WANTED TO CHAT QUICKLY ABOUT -- ASK A QUESTION ABOUT

                    THE SIXTH MONTH.  I -- I KNOW THAT YOU'VE TALKED ABOUT -- IT'S NOT AN

                    ARBITRARY NUMBER.  THERE'S SOME PRECEDENT IN TERMS OF THE LEGAL SYSTEM

                    ON SIX MONTHS BEING USED, AS, OBVIOUSLY, THE OTHER 11 STATES AND

                    JURISDICTIONS THAT USE IT, WHAT WOULD HAPPEN IF SOMEONE DID RECEIVE A

                    TERMINAL DIAGNOSIS WITH SIX MONTHS OR LESS TO LIVE, IS PRESCRIBED THIS

                    MEDICATION TO END THEIR LIFE, DOES NOT TAKE IT, AND ACTUALLY LIVES BEYOND

                    THE SIX MONTHS?

                                 MS. PAULIN:  THEN THAT'S THE -- THAT COULD EASILY

                    HAPPEN.  YOU KNOW, WE KNOW THAT DOCTORS, 85 PERCENT OF THE TIME, TELL

                                         151



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    YOU THAT YOU'RE GOING TO LIVE A CERTAIN AMOUNT OF TIME AND THAT, INDEED,

                    IT'S LESS.  BUT THEN THERE'S 15 PERCENT OF THE TIME WHERE THEY'RE -- THAT,

                    YOU KNOW, THEY ARE PEOPLE WHO ARE ABLE TO LIVE LONGER.  SO WE DO

                    KNOW 15 PERCENT OF THE CASES THAT THEY ARE GOING TO LIVE LONGER.

                    HOWEVER, BECAUSE OF THIS MEDICATION IS USED ALMOST ALWAYS AT THE VERY

                    END OF YOUR LIFE, WHEN YOU'RE IN SUCH DIRE PAIN, THAT'S THE REASON PEOPLE

                    TAKE IT; THAT, IT'S NOT GOING TO BE TAKEN IN THOSE EARLIER STAGES.

                                 IF, YOU KNOW -- YOU KNOW, HONESTLY, IF MY SISTER

                    WOULD HAVE HAD LONGER TO LIVE, SHE WOULD HAVE BEEN SO HAPPY AND SO

                    WOULD THE REST OF US.  AND -- AND I KNOW THAT'S THE CASE OF MY -- OF MY

                    GOOD FRIEND WHO HAS CANCER NOW.  WE WANT HER, AND SHE WANTS HERSELF,

                    TO LIVE AS LONG AS POSSIBLE.  BUT I ALSO WANT FOR MY LOVED ONES TO BE

                    ABLE TO DECIDE WHEN IT'S TOO MUCH FOR THEM, PHYSICALLY, AND THAT THEY

                    CAN'T COPE ANY LONGER.  I WANT THAT DIGNITY FOR THEM, TO THAT MAKE

                    DECISION.  AND THAT'S WHAT THIS BILL'S ALL ABOUT.

                                 MR. MAHER:  I CERTAINLY CAN UNDERSTAND THE INTENT

                    OF THIS BILL.  A LOT OF MY CONCERNS ARE THE UNINTENDED CONSEQUENCES

                    THAT COULD EXIST.

                                 AND I KNOW DURING A PREVIOUS DEBATE YOU MADE THE

                    STATEMENT THAT THIS COULD NOT HAPPEN, WOULD NOT HAPPEN IN TERMS OF THE

                    DOCTOR BEING ABLE TO SAY, HEY, YOU HAVE SIX MONTHS TO LIVE, AND THAT NOT

                    REALLY BEING THE CASE IN -- IN TERMS OF THE LOCALITIES AND STATES THAT HAVE

                    HAD THIS ON THE BOOKS.  BUT YOU ALSO JUST ADMITTED THAT IT COULD HAPPEN

                    THAT THEY LIVE PAST SIX MONTHS.  AND THEN YOU HAVE THAT 38 PERCENT

                    NUMBER WHERE THE MEDICATION IS NOT USED.  SO ARE THERE ANY RECORDS

                                         152



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    OF -- OF THAT 30 -- 38 PERCENT THAT SOME DID RECOVER MEDICALLY?

                                 MS. PAULIN:  YOU MEAN, THAT THEY WENT INTO

                    REMISSION --

                                 MR. MAHER:  YES.

                                 MS. PAULIN:  -- OR --

                                 MR. MAHER:  ANY OF THE ABOVE.

                                 MS. PAULIN:  IT COULD EASILY BE THE CASE.  I -- I HOPE

                    FOR THE SAKE OF THEM AND THEIR FAMILIES.  YES.  I DON'T KNOW, THOUGH.

                                 MR. MAHER:  OKAY.  BECAUSE -- BECAUSE I THOUGHT I

                    JUST REMEMBERED YOU TELLING MY COLLEAGUE THAT THAT'S NEVER GONNA TO

                    HAPPEN.  IT DOESN'T HAPPEN.  BUT I'M GLAD, ON THE RECORD, FOR -- FOR YOU

                    TO SAY THAT, BECAUSE I AGREE.

                                 I ALSO WANT TO RETURN TO ANOTHER CONVERSATION, AND THIS

                    IS ONE THAT GETS A LOT OF DEBATE, ESPECIALLY IN THE -- THE DISABILITY

                    COMMUNITY AND A LOT OF OTHER AREAS.  WHEN WE LOOK AT THE TEXT OF THE

                    BILL, WE HAVE THESE TWO DISTINCTIONS:  INCURABLE, NOT UNTREATABLE.  SO

                    "UNTREATABLE" IS NOT IN THE LANGUAGE.  AND I KNOW THAT YOU SAY YOU'RE

                    SETTING -- IT'S SETTING LEGAL PRECEDENT, THAT THAT'S WHAT THIS MEAN, BUT IT'S

                    NOT ACTUALLY IN THE BILL.

                                 MS. PAULIN:  THE WORDS THAT WE USED ARE

                    "IRREVERSIBLE" --

                                 MR. MAHER:  RIGHT.

                                 MS. PAULIN:  -- RIGHT?  SO IF THE ILLNESS IS

                    IRREVERSIBLE THROUGH A TREATMENT, A TRIAL, WHICH MAY NOT BE EXACTLY THE

                    SAME, THEN THAT'S -- THAT IS EXACTLY WHAT WE'RE INTENDING FOR IT TO MEAN.

                                         153



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. MAHER:  OKAY.  SO WHEN IT COMES TO

                    "UNTREATABLE," THAT WORD IS NOT IN THERE, BUT "IRREVERSIBLE," YOU'RE

                    SAYING --

                                 MS. PAULIN:  IS THAT WORD, YES.

                                 MR. MAHER:  -- IS THE INTENT --

                                 MS. PAULIN:  YES.

                                 MR. MAHER:  -- AND THAT IS THE PRACTICE, YOU'RE

                    SAYING, THROUGHOUT THE COUNTRY AND THE STATES WHERE THIS EXISTS?

                                 MS. PAULIN:  YES.  YES.

                                 MR. MAHER:  OKAY.  I ALSO HAVE SOME ISSUES WITH

                    THAT, BUT WE'LL MOVE ON.  THANK YOU FOR ANSWERING MY QUESTION.

                                 OKAY.  SO I -- I WANT TO GET INTO ANOTHER STATEMENT YOU

                    MADE ABOUT MOST PEOPLE BEING INFLUENCED BY THEIR LOVED ONES.  I

                    WOULD AGREE.  AND WHEN IT COMES TO THE ISSUE SPECIFICALLY ABOUT

                    SOMEONE WHO MAYBE HAS KIDNEY FAILURE AND IS ON DIALYSIS, WOULD IT BE

                    YOUR ASSERTION THAT IF THEY WERE ON DIALYSIS BUT CHOSE NOT TO CONTINUE

                    ON DIALYSIS, THAT'S THEIR CHOICE, THAT THEY SHOULD BE ELIGIBLE FOR, AND

                    WOULD THEY UNDER THIS LAW BE ELIGIBLE FOR THIS MEDICATION?

                                 MS. PAULIN:  SO THEY MIGHT BE ELIGIBLE FOR IT, BUT

                    USUALLY WHEN YOU COME OFF OF DIALYSIS, YOU DECIDE YOU'RE NOT GOING TO

                    TAKE IT ANYMORE, THE DEATH IS PRETTY QUICK.  SO YOU WOULDN'T HAVE TIME

                    FOR YOUR ATTENDING AND YOUR CONSULTING AND THE WRITTEN, YOU WOULD BE

                    DEAD.

                                 MR. MAHER:  OKAY.  SO YOU'RE SAYING IF AN

                    INDIVIDUAL MADE THE CHOICE TO GET OFF OF THE DIALYSIS, THEN THEY WOULD

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    BE QUALIFIED TO RECEIVE THIS MEDICATION, EVEN THOUGH IT'S A TREATABLE

                    DISEASE?

                                 MS. PAULIN:  I THINK IT'S -- YOU KNOW, WE HAVE SEEN

                    CASES LIKE THAT, YES.  BUT, AGAIN, THEY WOULD BE DEAD.  SO IT'S NOT -- IT'S

                    NOT EVEN A, YOU KNOW, IT'S NEVER GONNA GET TESTED.

                                 MR. MAHER:  I UNDERSTAND.  BUT YOU JUST SAID THAT IF

                    IT IS TREATABLE, THEY WOULDN'T BE ABLE TO QUALIFY.  BUT I JUST GAVE YOU AN

                    EXAMPLE OF A DISEASE THAT WOULD BE TREATABLE, BUT YOU'RE CHOOSING NOT

                    TO TAKE THAT TREATMENT, AND YOU SAID THAT IT WOULD.  SO I'M A LITTLE

                    CONFUSED.

                                 MS. PAULIN:  SO I -- I THINK IT'S A DEBATE THAT -- THAT

                    PEOPLE MIGHT HAVE.  BUT, AGAIN, IT'S NOT ONE BASED ON A REALITY.

                                 MR. MAHER:  OKAY.  WE'RE GONNA AGREE TO DISAGREE

                    AGAIN THERE, BUT I THANK YOU FOR ANSWERING THE QUESTION.

                                 I WANT TO ASK YOU ABOUT MENTAL HEALTH, ANOTHER

                    COLLEAGUE -- OR SEVERAL COLLEAGUES BROUGHT THIS UP.  WHEN IT COMES TO

                    MAJOR CLINICAL DEPRESSION, WOULD YOU CONSIDER THAT MEDICAL DISORDER

                    THAT COULD POTENTIALLY AFFECT SOMEONE'S COMPETENCY?

                                 MS. PAULIN:  IT WOULD BE COMPETENCY TO BE ABLE TO

                    DETERMINE OR ASSESS YOUR OWN OR -- IT WOULD BE COMPETENCY IN REGARDS

                    TO MAKING A MEDICAL DECISION OR HEALTH DECISION FOR YOURSELF.  SO IT

                    WOULD BE IDENTICAL TO -- TO MAKING A DECISION ABOUT HAVING HEART

                    SURGERY, OR IDENTICAL TO MAKING A DECISION ABOUT HAVING YOUR TOOTH

                    EXTRACTED, OR IDENTICAL TO MAKING A DECISION WHETHER OR NOT --

                    WHATEVER.

                                         155



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. MAHER:  DO -- DO YOU -- DO YOU BELIEVE THAT IF

                    SOMEONE IS SUFFERING FROM A MAJOR CLINICAL DEPRESSION DIAGNOSIS, THAT

                    IT AFFECTS THEIR COMPETENCY IN MAKING DECISIONS?

                                 MS. PAULIN:  I THINK THAT IT -- IT WOULD LIKELY VARY.

                    I'M NOT A PSYCHIATRIST OR A PSYCHIATRIC NURSE OR A PSYCHOLOGIST, SO I CAN'T

                    SAY THAT.

                                 I CAN TELL YOU THAT IF I WAS GOING TO DIE, I WOULD BE

                    DEPRESSED.  WHETHER I WOULD BE DEPRESSED ENOUGH TO IMPACT -- TO BE --

                    TO BE CONSIDERED SO DEPRESSED THAT I COULDN'T MAKE JUDGMENT, YOU

                    KNOW, THEN I WOULD GET ASSESSED FOR THAT --

                                 MR. MAHER:  OKAY.

                                 MS. PAULIN:  -- UNDER THIS BILL.

                                 MR. MAHER:  I WANT TO BRING UP A STUDY AND ASK A

                    QUESTION.  THIS WAS DONE IN OREGON.  IT WAS ON 200 TERMINALLY ILL

                    CANCER PATIENTS.  AND THE PREVALENCE IN THIS CASE OF DEPRESSIVE

                    SYNDROME WAS 59 PERCENT AMONG PATIENTS WITH A PERVASIVE DESIRE TO

                    DIE, BUT ONLY 8 PERCENT AMONG PATIENTS WITHOUT SUCH A DESIRE.  DESPITE

                    THAT FINDING, MANY HEALTH PROFESSIONALS AND FAMILY MEMBERS OF

                    PATIENTS IN OREGON WHO PURSUE TAKING THE MEDICATION GENERALLY DO NOT

                    BELIEVE THAT DEPRESSION INFLUENCES THE CHOICE OF FACING DEATH.

                    HOWEVER, A RECENT OREGON-BASED STUDY DEMONSTRATED THAT SOME

                    DEPRESSED PATIENTS ARE SLIPPING THROUGH THE CRACKS.  AMONG TERMINALLY

                    ILL PATIENTS WHO RECEIVED A PRESCRIPTION FOR A LETHAL DRUG, ONE IN SIX HAD

                    CLINICAL DEPRESSION.  AND OF THOSE PATIENTS IN THE STUDY WHO RECEIVED

                    THE PRESCRIPTION, THREE HAD MAJOR DEPRESSION.  ALL OF THEM WENT ON TO

                                         156



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    DIE BY LETHAL INJECTION BUT HAD BEEN ASSESSED BY A MENTAL HEALTH

                    SPECIALIST.

                                 SO IT BEGS THE QUESTION, IF WE HAVE THIS PROCESS WHERE

                    A PSYCHOLOGIST IS SEEING THAT SOMEONE HAS A MAJOR MEDICAL DEPRESSION

                    CONDITION, AND THEY ARE STILL SAYING THEY'RE COMPETENT ENOUGH TO MAKE

                    THIS DECISION, DOESN'T THAT LEAVE ROOM FOR SOME ERROR?

                                 MS. PAULIN:  NO, I DON'T THINK SO.  I THINK WHAT

                    YOU'RE ASSESSING ARE TWO DIFFERENT THINGS.  YOU KNOW, WHAT THE

                    ASSESSMENT THAT THE PSYCHIATRIST, NURSE -- PSYCHIATRIC NURSE OR A

                    PSYCHOLOGIST IS MAKING IS WHETHER YOU'RE COMPETENT TO MAKE A MEDICAL

                    DECISION.

                                 I THINK WE'VE ALL BEEN DEPRESSED.  MEMBERS OF THIS

                    CHAMBER HAVE LOST CHILDREN.  MEMBERS OF THIS CHAMBER HAVE LOST

                    OTHER LOVED ONES; THEIR -- THEIR SPOUSES, THEIR -- THEIR MOTHER, THEIR

                    FATHER.  AND, YES, YOU ARE DEPRESSED WHEN THAT HAPPENS.  ARE YOU SO

                    DEPRESSED THAT YOU CAN'T MAKE A MEDICAL DECISION?  NO.  SO WHY IS IT

                    DIFFERENT IF YOU HAVE -- IF YOU'RE DEPRESSED BECAUSE OF A MEDICAL

                    CONDITION?

                                 YOU KNOW, I DON'T SEE ANY -- ANY DIFFERENT.  YOU

                    KNOW, I THINK DEPRESSION COULD SOMETIMES BE WORSE, YOU KNOW, IF

                    YOU --

                                 MR. MAHER:  YEAH.  I AGREE --

                                 MS. PAULIN:  -- LOSE A -- LOSE A SIBLING, A MOTHER, A

                    FATHER OR A CHILD.

                                 MR. MAHER:  OKAY.  MY POINT BEING THAT, IT -- IN

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    MY -- IT'S MY BELIEF THAT A SEVERE CASE OF DEPRESSION WOULD QUALIFY FOR

                    SOMEONE NOT BEING IN THE RIGHT PLACE TO BE ABLE TO MAKE

                    THAT COMPETENCY --

                                 MS. PAULIN:  IT DEPENDS ON THE DEPRESSION.

                                 MR. MAHER:  AND I THINK THAT'S OPEN TO

                    INTERPRETATION, WHICH IS ANOTHER PROBLEM I HAVE WITH THIS -- THIS LAW AS

                    IT'S READ -- AS IT'S WRITTEN.

                                 WERE YOU ABLE TO MEET WITH ANY OF THE RELIGIOUS

                    LEADERS THAT HAD ANOTHER VIEW ON THIS?  DID YOU PERSONALLY MEET WITH

                    ANY RELIGIOUS LEADERS OR ORGANIZATIONS?

                                 MS. PAULIN:  I HAVE MET WITH MANY, BOTH PRO AND

                    CON.

                                 MR. MAHER:  I'M GLAD TO HEAR THAT.  AND I HAVE --

                    DID THE SAME THING TWO-AND-A-HALF YEARS NOW RESEARCHING THIS ISSUE.  I

                    HAVE AN OPEN HEART AND AN OPEN MIND TO REALLY MEET WITH ADVOCATES,

                    TALK TO THEM, CRY WITH THEM, HEAR THEIR STORIES.  AND WHEN I GOT TO A

                    PLACE WHERE I COULD NOT SUPPORT IT, I REMEMBER GOING FACE-TO-FACE

                    AND -- AND HAVING THOSE TOUGH CONVERSATIONS, SAYING THIS IS WHY I CAN'T

                    SUPPORT IT.  YOU DO SUPPORT IT.  SO I HAVE ONE MORE QUESTION.

                                 WHEN IT COMES TO CHILDREN WITH TERMINALLY, READY

                    ILLNESSES, WHY ARE NOT -- THEY NOT PART OF THIS BILL IF THIS IS SOMETHING

                    THAT REALLY YOU BELIEVE IN WHEN IT COMES TO ADULTS WHO ARE TERMINALLY

                    ILL?

                                 MS. PAULIN:  BECAUSE WE DON'T ALLOW CHILDREN TO

                    MAKE MEDICAL DECISIONS FOR THEMSELVES, AND MOST -- OR AT LEAST IN MOST

                                         158



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    INSTANCES.  YOU KNOW, 18 IS THE YEAR THAT WE'VE CHOSEN IN OUR LAW TO

                    ALLOW PEOPLE TO MAKE MEDICAL DECISIONS FOR THEMSELVES.  AND BECAUSE

                    THIS IS A MEDICAL DECISION FOR YOURSELF TO SELF INGEST, WE CHOSE THE SAME

                    NUMBER, 18.

                                 MR. MAHER:  ALL RIGHT.  THANK YOU FOR YOUR

                    QUESTIONS.

                                 THANK YOU, MADAM SPEAKER.

                                 ACTING SPEAKER HUNTER:  MR. DAIS.

                                 MR. DAIS:  WILL THE SPONSOR YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MR. DAIS:  THANK YOU, MADAM CHAIR.

                                 TO ENTER A HOSPICE CARE OR PALLIATIVE CARE, DOESN'T TWO

                    DOCTORS HAVE TO DETERMINE THAT YOU HAVE A TERMINAL DISEASE?

                                 MS. PAULIN:  YES.

                                 MR. DAIS:  AND THAT'S ONE OF YOUR OWN DOCTOR [SIC]?

                    THE -- THE FIRST DOCTOR IS YOUR OWN DOCTOR?

                                 MS. PAULIN:  YES.

                                 MR. DAIS:  AND THE SECOND DOCTOR HAS TO BE, I

                    BELIEVE, THE MEDICAL DIRECTOR OF THE HOSPICE?

                                 MS. PAULIN:  USUALLY, YES.

                                 MR. DAIS:  USUALLY.  SO THAT'S SIMILAR TO THE

                    MEDICAL -- TO -- TO YOUR BILL RIGHT NOW?

                                 MS. PAULIN:  YES.

                                 MR. DAIS:  SO OVER TIME I THINK THERE'S BEEN A STRONG

                                         159



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    BELIEF THROUGHOUT THIS CHAMBER THAT NO ONE HAS AN OBJECTION TO

                    HOSPICE OR PALLIATIVE CARE.  ACTUALLY, IN FACT, I BELIEVE WE NEED TO MAKE

                    IT MORE COMPASSIONATE, INCREASE FUNDING, AND MAKE IT BETTER FOR ALL

                    NEW YORKERS.

                                 MS. PAULIN:  YEAH.  IN FACT, WE CHANGED THE STATUTE

                    IN 2021 IN NEW YORK TO ALLOW IT TO BE ONE YEAR.

                                 MR. DAIS:  ONE YEAR?

                                 MS. PAULIN:  YEAH.  IF -- FOR HOSPICE CARE IN NEW

                    YORK.

                                 MR. DAIS:  SO YOU SAY IN THIS CHAMBER, THOUGH, WE

                    HAVE -- WE DO BELIEVE IN HOSPICE CARE.  WE BELIEVE IN PALLIATIVE CARE.

                    AND THE SYSTEM WHERE WE HAVE TWO DOCTORS, WHO ARE INDEPENDENT,

                    EVEN, GRANTED, THE HOSPICE MEDICAL DIRECTOR IS ONE OF THEM, WHO COULD

                    SAY THEY MIGHT HAVE ACTUAL -- SOME TYPE OF INVESTMENT IN THE DECISION,

                    BUT THE CHAMBER HAS AGREED THAT THAT IS OKAY?

                                 MS. PAULIN:  YES.

