The NYS Medical Aid in Dying law, Article 28-F of the Public Health Law, allows terminally ill adults to obtain a prescription for medication which they can choose to self-administer to end their life. The law will take effect on August 5, 2026.

To qualify for Medical Aid in Dying, a person must:

• Be an adult, aged 18 or older;
• Be a resident of New York State;
• Have a medically confirmed terminal illness that is incurable and irreversible and will likely cause death within 6 months whether or not treatment is provided;
• Have the ability to understand and appreciate the nature and consequences of Medical Aid in Dying, including the benefits, risks, and alternatives, and to reach an informed decision; and
• Be able to self-administer the medication.

The process for a patient to request Medical Aid in Dying is codified under Public Health Law § 2899-e and is summarized below.

A patient wishing to request medication under this law must make an oral request and submit a written request to their attending physician. Requests for a medical aid-in-dying prescription must be made by the patient and may not be made by the patient's health care agent, surrogate, or any other individual. The patient's request may not be made in an advance healthcare directive such as a living will.

• Oral Request: If a patient is not physically capable of making an oral request, such request can be made using an alternative method of communication familiar to the patient. Oral requests must be recorded by an audio or video device and permanently stored in the patient's medical record.
• Written Request: An eligible patient must make a written request to obtain Medical Aid in Dying using the DOH-5847 form titled "REQUEST FOR MEDICATION TO END MY LIFE."

The written request must be signed by the patient and witnessed by at least two legally and financially disinterested adults who, in the presence of the patient, attest that to the best of the witnesses' knowledge and belief the patient has

decision-making capacity, is acting voluntarily, is making the request for medication of the patient's own volition, and is not being coerced to sign the request.

Both witnesses must be adults who are not:

(i) A relative of the patient by blood, marriage or adoption;

(ii) A person who at the time the request is signed would be entitled to any portion of the estate of the patient upon death under any will or by operation of law or would otherwise benefit financially from the death of the patient;

(iii) An owner, operator, employee, or independent contractor of a health care facility where the patient is receiving treatment or is a resident;

(iv) A domestic partner of the patient (as defined in Public Health Law § 2994-a(7));

(v) A health care agent under the patient's health care proxy; or

(vi) An agent acting under a power of attorney for the patient.

The attending physician, consulting physician, and the mental health professional cannot serve as witnesses.

The Medical Aid in Dying law includes a long list of rigorous safeguards to ensure that the law is used appropriately and responsibly, including:

• The terminally ill person can withdraw their request for aid-in-dying medication, not take the medication once they have it, or otherwise change their mind at any time. In addition, a prescription for medication may not be written without the attending physician offering the qualified individual an opportunity to rescind the request.
• The law expressly states that no person shall qualify for Medical Aid in Dying solely because of age or disability.
• Anyone attempting to coerce a patient into accepting medical aid-in-dying may be criminally prosecuted.
• Requests for a medical aid-in-dying prescription must be made by the qualified individual and may not be made by the patient's health care agent, surrogate, or any other individual, and the request may not be made by the patient via advance healthcare directive.
• Patients must be mentally capable adults at least 18 years old with a prognosis of six months or less to live, as verified by two independent physicians;
• Patients must have a mental health evaluation to determine that they have decision-making capacity;
• Patients must make a verbal request for Medical Aid in Dying if capable of doing so, as well as submit a written request;
  • Such request must be witnessed by two individuals, neither of whom can be a relative, heir, or affiliated with an owner, operator, or employee of the health care facility where the patient is receiving care;
  • The witnesses must have no financial interest in the patient's estate;
  • Patients must be recorded making a request for Medical Aid in Dying.
• There is a mandatory waiting period of 5 days between when a prescription is written and when it may be filled, unless the attending physician determines that the patient is not expected to survive that period;
• Patients must be capable of self-administering the medication, ensuring that the final act is a voluntary and deliberate choice;
• Physicians are required to inform patients of all available end-of-life care options, including hospice and palliative care.

Health insurance benefits are unaffected by the availability of Medical Aid in Dying, and life insurance payments cannot be denied to the families of people who exercise their rights under the law. The sale, procurement, or issuance of a life insurance or annuity policy or third-party health care payer policy or coverage, or the rate charged for a policy or coverage, shall not be conditioned upon or affected by a patient making or rescinding a request for medication under this article.

