David Atkins says he brings the stillness of a Zen monastery into the homes of terminally ill New Yorkers who want greater control over the timing and circumstances of their deaths.
Since New York enacted its controversial Medical Aid in Dying Law in August, patients have paid his clinic as much as $12,000 to access the option.
With a doctor’s supervision, patients take a prescribed combination of lethal medications at home. Most lose consciousness within minutes and die within about an hour.
However, some people have lived for many hours afterward and, in rare instances, for several days.
Atkins, a former hospice worker who spent years living in Buddhist temples in South Korea, founded his startup, Quietus, in August, the same month New York’s law came into force.
The clinic’s service costs $11,000, Atkins told Our News Outlet, while the medication adds another $1,000. Assisted dying is not covered by private insurance, Medicare or Medicaid, leaving patients and relatives to pay the full amount.
Atkins says 15 people have died after using the clinic. Quietus serves the New York City metropolitan area, the Hudson Valley, Westchester and Nassau counties, and has also received direct inquiries or referrals involving another 40 to 50 people.
More than half of the inquiries have come from people with ALS, also known as Lou Gehrig’s disease, Atkins said. The progressive and incurable condition gradually destroys muscle control and can ultimately prevent patients from breathing.
Under New York’s law, eligible patients must be adults with a terminal illness and a life expectancy of six months or less. They are required to take the medication themselves.
David Atkins founded the boutique assisted-dying clinic Quietus in August, when the practice became legal in New York state
Atkins spent years at Mu Sang Sa temple, translating religious texts under the name Myong Hang Sunim
Compared with similar providers elsewhere in the country, Quietus is costly. Rights of Passage in New Mexico lists its service at $2,500, while Windsor Family Practice in Ventura, California, charges $3,000.
Atkins defended Quietus’s $12,000 total, although he said the clinic has reduced its fees substantially for families struggling to pay.
Some patients have contributed just $50 altogether, he said, while others have paid approximately half the standard price.
‘The idea is that people who can afford the service help offset the cost for those who cannot,’ Atkins told Our News Outlet. ‘When you look at the level of support we provide, I believe it is a reasonable fee.’
Quietus doctors travel to patients’ homes, where they create what Atkins described as an atmosphere of ‘tranquility.’ Staff remain present while the medication is taken, formally pronounce the death and contact hospice providers afterward.
Atkins said that support can be critical because the medication, often stirred into apple juice, generally has to be swallowed within roughly two minutes. Some patients, however, are unable to swallow.
The total number of New Yorkers who have used the law remains unknown. Columbia University estimates that roughly 20 patients may have received prescriptions during its first month, but the figure does not establish how many have died.
The New York State Department of Health has not released preliminary data.
Jessica Rodgers, of the Patient’s Rights Action Fund, which opposes assisted suicide, said clinics such as Quietus were likely to emerge because many doctors refuse to participate.
‘It is unfortunately not surprising to see these so-called kill-me clinics appear in New York, since most doctors want nothing to do with assisted suicide,’ Rodgers told Our News Outlet.
‘We are seeing rogue prescribers operate outside established medical practice and build businesses that profit from frightened and vulnerable patients.’
Critics also say the prospect of substantial earnings could encourage clinicians to approve patients who do not meet the legal requirements.
Atkins rejected that accusation, saying Quietus has refused requests from people who were not terminally ill and directed them instead to mental health services.
Supporters of assisted dying have highlighted the experience of Ayla Eilert
Eilert, an aspiring dancer, asked doctors to end her suffering as cancer advanced in April 2022
Atkins founded Quietus with Daniel Cogan, a nurse practitioner who has decades of experience
Quietus works with three experienced physicians authorized to prescribe the medication and employs two psychologists. Atkins is not a doctor, but he advises patients navigating the Medical Aid in Dying process.
He spent more than 10 years at Mu Sang Sa temple on South Korea’s Gye Ryong San mountain, translating Buddhist texts and using the name Myong Hang Sunim.
His journey toward assisted-dying advocacy began with a fundamental question.