                                 MR. DAIS:  SO NOW WE HAVE TWO INDEPENDENT

                    DOCTORS THAT HAVE NO FINANCIAL -- YOU HAVE NO FINANCIAL STAKE IN THE

                    DECISION-MAKING IN MEDICAL AID, WHICH, OUTWARDLY, WILL BE EVEN MORE

                    INDEPENDENT THAN OUR CURRENT MEDICAL -- THAN OUR CURRENT HOSPICE AND

                    PALLIATIVE CARE REGULATIONS?

                                 MS. PAULIN:  YES.

                                 MR. DAIS:  ADDITIONALLY -- WELL, ONE THING I THINK IS

                    CLEAR, IT'S NOT ONLY ABOUT THESE -- MOST OF THESE PEOPLE, IN THE MAJORITY,

                    HAVE SOME TYPE OF TERMINAL ILLNESS, BUT IT'S ALSO THAT THE PAIN AND

                                         160



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    SUFFERING IS THE NUMBER ONE CAUSE IN ADDITION TO THE TERMINAL DISEASE --

                                 MS. PAULIN:  YES.

                                 MR. DAIS:  -- TO -- TO TERMINAL DISEASE?

                                 MS. PAULIN:  YES.

                                 MR. DAIS:  AS WE HAVE SEEN, IT'S TO THE POINT WHERE

                    IT'S SUCH PHYSICAL IMPARTMENTS WHERE WE'VE HAD TO COME UP WITH WAYS

                    SO PEOPLE CAN ADMINISTER THE MEDICINE IN -- IN AN EFFECTIVE WAY OR

                    THEMSELVES?

                                 MS. PAULIN:  YES.

                                 MR. DAIS:  SO, TO YOUR POINT EARLIER, IT'S NOT THAT ONE

                    WE'RE DOING THIS IN THE BEGINNING OF THIS DETERMINATION, BUT USUALLY

                    AS -- AS A LAST OPTION BECAUSE EVERYTHING ELSE HAS RAN ITS COURSE?

                                 MS. PAULIN:  THAT'S USUALLY THE CASE.

                                 MR. DAIS:  THANK YOU.

                                 AND THE LAST PART -- TWO -- TWO PARTS TO -- ON THE

                    DISCUSSION, THE NEUTRAL WITNESS SIMILAR TO WE HAVE IN OUR STATES -- IN

                    OUR WILLS, AND OUR TRUST AND ESTATE LAW, CORRECT, ALSO?

                                 MS. PAULIN:  YES.

                                 MR. DAIS:  AND THE LAST PART, WHEN WE'RE TALKING TO

                    DOCTORS, ISN'T IT TRUE A LOT OF TIMES FAMILIES DON'T EVEN RESPECT THE DNRS

                    OF THEIR LOVED ONES?  BECAUSE EVEN IF THEIR LOVED ONE SIGNED IT AND THEY

                    MADE CLEAR, ISN'T IT OFTEN THE FAMILY THAT ASK THE DOCTORS AND OTHER

                    MEDICAL OFFICIALS TO BREAK THE COVENANT OF THEIR LOVED ONE?

                                 MS. PAULIN:  I THINK IT'S EXTRAORDINARILY HARD FOR A

                    LOVED ONE TO MAKE THAT DECISION.

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. DAIS:  AND THEREFORE THAT'S MORE IMPORTANT WHY

                    THE INDEPENDENT DECISION SHOULD BE OF THAT PERSON WHO HAS THE LIBERTY

                    TO MAKE THEIR OWN DECISION?

                                 MS. PAULIN:  ABSOLUTELY.

                                 MR. DAIS:  THANK YOU, MADAM CHAIR.

                                 ON THE BILL.

                                 ACTING SPEAKER TAYLOR:  ON THE BILL.

                                 MR. DAIS:  TO THE CHAMBER, I KNOW THIS IS AN

                    EMOTIONAL ISSUE.  TALKING ABOUT DEATH I CAN'T SPEAK FOR ANYONE ELSE BUT

                    I CAN SPEAK FOR MYSELF, DEATH GIVES ME NIGHTMARES.  TO UNDERSTAND OUR

                    OWN MORTALITY IS THE VERY MEANING OF LIFE.  WITHOUT DEATH THERE IS NOT

                    LIFE.  AND I TRULY BELIEVE THAT LIFE IS A GIFT.  AT THE SAME TIME SOMEONE'S

                    LIBERTY AND THE PURSUIT OF HAPPINESS.  THE ONE THING I KNOW ABOUT NEW

                    YORKERS THEY DON'T LIKE TO BE TOLD WHAT TO DO.  THIS IS A MOMENT TO GIVE

                    SOMEONE WHO'S IN THE MOST CRITICAL PART OF THEIR LIFE FREEDOM TO MAKE

                    THEIR DECISION.  THAT IS NOT MY RIGHT TO TAKE AWAY FROM THEM.  I MIGHT

                    HAVE A RELIGIOUS BELIEF AGAINST THIS, BUT MY RELIGION SHOULD NOT DICTATE

                    HOW SOMEONE ELSE LIVES THEIR LIFE.  FREEDOM OF RELIGION IS EQUALLY

                    FREEDOM FROM RELIGION.  SO I CAN STILL MAINTAIN MY MORALS OF HOW I LIVE

                    MY LIFE, BUT I'M NOT GOING TO PUT MY RELIGIOUS MORALS ON SOMEBODY

                    ELSE BECAUSE I DO NOT BELIEVE THAT IS WHAT WE SHOULD DO AS AMERICANS.

                    BUT MOST IMPORTANTLY WHAT WE NEED TO DO IS REMOVE OURSELVES FROM

                    THE SITUATION.  WE ALREADY HAVE PALLIATIVE CARE AND HOSPICE CARE THAT

                    RELATES TO THIS.  WE HAVE ALREADY APPROVED THAT.  WHAT IS THE DIFFERENCE

                    OF SOMEBODY MAKING DECISIONS WHERE A DOCTOR SAYS YOU HAVE SIX

                                         162



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    MONTHS TO LIVE AND THEY TAKE THEMSELVES OFF THE DIALYSIS, THEY TAKE

                    THEMSELVES OFF THE MEDICATION BY ALLOWING THEM TO LIVE, AND FORCE THAT

                    PERSON TO HAVE THE RIGHT TO DECIDE WHEN AND WHERE THEY WANT TO HAVE

                    THAT MOMENT FOR THEMSELVES.  HOW (INAUDIBLE) LOSS A LOVED ONE WHEN

                    YOU CAN HAVE THAT ONE FINAL GOODBYE, THAT ONE APOLOGY TO GO BACK AND

                    SAY YOU KNOW WHAT, I'M SORRY WHAT HAPPENED TO YOU BACK IN 1995, I

                    WISH I COULD MAKE THAT UP TO YOU.  THIS IS AN ABILITY TO GET PEOPLE TO

                    GRAB BACK THEIR DIGNITY OF LIFE AND JUST MAKE THAT FINAL DECISION.  WHEN

                    WE SAY 38 PERCENT DECIDED NOT TO USE IT, THAT SHOWS THAT THIS

                    (INAUDIBLE) -- THAT MEANS THEY CHANGED THEIR MIND, THEY HAVE THE

                    ABILITY TO HAVE THE FREEDOM TO CHANGE THEIR MIND.  HOWEVER, WHEN THAT

                    PAIN GETS SO EXCRUCIATING, WHEN THEIR QUALITY OF LIFE HAS DETERIORATED TO

                    SUCH A LEVEL WHERE THEY CAN NO LONGER TAKE IT, WHO ARE WE TO BE SELFISH

                    TO TAKE AWAY THAT DECISION FROM THEM?  THAT'S ONE OF THE GREATEST

                    FREEDOMS YOU CAN HAVE IS TO DECIDE HOW YOU LIVE YOUR LIFE, ESPECIALLY

                    AT THE VERY END.

                                 AND THIS MOMENT MEANS A LOT TO ME BECAUSE I

                    REMEMBER BACK IN 1997 I ACTUALLY DEBATED THIS IN HIGH SCHOOL, AND THE

                    ONE THING I CAME BACK AT THE END.  I WANT THE ABILITY TO CHOOSE MY

                    DESTINY AND I WILL NOT TAKE THAT AWAY FROM SOMEBODY.  I'LL BE VOTING IN

                    THE AFFIRMATIVE.

                                 THANK YOU.

                                 ACTING SPEAKER TAYLOR:  MR. JENSEN.

                                 MR. JENSEN:  THANK YOU, MR. SPEAKER.

                                 ON THE BILL.

                                         163



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 ACTING SPEAKER TAYLOR:  ON THE BILL.

                                 MR. JENSEN:  THANK YOU.  I APPRECIATE MY

                    CONFERENCE ALLOWING ME TO USE OUR CONFERENCE'S SECOND 15 MINUTES

                    ON DEBATE TO -- TO FURTHER TALK ABOUT THIS VERY IMPORTANT TOPIC AND SHARE

                    SOME OF THE THOUGHTS THAT I'VE HEARD THROUGHOUT THE DEBATE.  AND LIKE

                    MY COLLEAGUE TO MY LEFT JUST SAID, THIS HAS BEEN A VERY PASSIONATE AND

                    EMOTIONAL DEBATE TODAY AND CERTAINLY VERY GOOD QUESTIONS RAISED BOTH

                    BY OPPONENTS AND PROPONENTS OF THE LEGISLATION.

                                 AND IN MY FIVE YEARS IN THE ASSEMBLY THIS MAY BE THE

                    MOST INFLUENTIAL POLICY THAT I MAY BE A PART OF MAKING, AND MAYBE

                    THROUGHOUT MY CAREER.  AND I'M GLAD THAT TODAY THIS WAS NOT ABOUT

                    PARTISAN POLITICS, BUT RATHER IT'S BEEN A CONVERSATION ABOUT MORALITY.  IT

                    HAS NOT BEEN -- I'VE BEEN PROUD THAT MY COLLEAGUES DESPITE OUR STRONG

                    FAITH WHO MAY BE OPPOSED TO THIS BILL, I DON'T THINK ONCE HAVE USED OUR

                    OWN FAITH AS A REASON WHY WE ARE OPPOSED, EVEN IF THERE MAY BE

                    REASONS FOR THAT.  THIS QUESTION TODAY ON THIS BILL IS A QUESTION OF LIFE

                    AND DEATH.  AND THE DEFINITION OF WHO WOULD BE ELIGIBLE MEANS

                    TERMINAL.  WE'RE ALL TERMINAL.  LIVING IS A KEY COMPONENT OF DYING.  NO

                    ONE WANTS TO SEE ANYONE THEY LOVE, ESPECIALLY SOMEONE THEY LOVE,

                    ENDURE UNIMAGINABLE PAIN, UNIMAGINABLE SUFFERING.  HOWEVER, IS THE

                    GOVERNMENT SANCTIONING THE DEATH OF THOSE IN THAT PAIN AND IN THAT

                    SUFFERING CORRECT WITHOUT ENSURING THAT STEPS ARE TAKEN TO LESSON THAT

                    PAIN AND LESSON THAT SUFFERING.

                                 IN THE FIVE YEARS THAT I'VE BEEN IN THIS CHAMBER, MY

                    HEART HAS BROKEN FOR EVERY SINGLE ADVOCATE, INCLUDING THOSE ABOVE ME

                                         164



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WHO HAVE COME TO ME TO SHARE THEIR STORY.  IT IS BROKEN FOR MY

                    COLLEAGUES WHO SHARED THEIR STORY.  IT IS BROKEN FOR THE SPONSOR OF THIS

                    LEGISLATION WHO HAS SHARED THE STORY OF WHY SHE'S SO PASSIONATE FOR THIS

                    LEGISLATION.  MY HEART HAS BROKEN FOR MY CONSTITUENTS WHO HAVE COME

                    TO ME AND ASKED ME TO SUPPORT THIS BILL.  HOWEVER, MY HEART BREAKS FOR

                    THE PEOPLE WHO WILL UTILIZE THIS IF IT DOES BECOME LAW.  MY HEART WILL

                    BREAK FOR THE INDIVIDUALS WHO HAVE AND WILL HAVE TO DEAL WITH THE SIDE

                    EFFECTS OF THEY'RE LOVED ONE COMMITTING SUICIDE, WHETHER IT'S THROUGH

                    MEDICAL AID IN DYING OR THROUGH OTHER MEANS.  MY HEART BREAKS FOR

                    THE IDEA THAT AS A STATE WE ARE GOING TO TAKE STEPS TO SANCTION THE

                    GIVING UP OF HOPE.  SPEAKING FOR MYSELF, HOPE IS WHAT GETS ME THROUGH

                    THE DAY EVERY DAY.  I PRAY TO GOD FOR HEALTH AND STRENGTH AND HOPE THE

                    REST FIGURES ITSELF OUT.

                                 WE'VE HEARD A LITTLE BIT TODAY AND WE'VE HEARD

                    THROUGHOUT THIS DEBATE, I'VE HEARD FROM MY COLLEAGUES THAT THEY HAVE

                    TO SUPPORT THIS, THEY FEEL INSTILLED TO SUPPORT THIS BECAUSE OF POLLING.

                    AND IN POLITICS EVERYTHING WE DO, POLLING CAN BE A TOUGH THING TO

                    OVERLOOK.  WHILE WE ARE ALL HERE TO REPRESENT THE INTEREST OF OUR

                    CONSTITUENTS, OUR CONSTITUENTS ALSO TRUST US TO USE OUR BEST JUDGMENT.

                    AND ON SOME ISSUES, ON SOME POLICIES THEY ARE TOO NUANCED.  AND WE

                    HAVE TO USE THE TRUST THAT OUR CONSTITUENTS GAVE US ON AN ISSUE WE MAY

                    HAPPEN TO KNOW A LITTLE BIT MORE ABOUT THE LONG-TERM EFFECTS THAN THEY

                    DO.  AND I THINK A LOT PEOPLE IN OUR STATE, WHEN THEY SEE THIS ON A POLL

                    THEY DON'T KNOW WHAT IT MEANS.  THEY DON'T KNOW WHAT SAFEGUARDS ARE

                    AND ARE NOT IN THIS LEGISLATION.

                                         165



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 WE'VE HEARD A LOT OF TALK ABOUT HOSPICE AND PALLIATIVE

                    CARE, ABOUT HOW THIS IS NO DIFFERENT THAN HOSPICE AND PALLIATIVE CARE.  A

                    FEW WEEKS AGO THE SPONSOR AND I DEBATED LEGISLATION THAT WOULD

                    RESTRICT PROVIDERS OF HOSPICE AND PALLIATIVE CARE FROM OPERATING IN THE

                    STATE.  WE ARE LAST IN THE NATION IN HOSPICE AND PALLIATIVE CARE WITH THE

                    AMOUNT OF ONE PROVIDER FOR EVERY HALF MILLION NEW YORKERS.  WHILE AT

                    THE SAME TIME YOU'RE LOOKING TO MAKE IT EASIER FOR

                    TERMINALLY-DIAGNOSED NEW YORKERS TO END THEIR LIFE WHILE

                    SIMULTANEOUSLY RESTRICTING ACCESS TO PROVEN STEPS TO LESSEN PAIN AND

                    SUFFERING.

                                 RIGHT NOW THE UNITED KINGDOM IS GOING THROUGH THIS

                    VERY SAME DEBATE.  AND THE FORMER LEADER OF THE LABOR PARTY AND PRIME

                    MINISTER GORDON BROWN SAID FOR HIS COUNTRY'S DEBATE, QUOTE, "WE NEED

                    TO SHOW THAT WE CAN DO BETTER AT ASSISTED LIVING BEFORE DECIDING

                    WHETHER TO LEGISLATE ON WAYS TO DIE."  I THINK THAT'S POIGNANT AS A PART

                    OF THIS DEBATE.

                                 IN ADDITION, TO PALLIATIVE AND HOSPICE CARE WE HEAR

                    TIME AND TIME AGAIN FROM OUR COLLEAGUES IN THIS CHAMBER, DOWN THE

                    HALL AND ON THE SECOND FLOOR IN THE GOVERNOR'S OFFICE THAT WE NEED TO

                    DO MORE TO SUPPORT THE MENTAL HEALTH CHALLENGES NEW YORKERS ARE

                    FACING.  AND WHEN SOMEONE RECEIVED A TERMINAL DIAGNOSIS AND ARE TOLD

                    THAT THEY WILL DIE, WHAT BETTER TIME IS THERE FOR THEM TO NOT JUST RECEIVE

                    THAT MENTAL HEALTHCARE, SO THAT THEY CAN PROCESS EVERYTHING THAT GOES

                    ALONG WITH THAT DIAGNOSIS.

                                 AND LET'S BE HONEST.  A DIAGNOSIS IS NOT THE END.

                                         166



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    MEDICINE IS NOT AN EXACT SCIENCE.  IT IS A SCIENCE OF A CERTAINTY

                    COMBINED WITH THE ART OF PROBABILITY.  AND FOR INDIVIDUALS WHO HAVE

                    JUST RECEIVED A TERMINAL DIAGNOSIS AND HEAR A DOCTOR SAY, YOUR LIFE WILL

                    END IN SIX MONTHS, THEY ARE IN A PROFOUNDLY VULNERABLE STATE, AND I DO

                    NOT BELIEVE THAT THIS LEGISLATION PROVIDES ENOUGH SAFEGUARDS TO ENSURE

                    THAT THEY ARE EMOTIONALLY AND RESPONSIBLY PROCESSING THAT DIAGNOSIS, AS

                    WELL AS WHAT IT WOULD MEAN IF THEY DECIDE THAT THEY DO NOT WANT TO

                    FIGHT THAT FIGHT ANY LONGER.  AND THAT THEY WOULD BE ABLE TO HAVE THEIR

                    LIFE ENDED THROUGH THEIR OWN CHOICE WITHOUT ANY REQUIREMENT TO PURSUE

                    ALTERNATIVE TREATMENT OR ACCESS PALLIATIVE CARE TO END THAT PAIN AND

                    SUFFERING AND WITHOUT ANY GUARANTEE THAT THEY WILL RECEIVE THE

                    NECESSARY CARE THAT THEY WOULD NEED TO PROCESS THAT DIAGNOSIS.

                                 THERE'S BEEN TALK THROUGHOUT THIS DEBATE TODAY AND

                    THROUGHOUT THIS ISSUE THAT THE SCOPE OF THIS LEGISLATION CAN NEVER

                    CHANGE.  THAT THERE'S ENOUGH LANGUAGE IN THIS LEGISLATION TO ENSURE THAT

                    IT WILL STAY SIX MONTHS OF A TERMINAL DIAGNOSIS FOREVER, BUT THERE'S NO

                    GUARANTEES OF THAT.

                                 ON MATTERS OF LIFE AND DEATH WE HAVE SEEN THE NEW

                    YORK STATE COURT OF APPEALS OVERRULE THE LEGISLATURE BEFORE.  THE

                    LEGISLATURE DECIDED THAT THE DEATH PENALTY WAS LEGAL AND IT WAS THE

                    COURT OF APPEALS WHO STOPPED IT.  NEW YORK'S CONSTITUTION NOW

                    GUARANTEES AND PROHIBITS DISCRIMINATION BASED ON MANY THINGS.  AND

                    TWO OF THOSE CLASSIFICATIONS ARE AGE AND DISABILITY.  WHAT IS TO STOP AN

                    INDIVIDUAL, WHETHER LIKE MY LEARNED COLLEAGUE TO MY IMMEDIATE LEFT

                    WHEN TALKING ABOUT A MINOR, OR AN INDIVIDUAL WITH A DISABILITY THAT ISN'T

                                         167



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    COVERED UNDER THIS LEGISLATION TO CHALLENGE THE CONSTITUTIONALITY OF THIS

                    LAW AND SAY THAT WHY IS IT RESTRICTED ONLY TO THOSE WITH A TERMINAL

                    DIAGNOSIS IN THE EYES OF ONE PRESIDING PHYSICIAN AND A CONSULTING

                    PHYSICIAN THEY MAY NEVER HAVE MET IN PERSON?  ELEVEN STATES -- 11

                    STATES IN THIS COUNTRY HAVE MEDICAL AID IN DYING, BUT SOME OF THEM

                    ARE ALREADY LOOKING TO EXPAND THE SCOPE OF THEIR PRACTICE.  AND WE

                    HAVEN'T TALKED ABOUT THE OTHER NATIONS THAT HAVE MEDICAL AID IN DYING

                    (INAUDIBLE) LAWS ON THEIR OWN BOOKS.  OUR NEIGHBORS TO THE NORTH IN

                    CANADA HAVE SEEN THEIR MEDICAL ASSISTANCE IN DYING EXPANDED TO

                    INCLUDE ACCESS FOR PEOPLE WHOSE DEATHS ARE NOT REASONABLE FORESEEABLE,

                    AND THAT THERE ARE PLANS TO EXPAND TO THOSE WITH MENTAL ILLNESS.

                                 THE NETHERLANDS, BELGIUM, SWITZERLAND, SPAIN AND

                    LUXEMBOURG ALL ALLOW INDIVIDUALS TO COMMIT GOVERNMENT-SANCTIONED

                    DEATH FOR MENTAL CONDITIONS.  DO WE WANT TO EVEN CRACK OPEN THE DOOR

                    FOR FUTURE EXPANSION IN THOSE SAME WAYS THAT WE'VE SEEN IN THOSE

                    JURISDICTIONS?  WE DON'T WANT TO GET TO A POINT IN OUR STATE WHERE NEW

                    YORKERS LIVING WITH DISABILITIES WHO BELIEVE THAT THEY ARE A BURDEN TO

                    THEIR FAMILIES OR TO SOCIETY AND BELIEVE THAT DEATH IS PREFERABLE TO LIFE.

