A psychiatrist’s case for meaningful last words

When New York Gov. Kathy Hochul signed the Medical Aid in Dying Act into law on Feb. 6, 2026, she included an unusual provision: patients requesting medical aid in dying must make an audio or video recording of their oral request, which becomes a permanent part of their medical record.

To qualify, a patient must be mentally capable of making their own medical decisions, free from coercion, aware of their terminal diagnosis and prognosis, and informed of all risks, benefits, and alternatives under the law.

In a guest opinion published in Syracuse.com, retired psychiatrist and longtime medical aid in dying advocate Dr. Barry B. Perlman writes that he initially found the requirement perplexing. Most existing medical aid in dying laws require only an oral or written request — not a recorded one. Being compelled to make a recording at a time of extraordinary vulnerability, he argues, seemed like an arduous imposition on terminal patients. And if the recording simply reiterates what is already documented in writing, it is worth asking what it substantively adds. The specifics of how the process will work in practice will be determined by regulations the New York Department of Health is currently drafting.

Perlman does see a path to something meaningful, though. He proposes that the requirement could allow patients to go beyond the legally required elements and use the recording as an opportunity to leave a personal message for loved ones — expressions of gratitude, final wishes, or simply a goodbye in their own words. With the right framework, he argues, what feels like a burden could become a lasting farewell.

New York’s medical aid in dying law is new, and navigating it comes with real questions. Compassion & Choices is here to help.

If you are a New York resident navigating this process, we have the latest information on eligibility, next steps, and available resources.

Check out our New York medical aid in dying packet.