David Atkins says he brings the calm of a Zen monastery to the homes of terminally ill New Yorkers who want to choose when and how they die.
Since the state passed the controversial Medical Aid in Dying Law in August, patients have been paying his clinic up to $12,000 to end their lives.
As reported by the Daily Mail, Atkins, a former hospice worker who spent years in Buddhist temples in South Korea, launched his boutique startup, Quietus, in August, precisely when the new law took effect.
Under a doctor's guidance, patients consume a prescribed mixture of lethal drugs at home, typically losing consciousness within minutes and dying within an hour.
Some have survived for many hours or, in rare cases, days, underscoring that even a controlled death can be unpredictable despite the clinical packaging.
The service costs $11,000, Atkins told the Daily Mail, with another $1,000 for the lethal drugs, a price tag that places a literal dollar figure on the timing and manner of a persons death.
Private insurance, Medicare and Medicaid do not cover assisted dying, so the entire bill falls on patients and their families, raising serious questions about whether the choice to die is being rationed by wealth.
By his own count, 15 people have died after going through his clinic which offers services to those in the New York City metropolitan area, the Hudson Valley, and Westchester and Nassau counties while another 40 to 50 have either been referred or reached out directly.
More than half of the clinic's inquiries involve patients with ALS, or Lou Gehrig's disease, Atkins said, a devastating illness that gradually paralyzes patients and eventually leaves them unable to breathe.
Under the new law, only terminally ill adults with six months or less to live can request the lethal drugs, which they must administer themselves.
That requirement is supposed to serve as a safeguard, yet critics note that in practice such prognoses are often imprecise and can be influenced by subjective medical judgment.
Outside of New York, rival clinics make Quietus look expensive, highlighting the emerging marketplace around state-sanctioned death.
A New Mexico provider, Rights of Passage, advertises its services at $2,500, while Windsor Family Practice in Ventura, California, charges $3,000, suggesting that Quietus is positioning itself as a luxury brand in the assisted-suicide industry.
Atkins insisted the $12,000 price tag is fair but clarified that he has offered significant discounts to families desperate to use his service.
Some have paid a token $50 in total, he said, while others have paid half the going rate, a sliding scale that still leaves the power of life and death tethered to financial capacity.
"The goal is that those who can afford this will balance out those who cannot afford it, so I think it's a very reasonable price to charge when you consider the level of service that we're providing," he told the Daily Mail.
That level of service includes not only the prescription itself but the staging of the final moments, turning what used to be a solemn, natural passage into a curated event overseen by paid professionals.
Quietus doctors visit patients in their homes, provide a sense of "tranquility," Atkins said, while remaining by their side as they take the lethal drugs, pronounce them dead and notify hospices afterward.
Atkins said the at-home support matters because the lethal drugs, often mixed into apple juice, must be swallowed within about two minutes of being administered, and some patients cannot swallow at all, a practical complication that can turn a supposedly peaceful death into a frantic struggle.
The number of New Yorkers that have used the law is unclear, reflecting a troubling lack of transparency around such a profound policy shift.
Columbia University estimates that about 20 patients may have received prescriptions in the first month, though that is not a confirmed count of deaths, and the state Department of Health has declined to release preliminary numbers.
Jessica Rodgers of the Patient's Rights Action Fund, which opposes assisted suicide, said clinics like Atkins's were bound to appear because most doctors will not go near the practice.
"It's sadly no surprise to see kill-me clinics popping up in New York, because most doctors don't want to touch assisted suicide with a ten-foot pole," Rodgers told the Daily Mail, using stark language that reflects deep moral unease.
"We now see rogue prescribers acting outside the norm and setting up practices to make lucrative profits off of scared patients."
Opponents also argue that high profit margins tempt clinicians to approve patients who would not otherwise qualify, especially when the business model depends on a steady stream of people choosing death.
Atkins pushed back on that notion, noting his clinic has turned away non terminally-ill patients, and pointed them toward mental health help instead.
Atkins co-founded Quietus with Daniel Cogan, a nurse practitioner with decades of experience, and together they have built a small but growing operation around such stories of extreme pain and desperation.
Quietus works with three experienced doctors who can prescribe the lethal drugs, and has two psychologists on staff.
Atkins, who is not a doctor, provides expert guidance on those seeking Medical Aid in Dying, effectively acting as a gatekeeper and counselor in a process that ends with a deliberate, physician-facilitated death.
Atkins spent more than a decade at the Mu Sang Sa temple on Gye Ryong San mountain, where he translated sacred texts and was known as Myong Hang Sunim.
His path to this work began with a question, one that he says still shapes his view of life and death.