The relation of the Medical Aid in Dying law to other laws and contracts is codified under Public Health Law § 2899-n and is summarized below:

a) A patient who requests medication shall not, because of that request, be considered suicidal, and self-administering the medication shall not be deemed to be suicide for any purpose.

b) Action taken in accordance with the law shall not be construed for any purpose to constitute suicide, assisted suicide, attempted suicide, promoting a suicide attempt, euthanasia, mercy killing, or homicide, including as an accomplice or accessory or otherwise.

c) No provision in a contract, other agreement or testamentary instrument, whether written or oral, to the extent the provision would affect whether a person may make or rescind a request for medication or take any other action under this article, shall be valid.

d) No obligation owing under any contract, other agreement or testamentary instrument shall be conditioned or affected by the making or rescinding of a request by a person for medication or taking any other action under this article.

The Medical Aid in Dying law does not require the patient to inform family or anyone else of their intention to use Medical Aid in Dying. Nonetheless, it is recommended the patient discuss Medical Aid in Dying with those close to them. To avoid the possibility of emergency medical services personnel or others from attempting to resuscitate the patient after they take the medication, the patient should have Do Not Resuscitate (DNR) and Do Not Intubate (DNI) orders, which may be issued by the patient's physician using the Medical Orders for Life-Sustaining Treatment (MOLST) form, DOH-5003 to help ensure their wishes are respected. Also, having others present when the patient self-administers the medication ensures that the terminal illness or condition is correctly listed as the cause of death on the death certificate as required by PHL § 2899-p.

"Attending physician" means the physician who has primary responsibility for the care of the patient. Neither a physician assistant nor a nurse practitioner may be the attending physician under the Medical Aid in Dying law.

Yes, a hospitalist or other physician without a longstanding or established relationship with the patient may prescribe the medication. The establishment of care teams for the purpose of Medical Aid in Dying is not prohibited by the statute.

Upon a patient's request for a Medical Aid in Dying prescription, the attending physician shall examine the patient in person and review the patient's relevant medical records; provided, however, that the attending physician may waive the in-person examination requirement and conduct the examination via telehealth if the physician determines, within reasonable medical judgment, and documents in the patient's medical record that requiring an in-person visit would result in extraordinary hardship to the patient. The term "extraordinary hardship" means circumstances in which an in-person examination would cause the patient undue pain or suffering or would necessitate extraordinary expense or logistical burden for medically necessary transportation. In such cases, the examination may be conducted via telehealth once the attending physician affirms that all other requirements of Public Health Law Article 28-F have been fulfilled.

The attending physician may be located outside New York State when the examination is via telehealth, but the physician must be licensed to practice medicine in New York State.

The Department has developed educational materials regarding hospice and palliative care, available at: New York State Department of Health Center for Hospice and Palliative Care It is the responsibility of the attending physician to provide this information to patients and other appropriate available information in accordance with Public Health Law section 2899-f(1)(g).

The Medical Aid in Dying law does not define the term "resident." The patient must have a New York State address that is the address of the patient's place of abode, not merely a mailing address. The patient must live in New York State. Patients are required to attest to their New York State residency.

Yes, health care facilities can add an attestation of New York State residency to the DOH-5847 REQUEST FOR MEDICATION TO END MY LIFE form.

The file must be stored in the patient's medical record. The audio or video recording must be in standard formats playable on typical electronic devices used by health oversight agencies.

Patients who choose to self-administer the medication must make an affirmative, conscious, and voluntary act to ingest the medication. The medication may not be an injection or infusion. A patient may use a tool or assistive device to help them self-administer the medication, but the patient must perform a final, physical act to self-administer the medication.

Yes, self-administration means the patient ingests the medication without any assistance from a healthcare provider or any other person.

If the patient cannot self-administer medications, they cannot utilize Medical Aid in Dying. Instead, they should be provided information on alternative end-of-life care options including hospice and palliative care.

The medication may not be an injection or infusion. A patient may use a tool or assistive device to help them self-administer the medication, but the patient must perform a final, physical act to self-administer the medication. The patient must self-administer the medication into the patient's gastro-intestinal system, and the patient could do so using a feeding tube if necessary.

Alternative methods of communication are methods of communication familiar to the patient, such as sign language, or devices that allow patients to use their bodies (for example hands or eye-gaze) to generate speech.

Yes, provided that the other requirements for being a witness are met, an interpreter can serve as a witness.

Yes, an interpreter using sign language would need to sign the interpreter's

declaration form, which is on the DOH-5847 form.

No, the attending physician is not responsible for verifying that statements the witnesses or interpreter make in their attestation/declaration are true, but the attending physician may not accept an attestation/declaration if the attending physician knows the attestation/declaration is untruthful.