                                 CERTAINLY WHEN CAESAR CROSSED THE RUBICON IT WAS A

                    SHALLOW LITTLE RIVER, BUT LOOKING WHAT CROSSING IT DID.  PASSING THIS

                    LEGISLATION TODAY COULD HAVE UNFORESEEN CONSEQUENCES DESPITE THE BEST

                    ASSURANCES OF THE SPONSOR AND THE INDIVIDUALS WHO WILL VOTE FOR THIS

                    BILL.  AND IT'S NOT HARD TO BELIEVE AS WE'VE HEARD A COUPLE TIMES TODAY

                    THAT NO OTHER STATE WHERE THIS HAS BEEN LEGAL THAT THERE'S BEEN EVIDENCE

                    OF COERCION.  IT'S HARD TO ALLEGE COERCION WHEN YOUR HEART NO LONGER

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    BEATS AND THERE'S NO AIR IN YOUR LUNGS.  NEW YORKERS WILL STILL DIE ALONE

                    BECAUSE OF THIS.  FAMILIES WILL STILL HAVE UNIMAGINABLE PAIN AND

                    SUFFERING.  YOU TAKE THAT COCKTAIL OF THAT LIFE-ENDING MEDICATION THERE

                    ARE NO TAKE-BACKS.  THERE ARE NO SECOND CHANCES.  THERE ARE NOT LET'S

                    GO BACK ON THE FEEDING TUBE, LET'S START THAT TREATMENT AGAIN.  YOU

                    CHOOSE TO END YOUR LIFE AND YOUR LIFE IS OVER.  WHAT WILL BE THE IMPACT

                    ON FAMILY MEMBERS WHOSE FATHER, MOTHER, BROTHER, SISTER, SONS AND

                    DAUGHTERS WHO ARE SO SCARED OF WHAT LIVING WILL MEAN WITH A TERMINAL

                    DIAGNOSIS IF THEY CHOOSE THE UNCERTAINTY OF DEATH.  AND WHAT IMPACT

                    WILL THIS HAVE ON OUR SOCIETY AS A WHOLE IF NEW YORK STATE IS A

                    GOVERNMENT THAT SANCTIONS THE ENDING OF ONE'S LIVE BECAUSE OF THE

                    OPINION OF TWO PEOPLE?  THIS IS A HARD DEBATE.  THIS IS SOMETHING, MY

                    VERY FIRST MEETING WHEN I BECAME A MEMBER OF THE ASSEMBLY, WAS

                    WITH ADVOCATES FOR THIS BILL.  AND I UNDERSTAND MY COLLEAGUES WHO'VE

                    SHARED THEIR OWN PERSONAL STORIES ON WHY THEY HAVE COME AROUND AND

                    BELIEVE THAT THROUGH THEIR OWN EXPERIENCES THEY SEE THE WISDOM IN

                    THIS.  BUT WE ARE NOT JUST TALKING ABOUT THE EXPERIENCE OF 150 MEMBERS

                    OF THIS CHAMBER.  WE ARE TALKING ABOUT WHAT IT MEANS FOR THE 20

                    MILLION PEOPLE WHO CALL NEW YORK HOME TODAY AND FOR FUTURE

                    GENERATIONS.  AND IT'S TOUGH TO LEGISLATE ON A TOPIC SUCH AS THIS BASED

                    ON ASSUMPTIONS AND GUESSES.

                                 LIFE IS AN UNEXACT SCIENCE.  AND UNTIL WE HAVE

                    KNOWLEDGE AND ASSURANCES THAT THIS BILL WILL BE IMPLEMENTED ON THE

                    WAY THAT MANY PEOPLE BELIEVE IT WILL, I BELIEVE IT IS IMPROPER DESPITE

                    THE BEST INTENTIONS OF ALL THOSE INVOLVED AND WHO WANT TO SEE IT PASS TO

                                         169



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    MOVE TODAY.

                                 I APPRECIATE MY COLLEAGUES' ATTENTION.  I APPRECIATE THE

                    HONEST FEELINGS THAT WERE SHARED BY EVERYBODY TODAY AND I APPRECIATE

                    AND VALUE THAT WE ARE A SERIOUS INSTITUTION WHO CAN DISCUSS AN ISSUE

                    LIKE THIS IN GOOD FAITH AND WITH TRUE HEARTS.  THANK YOU, MADAM

                    SPEAKER.

                                 ACTING SPEAKER HUNTER:  MR. BLUMENCRANZ.

                                 MR. BLUMENCRANZ:  THANK YOU.  WILL THE

                    SPONSOR YIELD FOR SOME QUESTIONS?

                                 ACTING SPEAKER HUNTER:  WILL THE SPONSOR

                    YIELD?

                                 MS. PAULIN:  YES.

                                 ACTING SPEAKER HUNTER:  THE SPONSOR YIELDS.

                                 MR. BLUMENCRANZ:  I'M SURE YOU'VE HAD A FEW

                    TODAY, BUT I'LL GIVE YOU A FEW MORE.

                                 MS. PAULIN:  I HAVE GOOD SHOES ON.

                                 MR. BLUMENCRANZ:  SO GIVEN THAT NEW YORK

                    STATE RANKS 51ST IN HOSPICE UTILIZATION, HOW DOES THIS BILL ENSURE THAT

                    PATIENTS ARE NOT CHOOSING MEDICAL AID IN DYING DUE TO THEIR LACK OF

                    ACCESS OF PALLIATIVE CARE AND HOSPICE OPTIONS AS REFERENCED IN SECTION

                    D AND F OF YOUR BILL?

                                 MS. PAULIN:  SO WE PUT A FEW THINGS IN THE BILL THAT

                    I THINK WILL CREATE MORE HOSPICE OPPORTUNITIES AND PROVIDE MORE

                    ACCESS FOR PEOPLE.  WE REQUIRE THAT A PHYSICIAN, THE ATTENDING

                    PHYSICIAN NOTIFIES AND INFORMS ABOUT HOSPICE AND PALLIATIVE CARE.  WE

                                         170



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    REQUIRE THAT THERE'S AN OPTION OR THAT THE DOH PUTS ON THEIR WEBSITE

                    INFORMATION IN MULTIPLE LANGUAGES ABOUT HOSPICE, THOSE THINGS DON'T

                    EXIST.  AND WE'VE SEEN IN OTHER STATES THAT HAVE ALREADY ADOPTED

                    MEDICAL AID IN DYING THAT HOSPICE HAS ACTUALLY INCREASED.

                                 MR. BLUMENCRANZ:  SO YOU SAY THAT THE BILL HAS

                    SOME AFFECT ON -- ON INCREASING HOSPICE CARE?

                                 MS. PAULIN:  YES, YES.  I BELIEVE IT WILL.

                                 MR. BLUMENCRANZ:  CAN YOU ENUMERATE HOW

                    EXACTLY IT DOES THAT SPECIFICALLY?

                                 MS. PAULIN:  IT HAS DONE THAT ACROSS THE COUNTRY IN

                    JURISDICTIONS WHERE THERE HAS BEEN MEDICAL AID IN DYING ADOPTED.

                                 MR. BLUMENCRANZ:  OKAY.  SO THE BILL MENTIONS

                    THE FEASIBLE ALTERNATIVES AS YOU'RE TALKING ABOUT AND APPROPRIATE

                    TREATMENT OPTIONS INCLUDING BUT NOT LIMITED TO PALLIATIVE AND HOSPICE

                    CARE.

                                 GIVEN THE CURRENT STATE OF HOSPICE CARE IN NEW YORK,

                    WHAT CONCRETE MEASURES ARE YOU REFERENCING THAT WILL BE IMPLEMENTED

                    TO GUARANTEE THAT THESE ALTERNATIVES ARE GENUINELY ACCESSIBLE AND -- AND

                    AFFORDABLE TO PATIENTS REGARDLESS OF THEIR SOCIOECONOMIC AND --

                    (CROSSTALK/INAUDIBLE).

                                 MS. PAULIN:  SO MOST HOSPICE PATIENTS ARE ON

                    MEDICAID OR MEDICARE, SO INSURANCE IS NOT AN ISSUE FOR HOSPICE CARE.

                    FOR THE MOST PART I THINK IT'S 88 TO 98 PERCENT IN DIFFERENT -- DEPENDING

                    ON THE STATE.  SO I'M NOT WORRIED ABOUT THE AFFORDABILITY.  I -- AND MOST

                    HOSPICE IS DONE IN THE HOME NOW.  SO YOU DON'T NEED A PHYSICAL

                                         171



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ENVIRONMENT TO DO HOSPICE.  SO IT WOULD JUST BE -- AND -- AND SO THE

                    CURRENT -- THE CURRENT OPERATORS OF HOSPICE COULD SIMPLY EMPLOY MORE

                    NURSES TO GO INTO THE HOMES.  I REALIZE THAT THERE'S A WORKFORCE SHORTAGE

                    ON NURSES SO WE'D HAVE TO HELP THAT SITUATION, BUT THAT'S REALLY ALL WE'D

                    HAVE TO DO TO IMPROVE HOSPICE.

                                 MR. BLUMENCRANZ:  BUT NOT JUST NURSES, AND I'LL

                    TELL YOU.  IN MY EXPLORATION OF THIS PIECE OF LEGISLATION, AND I CAME IN

                    WITH A VERY OPEN MIND, I DISCOVERED IN TALKING TO HOSPICE NURSES IN

                    FACILITIES ACROSS THE STATE, THERE ARE AREAS WHERE THEY BASICALLY TELL YOU

                    THERE IS NO AT-HOME HOSPICE OPTIONS, ESPECIALLY IN UPSTATE NEW YORK.

                    THAT'S JUST -- IT'S NOT ON THE TABLE.  YOU'D HAVE TO GO REALLY FAR AWAY

                    FROM FRIENDS AND FAMILY OR WHERE YOUR HEALTHCARE PROVIDERS ARE.  IT'S

                    JUST NOT A GIVEN.  HOW -- HOW WILL THIS FIX THAT DISCREPANCY?  WILL WE

                    SIGN A WAIVER --

                                 MS. PAULIN:  I THINK THEY'LL BE MORE DEMAND.  RIGHT

                    NOW PART OF THE PROBLEM IS THAT THE DEMAND -- PEOPLE DON'T KNOW ABOUT

                    HOSPICE AND PALLIATIVE CARE.  WHEN THAT DEMAND INCREASES, BECAUSE OF

                    THE PROVISION OF INSURANCE THAT ALREADY EXISTS, WE WILL SEE THIS INDUSTRY

                    GROW.

                                 MR. BLUMENCRANZ:  HAS THE PROVISION -- THE

                    INSURANCE PROVISION YOU'RE REFERENCING, HAS THERE BEEN ANY EMPIRICAL

                    DATA TO SHOW THAT HAS INCREASED AWARENESS AND DEMAND --

                                 (CROSSTALK/INAUDIBLE)

                                 MS. PAULIN:  NO. THAT'S WHY WE PUT IN THE BILL THAT

                    THERE NEEDS TO BE MORE INFORMATION AVAILABLE TO PEOPLE AND IT SHOULD

                                         172



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    BE IN MULTIPLE LANGUAGES AND ON THE WEBSITE.  THAT WAS SOMETHING THAT

                    WE WORKED ON WITH THE HOSPICE ADVOCATES AND WE WERE VERY HAPPY TO

                    PUT THAT IN THE BILL.

                                 MR. BLUMENCRANZ:  SO NO MATTER THE LANGUAGE,

                    THOUGH, IF -- IF AT-HOME HOSPICE IS NOT AVAILABLE, WILL THE INFORMATION

                    PROVIDED FROM DOH SAY, SORRY.  YOU DON'T HAVE AN OPTION FOR AT HOME

                    OR REALLY MUCH OF A HOSPICE OPTION AT ALL, BUT HERE'S YOUR CARE OPTIONS

                    NOT INCLUDING --

                                 MS. PAULIN:  I -- I THINK WE HAVE SEEN ACROSS THE

                    COUNTRY WHEN THIS BILL IS IN LAW IT INCREASES HOSPICE.  IT INCREASES IT IN

                    AREAS THAT YOU'RE TALKING ABOUT WHERE THERE IS NO CURRENT HOSPICE, SO I

                    HAVE CONFIDENCE THAT THAT WILL BE THE SAME IN NEW YORK.

                                 MR. BLUMENCRANZ:  SO IF THIS LEGISLATION -- IF

                    THIS LEGISLATION PASSES THIS BILL, WHAT ASSURANCES DO YOU HAVE THAT WE

                    DON'T FURTHER DEPRIORITIZE ADDRESSING THE SYSTEMATIC PROBLEMS WITHIN

                    HOSPICE AND PALLIATIVE CARE INFRASTRUCTURE?  WE OFTEN DO THINGS TO

                    DISINCENTIVIZE CERTAIN HOSPICE AVENUES.  WHAT ARE WE DOING HERE

                    BESIDES JUST IN OTHER STATES WHERE THIS HAPPENS, THERE'S JUST MORE

                    HOSPICE CARE THAT --

                                 (CROSSTALK/INAUDIBLE)

                                 MS. PAULIN:  I THINK AS LEGISLATORS WE HAVE A

                    RESPONSIBILITY TO BRING UP -- WE'RE HEARING OUR CONSTITUENTS WANT

                    HOSPICE CARE AND CAN'T AVAIL THEMSELVES OF IT THAT, YOU KNOW, BECAUSE

                    OF A CERTAIN REASON OR INADEQUATE FUNDING OR A NEED FOR MORE

                    INFRASTRUCTURE, THEN IT'S UP TO US TO BRING THAT FORWARD AND COLLECTIVELY

                                         173



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WE WILL ADDRESS IT WHEN THE DEMAND IS THERE.  RIGHT NOW THE DEMAND IS

                    NOT THERE IN NEW YORK.  THIS WILL CREATE A DEMAND.

                                 MR. BLUMENCRANZ:  SO BUT HOW EFFECTIVE CAN

                    THE INFORMED CONSENT PROCESS BE AS DETAILED THROUGHOUT THE BILL WHEN

                    PATIENTS MAY NOT HAVE A CLEAR UNDERSTANDING OF WHAT TRUE

                    COMPREHENSIVE PALLIATIVE CARE CAN OFFER?  WE DON'T SEE WHAT THE DOH

                    IS GOING TO PROVIDE.  THERE'S NO RECORD TO SHOW THAT DOH HAS TO DO THIS

                    BEFORE.  THIS IS IMPLEMENTED IMMEDIATELY, SO IS THAT READY AND

                    AVAILABLE?  IS IT ALREADY UP ONLINE?

                                 MS. PAULIN:  WELL, WE ALSO REQUIRE FOR THE

                    ATTENDING PHYSICIAN TO PROVIDE THAT INFORMATION TO THEIR PATIENTS.  ONE

                    OF THE CRITICISMS THAT WE'VE HEARD FROM THE HOSPICE COMMUNITY IS THAT

                    THAT INFORMATION IS NOT PROVIDED.  THIS LAW REQUIRES THEM TO PROVIDE

                    THAT.  SO, IF SOMEBODY IS FACING TERMINAL ILLNESS AND THEY SAY OH, I WANT

                    TO TALK TO YOU ABOUT THE POSSIBLE PROVISION AT THE END OF THIS TERMINAL

                    ILLNESS WHEN I AM IN DIRE PAIN OF MEDICAL AID IN DYING, THEY WILL HEAR

                    ABOUT THOSE TREATMENT OPTIONS AS A RETIREMENT TO GET THE MEDICATION.

                    AND JUST HEARING ABOUT THOSE OPTIONS, THEY MAY CHOOSE TO AVAIL

                    THEMSELVES OF IT.  THEY CERTAINLY WILL IN MOST CASES TRY TO AVAIL

                    THEMSELVES OF THAT BEFORE THEY DECIDED TO TAKE MEDICATION LIKE THIS.

                                 MR. BLUMENCRANZ:  SO IN ESSENCE WHAT YOU'RE

                    SAYING IS ONLY WHEN THEY'RE AT THE DECISION-MAKING POINT WHERE

                    THEY'RE, DO I TAKE THE PILL OR DO I CONTINUE WITH CARE, WILL THEY BE

                    MANDATED TO HEAR THAT PALLIATIVE AND HOSPICE CARE IS AVAILABLE TO THEM.

                                 MS. PAULIN:  A DOCTOR CAN TELL THEM THAT AT ANY

                                         174



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    POINT IN THE -- IN THE PROCESS, CERTAINLY, BUT THIS REQUIRES THEM TO TELL

                    THEM ABOUT THAT IF THEY INQUIRE ABOUT MEDICAL AID IN DYING.  SO WE

                    HAVE -- WE HAVE NOT SEEN A REQUIREMENT OR THAT PROVISION OF

                    INFORMATION IN OUR LAW IN ANY OTHER PLACE EXPECT FOR THIS POTENTIAL

                    STATUTE.  SO I WOULD ARGUE THAT THIS IS A GOOD THING THAT WE ARE

                    REQUIRING INFORMATION ON PALLIATIVE CARE.

                                 MR. BLUMENCRANZ:  SO MUCH OF THE RESEARCH

                    AND ANALYTICS PROVIDED SURROUNDING THE UTILIZATION OF HOSPICE AND

                    PALLIATIVE CARE DOES SHOW THE DIVERSE BACKGROUND AND THE SCALE AND

                    SIZE OF THE AMOUNT OF PATIENTS WHO ARE IN GOVERNMENT-FUNDED

                    HEALTHCARE.  SO DOES THIS BILL ADEQUATELY ADDRESS THE POTENTIAL FOR

                    IMPLICIT BIAS WITHIN THE MEDICAL COMMUNITY WHICH WHEN COUPLED WITH

                    UNEQUAL ACCESS TO CARE COULD LEAD TO CERTAIN POPULATIONS BEING

                    DISPROPORTIONATELY ALL FOR OR CHOOSING MEDICAL AID IN DYING WITHOUT

                    BEING GIVEN THE FULL SCOPE THAT YOU'RE TALKING ABOUT HERE?

                                 MS. PAULIN:  SO WAIT.  I'M A LITTLE CONFUSED BY YOUR

                    QUESTION.

                                 MR. BLUMENCRANZ:  WILL -- WILL -- WILL -- IS

                    THERE A POTENTIAL FOR IMPLICIT BIAS WITHIN THE MEDICAL COMMUNITY

                    BECAUSE COUPLED WITH THE UNEQUAL ACCESS TO HEALTHCARE THAT WE HAVE IN

                    OUR STATE IN CERTAIN AREAS WITH COMPLETELY NO OPTION FOR AT-HOME

                    HOSPICE WHATSOEVER, IS THERE A DISPROPORTIONATE OFFERING HERE THAT MAY

                    LEAD TO GIVE MORE PEOPLE CHOOSING IT IN CERTAIN LOCATION BASED

                    DECISIONS VERSUS WHETHER THAT CARE IS PROVIDED OR NOT?  ARE THEY

                    WEIGHING THE SAME DECISIONS?  DECISIONS ARE NOT THE SAME DEPENDING

                                         175



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ON CARE OPTIONS AVAILABLE.

                                 MS. PAULIN:  SO THERE'S ALWAYS DISPARITY IN

                    HEALTHCARE UNFORTUNATELY.  YOU KNOW, I'M GOING TO SEE IT HERE.  WE'VE

                    SEEN IT AS THIS HAS GOTTEN IMPLEMENTED.  FOR EXAMPLE, WE KNOW THAT IF

                    YOU HAVE SOME COLLEGE AND/OR GREATER THAN THAT, YOU WILL MORE LIKELY

                    OPT FOR THIS.  WE KNOW THAT IF YOU'RE WHITE, YOU'RE GOING TO MORE LIKELY

                    OPT FOR THIS.  WE KNOW THAT, YOU KNOW, THAT IF YOU'RE -- SO IF YOU'RE

                    MORE EDUCATED AND YOU HAVE POTENTIALLY HIGHER WEALTH, YOU'RE GOING TO

                    OPT FOR THIS.  SO THERE'S ALWAYS DISPARITIES UNFORTUNATELY IN HEALTHCARE

                    AND WE HAVE TO ALWAYS WATCH FOR THEM.  THAT'S WHY WE -- YOU KNOW AS

                    ONE OF MY COLLEAGUES POINTED OUT THAT'S WHY WE ENSURE THAT PEOPLE

                    HAVE ACCESS TO INSURANCE HEALTH SO THAT THE DISPARITIES ARE LESS, BUT

                    THERE WILL BE DISPARITIES.  THERE'S NO QUESTION.  THEY EXIST EVERY DAY.

                                 MR. BLUMENCRANZ:  ALL RIGHT.  THANK YOU SO

                    MUCH.  THANK YOU.

                                 ACTING SPEAKER HUNTER:  COLLEAGUES, WE'RE

                    COMING TO ALMOST OUR CLOSE OF FOUR HOURS.

                                 MS. REYES, YOU'RE UP NEXT AND YOU'LL BE CLOSING THE

                    DEBATE.

                                 MS. REYES:  THANK YOU.

                                 ON THE BILL, MADAM SPEAKER.

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MS. REYES:  I WANTED TO ENTERED SOME THINGS INTO

                    THE RECORD.  I'VE HEARD SOME COMMENTS ABOUT -- I'VE HEARD THE TERM

                    PALLIATIVE CARE, PAIN MANAGEMENT, HOSPICE USED INTERCHANGEABLY AND

                                         176



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THEY ARE ABSOLUTELY NOT.  SOMEBODY WHO CHOOSES PALLIATIVE CARE IS NOT

                    SOMEBODY WHO IS TERMINAL.  IT IS SOMEBODY WHO HAS A CHRONIC

                    CONDITION THAT NEEDS PAIN MANAGEMENT WHO CAN LIVE FOR MANY, MANY

                    YEARS AND THAT YOU DO IN COMBINATION WITH SOME HOLISTIC TREATMENT AS

                    WELL; THERAPY, VISUALIZATION, AS WELL AS PAIN MANAGEMENT.

                                 HOSPICE IS RESERVED FOR PEOPLE WHO HAVE ABOUT SIX

                    MONTHS TO LIVE WHO WE HAVE COME TO THE DETERMINATION THAT THERE IS NO

                    LONGER ANYMORE TREATMENT THAT WE CAN PROVIDE FOR THIS PERSON AND WE

                    USUALLY SEND THEM HOME WITH HOSPICE CARE SO THAT THEY CAN BE

                    COMFORTABLE AT HOME FOR THE REMINDER OF THEIR DAYS.

