A New York Times article by Emma Goldberg describes the founding of Quietus, a startup created by physicians, nurses, psychologists, and palliative care specialists to help terminally ill patients end their lives according to their wishes under medical supervision. The organization was founded after New York legalized medical aid in dying, a practice also known as physician-assisted death.
The article centers on palliative care physician Tara Shapiro, who helped her mother-in-law, suffering from a degenerative muscle disease, end her life in Vermont in 2023. That experience led Shapiro to co-found Quietus, which provides medical and psychological evaluation, assistance with legal requirements, and logistical support to patients seeking to end their lives. The service costs approximately $12,000, with the organization pledging to help patients unable to afford it.
Creating the organization proved complex, according to the article, as the team faced questions rarely encountered in medical settings: how to find pharmacies willing to supply the drugs, how to arrange delivery to patients' homes, what legal responsibilities apply, and how to work with insurance companies. The team also debated operational details, including whether to provide "death doulas" to support patients and families and whether physicians should be available around the clock if a patient's condition deteriorates suddenly.
Daniel Kogon, who leads the organization, argued that accepting responsibility to help patients die means physicians must be available when patients need them, even in middle-of-the-night emergencies. Physician Christian Zanartu warned that working at such intensity could exhaust the team psychologically and physically, and that maintaining boundaries might be necessary to preserve physicians' capacity for humane presence.
The article describes a paradox within American medicine: there is broad physician support for legalizing medical aid in dying, but few doctors are willing to participate in practice. Some physicians and medical ethicists fear that allowing doctors to help end life could undermine the profession's foundational principle of protecting life and seeking to treat disease and restore health.
Shapiro and colleagues offer a different view: they argue that helping a terminally ill patient die does not contradict the principle of "do no harm," and that easing someone's suffering at life's end, when legal and medical means are available for the patient to choose the timing of death, represents an extension of palliative care rather than its opposite. The article notes that demand for such services remains uncertain, with other jurisdictions seeing modest uptake initially that has risen over time.