No, the NYS Medicaid program does not cover the cost of prescriptions administered for Medical Aid in Dying.

Yes, if a patient receives a prescription but it expires because the patient does not fill it within 30 days, the attending physician can re-issue the prescription without restarting the Medical Aid in Dying process; but if the patient does not die within six months, the process would have to be restarted.

Attending physicians must prescribe the medication and dosage in accordance with the community standards of care.

Yes, pharmacies may refuse to participate in Medical Aid in Dying dispensing.

New York will not be endorsing any particular ingestible medication regimen or protocol over another.

A prescription for medication shall not be filled until five days after the prescription has been written, unless the patient's attending physician has medically confirmed that the qualified individual may, within reasonable medical judgment, die before the expiration of the waiting period, in which case, the prescription may be filled once the attending physician affirms that all other requirements under Public Health Law Article 28-F have been fulfilled. Such prescriptions must indicate the date and time that the prescription for medication was written and indicate the first allowable date and time when it may be filled.

No, attending physicians may not delegate their responsibilities under the Medical Aid in Dying law to someone else.

Yes, the consulting physician's responsibilities may be conducted via telehealth.

A physician, pharmacist, other health care provider, or other person shall not be subject to civil, administrative, or criminal liability or penalty or professional disciplinary action by any government entity for taking any reasonable, good-faith action or for refusing to act under this article, including, but not limited to:

• engaging in discussions with a patient relating to the risks and benefits of end-of-life options in the circumstances described in Public Health Law Article 28-F;
• providing a patient, upon request, with a referral to another health care provider;
• being present when a patient self-administers medication for Medical Aid in Dying;
• refraining from acting to prevent a patient from self-administering medication for Medical Aid in Dying; or
• refraining from acting to resuscitate a patient after the patient self-administers medication for Medical Aid in Dying.

Yes, a hospital can prohibit self-administration at its facility. The hospital should have a formally adopted policy to address participation by the institution and physicians on staff. Where a health care facility has adopted a prohibition under a formally adopted policy, if a patient wishes to use Medical Aid in Dying, the health care facility must transfer the patient to another health care facility that is reasonably accessible and willing to permit the prescribing, dispensing, ordering, and self-administering of medication for Medical Aid in Dying.

The health care facility must have a formally adopted policy that is in writing and available upon request.

No, New York State will not have a centralized registry or database of providers that offer Medical Aid in Dying.

The Medical Aid in Dying law does not negate a licensed and regulated provider's reporting requirements. Adult Care Facilities and Assisted Living Program providers licensed by the NYS Department of Health are required to report all deaths in accordance with 18 NYCRR §§ 487.7(d)(11), 488.7(b)(11), and 490.7(d)(9).

Additionally, Social Services Law § 461-m requires that a resident death involving any resident who, at any time, received mental hygiene services, must also be referred to the Justice Center for the Protection of People with Special Needs. These reporting requirements remain unchanged.

When developing policies and procedures related to a facility's decision to permit Medical Aid in Dying, providers should check with their pharmacy provider to determine if the medication is available. Medications for Medical Aid in Dying may not require compounding and could be taken individually. If compounded medication is necessary and not available, the facility can utilize a publicly available listing of 369 pharmacies that compound medication by visiting Pharmacy Compounding Pharmacy Providers - NEW YORK. Providers should continue to take receipt, inventory, and store medications consistent with their license issued by the New York State Department of Health's Bureau of Narcotic Enforcement.

The educational materials regarding hospice and palliative care are available at the following link: New York State Department of Health Center for Hospice and Palliative Care

Yes, the statutory forms are available on the NYS DOH MAID webpage.

Yes, electronic signatures are permitted under the Electronic Signatures and Records Act (State Technology Law Article 3).

Yes, the attending physician could refer the patient to a new attending physician for Medical Aid in Dying.

A link to the State Education Department's guidance document for attending and consulting physicians will be provided here when it is available.

The consulting physician is a physician who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding a patient's terminal illness or condition. The responsibilities of consulting physicians are codified under Public Health Law § 2899-h and are summarized below.

Before a patient who is requesting Medical Aid in Dying may receive a prescription for medication, a consulting physician must examine the patient and such patient's relevant medical records and confirm, in writing, to the attending physician and the patient, whether: (a) the patient has a terminal illness or condition; (b) the patient is making an informed decision; (c) the patient has decision-making capacity; and (d) the patient is acting voluntarily. The consulting physician must also confirm that the patient's illness is terminal and that it is reasonably medically certain to cause death within 6 months with or without treatment.