‘For years I kept asking myself why we do anything if we are all going to die eventually,’ he said. ‘That question led me to Buddhism.’
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Atkins said he regards the human body as something temporarily entrusted to us.
‘You borrow your body from the universe. It is like renting a car, and eventually you have to return it,’ he said.
Many Buddhists oppose assisted dying because they believe deliberately ending a life creates harmful karma.
Atkins disagrees, arguing that Buddhist teachings do not categorically prohibit the practice and that his position is personal. He also recalled that his father died in hospice wishing he had the option, but was unable to obtain it.
Governor Kathy Hochul signed New York’s assisted-dying legislation on February 6, making the state the 14th US jurisdiction to authorize the practice.
More than 12,000 Americans have died after taking prescribed lethal medication since Oregon became the first state to legalize the practice in 1997. Cancer represents more than two-thirds of those cases, while neurological conditions such as ALS account for about 11 percent.
Supporters often cite people such as Ayla Eilert, a 24-year-old aspiring ballet dancer who died from tongue cancer in April 2022.
Despite heavy sedation, Eilert repeatedly asked relatives and medical workers for relief from her suffering.
‘This is no quality of life, and I am not scared of dying. I simply do not want to be in pain anymore,’ she said after the cancer had spread to 13 locations in her body.
New York’s law includes additional safeguards, including a mental health assessment, an in-person medical consultation, an audio or video recording of the patient’s request and a five-day waiting period between receiving the prescription and collecting it.
Former Canadian actress Claire Brosseau has urged her government to allow assisted dying, saying her mental health conditions have become unbearable
The 49-year-old Toronto actress and comedian, who is single and supported by family and friends, has said for years that she no longer wants to live (source: Linkedin)
Rodgers said those safeguards are already facing pressure. She claimed boutique clinics are seeking changes that would allow nurses, physician assistants and other clinicians with less training to prescribe the drugs.
‘These pop-up death boutiques resemble what has happened in Canada, where euthanasia has become the fifth-leading cause of death,’ she said.
Canada’s assisted-dying system, known as Medical Assistance in Dying, has triggered intense debate about eligibility, including the case of a former actress who has spent years seeking permission to end her life because of mental illness.
Claire Brosseau, 49, a former Toronto actress diagnosed with bipolar disorder and post-traumatic stress disorder, pursued assisted dying after years of psychiatric treatment failed to ease her condition.
An Ontario judge rejected her request for an exemption in September. Canadian law still bars assisted dying when mental illness is the patient’s sole underlying medical condition.
The broader debate is not limited to eligibility. Critics have also questioned how assisted deaths should be conducted and what role family members should play.
One man told Our News Outlet that his father’s assisted death at home became an event that felt less like a final farewell and more like a gathering.
Patients generally receive a drug mixture as pills or as a crushed preparation that can be delivered through a feeding tube
Cancer patient Robert Fuller used Washington’s assisted-dying law in 2019, holding a ceremony with family and friends
Christopher, 63, who requested that his last name not be published, said his father had stage-four lung cancer that had spread to his spine.
According to Christopher, his uncle became his father’s medical power of attorney and organized the assisted death at a home in Portland, Oregon, in 2010.
When Christopher and other relatives arrived to say goodbye, they saw what he described as a large spread of food laid out in the dining room. ‘Nobody wanted to eat,’ he said, adding that he drank only water.
‘It was deeply strange. It almost felt as if it were some kind of celebration,’ he said.
Christopher said his Catholic family opposed the decision. They left before his father took the medication and spent three hours in church praying, crying and singing.
Atkins said Quietus does not arrange banquets or gatherings like the one Christopher described.
Advocates argue that assisted dying gives people with devastating illnesses control over unbearable suffering. Opponents counter that it diminishes the value of life and risks presenting death as an answer for people who are sick, disabled, financially insecure or afraid of becoming a burden.
Public opinion generally favors the practice. In a 2024 Gallup poll, more than seven in 10 Americans said doctors should legally be allowed to end a patient’s life by painless means when requested by the patient and family.
Atkins said people with questions about Quietus, including concerns about its fees, are encouraged to contact the clinic.
