New York’s Medical Aid in Dying Act takes effect Aug. 5. Before it does, a coalition of Catholic sisters who have cared for the city’s dying since the cholera epidemics of the 1800s filed suit against Attorney General Letitia James to stop it.
A coalition of Catholic religious orders that has cared for New York’s dying for more than a century filed suit last week against Attorney General Letitia James, arguing that the state’s new assisted suicide law forces them to choose between their faith and their license.[1]
The plaintiffs include the Carmelite Sisters for the Aged and Infirm, the Dominican Sisters of Hawthorne, the Missionary Sisters of St. Benedict, the Little Sisters of the Poor, the Roman Catholic Diocese of Rockville Centre and Catholic Health, a hospital system descended from religious orders that have served Long Island since the 19th century. Filed July 17 in the U.S. District Court for the Northern District of New York and litigated by the Becket Fund for Religious Liberty, the complaint names James in her official capacity alongside state health commissioner James McDonald and Michael Iannuzzi, interim chair of the state’s medical conduct board.
At issue is the Medical Aid in Dying Act, which Governor Hochul signed on Feb. 6 and which takes effect Aug. 5.[2] The MAID Act builds on New York’s existing Palliative Care Information Act to create what the complaint calls a suicide counseling mandate. Physicians and nurse practitioners treating a terminally ill patient must proactively raise the option of obtaining lethal drugs, and if they will not do so themselves, they must arrange for a colleague who will or transfer the patient to one. California, Oregon and Washington, the states that pioneered assisted suicide laws, impose no such duty to raise the subject unprompted. New Zealand and the Australian state of Victoria go further and bar clinicians from initiating the conversation at all, a policy the complaint traces to documented evidence that public discussion of suicide is followed by increases in suicide rates.
New York’s religious opt-out is narrower still. A covered facility may decline to allow the prescribing, dispensing or self-administering of lethal drugs on its premises only if it adopts a formal policy grounded in sincerely held religious belief and discloses that policy before admission. Assisted living residences, including the Missionary Sisters’ St. Joseph’s Home for the Aged, do not qualify as covered facilities at all and get no opt-out whatsoever. Individual physicians fare no better. The law exempts them only from the final act of dispensing the drug itself, leaving the counseling, examination and referral obligations fully intact.
This is where the complaint identifies the sharpest conflict with existing federal law. The Assisted Suicide Funding Restriction Act of 1997 already bars the use of federal healthcare funds for any service furnished for the purpose of causing or assisting in causing a patient’s death.[3] The Affordable Care Act goes further, forbidding any state that accepts federal financial assistance from discriminating against a healthcare entity because it declines to provide such a service.[4] The complaint alleges that the Carmelite Sisters, the Little Sisters of the Poor and Catholic Health all receive federal healthcare funding directly. If the complaint is right that New York’s law conscripts those same institutions into facilitating assisted suicide on pain of losing their licenses, the conflict with the federal funding statutes is not a close call. It is the kind of direct statutory collision the Supremacy Clause was written to resolve. A judge can settle it by reading two statutes side by side, without ever reaching the harder constitutional balancing the other counts require.
The remaining counts rest on more familiar constitutional and statutory ground: the church autonomy doctrine, free exercise claims sounding in both non-neutrality and the absence of general applicability, compelled speech, expressive association, a Title II disability discrimination claim under the ADA and an Equal Protection claim treating terminally ill patients as a disabled class denied equal treatment. Each of these is a serious claim, but the statutory preemption argument is the one a judge can resolve on the papers without wading into the harder business of weighing free exercise against a state’s asserted interest in end of life autonomy.
The Sisters have cited no quarrel with New Yorkers who want assisted suicide and can find it elsewhere. Their request is narrower: let dying patients spend their final days in a home built to care for them without also being asked, by law, whether they would rather die sooner. Federal law already answers that request. New York’s task now is to explain to a federal judge why its own statute should not.
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Notes
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Carmelite Sisters for the Aged and Infirm, Inc. v. James, Verified Complaint (N.D.N.Y., filed July 17, 2026).
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N.Y. Pub. Health Law §§ 2899-d et seq.; Palliative Care Information Act, N.Y. Pub. Health Law § 2997-c.
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Assisted Suicide Funding Restriction Act of 1997 § 3(a)(1), 42 U.S.C. § 14402(a)(1).
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Affordable Care Act, 42 U.S.C. § 18113(a).
Letitia James, Medical Aid in Dying Act, assisted suicide, religious liberty, Becket Fund, ecclesiastical abstention, church autonomy, First Amendment, Supremacy Clause, Catholic healthcare, New York law