Open Bar: Medical Aid in Dying (MAID) Is Now Permitted in New York State

Effective August 5, 2026, terminally ill New York residents may request self-administered medication to end their life. After a decade-long legislative process, New York joins several other states in authorizing this option. Public Health Law (PHL) Article 28-F contains this new provision. The law requires two physicians to confirm that the patient has a prognosis of six months or less to live.

Guidelines For Implementation of the Law

1. The patient must be an adult (18 years of age or older) and have the mental capacity to understand and appreciate risks and benefits of healthcare decisions. PHL § 2899-d.  Patients must be a resident of New York and attest to this strict requirement for implementation of MAID. PHL § 2899-d
2. Patients must provide their attending physician with both oral and written requests for medication to end their life. PHL § 2899-e  Requests should be included in patients’ medical records. Oral requests should be recorded by an audio or video device and also maintained in patients’ records. Id.
3. A sample form for a written request is available at https://www.health.ny.gov/forms/doh-5847.pdf, and should be added to the patient’s record. A request for MAID in a healthcare proxy or living will is invalid. If a patient is incapacitated, a surrogate decisionmaker (i.e., agent; family member; guardian) is not permitted to request MAID.
4. In addition to the patient’s signature and date, the form requires signatures of two adult witnesses. PHL § 2899-e.  Witnesses may not be: a beneficiary of the patient’s estate; related by blood, marriage, or adoption; a domestic partner; healthcare proxy agent; power of attorney; facility employee; or either of the attending physicians or mental health professional involved in the patient’s process for obtaining medication. Id.
5. The written request must be in the same language as the conversation between the patient and at least one of the patient’s attending physicians. If an interpreter is required, the interpreter must not have any relationship or connection to the patient. Documentation of their role as interpreter must be included in the patient’s record. The interpreter must also sign the patient’s written request form.

Attending Physician’s Responsibilities: PHL § 2899-f

1. There is no legal duty to participate in honoring a patient’s request for MAID. PHL § 2899-m.  Physicians and facilities with religious, moral or ethical objections to participation have opt-out rights. Private health care facilities may opt out of MAID if it is contrary to a formally adopted policy based on sincerely held religious beliefs or moral convictions central to the facility’s operating principles.  PHL § 2899-m(2).  Patients shall be referred or transferred to a willing provider or facility. Id.
2. The attending physician has overall responsibility for MAID, obtaining informed consent, documentation, ordering medication, and reporting obligations. PHL § 2899-f.  A PA or NP may not serve as the attending under this law, although they may participate in discussions with patients. PHL § 2899-d.  Patients and their medical records should be evaluated by the attending physician to determine if patients have a terminal condition or illness ("an incurable and irreversible illness or condition that has been medically confirmed and will within reasonable medical judgment produce death within six months"). Evaluations may take place in person unless they may cause extraordinary hardship to the patient. Documentation should include why an in-person evaluation would be an undue burden. Telehealth is an option but should be rarely used. (MSSNY Webinar, 7/28/26).
3. There must be a determination and documentation of whether patients have decision-making capacity, that they made an informed decision, that requests are voluntary and without coercion, and that patients are physically capable of self-administration. PHL § 2899-f.
4. Patients should be referred to a consulting physician for a second opinion to confirm findings. PHL § 2899-h.
5. Patients should also be referred for a mandatory mental health evaluation by a NYS licensed psychiatrist, psychologist, or neurologist to determine whether they have decision-making capacity to make an informed decision. PHL § 2899-i.  If not, the attending physician must refuse to honor the patient’s request for MAID.
6. There should be documentation of a comprehensive and understandable discussion with patients, including: diagnosis and prognosis; risks; probable outcome; alternatives such as hospice and palliative care and that referrals for other treatment options were offered (resources are available from https://health.ny.gov/facilities/hospice/); that they were informed that their decision may be rescinded or that they may obtain the medication and not take it; and that unused medication should be safely disposed of if they change their mind. PHL § 2899-j. Educational material may be provided to patients.
7. Patients should be instructed to take the medicine in the presence of another person but not in a public place, and that only the patient should administer it. Patients’ family should be informed unless patients object. The written request form includes options for the patient to select as to whether family members should be notified about the patient’s decision to pursue MAID.
8. Before writing a prescription for medication, the attending must offer the patient an opportunity to rescind their decision to obtain MAID, which should be documented. The prescription cannot be filled for five days after it is written unless the attending confirms that the patient may die before this waiting period. The prescription should be dated and timed and include the first date it can be filled. The patient may rescind their request at any time and in any manner.
9. Within 5 days of writing a prescription, a completed MAID Reporting Form must be submitted on the Health Commerce System to the NYS Department of Health (DOH). Assistance with log in issues may be obtained by calling: 518-473-1809 or 1-866-529- 1890. The form is accessible from: http://smartforms.health.ny.gov/maid. Guidance for submitting the form may be obtained from: https://www.health.ny.gov/health_care/medical_aid_in_dying/docs/maid_reporting_guidance.pdf. The DOH will collect data and send an annual report to the state legislature to assess the use of MAID.
10. Patients should be instructed that unused medication should be properly discarded at the nearest qualified facility if the patient decides not to take the medication, or by a family member or friend after the patient’s death. Drop-off locations may be found at https://medtakebacknewyork.org/. Alternatively, a free mail back envelope may be ordered online or by calling 844-4-TAKE-BACK, or the medication can be mixed with coffee grounds or cat litter and placed in a sealed plastic bag for disposal with regular garbage, but not in the water supply.
11. To avoid resuscitation efforts after self-administration of the medication, patients should have DNR and DNI orders by completing a MOLST form which is available at https://www.health.ny.gov/forms/doh-5003.pdf.

