New York is set to legalize medically assisted suicide for terminally ill patients under an agreement reached between Governor Kathy Hochul and state legislative leaders, the governor announced on Wednesday.

Hochul said she plans to sign the bill next year after securing added safeguards, or “guardrails,” to ensure the law is applied carefully. Writing in an op-ed, the Democratic governor said her decision followed conversations with patients enduring severe pain, their families, and people of faith who oppose ending life on moral grounds.

The proposed Medical Aid in Dying Act would allow patients expected to die within six months to request life-ending medication. The request must be made in writing, signed by two witnesses to rule out coercion, and approved by both an attending physician and a consulting doctor. Additional provisions will require confirmation from a medical doctor of the patient’s prognosis and an evaluation by a psychologist or psychiatrist to ensure the decision is voluntary and informed.

The bill also includes a mandatory five-day waiting period and both written and recorded oral requests to confirm free will. Facilities tied to religious hospitals may opt out, and the measure will apply only to New York residents. The law would take effect six months after being signed.

Hochul described backing the bill as one of the most difficult decisions of her tenure, saying she could no longer deny terminally ill patients a choice they are pleading for at the end of life.

The legislation, first introduced in 2016, faced years of opposition from religious groups, including the New York State Catholic Conference, which argues it undermines the sanctity of life and the role of physicians. Church leaders renewed their criticism after the announcement, warning it could endanger vulnerable people.

Supporters say the law will ease suffering and allow terminally ill individuals to die with dignity. About a dozen other states and the District of Columbia have already enacted similar measures.