                                 THE REALITY THAT WE SEE OFTENTIMES, THOUGH, IS THAT

                    PEOPLE IN HOSPICE CARE COME BACK AND COME BACK AND COME BACK TO

                    THE INPATIENT SETTING, BECAUSE EVEN WITH HOSPICE CARE, WE HAVE A VERY

                    DIFFICULT TIME MANAGING THEIR PAIN.  AND IT IS A VERY UNFORTUNATE

                    CIRCUMSTANCE.  AND I APPRECIATE ALL OF MY COLLEAGUES AND ALL OF THEIR

                    CONCERNS AND THEIR POINTS OF VIEW, BUT I WANTED TO SPEAK AS SOMEBODY

                    WHO MANY OF YOU KNOW I AM A NURSE, BUT I AM A INPATIENT ONCOLOGY

                    NURSE AND I HAVE BEEN TASKED WITH THE INCREDIBLE RESPONSIBILITY OF

                    CARING FOR PEOPLE IN THEIR END OF DAYS.  AND WHEN WE TELL PEOPLE THAT

                    THEY HAVE ABOUT SIX MONTHS TO LIVE, IT'S NOT SOMEBODY WHO CAN WITH

                    FURTHER TREATMENT MAYBE LONGER.  I WANTED TO PROVIDE A LITTLE COLOR TO

                    SOME OF THOSE ARGUMENTS, SOME OF THE CASES THAT I'VE PERSONALLY CARED

                    FOR.

                                 I'VE HAD WOMEN WITH BREAST CANCER WHO AFTER MULTIPLE

                    ROUNDS OF CHEMOTHERAPY COME IN WITH A FUNGATING BREAST WOUND WHERE

                                         177



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THEIR BREAST LITERALLY FALLS OFF.  AND THEY -- THAT WOUND AS THIS CONTINUES

                    TO METASTASIZE SPREADS FROM THE BREAST TO THEIR ARM, TO THEIR BACK THAT

                    WE HAVE TO DRESS TWICE A DAY.  AND TELL ME, PLEASE DON'T TOUCH ME

                    ANYMORE.  AND I CAN'T SAY TO THEM I WON'T TOUCH YOU.  I HAVE TO CARE FOR

                    YOUR WOUND BECAUSE IF I DON'T I'M BEING NEGLIGENT, AND WE'RE TRYING TO

                    PREVENT ANY FURTHER INFECTION.

                                 I HAVE CARED FOR PATIENTS; YOUNG MEN WHO WE SEE

                    OFTENTIMES WITH ESOPHAGEAL CANCERS, WHO HAVE HAD MULTIPLE RESECTIONS

                    OF THEIR TUMORS, AND THE STAFF CAN LITERALLY FIT THEIR FIST THROUGH THEIR

                    FACE INTO THEIR ORAL CAVITY.  THAT IS NOT SOMEBODY WHO MAY WANT TO LIVE

                    ANY LONGER.  AND WITH ALL THE TREATMENT AND INTERVENTIONS IN THE WORLD

                    THEY HAVE GIVEN UP.

                                 I HAVE CARED FOR WOMEN IN THEIR 90S WHO HAVE BEAT

                    CANCER TWO AND THREE TIMES OVER WHO SAY TO ME, I DON'T WANT TO GET

                    TREATED.  I DON'T WANT IT, AND THE PAIN IS UNBEARABLE AND WE DON'T JUST

                    GIVE MORPHINE, WE ADMINISTER COPIOUS AMOUNTS OF FENTANYL ON THE

                    FLOOR EVERY DAY.  BECAUSE MORPHINE DOES NOT TOUCH CANCER PAIN AND

                    ANY CANCER PATIENT WILL TELL YOU THAT.  WE SEND THEM HOME WITH

                    FENTANYL PATCHES THAT THEY ABSORB TRANSDERMALLY.  WE SEND THEM HOME

                    FOR THOSE PATIENTS WHO NO LONGER TAKE PILLS WITH LIQUID MORPHINE THIS

                    BIG (INDICATING) THAT THEY CAN INGEST ORALLY.  AND EVEN EACH WITH ALL OF

                    THAT OFTENTIMES WE MAKE CONCOCTIONS OF METHADONE, NOT PEOPLE WITH

                    SUBSTANCE ABUSE, BUT TO MANAGE THEIR PAIN; METHADONE, DILAUDID,

                    FENTANYL.  SO WHEN THE SPONSOR SAYS THAT OFTENTIMES YOU DON'T KNOW

                    WHAT THE CAUSE OF DEATH IS AND IT COULD BE THE MEDICATION THAT WE ARE

                                         178



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ADMINISTERING, IT IS VERY LIKELY THAT WE CONTRIBUTE TO PEOPLE'S SPEEDY

                    DEATH BECAUSE WE HAVE TO MANAGE THEIR PAIN.  BECAUSE TO LIVE IN

                    CONSTANT, AGONIZING PAIN IS JUST UNBEARABLE AND THERE IS NO QUALITY OF

                    LIFE.

                                 I HAVE HAD PATIENTS WHO HAVE TUMORS IN THEIR -- IN

                    THEIR ABDOMEN, IN THEIR COLON, IN THEIR INTESTINES THAT DON'T ALLOW THEM

                    TO EAT ANYMORE AND ARE LITERALLY STARVING TO DEATH.  AND BECAUSE THEIR

                    LABS ARE SO OUT OF WHACK, WE CAN'T EVEN GIVE THEM SOME CALORIES

                    PERENNIALLY THROUGH IV BECAUSE IT AFFECTS THEIR LIVER FUNCTION, THEIR

                    KIDNEY FUNCTION.  AND AT THAT POINT THERE'S LITERALLY NOTHING ELSE FOR US

                    TO DO.  I HAVE PATIENTS WHO ARE SO OBSTRUCTED BY THE TUMOR, THE FECAL

                    MATTER IS COMING OUT OF THEIR MOUTH AND IT'S INTRACTABLE VOMITING OF

                    FECES, AND ALL THEY WANT TO DO IS MAKE IT END.

                                 WE HAVE - AND I'M GOING TO BE CLEAR - EVERY PATIENT,

                    EVERY SINGLE PATIENT, 100 PERCENT OF THEM WANT TO LIVE.  THEY WANT TO

                    LIVE. NOBODY WANTS TO DIE.  THEY COME TO SEEK TREATMENT BECAUSE THEY

                    WANT US TO HELP THEM LIVE, BUT WE ARE LIMITED.  WE ARE HUMAN BEINGS.

                    WE ARE AN IMPERFECT PRACTICE WITH LIMITED SCIENCE, AND WE CAN'T

                    ALWAYS HELP PEOPLE.  AND I HAVE SEEN HOW THAT VERY TREATMENT CAN BE

                    SO DAMAGING.  YOU KNOW, I'VE HAD YOUNG WOMEN THAT COME IN WITH

                    OVARIAN CANCER DUE TO HPV THAT COULD'VE BEEN PREVENTED WITH A

                    VACCINE, BUT THAT'S NOT HERE NOR THERE, WHO IT'S SO ADVANCED, WE DO A

                    PROCEDURE CALLED A TOTAL PELVIC EXENTERATION WHERE YOU REMOVE

                    EVERYTHING IN THEIR ABDOMEN AND EVERYTHING OUTSIDE OF IT; RECTUM,

                    COLON, VAGINA, UTERUS, OVARIES, EVERYTHING.  YOU GIVE THEM A COLOSTOMY

                                         179



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    FOR STOOL.  YOU GIVE THEM ILEAL CONDUIT FOR URINE AND YOU STITCH THEM

                    UP.  AND THE WOMEN WHO CHOOSE THAT DON'T CHOOSE THAT BECAUSE THEY

                    WANT TO DIE, THEY CHOOSE THAT BECAUSE THEY WANT TO LIVE.  AND ALL WE

                    ARE DOING IS PROLONGING A DISEASE THAT IS JUST GOING TO COME BACK AND

                    KILL THEM ANYWAY.

                                 I HAVE LOOKED TOO MANY PATIENTS IN THE EYES WHO HAVE

                    BEGGED FOR ME TO END THEIR SUFFERING AND I HAVE NO ANSWER FOR THEM.

                    AND SO MANY, I THINK, PROFESSIONAL WHO CARE FOR PEOPLE WHO ARE DYING

                    HAVE SIMILAR STORIES.  AND THAT'S WHY I THINK SO MANY ORGANIZATIONS

                    WHO PROVIDE END-OF-LIFE CARE ARE IN SUPPORT OF THIS, BECAUSE WE KNOW

                    THE REALITY OF DEATH AND DYING.  IT IS A VIOLENT, UGLY, MESSY PROCESS THAT

                    IS NEVER THE SAME AND IT'S HARD FOR, I THINK, ANY LEGISLATOR, EVEN WITH A

                    CLINICAL BACKGROUND, TO PUT ALL THOSE CONDITIONS INTO LANGUAGE BECAUSE

                    EVERYTHING PATIENT IS DIFFERENT AND EVERY CIRCUMSTANCE IS DIFFERENT AND

                    EVERY FAMILY IS DIFFERENT, EVERY CHOICE IS DIFFERENT.  SO I THINK THAT

                    WE'VE DONE A REALLY GOOD JOB HERE TO PROVIDE THE NECESSARY GUARDRAILS

                    SO THAT PEOPLE HAVE A CHOICE, A CHOICE.  AND IF YOU DON'T BELIEVE IN IT,

                    THEN DON'T AVAIL YOURSELF OF THAT CHOICE.  BUT I THINK IT IS INHUMANE FOR

                    US TO TELL PEOPLE THAT WE HAVE TO -- WE ARE FORCING THEM TO CONTINUE

                    THEIR SUFFERING.  AND MANY PEOPLE CHOOSE TO END THEIR LIVES IN OTHER

                    WAYS AND WE CAN'T PREVENT THAT AND WE CAN NEVER LEGISLATE THAT.  THIS IS

                    JUST THE REALITY OF THE PEOPLE WHEN THEY COME TO THE END OF THEIR -- OF

                    THEIR ROPE.  AND I THINK IT'S DIGNIFIED TO -- TO BE ABLE TO CHOOSE THIS, TO

                    DO IT AT THE TIME WHEN YOU THINK IS RIGHT, TO BE ABLE TO HAVE THE

                    OPPORTUNITY TO SAY GOODBYE TO YOUR LOVED ONES, TO SAY ALL THE THINGS

                                         180



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THAT WERE LEFT UNSAID AND TO JUST GO IN PEACE.

                                 SO I COMMEND THE SPONSOR FOR THIS. FOR ME IT'S VERY

                    PERSONAL.  I LIVE IT EVERY DAY AND I WILL OF COURSE BE VOTING IN THE

                    AFFIRMATIVE AND, YOU KNOW, I PLEAD TO MY COLLEAGUES, EVEN THOSE WHO

                    MAY NOT SUPPORT THIS OR WHO ARE ON THE FENCE, TO RECONSIDER THAT,

                    BECAUSE THE REALITY IS THAT THERE ARE THINGS WE'RE NOT GOING TO BE ABLE TO

                    CONTROL.  PERSONAL CHOICE IS ONE OF THOSE, BUT WE HAVE A RESPONSIBILITY

                    TO GIVE PEOPLE CHOICES.  AND I THINK THAT'S WHAT WE'RE DOING HERE

                    TODAY.

                                 THANK YOU.

                                 (APPLAUSE)

                                 ACTING SPEAKER HUNTER:  MS. FORREST, WE

                    HAVE FIVE MINUTES REMAINING LEFT.  YOU HAVE FIVE MINUTES.

                                 MS. FORREST:  I WANT TO -- THANK YOU, MADAM

                    SPEAKER, FOR LETTING ME SPEAK ON THE BILL.

                                 ACTING SPEAKER HUNTER:  ON THE BILL.

                                 MS. FORREST:  I WANT TO THANK THE SPONSOR FOR HER

                    COURAGE TO BRING UP THIS VERY IMPORTANT ISSUE.  THIS ISSUE AROUND

                    COMPASSION AND CHOICE.  I WANT TO ALSO THANK MY OTHER NURSE COLLEAGUE

                    FOR HER CLINICAL PICTURE OF WHAT IT IS LIKE TO BE BOTH AT THE BEGINNING

                    AND AT THE END OF LIFE AND I HAVE BEEN THERE.  I HAVE BEEN THERE WHEN

                    YOU HAVE THE LITTLEST HAND IS BORN, BABY COMES OUT AND I'VE BEEN THERE

                    IN ICU WHEN I'M TAKING -- HELPING A PATIENT COME OFF THE VENT.  BUT I

                    ALSO WANT TO TALK ABOUT THE REASON WHY I'M A SPONSOR OF THIS BILL.  THE

                    REASON WHY IS BECAUSE I GOT TO HOLD MY DAD'S HAND.  MY DAD DIED OF

                                         181



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    PNEUMONIA.  WHEN HE HAD PNEUMONIA HE WAS BRAIN DEAD.  BUT BEFORE

                    EVEN BEING BRAIN DEAD, MY DAD'S BATTLE WITH END STAGE RENAL DISEASE --

                    AND MY DAD CHOSE HIS LIFE AND HIS END, HE WAS A GREAT MAN.  HE CHOSE

                    HIS BURIAL PLOT.  HE CHOSE TO BE DO NOT RESUSCITATE.  HE CHOSE THE

                    SONGS AT HIS WAKE AND HE CHOSE TO LOVE US TO THE VERY END, AND MY

                    FAMILY ARE GRATEFUL FOR HIS CHOICES AND WE SUPPORTED HIM IN HIS CHOICE

                    BECAUSE WE LOVED HIM AND WE STILL HONOR HIS CHOICES TODAY.

                                 LET'S BE CLEAR.  AS A NURSE, I TELL YOU THAT THIS BILL IS A

                    COMPASSIONATE BILL.  IT IS A BILL THAT IS AROUND CARING.  I CANNOT GO

                    AGAINST MY CODE OF ETHICS WHICH SAYS DO NO HARM.  BUT AS MY OTHER

                    NURSE COLLEAGUE HAD SAID, WHEN THERE IS NOTHING ELSE TO DO, WHEN THE

                    PERSON HAS NO OTHER HOPE, AND TRUST ME, MY COLLEAGUE, I HEAR YOU WHEN

                    YOU SAY HOPE KEEPS YOU GETTING UP IN THE MORNING, BUT THERE IS NO HOPE

                    WHEN FENTANYL IS YOUR ONLY CHOICE.  THE CHOICE THEN IS HOW DO I DO IT

                    WITH DIGNITY?  HOW DO I DO IT WITH MY NAME AND MY SPIRIT INTACT,

                    BECAUSE THAT'S THE ENEMY OF DEATH, LACK OF DIGNITY.  I'M NOT HERE TO

                    CONVINCE YOU, I'M CONVINCED, BUT I'M TELLING YOU FOR ALL OF MY

                    COLLEAGUES HERE, I PRAY, I PRAY THAT YOU HAVE COMPASSION, LOVE IN YOUR

                    LIFE.  AND I PRAY FOR COMPASSION AND LOVE FOR YOUR FAMILY, YOUR

                    NEIGHBORS, BUT AS A LEGISLATOR TODAY, I AM CHOOSING TO MAKE SURE THAT

                    THE SAME RIGHTS THAT YOU HAVE IN YOUR CHOICES, THAT EVERYONE GETS THAT

                    SAME CHOICE AS WELL, THAT THEY GET TO DO IT IN THE WAY THAT IT FITS THEM

                    BEST.

                                 THIS BILL GOES NOTHING AGAINST MY CHRISTIAN IDENTITY.

                    THIS GOES NOTHING AGAINST MY BLACK IDENTITY.  TRUST ME, MY

                                         182



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    COMMUNITY WILL BE FINE WHEN HEALTHCARE IS EXCESSED [SIC], WHEN THERE

                    ARE DISPARITIES MET, THAT'S WHAT YOU NEED TO DO, AND WE CAN DO THAT

                    TOGETHER, BUT RIGHT NOW WE'RE GIVEN THE CHOICE, THE CHOICE, THE

                    COMPASSION, THE CARE, THE LOVE THAT EVERY NEW YORKER NEEDS.

                                 THANK YOU SO MUCH, MADAM SPEAKER, FOR ALLOWING

                    ME TO SPEAK.

                                 (APPLAUSE)

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 READ THE LAST SECTION.

                                 THE CLERK:  THIS ACT SHALL TAKE IMMEDIATELY.

                                 ACTING SPEAKER HUNTER:  A SLOW ROLL CALL HAS

                    BEEN REQUESTED.

                                 THE CLERK WILL RECORD THE VOTE.

                                 (THE CLERK RECORDED THE VOTE.)

                                 IF YOU'RE NOT IN THE CHAMBER YOU NEED TO MAKE YOUR

                    WAY TO THE CHAMBER TO PHYSICALLY VOTE.

                                 MS. LUCAS TO EXPLAIN HER VOTE.

                                 MS. LUCAS:  THANK YOU, MADAM SPEAKER AND THANK

                    YOU TO THE SPONSOR FOR A SPIRITED AND THOROUGH DEBATE ON THIS TOPIC.

                                 I DO NOT HAVE THE TIME THAT I THOUGHT I WOULD HAVE TO

                    SPEAK ON THE BILL IN THE WAY THAT I WANT TO SPEAK ON THE BILL, BUT I AM

                    RISING TODAY NOT IN OPPOSITION, THE CHOICE.  I RISE IN DEFENSE OF EQUITY.

                    I RISE IN DEFENSE OF DIGNITY.  AND I RISE IN DEFENSE OF MY CONSTITUENTS

                    FROM THE 60TH ASSEMBLY DISTRICT, SOME OF WHO ARE THE MOST VULNERABLE

                    NEW YORKERS WHOSE VOICES, WHOSE FEARS, WHOSE LIVES ARE AT TIMES

                                         183



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    IGNORED IN LEGISLATIVE DEBATES SUCH AS THIS ONE.

                                 I WANT TO BEGIN BY ACKNOWLEDGING THAT I AM PROUDLY

                    PRO-CHOICE.  I BELIEVE DEEPLY IN AUTONOMY AND COMPASSION AND IN

                    GIVING PEOPLE THE ABILITY TO MAKE DECISIONS ABOUT THEIR OWN LIVES AND

                    BODIES.  BUT CHOICE, REAL CHOICE MUST BE MEANINGFUL, IT MUST BE

                    GROUNDED, NOT IN DESPERATION, NOT IN DESPAIR, NOT IN THE LACK OF OPTIONS

                    BUT IN HOPE AND DIGNITY AND SUPPORT.  AND I ASK, HOW CAN WE CALL THIS

                    CHOICE WHEN SO MANY OF OUR COMMUNITIES, COMMUNITIES LIKE MY OWN

                    HAVE BEEN DENIED THE VERY THINGS THAT WOULD MAKE A DIFFERENT CHOICE

                    POSSIBLE?  IN NEW YORK TODAY IN THE VERY NEIGHBORHOODS I REPRESENT,

                    END-OF-LIFE CARE IS NOT EQUALLY ACCESSIBLE.  PALLIATIVE CARE IS PATCHY.

                    HOSPICE IS TOO OFTEN UNAFFORDABLE, CULTURALLY INACCESSIBLE.  PAIN

                    MANAGEMENT, MENTAL HEALTH SUPPORT, HOME CARE, THESE ARE LUXURIES, NOT

                    GUARANTEES.  IF YOU ARE BLACK, HISPANIC, LOW INCOME, THE LIKELIHOOD IS

                    HIGHER THAT YOU WILL EXPERIENCE YOUR LAST DAYS NOT WITH COMFORT, BUT

                    WITH SUFFERING, FEAR AND ISOLATION.  IT IS THESE STRUCTURAL INEQUALITIES THAT

                    CONCERN ME, BECAUSE WHEN A SYSTEM HAS FAILED TO PROVIDE QUALITY OF

                    LIFE, IT CANNOT SUDDENLY BE TRUSTED --

                                 ACTING SPEAKER HUNTER:  THANK YOU, MS.

                    LUCAS.  HOW DO YOU VOTE?

                                 MS. LUCAS:  I OPPOSE THIS BILL.  I --

                                 ACTING SPEAKER HUNTER:  MS. LUCAS IN THE

                    NEGATIVE.

                                 MR. ARI BROWN TO EXPLAIN HIS VOTE.

                                 MR. A. BROWN:  THANK YOU, MADAM SPEAKER.

                                         184



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 IF I HAD THE OPPORTUNITY TO DEBATE THE BILL I WOULD'VE

                    ASKED OR CLARIFIED SOMETHING ABOUT THE ADMINISTRATION OF THE DRUG.

                    FROM WHAT I UNDERSTAND THAT IT HAS TO BE SELF-ADMINISTRATED.  NO ONE

                    CAN PUT THE DRUG IN THE PERSON'S MOUTH OR PRESS A BUTTON FOR THEM.  I

                    THEN WOULD'VE ASKED ABOUT DISCRIMINATION.  WOULD THERE BE ANY

                    PARTICULAR CLASS OF PERSON WHO WOULD BE DISCRIMINATED FROM GETTING

                    THIS AND THE ANSWER I'M SURE WOULD'VE BEEN NO. AND I WOULD THEN HAVE

                    PROCEEDED WITH ASKING IF THE SPONSOR WAS FAMILIAR WITH THE AMERICANS

                    WITH DISABILITIES ACT.  AND THEREIN LIES THE PROBLEM, BECAUSE WHETHER

                    IT'S NOW, A YEAR FROM NOW OR TWO YEARS FROM NOW WHEN WE WOULD HAVE

                    THIS DISCUSSION IN COURT, IF THAT SOMEONE WHO'S MENTALLY COMPETENT BUT

                    TOTALLY INABLE -- UNABLE TO MOVE THEIR ARMS OR LEGS BECAUSE THEY'RE A

                    PARAPLEGIC WHY WOULD THEY BE DENIED THE ABILITY TO END THEIR LIVES

                    SPECIFICALLY WHEN THERE'S SUPPOSED TO BE SPECIAL ACCOMMODATIONS IN

                    THE AMERICAN DISABILITIES ACT FOR THOSE TYPES OF PEOPLE.  AND THAT'S

                    WHERE THE PROBLEM IS AND THAT'S EXACTLY WHERE CANADA STARTED.