A link to the State Education Department's guidance document for mental health professionals will be provided here when it is available.

The mental health professional means an individual licensed to practice medicine in New York state who is a diplomate of the American board of psychiatry and neurology or is eligible to be certified by that board or is certified by the American osteopathic board of neurology and psychiatry or is eligible to be certified by that board; or licensed to practice psychology under Title Eight of the Education Law. The responsibilities of mental health professionals are codified under Public Health Law § 2899-i and are summarized below.

Before a patient who is requesting medication may receive a prescription for medication under the law, a mental health professional must evaluate the patient and report, in writing, to the attending physician and the consulting physician the mental health professional's independent conclusions about whether the patient has decision-making capacity to make an informed decision, provided that if, at the time of the report, the patient has not yet been referred to a consulting physician, then upon referral the attending physician shall provide the consulting physician with a copy of the mental health professional's report.

If the mental health professional determines that the patient lacks decision-making capacity, the patient shall not be deemed a qualified individual, and the attending physician shall not prescribe medication to the patient.

A determination made pursuant to this section that an adult patient lacks decision-making capacity shall not be construed as a finding that the patient lacks decision-making capacity for any other purpose.

An interpreter may be required for patients who use a language other than English. The written request may be prepared in English even when such conversations or consultations were conducted in a language other than English.

If an interpreter is used, the interpreter must sign the INTERPRETER'S DECLARATION on the DOH-5847 REQUEST FOR MEDICATION TO END MY LIFE form, asserting that the interpreter is not a relative of the patient, nor is entitled to any portion of the estate of the patient or be otherwise in a position to benefit financially from the patient's death. Further, the interpreter must assert they are not a domestic partner of the patient, an agent under the patient's health care proxy, or an agent acting under a power of attorney for the patient.

The interpreter must further assert that they are not an owner, operator, employee, or independent contractor of a health care facility where the patient is receiving treatment or is a resident, unless the interpreter has been trained to provide interpreter services and provides interpreter services as part of their job description at such health care facility.

Medications prescribed under medical aid in dying (MAID) are unlike other medications due to the extremely high concentration of controlled (and in some cases non-controlled) substances that are, by design, intended to result in the death of the patient, and as such, require extreme care in handling and disposal.

Be sure medications are kept in a safe place in your home, preferably locked up away from children and other family members, and arrange for any remaining or unused medication to be safely disposed.

A person who has custody or control of Medical Aid-in-Dying medication dispensed under this law that the terminally ill individual does not use is advised to drop off the remaining medication(s) at a nearby, secure disposal location of their choice. The Department's statewide Drug Takeback Program directory (medtakebacknewyork.org; (844) 4-TAKE-BACK or (844) 482-5322) allows users to find nearby, convenient, and secure disposal drop-off locations with an option to mail back medications. Patients' families can also use the website or phone number to request mail-back envelopes at no cost.

However, remaining/unused medication can also be mixed with used coffee grounds or used cat litter in a plastic bag and disposed of in the trash.

These medications must be disposed of in a safe and approved manner. Do not flush unused medications in the toilet or sink. Your pharmacist can provide counseling concerning other approved methods of safely disposing of the prescribed medications.

Health Care Facilities licensed by the New York State Bureau of Narcotic Enforcement are responsible for storing controlled substances in accordance with the requirements set forth in section 80.50 of Title 10 NYCRR Part 80 Controlled Substance Regulations. Section 80.6 of Title 10 NYCRR Part 80 Controlled Substance Regulations contains parameters to safeguard controlled substances in a manner that will prevent accidental administration.

Hospice residences are advised to store medications securely and safely in a locked cabinet or drawer, in a manner that preserves their effectiveness and prevents accidental ingestion by others. Guidelines can be found at NYS 10 NYCCR Section 80.50, which provides the minimum-security standards for Class 3A licensees.

10 NYCRR Section 80.51, which includes hospice residences, requires licensees to obtain prior written approval for on-site destruction, including the manner and detail of all such disposal/destruction. To obtain approval, regulated and licensed providers must submit a Request for Approval of Disposal/Destruction of Controlled Substances (DOH-2340) and a Controlled Substance Inventory Form (DOH-166) to the Bureau of Narcotic Enforcement. Hospice residences should have clear policies and procedures to govern narcotic destruction for all unused and outdated narcotics, and such policies must be communicated to all appropriate licensed staff.

NYS tracking and reporting will be conducted in accordance with 2899-q.