"I had this question for many years, like, why do anything if we die in the end? And that question led me to Buddhism," he said.
Atkins told the Daily Mail that he views the human body as a loan, a metaphor that, to critics, risks trivializing the sanctity of life by likening it to a disposable commodity.
"You borrow this body from the universe. It's like a rental car, and then at a certain point, you got to return the rental car," he said.
Many Buddhists oppose assisted dying, holding that ending life brings bad karma, but Atkins rejects that, claiming that Buddhist teaching doesn't forbid it and that, for him, the choice is personal.
He also pointed to his father, who died in hospice wanting the option but could not get it, a family story he uses to humanize his advocacy.
Governor Kathy Hochul signed the law on February 6, making New York the 14th US jurisdiction to do so, despite longstanding concerns from disability advocates, religious leaders and many physicians.
More than 12,000 Americans have died after taking prescribed lethal drugs since the practice was first legalized in Oregon in 1997.
Cancer accounts for more than two-thirds of cases, while neurological diseases, including ALS, account for another 11 percent, illustrating how the policy has steadily expanded from a controversial experiment to a normalized end-of-life option in some states.
Supporters of assisted dying point to people like Ayla Eilert, a 24-year-old aspiring ballet dancer who died of tongue cancer in April 2022.
Even under heavy sedation, she repeatedly pleaded with family and medical staff for a peaceful death, a plea that advocates say the law finally answers while critics argue that better palliative care, not lethal drugs, should be the response.
"This is not a quality of life, and I am not afraid to die. I just don't want to be in pain anymore," she said as the cancer spread to 13 places in her body.
New York added extra guardrails: a mental health evaluation, an in-person doctor visit, recorded audio or video of the request and a five-day wait between prescription and pickup, measures that supporters tout as robust but opponents fear will erode over time under pressure from the assisted-dying lobby.
Rodgers warned that the state's guardrails are already under pressure, claiming that boutique clinics are lobbying to let nurses, physician assistants and other less qualified clinicians prescribe the drugs.
"These pop-up death boutiques are reminiscent of Canada, a country where euthanasia is now the fifth leading cause of death," she said, invoking a stark statistic that alarms many conservatives who see Canada as a cautionary tale rather than a model.
Canada's assisted dying laws, known as Medical Assistance in Dying, have sparked fierce debate over who should qualify, including the case of an actress who has spent years fighting for the right to end her life because of mental illness.
Claire Brosseau, 49, a Toronto-based former actress who suffers from bipolar disorder and post-traumatic stress disorder, has sought access to assisted dying after decades of psychiatric treatment failed, but an Ontario judge rejected her bid for an exemption in September, as Canadian law continues to prohibit assisted dying for people whose sole underlying condition is mental illness.
The international debate goes beyond who should be allowed to end their own life, as critics have also questioned how the process should unfold.
One man told the Daily Mail how his father's assisted death at home turned into something that felt more like a party than a final goodbye, a scene that many traditional families would find deeply disturbing.
Christopher, 63, who asked that his surname be withheld, said his father, a California resident, had stage four lung cancer that had spread to his spine.
His uncle took over the medical power of attorney, Christopher said, and arranged an assisted death at his own home in Portland in 2010, effectively deciding the timing and setting of his brothers final moments.
When Christopher and his family arrived to say goodbye, they found "this complete spread of food in the dining room."
"No one wanted to eat," he said, and he drank only water, overwhelmed by the surreal atmosphere.
"It was very weird. It's almost like, you know, this is a celebration or something," he said.
Christopher and his family are Catholic and opposed, and they left before his father took the drugs, he said, spending three hours at church, praying, crying and singing instead of participating in what they saw as a morally unacceptable act.
Atkins told the Daily Mail that Quietus does not offer banquets like what Christopher experienced.
Supporters say assisted dying lets desperately ill people end their suffering, while critics say it devalues human life and offers death as a solution to the infirm, the disabled and those who are short of money or feel like a burden, a concern that resonates strongly with conservatives who emphasize the inherent dignity of every person.
Polling suggests most Americans side with supporters, at least in the abstract.
A 2024 Gallup survey found more than seven in ten believe doctors should be allowed by law to end a patient's life by painless means if the patient and family request it, though such topline numbers rarely capture the complex ethical, economic and cultural pressures surrounding real-world cases.
Atkins said anyone with concerns about Quietus, including its price, are welcome to get in touch.
As New Yorks experiment with legalized assisted suicide unfolds, the rise of high-priced death boutiques like Quietus ensures that the debate will not only be about autonomy and suffering, but also about whether a civilized society should turn the final act of human life into a billable service marketed to the sick, the frightened and the vulnerable.
Login