                    CANADA'S EXPERIENCE SHOWS US THAT THE SO-CALLED MEDICAL AID IN DYING

                    QUICKLY EXPANDED FROM TERMINAL ILLNESS TO CHRONIC CONDITIONS AND EVEN

                    MENTAL ILLNESS, ANOREXIA AND ARTHRITIS.  THAT'S ABOUT TO HAPPEN AT ANY

                    MOMENT.

                                 COLLEAGUES, LOOK TO CANADA.  REMEMBER WE HAD THE

                    SAME CIRCUMSTANCE.  IF YOU LIKE YOUR DOCTOR, KEEP YOUR DOCTOR.  YOUR

                    MEDICAL BILL IS ONLY GOING TO GO DOWN 2,500.  I'M A LITTLE BIT OLDER THAN

                    EVERYBODY.  THALIDOMIDE, SUPPOSED TO BE A MAGIC THING SO PREGNANT

                    WOMEN WOULDN'T BE NAUSEOUS DURING PREGNANCIES.  WE KNOW HOW THAT

                                         185



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WENT.

                                 IN CANADA, THE SO-CALLED MEDICAL AID IN DYING

                    EXPANDED IN JUST A FEW SHORT YEARS FROM THE TERMINALLY-ILL TO THOSE WITH

                    ARTHRITIS LIKE I SAID, DEPRESSION, EVEN ANOREXIA.  IF WE OPEN UP THIS DOOR

                    THERE'S NO TURNING BACK.

                                 YOU KNOW, I LIKED IT A COUPLE WEEKS AGO WHEN THE

                    MAJORITY LEADER AND I WORE THE DONATE TO LIFE PIN.  I HATE TO SEE THE

                    PULL THE PLUG ON LIFE PIN COME OUT ON THE REST OF US.

                                 THANK YOU, MADAM SPEAKER.

                                 ACTING SPEAKER HUNTER:  HOW DO YOU VOTE?

                                 MR. A. BROWN:  I VOTE NO.

                                 ACTING SPEAKER HUNTER:  MR. BROWN IN THE

                    NEGATIVE.

                                 MR. LAVINE TO EXPLAIN HIS VOTE.

                                 MR. LAVINE:  FOR MUCH A HUMAN HISTORY, YOU AND I,

                    INDIVIDUALS WERE OWNED BY EMPERORS, CZARS, KINGS AND MASTERS.  THAT

                    BEGAN TO CHANGE WITH THE HUMANIST MOVEMENT WHICH LED TO THE

                    RENAISSANCE WHICH LED TO THE ENLIGHTENMENT AND THE RESULT OF THE

                    ENLIGHTENMENT WAS THAT WE BELIEVE WE HAVE NATURAL RIGHTS.  WE HAVE

                    HUMAN RIGHTS.  THAT BELIEF LED TO THE AMERICAN REVOLUTION AND LED TO

                    US HAVING THE BASIC AMERICAN PHILOSOPHY THAT WE'RE ENTITLED TO LIFE,

                    LIBERTY AND THE PURSUIT OF HAPPINESS, BUT WHAT HAPPENS IF LIFE IS NOT

                    GOING TO CONTINUE?  WHAT HAPPENS IF LIBERTY IS NOT GOING TO CONTINUE?

                    WHAT HAPPENS IF THERE WILL NO LONGER BE HAPPINESS?  MY FRIENDS, PAIN

                    IS THE WINDOW INTO HELL.

                                         186



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 WE HAVE THE RIGHT TO DETERMINE OUR FUTURES.  I FULLY

                    SUPPORT THIS BILL.  THE STATE DOES NOT OWN YOU.  THE STATE DOES NOT OWN

                    ME.  WE OWN OURSELVES.  WE HAVE OUR OWN BODILY AUTONOMY.  I

                    COMMEND THE SPONSOR FOR HER LONG FIGHT TO ACCOMPLISH THIS NOBLE GOAL,

                    HUMANE GOAL.  AND I SIMPLY SAY I AM VOTING IN THE AFFIRMATIVE.  THAT IS

                    THE AMERICAN WAY.  THANK YOU.

                                 ACTING SPEAKER HUNTER:  MR. LAVINE IN THE

                    FIRM.

                                 MR. MORINELLO TO EXPLAIN THIS VOTE.

                                 MR. MORINELLO:  IT WON'T GO ON.  OH!  THERE IT IS.

                    THANK YOU.

                                 TO EXPLAIN MY VOTE, I'M GOING TO READ A STATEMENT

                    FROM VICTORIA REGGIE KENNEDY, SENATOR TED KENNEDY'S WINDOW --

                    WIDOW ON THE DEATH WITH DIGNITY INITIATIVE.

                                 THERE IS NOTHING MORE PERSONAL OR PRIVATE THAN THE

                    END OF A FAMILY MEMBER’S LIFE, AND I TOTALLY RESPECT THE VIEW THAT

                    EVERYONE ELSE SHOULD JUST GET OUT OF THE WAY.  I WISH WE COULD LEAVE IT

                    THAT WAY.  UNFORTUNATELY, THE SO-CALLED “DEATH WITH DIGNITY” INITIATIVE,

                    FORCES THAT ISSUE INTO THE PUBLIC SQUARE AND PLACES THE GOVERNMENT

                    SQUARELY IN THE MIDDLE OF A PRIVATE FAMILY MATTER.  I DO NOT JUDGE NOR

                    INTEND TO PREACH TO OTHERS ABOUT DECISIONS THEY MAKE AT THE END OF LIFE,

                    BUT I BELIEVE WE’RE ALL ENTITLED TO KNOW THE FACTS ABOUT THE LAW WE’RE

                    BEING ASKED TO ENACT.



                    HERE’S THE TRUTH.  THE LANGUAGE OF THE PROPOSED LAW IS NOT ABOUT

                                         187



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    BRINGING FAMILY TOGETHER TO MAKE END OF LIFE DECISIONS; IT’S INTENDED TO

                    EXCLUDE FAMILY MEMBERS FROM THE ACTUAL DECISION-MAKING PROCESS TO

                    GUARD AGAINST PATIENTS’ BEING PRESSURED TO END THEIR LIVES PREMATURELY.

                    IT’S NOT ABOUT DOCTORS ADMINISTERING DRUGS SUCH AS MORPHINE TO EASE

                    PATIENTS’ SUFFERING; IT’S ABOUT THE ORAL INGESTION OF UP TO 100 CAPSULES

                    WITHOUT THE REQUIREMENT OR EXPECTATION THAT A DOCTOR BE PRESENT.  IT’S

                    NOT ABOUT GIVING CHOICE AND SELF-DETERMINATION TO PATIENTS WITH

                    DEGENERATIVE DISEASES LIKE ALS OR ALZHEIMER’S; THOSE PATIENTS ARE

                    UNLIKELY TO QUALIFY.

                                 MY LATE HUSBAND, SENATOR EDWARD KENNEDY, CALLED

                    QUALITY AFFORDABLE HEALTHCARE THE MOST IMPORTANT CAUSE OF HIS LIFE.  IT

                    TURNS HIS VISION OF HEALTH CARE FOR ALL ON ITS HEAD BY ASKING US TO

                    ENDORSE PATIENT SUICIDE, NOT PATIENT CARE.  AS OUR PUBLIC POLICY FOR

                    DEALING WITH PAIN AND THE FINANCIAL BURDENS OF CARE AT THE END OF LIFE

                    WERE BETTER THAN THAT.  WE SHOULD EXPAND PALLIATIVE CARE, PAIN

                    MANAGEMENT, NURSING HOME AND HOSPICE CARE.  HE WAS GIVEN SIX

                    MONTHS OR LESS TO LIVE, BUT EVEN DOCTORS ADMIT IT'S UNKNOWABLE.  BEING

                    THAT PROGNOSIS WAS WRONG, TEDDY LIVED FIFTEEN MORE --

                                 ACTING SPEAKER HUNTER:  THANK YOU, MR.

                    MORINELLO.  HOW DO YOU VOTE?

                                 MR. MORINELLO:  IN THE NEGATIVE.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MR. MORINELLO IN THE NEGATIVE.

                                 MR. STECK TO EXPLAIN HIS VOTE.

                                 MR. STECK:  THANK YOU VERY MUCH, MADAM

                                         188



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    SPEAKER.  I HAVE SUPPORTED THIS BILL FROM DAY ONE.  IT IS SIMPLY

                    COMMON SENSE.  THERE ARE MANY ILLNESSES THAT CAUSE UNTOLD SUFFERING

                    FOR THE PATIENT; RELIEF IS AN IMPORTANT PART OF THE PRACTICE OF MEDICINE.

                    MANY OF THE OBJECTIONS TO THIS LEGISLATION HAVE THEIR ORIGIN IN RELIGION,

                    BUT WE HAVE FREEDOM OF RELIGION IN THIS NATION.  IF YOUR RELIGION DOES

                    NOT PERMIT UTILIZING THIS LEGISLATION, YOU CERTAINLY DO NOT HAVE TO AVAIL

                    YOURSELF OF HIS OPTION.  BUT IF YOUR RELIGIOUS BELIEF OR NON-BELIEF DOES

                    NOT PROHIBIT TAKING THIS ACTION, YOU SHOULD HAVE THE FREEDOM TO

                    PROCEED IN ACCORDANCE WITH YOUR WISHES AND YOUR CONSCIENCE

                    REGARDLESS OF ANOTHER PERSON'S RELIGIOUS OBJECTION.

                                 I VOTE IN THE AFFIRMATIVE.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MR. STECK IN THE AFFIRMATIVE.

                                 MS. LUNSFORD TO EXPLAIN HER VOTE.

                                 MS. LUNSFORD:  THANK YOU VERY MUCH, MADAM

                    SPEAKER.  I RISE TODAY AS THE DAUGHTER OF A VERY PROUD WHO SPENT THE

                    LAST TWO MONTHS OF HIS LIFE IN THE ICU AND THEN IN HOSPICE SUFFERING

                    INDIGNITIES THAT I WON'T SHARE WITH YOU BECAUSE IT WOULD BE

                    EMBARRASSING TO HIM.  AND I KNOW THAT THAT IS NOT THE WAY THAT HE

                    WANTS ME TO REMEMBER HIM.  I KNOW HE DID NOT WANT TO PUT ME IN A

                    POSITION TO MAKE THE DECISION ABOUT WHETHER OR NOT HE STOPPED

                    BREATHING, BUT THAT WAS THE POSITION I LEFT WITH.  I ALSO STAND HERE AS AN

                    ATTORNEY WHO HANDLED PERSONAL INJURY, WORKERS' COMPENSATION AND

                    SOCIAL SECURITY DISABILITY CASES INVOLVING PEOPLE AT THE END OF LIFE,

                    AND I'VE SEEN THEM DIE SURROUNDED BY FRIENDS AND FAMILY.  I'VE SEEM

                                         189



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THEM DIE ALONE.  I'VE SEEN THEM DIE SUDDENLY AND OVER PROLONGED

                    PERIODS OF TIME.  AND I'VE SEEN THEM MAKE DECISIONS REGARDLESS OF

                    WHAT OUR LAW WAS TO DIE ON THEIR OWN TERMS LEAVING THEIR FAMILIES

                    WITHOUT BENEFITS, WITHOUT LEGAL OPTIONS THAT THEY WOULD'VE OTHERWISE

                    HAD IF THEY HAD NOT MADE THAT CHOICE.

                                 BUT MOST IMPORTANTLY I STAND HERE TODAY AS A

                    LEGISLATOR THAT REPRESENTS THE 135TH DISTRICT, A DISTRICT THAT

                    OVERWHELMINGLY SUPPORTS THIS BILL.  SINCE THE DAY I TOOK OFFICE I HAVE

                    HEARD ABOUT THIS BILL MORE THAN ANY OTHER.  WHENEVER I SPEAK TO A

                    GROUP, SOMEBODY ASKS ME ABOUT THIS BILL AND PEOPLE HAVE BEEN

                    BEGGING ME TO PASS IT SINCE I TOOK OFFICE.  IT IS WITH AN INCREDIBLE

                    AMOUNT OF PRIDE AND RESPECT FOR THE DIGNITY OF EVERYONE IN THIS STATE

                    THAT I VOTE IN THE AFFIRMATIVE TODAY AND I COMMEND THE SPONSOR FOR HER

                    TENACITY IN HELPING BRING THIS OPTION TO EVERYONE IN THIS STATE.

                                 THANK YOU.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MS. LUNSFORD IN THE AFFIRMATIVE.

                                 ACTING SPEAKER HUNTER:  MR. BLUMENCRANZ TO

                    EXPLAIN HIS VOTE.

                                 MR. BLUMENCRANZ:  THANK YOU, MADAM

                    SPEAKER.

                                 TODAY I RISE TO ASK THE SAME QUESTION I ASKED AT THE

                    START OF THIS DEBATE MANY YEARS AGO.  WHAT ARE THE BIOETHICAL GUIDELINES

                    THAT DOCTORS OFTEN ASK; AUTONOMY, BENEFICENCE, NON-MALEFICENCE AND

                    JUSTICE.  THIS IS THE GUIDELINE I'VE USED AS I'VE DEBATED THIS BILL MYSELF.

                                         190



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THIS IS NOT AN INDICTMENT TO THIS BILL, BUT OUR STATE AND THIS BODY'S

                    CALLOUS IGNORANCE AND MISUNDERSTANDING OF HOW WE ARE A PART OF THE

                    PROBLEM WHEN IT COMES TO PALLIATIVE AND END-OF-LIFE AND HOSPICE CARE.

                    WE CONTINUE TO SIT DEAD LAST AT THE BOTTOM OF THE LIST, 51ST FOR

                    UTILIZATION.  AUTONOMY IS ILLUSIONARY WITHOUT THE ACCESS TO

                    COMPREHENSIVE OPTIONS FOR INDIVIDUALS FOR HOSPICE AND PALLIATIVE.  THE

                    BENEFICENCE AND NON-MALEFICENCE DEMAND THAT WE PRIORITIZE CARE FIRST,

                    NOT DEATH, IN OUR RESPONSES TO CREATING THESE OPTIONS, AND JUSTICE

                    REQUIRES EQUITABLE ACCESS TO ALL FORMS OF CARE, NOT JUST OPTIONS THAT

                    HASTEN DEATH WHICH DISPROPORTIONATELY AFFECTS VULNERABLE POPULATIONS.

                    WE MUST BE MORE COGNIZANT OF HOW WE CAN CREATE A FULL SOLUTION FOR

                    PEOPLE AT THE END OF LIFE.  WE'RE NEVER GONNA END SUFFERING, EVEN WITH

                    A BILL LIKE THIS.  WE NEED TO CREATE A SOLUTION THAT PROVIDES OPTIONS FOR

                    ALL NEW YORKERS.

                                 I VOTE NO AND I HOPE THAT WE LOOK FORWARD TO SEEING

                    MORE OPTIONS FOR END-OF-LIFE CARE.  THANK YOU.

                                 ACTING SPEAKER HUNTER:  MR. BLUMENCRANZ IN

                    THE NEGATIVE.

                                 MR. LASHER TO EXPLAIN HIS VOTE.

                                 MR. LASHER:  THANK YOU, MADAM SPEAKER.  THANK

                    YOU TO THE SPONSOR FOR HER INCREDIBLE DILIGENCE AND CHAMPIONSHIP OF

                    THIS ISSUE AND SUCH A CAREFULLY CRAFTED BILL.  AND TO ALL OF MY

                    COLLEAGUES ON BOTH SIDES OF THE ISSUE, BOTH SIDES OF THE AISLE, I'VE BEEN

                    ENRICHED BY THE CONVERSATION TODAY.  I WILL CONFESS I'VE BEEN A SPONSOR

                    IN SUPPORT OF THIS BILL FOR MANY MONTHS AND YET AS THIS DAY CAME, I

                                         191



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    HAVE WRESTLED WITH THIS BILL.  I HAVE WRESTLED WITH THE EXPERIENCE IN

                    CANADA, WHICH I DO ENCOURAGE EVERYONE TO READ ABOUT.  IT IS A HORROR

                    SHOW.  AND I HAVE WRESTLED WITH THE TENSION BETWEEN WANTING TO

                    RELIEVE SUFFERING AND NOT SENDING A MESSAGE THAT WE TAKE OUR LIVES FOR

                    GRANTED.

                                 THE CHALLENGE, I THINK, WITH THIS BILL AT THE END OF THE

                    DAY IS JUST HOW CAREFULLY CRAFTED IT IS.  IT IS NOT A CANADIAN APPROACH TO

                    MEDICAL AID IN DYING.  IT IS A CAREFULLY SAFEGUARDED, GUARDRAILED

                    APPROACH.  THE CHALLENGE WITH THAT IS THAT IT INEVITABLY, IN MAKING

                    THOSE GUARDRAILS, MAKES SOME ARBITRARY LINES.  AND I DO THINK WE WILL

                    BE BACK HERE.  WE'LL BE BACK HERE BECAUSE THE COURTS TELL US TO BE BACK

                    HERE.  WE WILL BE BACK HERE BECAUSE THE POLITICS PUTS US BACK HERE.

                    AND I AM VOTING AYE ON THIS BILL BECAUSE I THINK IT RELIEVES SUFFERING IN

                    THE MOST EXTREME CASES AND IT'S BEEN CAREFULLY WRITTEN TO DO THAT.  BUT I

                    DON'T KNOW THAT I WILL BE AYE THE NEXT TIME WE ARE HERE TALKING ABOUT

                    EXPANDING IT.

                                 SO I THANK THE SPONSOR FOR HER CARE AND COMPASSION

                    AND INTELLIGENCE AND THOUGHTFULNESS IN HANDLING THIS DIFFICULT ISSUE.  I

                    VOTE IN THE AFFIRMATIVE.  THANK YOU.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MR. LASHER IN THE AFFIRMATIVE.

                                 MR. HEVESI TO EXPLAIN HIS VOTE.

                                 MR. HEVESI:  THANK YOU, MADAM SPEAKER.  THANK

                    YOU, MY COLLEAGUES.  JUST A COUPLE OF QUICK OBSERVATIONS.

                                 NUMBER ONE, I'M REALLY PROUD TO BE A MEMBER OF THIS

                                         192



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    HOUSE TODAY.  THE WAY --

                                 (APPLAUSE)

                                 -- YEAH.  YEAH.  WE CAN GIVE A ROUND OF APPLAUSE FOR

                    THAT IF YOU WANT.

                                 (APPLAUSE)

                                 THE LEVEL OF RESPECT AND DIGNITY ON THIS VERY DIFFICULT

                    TOPIC IS SOMETHING WE SHOULD ALL BE COMMENDED FOR.

                                 NUMBER TWO, FOR ALL THE NEW MEMBERS, IF YOU WANT TO

                    SEE WHAT PERSEVERANCE AND STRENGTH AND WHAT BEING A GREAT LEGISLATOR IS

                    LIKE, AMY PAULIN ON THIS ONE, BEEN WATCHING THIS FOR YEARS, YOU ARE TO

                    BE COMMENDED.

                                 (APPLAUSE)

                                 THANK YOU FOR THE CLAPPING.  YOU'RE MAKING ME FEEL

                    GUILTY ABOUT MY LAST POINT WHICH IS A LITTLE BIT SELFISH.  HERE -- HERE'S

                    MY LAST SELFISH POINT.

                                 THIS ONE'S FOR MY OLD MAN, AND LET ME TELL YOU WHY.

                    IN THE 1970S MY FATHER WAS A MEMBER OF THIS HOUSE AND HE WROTE THE

                    FIRST HOSPICE LAW IN THE UNITED STATES THAT BROUGHT HOSPICE TO NEW

                    YORK STATE, AND IT'S WITH THAT SAME LEVEL OF CARE AND DIGNITY AND

                    COMPASSION THAT I VOTE AYE TODAY.  I'M HONORED AND PROUD TO DO IT.

                                 THANK YOU FOR ALLOWING ME TO SPEAK TODAY.

                                 (APPLAUSE)

                                 ACTING SPEAKER HUNTER:  MR. HEVESI IN THE

                    AFFIRMATIVE.

                                 MS. SOLAGES TO EXPLAIN HER VOTE.

                                         193



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MS. SOLAGES:  THANK YOU, MADAM SPEAKER.  YOU

                    KNOW, I DON'T TAKE THIS DECISION LIGHTLY TODAY.  FREQUENTLY WHEN I HAVE

                    BILLS LIKE THIS I ALWAYS GO TO MY BEST SOURCE, WHICH IS MY MOTHER, AND

                    SHE TALKED ABOUT HOW HER SISTER-IN-LAW SUFFERED WHEN SHE DIED, BUT

                    THEN SHE ALSO TALKED ABOUT THE MORAL OBLIGATION AS LEGISLATORS THAT WE

                    HAVE.

                                 I AM VOTING NO TODAY BECAUSE WE DO LIVE IN A PLACE

                    WHERE OUR HEALTHCARE SYSTEM IS A BUSINESS.  IT'S NOT ABOUT A RIGHT, IT'S

                    ABOUT IF YOU HAVE MONEY.  AND ACCESS TO CARE, INCLUDING PALLIATIVE CARE

                    AND HOSPICE CARE, IS DEEPLY UNEQUAL.  IN A SYSTEM WHERE PEOPLE ARE

                    ROUTINELY DENIED TREATMENT BECAUSE OF THEIR INCOME OR INSURANCE OR

                    EVEN THEIR ZIP CODE, HOW CAN WE IN CONFIDENCE SAY THAT WE ARE

                    SUPPORTING THIS?  POVERTY, DISCRIMINATION, A LACK OF SUPPORT - THESE ARE

                    CONDITIONS NOT OF FREE SUPPORT BUT OF A SYSTEM THAT IS UNEQUAL, A

                    SOCIETAL SYSTEM.