Mental Health Professional’s Responsibility: PHL § 2899-i

NY is the first state to require a mental health evaluation for patients requesting MAID. The patient must be evaluated by a NYS licensed psychologist, psychiatrist, or neurologist to independently determine whether the patient has the capacity to make an informed and voluntary decision, and understands the risk, benefits and alternatives to receiving the medication. A written report must be provided to the attending and consulting physicians. If the patient lacks capacity, the attending must not prescribe the medicine. Additional guidance is available at: https://www.op.nysed.gov/MAID-Mental-Health-Professional-Guidance.

Attending Physician’s Documentation in The Patient’s Chart: PHL § 2899-j

1. In addition to the documentation requirements specified above under Attending Physician’s Responsibilities, the attending should include all oral, written, audio and video requests for MAID in patients’ records. If an electronic record lacks capacity to store videos, they should be safely maintained, and the record should refer to a video file to access. (MSSNY Webinar, 7/28/26)
2. There should be documentation of the diagnosis, prognosis, determination of decision-making capacity, that the patient acted voluntarily without coercion, and an informed decision was made after receiving detailed information and providing informed consent.
3. Documentation should include that the patient was informed that they must be evaluated by a consulting physician and mental health professional.
4. Written documentation should also include that all requirements were met, the actions that were taken, and the medication that was prescribed.
5. The death certificate should state the underlying illness as the cause of death. (Patients are not considered to be suicidal and life insurance benefits will not be impacted.)

Immunity

The law includes provisions of immunity. PHL § 2899-l. If a medical professional takes good faith and reasonable actions or refuses to act, they cannot be held civilly, administratively, or criminally liable or face disciplinary sanctions. Id. However, protections do not apply to negligent, reckless, or intentional misconduct. Violations of the statute are included in the definition of professional misconduct in Section 6530.51 of the Education Law. Id.

Conclusion

Medical Aid in Dying legislation provides a significant end-of-life option for New York residents by offering a compassionate choice for death with dignity. The law affords potential participants who are interested in this approach with a well-thought-out and caring process for the improvement of patient autonomy.

Questions and Answers about the legislation are available online from:

1. New York State Education Department and Department of Health (https://www.op.nysed.gov/MAID-Joint-Q-and-A); and
2. NYS Department of Health (https://www.health.ny.gov/health_care/medical_aid_in_dying/faqs.htm)

Questions may be sent to: health.sm.maidinfo@health.ny.gov

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This document is for general purposes only and should not be construed as medical, dental or legal advice. This document is not comprehensive and does not cover all possible factual circumstances. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors for any questions related to legal, medical, dental or professional obligations, the applicable state or federal laws or other professional questions.