Q: New York is expected to legalize medical aid in dying. What should New Yorkers understand about this new law?
A: After more than a decade of legislative debate, medical aid in dying is close to becoming law in New York State. Governor Kathy Hochul has publicly announced her intent to sign the Medical Aid in Dying Act, which would allow certain terminally ill adults, under narrowly defined circumstances, to request and self-administer prescribed medication to bring about a peaceful death.
If signed, the law will not take effect immediately. Instead, it includes a six-month delayed effective date to allow time for regulatory guidance, provider training, and implementation by the New York State Department of Health.
Eligibility under the law is limited and specific. To qualify, an individual must be at least 18 years old and have a medically confirmed terminal illness with a prognosis of six months or less to live. The individual must be mentally capable of making medical decisions and must voluntarily request the medication. Importantly, a person does not qualify based solely on age or disability, and the law does not apply to non-terminal conditions.
The proposed law establishes a clear, step-by-step process for obtaining medical aid in dying. A patient must make both a written request and an oral request, with the oral request recorded by audio or video. Two physicians must independently confirm the diagnosis, prognosis, and the patient’s ability to make informed medical decisions. A mental health evaluation may also be required if there are concerns about the patient’s decision-making capacity. Finally, there is a required five-day waiting period between when the medication is prescribed and when it can be filled, giving patients additional time to reflect.
Medical aid in dying medication is typically prepared by compounding pharmacies rather than standard retail pharmacies, so availability may be limited. The medication must be self-administered by the patient, most commonly by ingestion, although alternative methods, such as administration through a feeding tube, may be permitted. Because self-administration is required, some patients who otherwise meet the eligibility criteria may not be physically able to participate.
Participation is entirely voluntary for physicians, hospitals, hospice providers, and pharmacies, and providers may opt out if participation conflicts with their professional or personal beliefs. In addition, most health insurance plans do not cover medical aid in dying, and federally funded programs such as Medicare cannot pay for it, meaning associated costs are generally paid out of pocket.
From an estate planning and elder law perspective, the new law also highlights important limitations in advance care planning. While a health care proxy allows an appointed agent to make many medical decisions on behalf of an incapacitated person, the request for medical aid in dying must come directly from the patient, not the health care agent. The law also restricts individuals who may benefit financially from a patient’s death from serving as witnesses to certain requests, underscoring the importance of thoughtful planning and clear communication.
Medical aid in dying represents a meaningful shift in how New York approaches end-of-life decision-making. As with many changes in this area, understanding the law’s requirements, safeguards, and limitations is essential for patients, families, and professionals navigating end-of-life planning.
By Alma Muharemovic, Esq., and Michal Lipshitz, Esq.
Alma Muharemovic, Esq., is an associate attorney at Burner Prudenti Law, P.C., focusing her practice on estate planning. Michal Lipshitz, Esq., is a senior associate attorney at Burner Prudenti Law, P.C., focusing her practice on estate planning and elder law. Burner Prudenti Law, P.C., serves clients from New York City to the East End of Long Island, with offices in East Setauket, Westhampton Beach, Manhattan, and East Hampton.