                                 AND SO FOR THIS REASON, BECAUSE OF THIS BROKEN

                    HEALTHCARE SYSTEM THAT WE HAVE, BECAUSE OF THE SYSTEMIC INEQUALITIES,

                    BECAUSE OF OUR COMMITMENT TO PROTECT THE MOST VULNERABLE, I MUST

                    RESPECTFULLY AND FIRMLY VOTE NO.

                                 ACTING SPEAKER HUNTER:  MS. SOLAGES IN THE

                    NEGATIVE.

                                 (APPLAUSE)

                                 MS. SEPTIMO TO EXPLAIN HER VOTE.

                                 MS. SEPTIMO:  I AM EXTRAORDINARILY PROUD TO BE A

                    MEMBER OF THE ASSEMBLY TODAY AS WE VOTE TO ADVANCE THIS CRITICAL

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                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    LEGISLATION, AND I WANT TO COMMEND THE SPONSOR AND THE SPEAKER FOR

                    CHAMPIONING THIS ISSUE AND ALLOWING ALL OF US THE SPACE TO FIND THE

                    MORAL CLARITY AND BRAVERY THAT IS NEEDED TO ADVANCE A BILL LIKE THIS.

                                 WE HAVE A RESPONSIBILITY AS LEGISLATORS TO CRAFT

                    LEGISLATION THAT IS FAIR, THAT IS JUST.  BUT WE ALSO HAVE A RESPONSIBILITY TO

                    CRAFT LEGISLATION THAT UPLIFTS AND HONORS THE REALITY OF THE HUMAN

                    EXPERIENCE.  WE HAVE A RESPONSIBILITY TO PASS LAWS THAT UPHOLD AND

                    SUPPORT AND MAINTAIN THE DIGNITY OF EVERY SINGLE NEW YORKER AND

                    EVERY OPPORTUNITY POSSIBLE.  THAT IS WHAT THIS BILL DOES.  IT GIVES NEW

                    YORKERS WHO HAVE BEEN ROBBED OF THEIR AGENCY BY A RAVAGING ILLNESS TO

                    RECLAIM THEIR POWER AND TO LEAVE THIS WORLD IN A WAY THAT IS DIGNIFIED

                    FOR THEM AND FOR THEIR FAMILIES.  AND IF YOU HAVE NEVER HAD AN UP-CLOSE

                    EXPERIENCE OF WATCHING SOMEONE YOU LOVE BE RAVAGED BY AN ILLNESS, I

                    HOPE THAT YOU NEVER HAVE THAT EXPERIENCE.  BUT I CAN PERSONALLY TELL

                    YOU THAT IT IS GUT-WRENCHING.  AND WHAT WE ARE DOING TODAY IS RESTORING

                    POWER TO PEOPLE WHO ARE GOING THROUGH AN INCREDIBLY DIFFICULT TIME,

                    BRINGING PEACE TO FAMILIES ACROSS NEW YORK BY SIMPLY GIVING THEM THE

                    OPTION.

                                 SO I WILL BE VOTING IN THE AFFIRMATIVE TODAY FOR MY

                    FRIEND BRIAN MOFFETT WHO WAS AN ADVOCATE FOR THIS BILL WHO DIED LAST

                    YEAR BEFORE HE COULD SEE IT PASS.  FOR DR. BOAL WHO IS ANOTHER ADVOCATE

                    WHO IS ALWAYS HERE PUSHING AS HE BATTLES HIS OWN ILLNESS, AND FOR MY

                    CONSTITUENT JULES NETHERLAND WHO HAS ALSO BEEN HERE SEVERAL TIMES

                    WHO IS FACING HER OWN ILLNESS AND WILL NOW HAVE THE PIECE OF MIND TO

                    KNOW THAT SHE WILL GET TO MAKE THE DECISION ABOUT HOW HER TIME HERE

                                         195



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ENDS.

                                 THANK YOU.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MS. SEPTIMO IN THE AFFIRMATIVE.

                                 (APPLAUSE)

                                 MR. NORBER TO EXPLAIN HIS VOTE.

                                 MR. NORBER:  THANK YOU, MADAM SPEAKER.  I JUST

                    WANT TO SAY HOW PROUD I AM TO BE A NEW MEMBER HERE TODAY IN THE

                    ASSEMBLY.  THE DEBATES THAT WE SAW TODAY WERE REALLY MOVING ON BOTH

                    PARTS.  I WANT TO SAY THANK YOU TO THE SPONSOR, TO EVERYBODY.  JUST TO

                    WITNESS AND HEARING ALL THE STORIES, I COMPLETELY UNDERSTAND WHERE

                    EVERYBODY IS COMING FROM.  BUT AT THE END OF THE DAY, WE ALL COME

                    BACK TO OUR OWN PERSONAL EXPERIENCES IN LIFE.  MY FATHER, WHO I

                    INTRODUCED HERE A COUPLE WEEKS AGO, SEVEN YEARS AGO SUFFERED FROM

                    RENAL FAILURE IN BOTH KIDNEYS WITH CANCER.  IMMEDIATELY, THE

                    NEPHROLOGIST WHO WAS IN CHARGE OF HIM SAID, HE'S NOT GONNA MAKE IT.

                    EVEN DIALYSIS WILL NOT HELP HIM.  WITHIN SIX MONTHS WE'RE NOT GONNA

                    HAVE HIM ANYMORE.  WE DECIDED TO FIGHT AND DO WHATEVER WE CAN TO

                    MAKE SURE HE FEELS COMFORTABLE WITH THE DIALYSIS IN ANY WAY WE CAN,

                    AND WITHIN A FEW MONTHS, A YEAR OR SO ON DIALYSIS IN WHICH WE

                    COMPLETELY FORGOT WHAT THE DOCTOR SAID, HE ENDED UP GETTING A KIDNEY

                    AND HE IS STILL WITH US.  SO I AM THANKFUL FOR THAT AND THANKFUL THAT THE

                    DOCTOR WAS ULTIMATELY INCORRECT ABOUT WHAT HE SAID.  SO WE JUST HAVE TO

                    ALWAYS MAKE SURE THAT WE HAVE THE RIGHT TOOLS, THE RIGHT KNOWLEDGE TO

                    MAKE SURE WE MAKE THE BEST DECISIONS FOR OURSELVES AND FOR OUR

                                         196



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    FAMILIES.  EVEN WHEN THE DOCTORS SAY SOMETHING, IT'S NOT ALWAYS THE

                    WORD OF GOD.  IT'S JUST SOMETHING WE ALL -- I EXPERIENCED MYSELF SO

                    THAT'S HOW IT IS.  AND WE HAVE TO MAKE SURE THAT OTHER PEOPLE IN OUR --

                    IN OUR COMMUNITIES AND OUR STATE JUST ALSO HAVE THAT TYPE OF

                    KNOWLEDGE WHEN MAKING THESE TYPES OF DECISIONS.

                                 AND THIS BILL ITSELF, I JUST FEEL LIKE THERE'S JUST ONE

                    THING THAT IS THERE THAT'S LACKING, AND IT'S THE ISSUE OF SIX MONTHS WHICH,

                    TO ME, SEEMS TO BE VERY VAGUE AND ARBITRARY.  WHY SIX MONTHS?  WHY

                    NOT THREE MONTHS?  WHY NOT ONE YEAR?  I FEEL LIKE WE SHOULD COME

                    TOGETHER A LITTLE BIT MORE ABOUT THAT ISSUE, AND BECAUSE OF THAT I WILL BE

                    VOTING IN THE NO.

                                 THANK YOU VERY MUCH.

                                 ACTING SPEAKER HUNTER:  MR. NORBER IN THE

                    NEGATIVE.

                                 MS. KELLES TO EXPLAIN HER VOTE.

                                 MS. KELLES:  SO, ONE OF THE THINGS THAT I -- IS VERY

                    HARD FOR ME IS HOW MUCH THERE'S FEAR MONGERING ABOUT WHAT COULD

                    HAPPEN WHEN WE HAVE 30 YEARS OF DATA ON WHAT HAS HAPPENED.  AND I

                    WILL NOTE THAT THERE HAVE BEEN NO -- BEEN NO REPORTED CASES WHERE

                    PHYSICIANS ACTING IN ACCORDANCE WITH THE STATE MEDICAL AID IN DYING

                    LAWS HAVE FACED CIVIL OR CRIMINAL LIABILITIES.  THAT'S ZERO IN 30 YEARS,

                    TEN STATES AND THE -- AND WASHINGTON, D.C.  SO I THINK THAT IT'S REALLY

                    IMPORTANT THAT WE AVOID DOING THAT FEAR MONGERING, AND I'VE HEARD A LOT

                    OF THAT TODAY.

                                 WHEN I FIRST RAN FOR OFFICE, THE NUMBER ONE BILL THAT

                                         197



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WAS ASKED OF ME PLEASE, PLEASE IS THE MEDICAL AID IN DYING.  THAT WAS

                    FIVE YEARS AGO.  I CONTINUE TO HEAR THAT FROM PEOPLE ACROSS MY DISTRICT.

                    THE NUANCE PROTECTIONS IN THIS BILL ARE NOT PARALLEL TO WHAT I'VE HEARD

                    IN CANADA.  THERE ARE PHENOMENAL LISTS OF RESTRICTIONS THAT HAVE ALL

                    BEEN SPOKEN ABOUT TODAY THAT ARE VERY IMPORTANT AND PROTECTIONS.  AND

                    THE COMPARISON IS PROFOUNDLY DISINGENUOUS.

                                 I -- I WANT TO NOTE THE IMPORTANCE OF WHAT PEOPLE HAVE

                    SAID ABOUT THE DIGNITY, DYING WITH DIGNITY AND CHOOSING TO DIE WITH

                    YOUR FAMILY BY YOUR SIDE BECAUSE YOU CAN MAKE THE CHOICE OF WHEN,

                    WHEN YOU ARE ALREADY DYING, YOU HAVE LESS THAN SIX MONTHS TO LIVE.

                    THAT IS A REALLY IMPORTANT RESTRICTION OF THIS BILL.  AND I HAD SOMEONE

                    SAY TO ME RECENTLY, I AM A VERY RELIGIOUS PASTOR AND THE THING THAT

                    MATTERS MOST IS CHOICE, AND A PERSON'S RELATIONSHIP WITH GOD IS THEIR

                    OWN RELATIONSHIP AND IS NO ONE ELSE'S TO DICTATE.  AND THIS PRESERVES

                    THAT RELATIONSHIP AND THAT CHOICE.

                                 I SPENT THE LAST, AS PEOPLE KNOW HERE, COUPLE MONTHS

                    WITH MY FATHER.  MY FATHER DIED A FEW WEEKS AGO.  HE WAS A BEAUTIFUL,

                    BIG FOOTBALL PLAYER, 220 POUNDS, AND HE DIED AT 100 POUNDS.  I COULD

                    SEE EVERY ORGAN, I COULD SEE EVERY -- EVERY RIB, AND I WATCHED MY

                    FATHER IN PROFOUND PAIN AND SUFFERING.

                                 ACTING SPEAKER HUNTER:  THANK YOU, MS.

                    KELLES.  HOW DO YOU VOTE?

                                 MS. KELLES:  I AM VOTING TODAY IN SUPPORT OF AND IN

                    REMEMBRANCE OF MY FATHER AND MY FATHER-IN-LAW WHO WANTS THIS BILL.

                    THANK YOU.

                                         198



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 ACTING SPEAKER HUNTER:  MS. KELLES IN THE

                    AFFIRMATIVE.

                                 (APPLAUSE)

                                 MS. WALKER TO EXPLAIN HER VOTE.

                                 MS. WALKER:  THANK YOU, MADAM SPEAKER.  I

                    RESPECTFULLY REQUEST TO ABSTAIN FOR THE PURPOSES OF EXPLAINING MY VOTE.

                                 MANY OF THE INDIVIDUALS WHO I'VE HEARD ABOUT, THEY

                    ARE IN UNINSURED AND UNDERINSURED CIRCUMSTANCES, MANY OF WHOM

                    WOULD NOT BE ABLE TO AFFORD THE MEDICATION IN ORDER TO SEE EVEN IF --

                    EVEN IF THEY DID HOPE FOR AN OPPORTUNITY HERE.  AND SO THIS IS ABOUT

                    HEALTHCARE JUSTICE.  AND I COULDN'T UNDERSTAND WHY IS THIS COMING

                    THROUGH THE CODES COMMITTEE, BECAUSE THIS ISN'T ABOUT STOPPING

                    SOMEONE FROM COMMITTING SUICIDE OR GIVING SOMEONE THE OPPORTUNITY.

                    THIS IS ABOUT REMOVING THE PUNISHMENT FOR ASSISTING IN SOMEONE'S

                    DEATH.  AND THAT'S ONE OF THE ISSUES THAT I HAVE A PROBLEM WITH.  LIKE AS

                    A CRIMINAL JUSTICE REFORM ADVOCATE, WE CAN'T ON THE ONE HAND LOOK FOR

                    HARSHER PENALTIES AND THEN REMOVE PENALTIES FOR THE SAME ACT THAT YOU

                    WILL GIVE PEOPLE 28 AND 40 YEARS IN PRISON FOR, AND THAT I HAVE A

                    PROBLEM WITH.  AND AT THE END OF THE DAY WE'RE STILL SEEING PEOPLE WHO

                    ARE BEING PROSECUTED FOR ADMINISTERING THIS DRUG TO INDIVIDUALS WHO DO

                    NOT REQUIRE IT.  AND THEY'RE BEING PROSECUTED IN THIS DAY, IN THIS TIME, IN

                    THE NETHERLANDS.  I DON'T KNOW ABOUT IN OREGON, BUT I KNOW IF

                    SOMETHING IS HAPPENING IN OREGON, BY THE TIME IT HITS NEW YORK STATE

                    IT IS GONNA BE VASTLY, VASTLY HIGHLIGHTED.

                                 AND SO I AM CONCERNED.  WHAT HAPPENS WHEN A

                                         199



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    PERSON SAYS, I DON'T WANT TO TAKE THIS DRUG ANYMORE, AND PEOPLE DO IT

                    ALL THE TIME.  IS THERE A SAFE WAY TO DISPOSE IT?  OR WILL THIS BE

                    SOMETHING THAT WILL WIND UP IN A BLACK MARKET AND ON THE STREETS OF

                    COMMUNITIES OF COLOR ALL ACROSS THE STATE OF NEW YORK?

                                 I THINK THAT THERE ARE OPPORTUNITIES FOR US TO BE ABLE TO

                    MAKE THIS CIRCUMSTANCE BETTER.  CONGRATULATIONS.

                                 ACTING SPEAKER HUNTER:  THANK YOU, MS.

                    WALKER.  HOW DO YOU VOTE?

                                 MS. WALKER:  I WITHDRAW MY REQUEST AND I VOTE IN

                    THE NEGATIVE.

                                 ACTING SPEAKER HUNTER:  MS. WALKER IN THE

                    NEGATIVE.

                                 (APPLAUSE)

                                 MS. SHIMSKY TO EXPLAIN HER VOTE.

                                 MS. SHIMSKY:  THANK YOU VERY MUCH, MADAM

                    SPEAKER.  EVERYONE'S DEATH AND THE CIRCUMSTANCES ARE DIFFERENT, ALWAYS

                    HAVE BEEN.  BUT IN RECENT GENERATIONS OUR HEALTHCARE SYSTEM HAS

                    RESULTED IN PEOPLE WASTING AWAY FROM DEGENERATIVE DISEASES AND

                    HAVING LONGER, MORE PAINFUL DEATHS WITH MORE HUMILIATION AND LESS

                    AGENCY.  THAT IS WHY WE NEED A BILL WHICH GIVES PEOPLE THE

                    OPPORTUNITY TO END THEIR LIVES AS THEY ARE WASTING AWAY.

                                 THE PARTISAN DIVIDE ON THIS ISSUE IS MUCH NARROWER

                    THAN IT IS ON JUST ABOUT ANYTHING ELSE WE TALK ABOUT.  AND I THINK PART OF

                    THAT IS BECAUSE WHETHER YOU'RE A DEMOCRAT, A REPUBLICAN, MEMBER OF A

                    THIRD-PARTY OR NO PARTY, YOU'VE HAD SOME PERSONAL EXPERIENCE WITH THIS

                                         200



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ISSUE AND YOU KNOW EXACTLY WHY THIS BILL IS NEEDED.  AND I UNDERSTAND

                    IT, TOO, FROM PERSONAL CIRCUMSTANCES AND LISTENING TO THE CIRCUMSTANCES

                    OF OTHERS.  AND THAT IS WHY, MADAM SPEAKER, I'M VOTING IN THE

                    AFFIRMATIVE.

                                 ACTING SPEAKER HUNTER:  MS. SHIMSKY IN THE

                    AFFIRMATIVE.

                                 MS. BICHOTTE HERMELYN TO EXPLAIN HER VOTE.

                                 MS. BICHOTTE HERMELYN:  THANK YOU, MR. --

                    THANK YOU, MADAM SPEAKER, FOR ALLOWING ME TO EXPLAIN MY VOTE.  THE

                    PURPOSE OF THIS BILL WOULD BE TO ASSIST CERTAIN INDIVIDUALS IN ENDING

                    THEIR LIFE EARLY IN CERTAIN CIRCUMSTANCES.  SOME PEOPLE CALL THIS CHOICE

                    OF PASSING PEACEFULLY WHILE OTHERS CALL IT ASSISTED SUICIDE.  WHILE I DO

                    SUPPORT THE CHOICE OF BEING ABLE TO END ONE'S OWN SUFFERING EARLY,

                    WHILE I DO SUPPORT THE FREEDOM TO CHOOSE AND FREEDOM TO DECIDE IN THE

                    PURSUIT OF HAPPINESS, MY CONCERN AND OPPOSITION OF THIS BILL COMES

                    FROM THE GREAT RISK OF TARGETING VULNERABLE COMMUNITIES OF COLOR GIVEN

                    THE HISTORICAL HEALTH DISPARITIES THAT THEY CONTINUE TO FACE.

                                 I DID REQUEST A STUDY.  I REQUEST A STUDY AS IT RELATES TO

                    THE MISUSE, TRUE MENTAL COMPETENCY DETERMINATION AND WRONGFUL

                    INTENT, BUT THAT REQUEST WAS DISMISSED.  DEATH IS SOMETHING THAT I

                    STRUGGLE WITH.  HAVING TO LOSE A BABY, HAVING TO LOSE ALL MY BROTHERS,

                    MY FATHER AND THEN MY MOTHER.  AND I STILL CRY TODAY FOR HER.  I WAS HER

                    CAREGIVER AND I WANTED HER TO LIVE LONGER, BUT THERE WAS A POINT WHERE

                    SHE DID EXPRESS THAT SHE DID NOT WANT TO CONTINUE TO BE INTUPATED [SIC]

                    IF SHE WOULD BE INTUBATED.  BUT SHE TOLD ME THAT WHEN SHE WAS

                                         201



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    MENTALLY COMPETENT.  AND SO MY CONCERN FOR THE COMMUNITIES, THE

                    VULNERABLE COMMUNITIES THAT ARE NOT INFORMED.  THAT ARE NOT GIVEN THE

                    CHANCE TO REALLY SEE IF THEY ARE LEGITIMATELY MENTALLY COMPETENT.

                                 ALTHOUGH THIS BILL IS ROOTED IN EMPATHY, IT RAISES REAL

                    CONCERNS FOR COMMUNITIES THAT ARE ALREADY STRUGGLED TO RECEIVE FAIR

                    TREATMENT -- FAIR TREATMENT, AND FOR THIS REASON IN GOOD FAITH I CANNOT

                    SUPPORT THIS LEGISLATION WITHOUT WORRYING ABOUT HOW THIS WILL AFFECT

                    OUR MOST VULNERABLE POPULATIONS.

                                 AND I DO WANT TO SAY THAT PART OF MY COMMUNITY --

                                 ACTING SPEAKER HUNTER:  THANK YOU, MS.

                    HERMELYN.  HOW DO YOU VOTE?

                                 MS. BICHOTTE HERMELYN: -- OF THE VAST

                    MAJORITY DO NOT SUPPORT THIS.  I WILL VOTE IN THE NEGATIVE.

                                 ACTING SPEAKER HUNTER:  MS. BICHOTTE

                    HERMELYN IN THE NEGATIVE.

                                 MR. BURKE TO EXPLAIN HIS VOTE.

                                 MR. BURKE:  THANK YOU, MADAM SPEAKER.  I GREW

                    UP IN A VERY CATHOLIC FAMILY.  I'M A PART OF A VERY CATHOLIC FAMILY.

                    AND WHILE -- WHILE I WAS GROWING UP IN THE 90'S, THIS ISSUE WAS TALKED

                    ABOUT A LOT.  THIS WAS A MAJOR NATIONAL ISSUE.  WE TALKED ABOUT IT ALL

                    THE TIME.  YOU KNOW, MY FAMILY WAS CATHOLIC BUT THEY WEREN'T

                    DOGMATIC.  I REMEMBER SITTING WITH MY GRANDMA, IRENE BURKE, HAVING A

                    CUP OF TEA AND TALKING ABOUT THIS.  AND I ASKED HER WHAT SHE THOUGHT --

                    I THINK MIGHT'VE BEEN 11 YEARS OLD -- AND SHE POINTED TO HER WALL WHERE

                    THERE WAS THE BEATITUDES.  AND SHE SAID, BLESSED ARE THE MERCIFUL FOR

                                         202



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THEY SHALL RECEIVE MERCY.  AND IT IMPRINTED SOMETHING ON ME THAT THERE

                    -- THERE IS -- THIS IS A TOUGH ISSUE TO TALK ABOUT.  IT'S PERSONAL FOR ALL US.

