New York startup Quiĕtus offers terminally ill patients ‘a good death’ at home for $12,000
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Imagine that instead of taking medication to fend off death from a terminal illness, a person could pay to take a concoction that will end their life in minutes — giving them full control of when and where they die.
This process, known as medical aid in dying (MAID), is legal in 13 states. New York just made it legal on August 5. And one startup, Quiĕtus, launched on the very same day to grant terminally ill patients “a good death” for just under $12,000.
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Quiĕtus was recently profiled by The New York Times. It’s made up of a group of nine doctors, nurses, psychologists and other clinicians. It has no dedicated office because it visits and treats patients in their home.
Before their scheduled death, patients get two medical evaluations and a mental health screening, as well as a prescription for the drugs needed, including lethal doses of cardiac medication, that will end their life. The $12,000 cost for the patient covers all of this and help for the grieving family after their passing.
The complexities of running Quiĕtus
Before Quiĕtus even launched this summer, the group of clinicians had to figure out how they would spread the word about the new practice, how much would a patient need to pay and how would they even source the drugs, among other mind-rattling questions.
After multiple rejections from pharmacies around the city, Quiĕtus member Dr. Rob Siegel eventually found a family-owned pharmacy in Midtown Manhattan that was willing to supply lethal doses of drugs. The business, however, asked that it not be named by The New York Times for fear of retaliation.
Arguably the most important question was around how on-demand the service would be. During a team meeting in April, Daniel Cogan, the leader of Quiĕtus, argued that the startup always had to be available for patients. He imagined a situation where a patient feeling piercing pain in the middle of night could want to die sooner than planned, according to The New York Times.
However, his colleague, Dr. Cristian Zanartu, rejected the idea, arguing that always being available could lead to serious burnout for the group. And if Quiĕtus medical professionals are always on the go, the startup risks making every death less tender and intimate. He added that if a patient started thinking about drinking the medication in the middle of the night, they could afford to wait until the morning.
“I hate to say it, but we’re going to have to establish some boundaries,” Zanartu said.
Not everyone qualifies for MAID in New York
Then there’s the matter of having to turn away patients who don’t qualify for MAID despite dealing with chronic illnesses. Dr. Tara Shapiro told her colleagues in the spring that advocates for MAID in New York warned her that she should be cautious about the calls that trickle in from would-be customers.
“It’s a lot of people who don’t qualify,” she said. For example, some patients who had Parkinson’s but whose doctors said they had more than six months to live.
Though New York State made medical aid in dying legal in August, it has among the strictest regulations in the U.S.. Patients must be state residents, have six months or less to live and wait five days between getting a prescription and filling it. It’s also legally required for patients to be recorded saying they want to die, according to The New York Times.
That means that many people will be turned away.
“If somebody is like, ‘I’m paraplegic and the doctor says I might live for years but I want to kill myself, can you help me?’ — the short answer is, I have tremendous sympathy for your situation, and tell me more about what’s going on, but these are the terms of the law,” Cogan said, using a made-up scenario to describe to the broader group what they should do.
A 2019 study found that 60% of physicians favored the idea of legalizing assisted death, but only 13% wanted any part in helping patients do it if it were legalized. This is likely because of the Hippocratic oath, which says medical professionals should do no harm to patients.
“The Hippocratic oath says do no harm,” Dr. Shapiro told The New York Times. “And I don’t think we’re harming anyone by doing this. I think we’re actually being compassionate and relieving suffering.”
Shapiro’s connection to Quiĕtus’ mission is arguably deeper than her startup colleagues. Her mother-in-law, Janice Shapiro, died in 2023 through assisted death in Vermont, which had just made medical aid in dying legal for out of state patients.
Months before, on a drive up to her son’s college graduation, Dr. Shapiro recalled her mother-in-law was choking in the front seat. Her husband saved her, but instead of getting a thank you, she scolded her son.
“Don’t ever do that to me again,” she said. Shapiro was 81 and had a degenerative muscle disease, and knew that she wanted to die. That night, they started looking into options for doctors who would be willing to help her end her life.
The day of Shapiro’s death, the family played Frank Sinatra’s “My Way.” Dr. Shapiro mixed powders in a cup with apple juice and handed it to her mother-in-law who gulped it down, she told The New York Times.
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