Medical Aid in Dying Enacted in New York State

With the recent passage of New York’s Medical Aid in Dying Act, clinicians and healthcare institutions across the state are considering how the law will impact clinician training, patient care, institutional policy, and professional responsibilities. In this article, colleagues David Hoffman, JD, and Meg B Menzel, MS, CGC, HEC-C provide an overview of the law and its implications for healthcare providers.

After over a decade of debate and discussion, on February 6, 2026 Governor Kathy Hochul signed the Medical Aid and Dying Act into law.  New York, as the 14^th jurisdiction to legalize Medical Aid and Dying, will now permit a voluntary process by which an adult with capacity and a terminal illness which includes a prognosis of 6 months or less to live, may be legally prescribed a medication by a physician which they may then self–ingest to end their suffering by ending their life.  For the vast majority of patients, timing and personal preference mean that this is ultimately carried out at home or in an outpatient setting.  The request by the patient for information about MAID, however, may occur when the patient is hospitalized and it is now the obligation of all New York hospitals to ensure that MAID is accessible to all who wish it, and none who don’t.

U.S. History with Medical Aid in Dying

The first state to create Medical Aid in Dying (MAID) into law was Oregon where the Death with Dignity Act became effective in 1997.  Nearly thirty years later, approximately 1 in 5 Americans have access to MAID in their state of residence. 

The MAID bill in New York state was first introduced in 2016 and the path to legislation has taken multiple turns.  After the legislature passed the bill in the summer of 2025, Governor Hochul insisted on additional safeguards that “toughened” the NY law in comparison to those of other states, (including neighboring New Jersey ‘s law effective 2019), with a commitment to ensuring that no provider or religiously affiliated healthcare institution was required to offer MAID. 

What NYS medical providers need to know

An important insight for employees and providers of the hospital community is that this law does not create any obligation for anyone to do anything connected to assessment for, or provision of medical assistance in dying.

The only duties that this new law will impose when it goes into effect on August 5^th, 2026, are those that already existed as part of the standard of care for the provision of healthcare services:  1) Clear guidelines in hospital policy regarding whether or not medical assistance in dying may be carried out under the hospital's roof, 2) Advising clinician staff members of healthcare organizations of their right to exercise conscientious objection and decline to participate in any aspect of its provision, 3) Educating patients regarding end-of-life services and/or referring a patient out for appropriate education when an institution is not willing or able to provide the service and 4) Obligating providers to give copies of a patient's medical record to any clinician who assumes responsibility for care of one of the hospitals current or former patients. In all other respects clinician behavior will be guided by existing standards of care and professional ethical principles.

The work at hand for healthcare institutions includes preparing new internal policy and patient facing information throughout the state.  Much of this is already completed.  New York State hospitals have for decades maintained policies and procedures for institutional refusal to provide care such as MAID. There are also already processes in place by which individual clinician employees may assert their individual conscientious objection rights to decline participation in the facilitation or provision of services such as MAID. Those existing policies are the same ones created to facilitate organizational and individual conscientious objection to provision of services such as termination of pregnancy.  Hospitals across the state are referring to conscientious objection policies to fashion the new policies required by this law to ensure that every employee and every patient of every hospital across the State knows what services they can expect to receive and which services will require referral to a different provider.

What are the Governor’s MAID Amendments?

The Legislature added amendments to the Medical Aid in Dying Act requested by Governor Hochul, including:

• A mandatory waiting period of 5 days between when a prescription is written and filled, unless the patient’s attending physician believes the patient will die within that period;
• An oral request by the patient for medical aid in dying must be recorded by video or audio and permanently stored in the patient’s medical record;
• A mandatory mental health evaluation of the patient seeking medical aid in dying by a psychologist, neurologist, or psychiatrist; 
• Requiring that the initial evaluation of a patient by a physician be in person, unless attending physician believes an in-person visit would result in extraordinary hardship; 
• Limiting the availability of medical aid in dying to New York residents;
• Allowing religiously-oriented home hospice providers to opt out of offering medical aid in dying, while ensuring a patient receiving hospice care within their own home is not restricted from accessing medical aid in dying; 
• Strengthening a prohibition against anyone who may benefit financially from the death of a patient from being eligible to serve as a witness to the oral request or an interpreter for the patient;  
• Specifying that a violation of the law is defined as professional misconduct under the Education Law; and 

Extending the effective date of the bill to August 5, 2026 to allow the Department of Health to put into place reporting regulations required to implement the law, and ensuring that health care facilities can properly train staff on the law and patient care standards.

Comparisons to the NJ Medical Aid in Dying for the Terminally Ill Act: 

• NJ does not have a mandatory waiting period of 5 days between when a prescription is written and filled
• NJ requires an oral request but it does not require the oral request by the patient must be recorded by video or audio
•   NJ only requires a mandatory mental health evaluation of the patient seeking medical aid in dying by a psychologist or psychiatrist if a physician has questions about the patient’s decisional capacity. 
• In NJ, the initial evaluation of a patient by a physician may be by telehealth in all cases. 

 NJ’s law does not specify that religiously-oriented home hospice providers can opt out of offering medical aid in dying.  This is not addressed one way or another in the NJ law. 

Governor Hochul eloquently described her personal journey to signing the NY made bill:

“Our state will always stand firm in safeguarding New Yorkers' freedoms and right to bodily autonomy, which includes the right for the terminally ill to peacefully and comfortably end their lives with dignity and compassion.“This journey was deeply personal for me. Witnessing my mother's suffering from ALS was an excruciating experience, knowing there was nothing I could do to alleviate the pain of someone I loved. It took years of intimate discussions with our bill sponsors, health experts, advocates, and most importantly, families who have similar firsthand experiences. New Yorkers deserve the choice to endure less suffering, not by shortening their lives, but by shortening their deaths — I firmly believe we made the right decision.” (governor.ny.gov)