                    I'M SURE MOST OF THE PEOPLE IN THIS ROOM UNFORTUNATELY HAVE A VERY

                    PAINFUL MEMORY THAT WE ATTRIBUTE TO THIS DISCUSSION; I KNOW I DO.  I

                    DON'T FEEL COMFORTABLE SHARING IT.  BUT -- BUT FOR ME AND FOR MY FAITH

                    AND FOR MY FAMILY'S PERSPECTIVE, THIS IS A RIGHTEOUS CAUSE AND THIS IS

                    JUST.  SO I WILL BE VOTING IN THE AFFIRMATIVE.

                                 THANK YOU.

                                 ACTING SPEAKER HUNTER:  MR. BURKE IN THE

                    AFFIRMATIVE.

                                 MR. MAHER TO EXPLAIN HIS VOTE.

                                 MR. MAHER:  THANK YOU, MADAM SPEAKER.  I RISE TO

                    EXPLAIN MY VOTE.  WE HAD A VERY SPIRITED DEBATE HERE TODAY, AND AS WE

                    ALL CAN SEE, THIS DEBATE TRANSCENDS PARTY LINES.

                                 ONE OF THE ISSUES THAT I BROUGHT UP WAS WHEN WE HAVE

                    38 PERCENT OF WHAT WOULD BE BROUGHT ABOUT WITH THIS MEDICATION NOT

                    USED, THAT IS THOUSANDS AND THOUSANDS THAT WE'RE TALKING ABOUT.  AND A

                    FEW MINUTES LATER AFTER THE DEBATE, I WAS HANDED A PIECE OF PAPER

                    WHERE THERE ACTUALLY WAS AN ISSUE IN THE STATE OF COLORADO WHERE THIS

                    TOOK PLACE.  SO IT'S REAL.  AND WE DON'T KNOW YET HOW MUCH HAS BEEN

                    GOTTEN TO.  WE DON'T WANT HOW TO QUANTIFY IT.

                                 THE SECOND THING I WANT TO BRING UP IS CARDINAL DOLAN

                    AND THE NEW YORK STATE BISHOPS PUT A STATEMENT TOGETHER, AND I KNOW

                    EARLIER THIS WEEK WE HAD A -- A QUOTE FROM POPE FRANCIS AND I JUST WANT

                    TO READ ANOTHER ONE.  "EUTHANASIA AND ASSISTED SUICIDE ARE A DEFEAT FOR

                                         203



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    ALL.  WE ARE ALL CALLED NEVER TO ABANDON THOSE WHO ARE SUFFERING, NEVER

                    GIVING UP BUT CARING AND LOVING TO RESTORE HOPE."  NOW, I READ THAT AND

                    I THINK OF THE WORD "HOPE" BECAUSE TODAY IT WAS BROUGHT ABOUT IN A

                    WAY THAT WAS VERY SPECIFIC TO SOMEONE WHO IS NOT GOING TO DIE, MAYBE

                    A MIRACLE MIGHT HAPPEN.  BUT WHEN POPE FRANCIS USES THE WORD "HOPE"

                    I THINK OF IT AS A GOD-FEARING MAN, AS HOPE TO HAVE THE STRENGTH TO FACE

                    WHAT'S NEXT.  AND THAT'S SOMETHING THAT WE ALL OUGHT TO THINK ABOUT.

                    THAT WORD "HOPE" ISN'T JUST ABOUT HOPE TO LIVE, BUT TO HAVE THE STRENGTH

                    TO DIE, TO GO TO THAT NEXT PLACE THE WAY THAT THEY WOULD LIKE TO.

                                 FOR THIS AND MANY OTHER REASONS I WILL VOTE IN THE

                    AFFIRMATIVE.  THANK YOU, MADAM SPEAKER.

                                 ACTING SPEAKER HUNTER:  MR. MAHER IN THE

                    AFFIRMATIVE.

                                 MR. BURDICK.

                                 MR. MAHER:  NEGATIVE, NEGATIVE, NEGATIVE.

                                 ACTING SPEAKER HUNTER:  OOPS, SORRY.  SORRY.

                                 MR. MAHER IN THE NEGATIVE.

                                 MR. BURDICK TO EXPLAIN HIS VOTE.

                                 MR. BURDICK:  THANK YOU, MADAM SPEAKER.  I

                    ARRIVED AT MY POSITION ON THIS BILL AFTER CONSIDERABLE THOUGHT.  IT IS

                    SHAPED IN PART BY A VERY PERSONAL EXPERIENCE.  SEVERAL YEARS AGO, MY

                    WIFE'S STEPMOTHER, A CITIZEN OF THE NETHERLANDS, SUFFERED A MASSIVE

                    STROKE WHICH SENT HER INTO A PERMANENT VEGETATIVE STATE.  HER DOCTORS

                    OVERWHELMINGLY CONCLUDED THAT SHE WOULD NEVER RECOVER.  YEARS PRIOR

                    TO THE STROKE, SHE HAD AVAILED HERSELF UNDER THE 2002 NETHERLANDS LAW

                                         204



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WHICH ALLOWED FOR ADVANCED DIRECTIVES TO END LIFE UNDER VERY STRICT

                    CRITERIA.  HER CHILDREN HONORED THEIR MOTHER'S DIRECTIVE.

                                 IN PASSING THIS LAW, NEW YORK WOULD JOIN SEVERAL

                    STATES WHO HAVE ADOPTED LAWS SIMILAR.  AND THE OVERWHELMING

                    EVIDENCE IS THAT THE STRINGENT SAFEGUARDS UNDER THOSE LAWS HAVE BEEN

                    SUCCESSFUL IN PREVENTING COERCION AND UNDUE INFLUENCE.  AS A MEMBER

                    OF THE PEOPLE WITH DISABILITIES COMMITTEE, I'VE CONSIDERED THE BILL

                    FROM THAT PERSPECTIVE AS WELL.  COLLEAGUES ON THE OTHER SIDE OF THE AISLE

                    HAVE SUGGESTED THAT THERE'S A MONOLITHIC DEAL IN THE DISABILITY

                    COMMUNITY IN OPPOSITION.  AS THE SPONSOR MENTIONED IN DEBATE, THERE

                    IS STRONG SUPPORT AMONG NEW YORKERS WHO SELF-IDENTIFY AS HAVING A

                    DISABILITY.

                                 MY VIEW IS THAT GOVERNMENT SHOULD NOT INTERFERE WITH

                    FREELY-MADE END-OF-LIFE DECISIONS.  I COMMEND THE SPONSOR FOR HER

                    TENACITY AND ENSURING THE STRICT CRITERIA AND PROTECTIONS IN THE BILL,

                    INCLUDING FOR THOSE WITH DISABILITIES.  THIS BILL IS FOUNDED ON

                    COMPASSION AND CARING FOR THOSE WHOM WE LOVE.  WE WANT TO GIVE

                    THEM THE RIGHT TO MAKE A FULLY-INFORMED AND FREE CHOICE IN ENDING

                    THEIR LIFE.

                                 I VOTE IN THE AFFIRMATIVE.  THANK YOU.

                                 ACTING SPEAKER HUNTER:  MR. BURDICK IN THE

                    AFFIRMATIVE.

                                 MR. DURSO TO EXPLAIN HIS VOTE.

                                 MR. DURSO:  THANK YOU, MADAM SPEAKER, TO

                    EXPLAIN MY VOTE.  OBVIOUSLY, THIS IS A VERY PERSONAL ISSUE FOR EVERYONE

                                         205



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    IN HERE AND IT'S -- IN SOME WAY, SHAPE OR FORM WE'VE ALL AN HAD EFFECT

                    BY A LOVED ONE WHO HAS PASSED AWAY OR IF GOD FORBID YOU'VE HAD TO

                    WATCH IT IN FRONT OF YOU, WHICH I HAVE.  IT -- IT DEFINITELY LEAVES AN

                    EFFECT ON YOU AND MAKES YOU THINK A DIFFERENT WAY.  I UNFORTUNATELY

                    HAD THE -- TO WATCH MY MOTHER TAKE HER LAST BREATH DIRECTLY IN FRONT OF

                    ME.  AND I UNDERSTAND THAT SHE WAS IN A LOT OF PAIN AND HER FAMILY,

                    HERSELF, NOBODY WANTED TO SEE HER IN PAIN.  BUT THE ONE THING MY

                    MOTHER DID INSTILL IN ME IS TO DO WHAT YOU BELIEVE IS RIGHT.  AND I

                    BELIEVE THAT SHE WOULD THINK THAT THIS BILL'S NOT QUITE READY YET.  AGAIN,

                    DOCTOR SHOPPING, AS WE SPOKE ABOUT, THE DEFINITION OF TERMINAL ILLNESS.

                    ALL THESE THINGS THAT THE GUARDRAILS AREN'T IN PLACE AT THIS TIME, I JUST

                    DON'T THINK IT'S READY.  ON TOP OF THE FACT THAT WE DO HAVE A

                    RESPONSIBILITY AS A LEGISLATURE WHEN IT COMES TO MAKING SURE THAT OUR

                    CONSTITUENTS AND THE PEOPLE OF THE STATE UNDERSTAND WHAT THE REASONS

                    THAT WE DO WHAT WE DO HERE.

                                 ONE OF THE THINGS I JUST WANT TO SPEAK ABOUT QUICKLY IS

                    LAST YEAR ALONE IN THE BUDGET WE SPENT $1 BILLION ON SUICIDE PREVENTION.

                    NOW, I'M A BIG BELIEVER IN THAT AND I SUPPORT THAT 100 PERCENT.  WE

                    HAVE OUR FIRST RESPONDERS, VETERANS WHO ARE TAKING THEIR OWN LIVES AT AN

                    ENORMOUS AMOUNT.  OVER 1,700 PEOPLE A YEAR COMMIT SUICIDE IN NEW

                    YORK STATE.  HOW CAN WE SIT THERE AND PUT MONEY TOWARDS AND TALK

                    ABOUT EDUCATION ABOUT SAVING PEOPLE'S LIVES, SUICIDE PREVENTION, AND

                    THEN SIT HERE AND DO THIS BILL?

                                 ALSO, THE SENATE SPONSOR OF THIS BILL LITERALLY HAS A BILL

                    CALLED THE SUICIDE PREVENTION ACT.  THE BILL SPONSOR HERE TALKED ABOUT

                                         206



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    HOW THE NUMBERS SAY THAT HOSPICE CARE HAS GONE UP SINCE THE

                    IMPLEMENT -- IMPLEMENTATION OF THIS LEGISLATION IN OTHER STATES, BUT YET

                    PASSED A BILL TWO WEEKS AGO (INAUDIBLE/CROSSTALK).

                                 ACTING SPEAKER HUNTER:  THANK YOU, MR.

                    DURSO.  HOW DO YOU VOTE?

                                 MR. DURSO:  I VOTE IN THE NEGATIVE.

                                 ACTING SPEAKER HUNTER:  MR. DURSO IN THE

                    NEGATIVE.

                                 MR. TAGUE TO EXPLAIN HIS VOTE.

                                 MR. TAGUE:  MADAM SPEAKER, TO EXPLAIN MY VOTE.

                    FIRST OFF, MADAM SPEAKER, I DIDN'T HEAR FEAR MONGERING TODAY AS WAS

                    SUGGESTED.  I SAW TWO DIFFERENT -- TWO DIFFERENT TYPES OF PEOPLE

                    DISCUSSING RESPECTFULLY AND DEBATING RESPECTFULLY A VERY DIFFICULT PIECE

                    OF LEGISLATION.  PEOPLE WHO ARE DEEPLY COMPASSIONATELY AND FAITHFULLY

                    COMMITTED TO THEIR POSITION.

                                 AS A DEVOUT IRISH CATHOLIC, IT IS GOD ALMIGHTY, THE

                    GIVER AND THE TAKER OF LIFE.  IT IS NOT FOR MAN TO TAKE LIFE, BUT TO

                    UNDERSTAND THAT GOD IS THE GIVER AND TAKER OF LIFE, AND THIS APPLIES TO

                    ALL.

                                 I VOTE IN THE NEGATIVE.

                                 ACTING SPEAKER HUNTER:  MR. TAGUE IN THE

                    NEGATIVE.

                                 MS. LEVENBERG TO EXPLAIN HER VOTE.

                                 MS. LEVENBERG:  THANK YOU, MADAM SPEAKER.

                    WE HAVE HEARD SO MUCH TODAY, AND I WANT TO THANK THE SPONSOR FOR HER

                                         207



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    INCREDIBLE PERSEVERANCE ON THIS AND HER VERY HARD WORK, AS SHE DOES ON

                    ALL BILLS, BUT THIS ONE ESPECIALLY.  I THINK IT'S BEEN 20 YEARS; IS THAT

                    CORRECT?

                                 MS. PAULIN:  ELEVEN.

                                 MS. LEVENBERG:  ELEVEN YEARS.  STILL A VERY LONG

                    TIME.

                                 THE -- THE BILL HAS A LOT OF NAMES.  IT'S CALLED DEATH

                    WITH DIGNITY AND COMPASSION AND CHOICES.  AND WHEN I THINK ABOUT

                    MY PERSONAL EXPERIENCE WITH MY -- MY FATHER, HE WAS -- HE HAD A HEART

                    ATTACK IN HIS MID-40S.  HE WAS A PACK-AND-A-HALF-A-DAY SMOKER.  THE

                    DOCTOR SAID, IF YOU QUIT SMOKING, YOU KNOW, YOU MAY LIVE TEN TO 15

                    YEARS.  IF YOU DON'T, YOU'VE PROBABLY GOT FIVE.  HE LIVED 'TIL HE WAS 88.

                    BUT IN HIS -- IN HIS LATER YEARS HE DEVELOPED DIABETES AND ULTIMATELY

                    HAD RENAL FAILURE AND WAS ON DIALYSIS.  AND -- AND HE WAS A REALLY GOOD

                    CANDIDATE FOR DIALYSIS.  HE LOVED TO READ.  AND I THOUGHT HE'D BE ON

                    DIALYSIS, YOU KNOW, UNTIL -- UNTIL HE COULDN'T BE ON DIALYSIS ANYMORE.

                    BUT ONE DAY HE JUST UP AND ANNOUNCED HE WAS DONE.  HE WAS DONE

                    WITH DIALYSIS.  HE DIDN'T WANT TO DO IT ANYMORE.  AND WE WERE ALL

                    CONFUSED AND MY STEP-MOM WAS REALLY UPSET AND, YOU KNOW, LOTS OF

                    EVENTS STILL TO COME AND LOTS OF -- LOTS OF LIFE EXPERIENCES STILL TO

                    HAPPEN AND TO SHARE WITH HIM.  BUT I THINK THAT WE HAVE A REALLY TOUGH

                    RELATIONSHIP WITH DEATH IN THIS COUNTRY, AND I THINK THAT THIS IS PART OF

                    OUR ANGST OVER THIS LEGISLATION.  AND I THINK THAT WHEN PEOPLE DO HAVE

                    THE CHOICE, AND AGAIN WITHOUT -- AS ONE OF MY -- AS ONE OF MY

                    COLLEAGUES POINTED OUT -- WITHOUT HAVING TO JUMP THROUGH ANY HOOPS

                                         208



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    HE JUST GOT TO DECIDE TO UNPLUG FROM DIALYSIS AND CHOOSE HIS -- HIS

                    ENDING.  I THINK THAT WE NEED TO LOOK AT THESE OTHER OPTIONS THAT WHERE

                    PEOPLE ARE HAVING THAT ABILITY TO DO SO AND TO END THEIR LIVES WITH

                    DIGNITY AND WITH COMPASSION.

                                 ACTING SPEAKER HUNTER:  THANK YOU, MS.

                    LEVENBERG.  HOW DO YOU VOTE?

                                 MS. LEVENBERG:  I VOTE IN THE AFFIRMATIVE.

                                 ACTING SPEAKER HUNTER:  MS. LEVENBERG IN

                    THE AFFIRMATIVE.

                                 MS. GIGLIO TO EXPLAIN HER VOTE.

                                 MS. GIGLIO:  THANK YOU, MADAM SPEAKER.

                                 SO, LIFE IS A GIFT FROM GOD.  I HAVE A PERSONAL

                    EXPERIENCE.  I LOST MY FIRST HUSBAND AT A VERY LUNG -- YOUNG AGE OF

                    METASTATIC LUNG CANCER.  THEY GAVE HIM THREE MONTHS TO LIVE, BUT HE

                    LIVED FOR 15 MONTHS.  AND DURING THAT 15 MONTHS WE WENT TO HEALING

                    MASSES.  I TOOK MACROBIOTIC COOKING WHERE, YOU KNOW -- BUT AT THE END

                    WHEN THE HOSPICE NURSES WERE COMING HE WAS SAYING THE ONLY THING HE

                    WANTED WAS A STEAK.  YOU KNOW, HE WASN'T ASKING FOR A PILL TO END HIS

                    LIFE.  AND THE DAY HE DIED HE SAID, TODAY IS THE DAY I'M GOING TO DIE.

                    BRING MY FAMILY, BRING MY FRIENDS.  I WANT TO SAY GOODBYE.  AND WHEN

                    THEY ALL DEPARTED AT 8:00 P.M., HE SAID, HE'S HERE TO GET ME.  I'M GOING.

                    HE PUT HIS HEAD INTO MY STOMACH AND HE PASSED AWAY PEACEFULLY.  THE

                    HOSPICE NURSES KEPT HIM COMFORTABLE.  HE HAD METASTATIC IN HIS LUMBAR

                    SPINE, IN HIS -- ALL OVER HIS BODY IT HAD SPREAD.  AND THE DOCTORS KEPT

                    HIM VERY COMFORTABLE AND SO DID THE HOSPICE NURSES.

                                         209



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 SO I -- I THINK THAT, YOU KNOW, AS I SAID, LIFE IS A GIFT

                    AND ONE THAT SHOULD BE NOURISHED AND TREASURED.  I AM VERY WORRIED

                    ABOUT THE VULNERABLE COMMUNITY AND VULNERABLE POPULATION THAT IT'LL

                    JUST BE AN OPTION BECAUSE THE HEALTHCARE WILL NOT BE AVAILABLE TO THEM.

                    I -- I WORRY THAT THERE ARE PEOPLE THAT ARE GOING TO GET A PILL AND THEY'RE

                    GONNA GO HOME.  MAYBE THEY GOT THE PILL AND ASKED FOR THE PILL

                    BECAUSE THEIR FAMILY MEMBERS WERE SAYING GET IT BECAUSE IT'S AN

                    OPTION.  I UNDERSTAND THAT.  BUT THEY MAY NOT BE READY TO TAKE THAT STEP

                    AND MAY BE COERCED ONCE THEY GET HOME.  AND BECAUSE THEM

                    PHYSICALLY TAKING THE PILL THEMSELVES IS NOT SOMETHING THAT WOULD BE

                    SEEN BY THE DOCTOR AND THERE WOULD BE NO WAY OF ENFORCING TO MAKE

                    SURE THAT THAT PERSON ACTUALLY TOOK THE PILL THEMSELVES.

                                 SO I -- I WORRY ABOUT A LOT OF THINGS WITH THIS BILL

                    THAT --

                                 ACTING SPEAKER HUNTER:  THANK YOU, MS.

                    GIGLIO.  HOW DO YOU VOTE?

                                 MS. GIGLIO:  THANK YOU.  I VOTE IN THE NEGATIVE.

                    THANK YOU.

                                 ACTING SPEAKER HUNTER:  MS. GIGLIO IN THE

                    NEGATIVE.

                                 MS. WALSH TO EXPLAIN HER VOTE.

                                 MS. WALSH:  THANK YOU.  SO, HERE'S WHERE I'M

                    COMING DOWN ON THIS AFTER HAVING HAD SO MUCH TIME OVER THE LAST FEW

                    YEARS TO REALLY THINK ABOUT THIS.  I THINK THAT WHAT WE NEED TO

                    UNDERSTAND, ANYBODY WHO STILL HASN'T CAST A VOTE OR IS ON THE FENCE, IS

                                         210



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    THAT THERE'S A YES VOTE FOR ANY NUMBER OF REASONS, THERE'S A NO VOTE FOR

                    ANY NUMBER OF REASONS.  I JUST THINK THAT WE CAN DO BETTER.  I THINK WE

                    CAN DO BETTER THAN THIS.  I DON'T THINK THAT A NO VOTE NECESSARILY MEANS

                    THAT WE DON'T HAVE COMPASSION FOR THE PEOPLE WHO HAVE BEEN COMING

                    TO OUR OFFICES, WHO WE'VE BEEN PASSING THROUGH THE TUNNEL WHO WE'VE

                    BEEN TALKING TO.  I'M JUST SAYING THAT I DON'T THINK THIS BILL IS IT.  I THINK

                    THAT MAKING THE BEST INVESTMENTS THAT WE CAN TO RAISE NEW YORK UP

                    FROM DEAD LAST IN HOSPICE AND PALLIATIVE CARE IS WHERE WE SHOULD BE

                    PUTTING OUR ENERGY AND OUR EFFORTS AND OUR MONEY.  AND THIS -- AND THE

                    STATE'S MONEY.  THAT'S WHERE WE'VE GOT TO PUT THE EFFORT.

                                 I -- I HAVE ENORMOUS COMPASSION FOR PEOPLE WHO ARE

                    IN UNRELENTING PAIN, AND -- AND I, FRANKLY, FOR ALL THE TIMES THAT I'VE READ

                    OBITUARIES THAT THANK HOSPICE, I THINK HOSPICE COMES IN TOO LATE AND

                    THEY DON'T DO ENOUGH.  THEY DON'T DO ENOUGH.  THANK GOD MY SISTER,

                    WHO'S A NURSE PRACTITIONER, WAS THERE TO HELP BOTH OF MY PARENTS DIE.