The NYS Department of Health will collect basic data entered by the Attending Physician: Patient identifier, Terminal illness, Patient setting, County, Prescription sent, Attending Physician, Consulting Physician, Mental Health Provider and attestations that statute has been followed.

Section 2899-p(2) states: The cause of death listed on a qualified individual's death certificate who dies after self-administering medication under this article will be the underlying terminal illness or condition.

There are currently no plans for training to medical examiner offices.

There is no requirement for the Attending Physician (who is the one who writes the prescription) to certify the death certificate. The death certificate should be certified in the usual manner, with the cause of death as the terminal illness or condition.

§ 2899-g. Right to rescind request; requirement to offer opportunity to rescind. 1. A patient may at any time rescind the request for medication under this article without regard to the patient's decision-making capacity.

Cause of death on the death certificate in Medical Aid in Dying is covered in 2899-p.

The statute does not address standard cremation review. Routine procedures should be followed.

If the family alleges criminal actions occurred, presumably those complaints would be referred to law enforcement.

A prior injury would not necessarily result in a terminal diagnosis in itself. If a situation of quadriplegia, e.g., resulted in recurrent pneumonias or severe decubiti likely to cause death in 6 months, the cause of death would be the resulting complication, not the quadriplegia. The terminal illness or condition is (by statute) the cause of death in Medical Aid in Dying.

Medications prescribed for Medical Aid in Dying are specific to the person to whom they are prescribed and not to be given to someone else. Individuals who might give their Medical Aid in Dying medication to another person would be subject to the prevailing laws pertaining to such an act.

No, after a patient legally obtains medication under Medical Aid in Dying, the patient may choose to self-administer the medication, and it is not necessary to make another determination that the patient continues to have decision-making capacity.

No, the patient will not be required to provide a decision on post-mortem care of their body.

Medications are prescribed and protocols are developed by each Attending Physician or institution with Attending Physicians based on the available evidence and experience, so there will not be a standardized regimen provided by the Department of Health.

The patient's medical record should contain all the requests, evaluations and other documents ensuring Medical Aid in Dying was done according to statute. The statute does not require any documentation to be available at the scene.

No, the State will not be maintaining a centralized registry of certifying providers.

A62 . If the certifying provider is not the Attending Physician, then there is no confirmation system for that provider. It is the Attending Physician's responsibility to make sure the statute is complied with in its entirety.

Standard protocols for an unattended death should still be followed.

Standard protocols for an unattended death should still be followed.

By statute, the cause of death for MAID is the underlying terminal illness or condition.

If criminal, allegations should be referred to law enforcement. Complaints against the Attending Physician, consulting physician, or a physician who is a psychiatrist acting as the mental health professional making the capacity determination may be referred to the Department's Office of Professional Medical Conduct. Complaints against a psychologist acting as the mental health professional or a pharmacist may be made to the Office of the Professions in the State Education Department.

If the MAID protocols have been appropriately followed the death certificate has to list the terminal illness or condition as the cause of death. By law, the death certificate cannot have Medical Aid in Dying or the medications as the cause of death.

If an individual changes their mind about Medical Aid in Dying after ingesting the medication, wants treatment ,and 911 is activated, that treatment should be rendered. If a family member or friend tries to counter the known wishes of an individual after ingestion of medications for Medical Aid in Dying when the person is no longer able to respond, the individual's (patient's) wishes should be honored.

To avoid the possibility of emergency medical services personnel or others attempting to resuscitate the patient after they take the medication, the patient should have Do Not Resuscitate (DNR) and Do Not Intubate (DNI) orders, which may be issued by the patient's physician using the Medical Orders for Life-Sustaining Treatment (MOLST) form, DOH-5003. Also, having others present when the patient self-administers the medication ensures that the terminal illness or condition is correctly listed as the cause of death on the death certificate as required by PHL § 2899-p. EMS should follow its normal protocols.

If the patient becomes incapacitated, specifically being unable to perform the final act of taking (ingesting) the medications, then they are no longer eligible for Medical Aid in Dying.

The statute is clear that a health care professional or other person shall not administer the medication to the patient. Patients who choose to self-administer medications for Medical Aid in Dying (MAID) must make an affirmative, conscious, and voluntary act to ingest the medication. The medication may not be an injection or infusion. A patient may use a tool or assistive device to help them self-administer the medication, but the patient must perform a final, physical act to self-administer the medication. If the patient cannot self-administer medications, they cannot utilize Medical Aid in Dying. Instead, they should be provided information on alternative end-of-life care options including Hospice and Palliative Care.