                    BECAUSE I -- I -- I WOULD HATE TO THINK THAT THEY HAD TO JUST RELY UPON A

                    PHONE CALL OR AN OCCASIONAL VISIT FROM HOSPICE.  THANK GOD MY SISTER

                    WAS THERE.

                                 I THINK WE CAN DO BETTER THAN THIS.  I DON'T THINK THAT

                    THIS IS SOMETHING THAT CAN BE FIXED WITH A CHAPTER AMENDMENT.  THIS

                    BILL NEEDS WORK.  THE THINGS -- THE PROTECTIONS THAT ARE IN PLACE

                    REGARDING COERCION, CONSENT, CAPACITY, THOSE ARE ALL BEFORE THE

                    PRESCRIPTION IS ISSUED.  ONCE IT'S ISSUED, WE HAVE A HOST OF PROBLEMS

                    WITH THIS BILL, AND I THINK WE NEED TO FIX THOSE.

                                 SO IF YOU VOTE NO, IT DOESN'T MEAN YOU DON'T CARE.  IT

                                         211



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    JUST MEANS THAT THIS BILL IS NOT QUITE THERE YET.  I'M VERY UNCOMFORTABLE

                    WITH THE IDEA OF ANSWERS GIVEN BY THE SPONSOR THAT (INAUDIBLE/

                    CROSSTALK) --

                                 ACTING SPEAKER HUNTER:  THANK YOU, MS.

                    WALSH.  HOW DO YOU VOTE?

                                 MS. WALSH: -- WOULD MAKE THIS LEGISLATIVE INTENT

                    UP ON THE SPOT.

                                 I VOTE IN THE NEGATIVE.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MS. WALSH:  THANK YOU, COLLEAGUES.

                                 ACTING SPEAKER HUNTER:  MS. WALSH IN THE

                    NEGATIVE.

                                 MS. ROSENTHAL TO EXPLAIN HER VOTE.

                                 MS. ROSENTHAL:  TO EXPLAIN MY VOTE.  I FIRST WANT

                    TO THANK THE BILL SPONSOR FOR HER UNDYING EFFORTS AND THE TENACIOUS

                    ADVOCATES WHO HAVE BEEN COMING UP TO ALBANY FOR YEARS ON END TO

                    MAKE THE PASSAGE OF THIS BILL A REALITY.

                                 MANY OF US IN THIS CHAMBER HAVE OUR OWN STORIES TO

                    SHARE, WATCHING FRIENDS AND FAMILY MEMBERS SUFFER INCREDIBLE PAIN AND

                    GRUELING ILLNESSES.  BEING DIAGNOSED WITH A TERMINAL ILLNESS STIRS UP SO

                    MANY EMOTIONS; SADNESS, GRIEF, REGRET, ANGER AND THE FEELING OF THE LOSS

                    OF CONTROL.  AT A TIME WHEN SO MUCH IS OUT OF ONE'S HANDS, HAVING THE

                    OPTION TO DIE WITH DIGNITY RATHER THAN SLOWLY CRUMBLE AMIDST PAIN IS

                    SOMETHING THAT SHOULD BE AVAILABLE TO ANYONE IN THIS POSITION.

                                 WE DON'T KNOW WHAT HAPPENS AFTER WE DIE.  SOME

                                         212



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    BELIEVE THAT THERE'S A HEAVEN AND HELL.  SOME BELIEVE IN REINCARNATION.

                    SOME BELIEVE THAT THAT'S THE END.  AND SOME BELIEVE THAT WE CONTINUE

                    TO EXIST IN SOME NON-PHYSICAL REALM.  WE DON'T KNOW.  BUT WE DO

                    KNOW WHAT IT'S LIKE TO SUFFER.  WE DO KNOW WHAT IT'S LIKE TO HAVE PAIN.

                    WE'VE HEARD THE TESTIMONY OF NURSES ABOUT THE WRETCHED THINGS THE

                    BODY GOES THROUGH.  SO WHO AM I TO JUDGE HOW YOU WANT TO END YOUR

                    LIFE?  WHO ARE WE TO IMPOSE OUR WILL TO FORBID PEOPLE AND DOCTORS

                    FROM HELPING THOSE WHO ARE TERMINALLY ILL?

                                 I'VE SUPPORTED THIS BILL SINCE ITS INTRODUCTION.  I AM

                    GRATEFUL TO EVERYBODY WHO POURED THEIR HEARTS INTO ITS PASSAGE.  ONCE

                    AGAIN, I THANK THE SPONSOR FOR HER TENACIOUSNESS AND I VOTE IN THE

                    AFFIRMATIVE.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MS. ROSENTHAL IN THE AFFIRMATIVE.

                                 MR. GIBBS TO EXPLAIN HIS VOTE.

                                 MR. GIBBS:  THANK YOU, MADAM SPEAKER.  NOT ONLY

                    SHOULD ALL NEW YORKERS DIE WITH DIGNITY, I BELIEVE THEY SHOULD ALL LIVE

                    WITH IT.  LET'S GIVE ALL NEW YORKERS THE DIGNITY THAT ROBERT BROOKS

                    DIDN'T GET.

                                 MADAM SPEAKER, I STAND WITH MY SPEAKER AND I VOTE

                    IN THE AFFIRMATIVE.

                                 ACTING SPEAKER HUNTER:  THANK YOU.

                                 MR. GIBBS IN THE AFFIRMATIVE.

                                 MR. FITZPATRICK TO EXPLAIN HIS VOTE.

                                 MR. FITZPATRICK:  THANK YOU, MADAM SPEAKER.

                                         213



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    IT WAS SAID A FEW MOMENTS AGO THAT WE, AS A SOCIETY, SEEM TO STRUGGLE

                    WITH DEATH.  ANYONE WHO BELIEVES THAT HAS NEVER BEEN TO AN IRISH

                    WAKE.

                                 (LAUGHTER)

                                 AN IRISH WAKE, WE CELEBRATE LIFE.  WE'RE SAD.  MY

                    MOTHER JUST DIED, JUST AS SOME OF MY COLLEAGUES, THEIR PARENTS HAVE

                    RECENTLY PASSED AWAY.  MY FATHER DIED 36 YEARS AGO.  I STILL CELEBRATE

                    HIS LIFE.  BOTH OF THEM SUFFERED.  BUT WE DON'T GET TO CHOOSE WHEN WE

                    COME INTO THIS WORLD.  AND AS MY COLLEAGUE SAID, I BELIEVE LIFE IS A GIFT

                    FROM GOD.  AND YOU DON'T REJECT THAT GIFT BY CHOOSING TO END YOUR LIFE.

                    SUFFERING IS A PART OF LIFE.  IN MY FAITH TRADITION WE ARE TAUGHT THAT

                    SUFFERING IS SOMETHING WE ALL MUST ENDURE.  AND YES, SOME SUFFER MORE

                    THAN OTHERS, BUT SUFFER WE ALL WILL.  WE ALL MUST IF WE WANT TO GET TO

                    HEAVEN, AND I BELIEVE THERE IS A HEAVEN.  BUT I'M CONCERNED ABOUT THIS

                    BEING MAYBE THE CAMEL'S NOSE UNDER THE TENT.  I FEAR EXPANSION OF THIS

                    BILL IN THE FUTURE.  THERE WILL BE OPPORTUNITIES TO DO THAT.  PEOPLE WILL

                    WANT TO SAY I WANT TO BE ABLE TO CHOOSE THE END OF LIFE BECAUSE OF THIS

                    AFFLICTION OR THAT AFFLICTION.  AND I THINK WE'RE GOING DOWN -- WE WILL

                    GO DOWN A DANGEROUS PATH IF THAT HAPPENS.  BUT I WILL CONTINUE.

                                 YOU KNOW, I DON'T SUPPORT THIS BILL.  I WILL BE VOTING

                    IN THE NEGATIVE.  I APPRECIATE THE HARD WORK OF THE SPONSOR AND HER

                    DEDICATION TO THIS -- TO THIS EFFORT.  I KNOW IT'S SINCERE.  SHE HAS

                    SUFFERED A DEATH OF HER SISTER.  WE ALL HAVE BEEN THROUGH THIS, AT LEAST

                    MOST OF US HAVE.

                                 ACTING SPEAKER HUNTER:  THANK YOU, MR.

                                         214



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    FITZPATRICK.  HOW DO YOU VOTE?

                                 MR. FITZPATRICK:  I VOTE IN THE NEGATIVE.

                                 ACTING SPEAKER HUNTER:  MR. FITZPATRICK IN

                    THE NEGATIVE.

                                 MRS. PEOPLES-STOKES TO EXPLAIN HER VOTE.

                                 MRS. PEOPLES-STOKES:  THANK YOU.  THANK YOU,

                    MADAM SPEAKER, FOR THE OPPORTUNITY TO EXPLAIN MY VOTE.

                                 I FIRST WANT TO REALLY HONOR MY COLLEAGUE MS. PAULIN

                    ON -- SHE HAS LITERALLY BROUGHT THIS BILL I WOULD SAY ALMOST FROM THE

                    GRAVEYARD, SHE'S BROUGHT IT ALIVE.  AND I WANT TO CONGRATULATE HER ON

                    THAT BECAUSE IT TOOK A LOT -- IT TAKES A LOT OF WORK TO DO THAT.

                                 THERE ARE A NUMBER OF PEOPLE, AS EVERYONE HAS SAID,

                    WHO HAVE ALL DIFFERENT SORTS OF EXPERIENCES ABOUT THIS, BUT IT'S ALL

                    PERSONAL AND IT'S ALL EMOTIONAL.  AND I HAVE FROM DAY ONE WHEN I FIRST

                    HEARD ABOUT THIS BILL WAS ADAMANTLY OPPOSED.  I WATCHED MY FATHER DIE.

                    HE ACTUALLY ASKED ME -- HE WANTED TO DIE TWO YEARS BEFORE HE DID, BUT

                    HE DIDN'T.  AND BECAUSE HE DIDN'T MY GRANDSON GOT A CHANCE TO KNOW

                    HIM.  AND I WATCHED MY MOM DIE, I WATCHED MY DAUGHTER DIE.  AND I

                    KNOW THAT FOR A FACT THAT NONE OF US ARE GETTING OUT OF HERE ALIVE.  AT

                    SOME POINT OR THE OTHER, WE'RE ALL GONNA GO.  BUT I DON'T BELIEVE THAT

                    THERE SHOULD BE A COMBINATION OF SIX DRUGS OFFERED TO SOMEONE TO END

                    THEIR LIFE.  I -- I'M SORRY FOR THE SUFFERING.  I -- HONESTLY, I KNOW PEOPLE

                    SOMETIMES SUFFER AND I WISH THAT THEY DIDN'T HAVE TO.  BUT -- AND I WISH

                    THERE WAS OTHER WAYS NOT FOR THEM NOT TO SUFFER TO GET THROUGH THEIR

                    ILLNESS.  MAYBE THE SCIENCE IS NOT DONE ON THAT YET, BUT I CANNOT

                                         215



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    IMAGINE A COMBINATION OF SIX DRUGS ROAMING AROUND IN OUR SOCIETY.

                                 WHEN I WAS IN HIGH SCHOOL I NEVER HEARD OF FENTANYL,

                    EVER.  NOW, PEOPLE LITERALLY BREAK INTO HOSPITALS TO STEAL FENTANYL.  I

                    DON'T KNOW WHERE WE'RE GOING AS A COUNTRY.  I DON'T THINK WE HAVE A

                    HANDLE ON HOW TO DEAL WITH DRUGS, PARTICULARLY AS THEY RELATE TO

                    COMMUNITIES OF COLOR, AND I CANNOT SUPPORT THIS BILL.  BUT I DO WANT TO

                    CONGRATULATE THE SPONSOR.  GREAT WORK, AMY.

                                 ACTING SPEAKER HUNTER:  MRS. PEOPLES-

                    STOKES IN THE NEGATIVE.

                                 MS. PAULIN TO EXPLAIN HER VOTE.

                                 MS. PAULIN:  THANK YOU.  I HAVE SO MANY THANK

                    YOUS.  FIRST, TO EVERYONE IN THIS CHAMBER FOR PUTTING UP WITH MY TEXTS

                    AND MY CALLS AND MY TEXTS AND MY TEXTS AND MY TEXTS.  THANK YOU TO

                    MY PREDECESSOR, THE CHAIR OF THE HEALTH COMMITTEE, FOR HELPING TO

                    WRITE THE BILL AND EVEN HELPING AS OF YESTERDAY TO BRIEF ME ON THE BILL.

                    THANK YOU TO THE SPEAKER WHO NOT ONLY WHEN I ASKED GAVE ME A PATH

                    TO PUT THIS BEFORE US TODAY, BUT WHO GUARANTEED THAT PATH AND WORKED

                    WITH ME TO CREATE A PATH.  I AM SO INDEBTED AND APPRECIATIVE.

                                 AND TO ALL THE YELLOW SHIRTS UP IN THE BALCONY FOR

                    BEING HERE AND BEING HERE AND BEING HERE AND BEING HERE.

                                 (APPLAUSE)

                                 FOR GIVING US THE MORAL COURAGE TO TAKE THIS VOTE

                    TODAY.

                                 EVERYONE HAS A PERSONAL STORY, WHETHER IT'S HAVING

                    HEARD ONE OF THE YELLOW SHIRTS' PERSONAL STORIES AND TAKING THAT IN, OR

                                         216



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    WHETHER IT'S FROM YOUR OWN.  FOR ME, MY PERSONAL STORY STARTED ON

                    MARCH 28, 2012 WHEN MY SISTER WAS DIAGNOSED WITH OVARIAN CANCER.  I

                    LEARNED ABOUT IT A DAY AFTER SHE WAS DIAGNOSED, AND I WAS HERE, IT WAS

                    MARCH.  THREE YEARS LATER, 2015, SHE DIED ON MOTHER'S DAY.  SHE LIVED

                    IN ANOTHER STATE, SO I WASN'T THERE.  AND HER DYING WISH WAS THAT SHE'D

                    HAVE HER SISTERS IN THE ROOM WITH HER, WHICH I LEARNED FROM MY

                    BROTHER-IN-LAW AFTER SHE ALREADY DIED.  BUT I COULDN'T BE THERE BECAUSE

                    SHE DIED ON MOTHER'S DAY AND MY MOTHER WAS STILL ALIVE HERE BACK IN

                    NEW YORK AND I WAS WITH HER.  THE LAST TIME I SAW HER WAS ABOUT

                    TODAY, 2015.

                                 ACTING SPEAKER HUNTER:  THANK YOU, MS.

                    PAULIN.  HOW DO YOU VOTE?

                                 MS. PAULIN:  I VOTE IN THE AFFIRMATIVE.  THANK YOU,

                    ALL.

                                 ACTING SPEAKER HUNTER:  MS. PAULIN IN THE

                    AFFIRMATIVE.

                                 (APPLAUSE)

                                 MRS. PEOPLES-STOKES.

                                 MRS. PEOPLES-STOKES:  MADAM SPEAKER, WOULD

                    YOU PLEASE CALL OUR COLLEAGUES ON LINE?

                                 THE CLERK:  MR. ALVAREZ, FOR THE RECORD PLEASE

                    STATE YOUR NAME AND HOW YOU WISH TO VOTE.

                                 MR. ALVAREZ:  GEORGE ALVAREZ AND I VOTE IN THE

                    AFFIRMATIVE.

                                 THE CLERK:  MR. ALVAREZ IN THE AFFIRMATIVE.

                                         217



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 MR. DIPIETRO, FOR THE RECORD PLEASE STATE YOUR NAME

                    AND HOW YOU WISH TO VOTE.

                                 MR. DIPIETRO:  DAVID DIPIETRO.  I VOTE WITH THE

                    GOD OF ABRAHAM, ISAAC AND JACOB AND MY LORD AND SAVIOR JESUS

                    CHRIST, I VOTE IN THE NEGATIVE.

                                 THE CLERK:  MR. DIPIETRO IN THE NEGATIVE.

                                 MR. MAMDANI, FOR THE RECORD PLEASE STATE YOUR NAME

                    AND HOW YOU WISH TO VOTE.

                                 MR. MAMDANI:  ZOHRAN MAMDANI.  I VOTE YES.

                                 THE CLERK:  MR. MAMDANI IN THE AFFIRMATIVE.

                                 MR. MCDONOUGH, FOR THE RECORD PLEASE STATE YOUR

                    NAME AND HOW YOU WISH TO VOTE.

                                 (PAUSE)

                                 MR. MCDONOUGH?

                                 (PAUSE)

                                 MR. MCDONOUGH.

                                 MR. MCDONOUGH:  YES.

                                 THE CLERK:  MR. MCDONOUGH IN THE --

                                 MR. MCDONOUGH:  I VOTE NO.

                                 THE CLERK:  MR. MCDONOUGH IN THE NEGATIVE.

                                 MS. TORRES, FOR THE RECORD PLEASE STATE YOUR NAME AND

                    HOW YOU WISH TO VOTE.

                                 MS. TORRES:  EMÉRITA TORRES.  I VOTE IN THE

                    AFFIRMATIVE.

                                 THE CLERK:  MS. TORRES IN THE AFFIRMATIVE.

                                         218



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                                 ACTING SPEAKER HUNTER:  ARE THERE ANY OTHER

                    VOTES?  ANNOUNCE THE RESULTS.

                                 (THE CLERK ANNOUNCED THE RESULTS.)

                                 THE BILL IS PASSED.

                                 (APPLAUSE)

                                 MRS. PEOPLES-STOKES.

                                 (PAUSE)

                                 MRS. PEOPLES-STOKES.

                                 MRS. PEOPLES-STOKES:  MADAM SPEAKER, DO YOU

                    HAVE ANY FURTHER HOUSEKEEPING OR RESOLUTIONS?

                                 ACTING SPEAKER HUNTER:  YES.  WE DO HAVE A

                    BIT OF HOUSEKEEPING.

                                 ON A MOTION BY MR. WEPRIN, PAGE 15, CALENDAR NO.

                    96, BILL NO. A07038, THE AMENDMENTS ARE RECEIVED AND ADOPTED.

                                 ON BEHALF OF MR. JONES, BILL NO. A06769, ASSEMBLY

                    BILL RECALLED FROM SENATE.  THE CLERK WILL READ THE TITLE OF THE BILL.

                                 THE CLERK:  AN ACT TO AMEND THE GENERAL

                    MUNICIPAL LAW.

                                 ACTING SPEAKER HUNTER:  MOTION TO

                    RECONSIDER THE VOTE BY WHICH THE BILL PASSED THE HOUSE.

                                 THE CLERK -- THE CLERK WILL RECORD THE VOTE.

                                 (THE CLERK RECORDED THE VOTE.)

                                 THE CLERK WILL ANNOUNCE THE RESULTS.

                                 (THE CLERK ANNOUNCED THE RESULTS.)

                                 THE BILL IS BEFORE THE HOUSE AND THE AMENDMENTS ARE

                                         219



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    RECEIVED AND ADOPTED.

                                 WE HAVE A NUMBER OF RESOLUTIONS BEFORE THE HOUSE.

                    WITHOUT OBJECTION, THESE RESOLUTIONS WILL BE TAKEN UP TOGETHER.

                                 ON THE RESOLUTIONS, ALL THOSE IN FAVOR SIGNIFY BY SAYING

                    AYE; OPPOSED, NO.  THE RESOLUTIONS ARE ADOPTED.

                                 (WHEREUPON, ASSEMBLY RESOLUTION NOS. 386-394

                    WERE UNANIMOUSLY ADOPTED.)

                                 MRS. PEOPLES-STOKES.

                                 MRS. PEOPLES-STOKES:  MADAM SPEAKER, BEFORE

                    I ASK YOU TO INTRODUCE OUR COLLEAGUE MS. CLARK, I WOULD ASK YOU TO

                    WELCOME OUR COLLEAGUE --

                                 ACTING SPEAKER HUNTER:  CAN WE HAVE QUIET

                    IN THE CHAMBER, PLEASE?

                                 MRS. PEOPLES-STOKES:  BEFORE WE MOVE TO OUR

                    ANNOUNCEMENT, CAN I ASK YOU TO PLEASE WELCOME OUR FORMER COLLEAGUE

                    MARCOS CRESPO WHO'S IN THE CHAMBERS WITH US TODAY?

                                 (APPLAUSE)

                                 ACTING SPEAKER HUNTER:  WELCOME, MR.

                    CRESPO.  WELCOME BACK.

                                 MRS. PEOPLES-STOKES:  NOW IF YOU COULD

                    INTRODUCE MS. CLARK.

                                 ACTING SPEAKER HUNTER:  MS. CLARK FOR THE

                    PURPOSES OF AN ANNOUNCEMENT.

                                 MS. CLARK:  ON A VERY MUCH LESS DRAMATIC NOTE,

                    THERE WILL BE MAJORITY CONFERENCE FOLLOWING SESSION, IMMEDIATELY

                                         220



                    NYS ASSEMBLY                                                       APRIL 29, 2025

                    FOLLOWING SESSION IN HEARING ROOM C.  MAJORITY CONFERENCE IN

                    HEARING ROOM C.

                                 ACTING SPEAKER HUNTER:  IMMEDIATE MAJORITY

                    CONFERENCE IN HEARING ROOM C.

                                 MRS. PEOPLES-STOKES.

                                 MRS. PEOPLES-STOKES:  I NOW MOVE THAT THE

                    ASSEMBLY STAND ADJOURNED AND THAT WE RECONVENE AT 11:00 A.M.,

                    WEDNESDAY, APRIL THE 30TH, TOMORROW BEING A SESSION DAY.

                                 ACTING SPEAKER HUNTER:  ON MRS. PEOPLES-

                    STOKES' MOTION, THE HOUSE STANDS ADJOURNED.

                                 (WHEREUPON, AT 5:06 P.M., THE HOUSE STOOD ADJOURNED

                    UNTIL WEDNESDAY, APRIL 30TH AT 11:00 A.M., THAT BEING A SESSION DAY.)



























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