Understanding New York’s Medical Aid in Dying Act

In early February, Governor Hochul signed legislation that made New York the 14th jurisdiction in the United States to authorize medical aid in dying. What does this mean now for New York residents?

D. H. Individuals across the state who are receiving care for serious conditions should view this moment as an opportunity to educate themselves about medical aid in dying (MAID). Although very few New Yorkers will ever find themselves in a situation where MAID needs to be seriously considered, it is in all patients interest to be aware of MAID, and particularly to understand how MAID differs from other end-of-life care options. Similarly, family members of individuals who are managing serious illnesses would benefit from understanding when MAID may be an appropriate intervention. For New Yorkers who are healthcare providers in any discipline, this is an excellent time to seek out education on the roles and responsibilities of clinicians who choose to be involved in end-of-life care.

The law was signed in February, and went into effect on August 5, 2026. Why was there a delay in implementation?

D. H. The delay was one of the additional safeguards that Governor Hochul insisted on in order to give patients, families, clinicians, and health systems adequate time to educate themselves and undergo training. The delay also helped to establish critically important referral relationships for patients as they transition through different stages of care, from curative care to ending life care.

Healthcare leaders from across the state made good use of this time to provide education to the public, technical assistance to healthcare organizations and training to clinicians.

You are a legal expert on medical aid in dying. What do you like about the New York law, and are there any parts of the law that you would change?

D. H. The most important feature of New York’s MAID law is that it is built on 30 years of medical aid in dying experience in the United States, dating back to Oregon’s legalization of MAID in the 90s. This should provide great comfort to patients and clinicians across the state.

There are two features of the law that cause me some concern. The first is the mandate that all patients that are being evaluated for MAID must see a mental health professional (psychiatrist, psychologist, or neurologist) to receive an assessment of decision-making capacity. That mental health professional will be the fifth individual required under the law to evaluate the patient’s decision-making capacity. The initial four are the attending physician, the consulting physician and each of the two individuals who witnessed the patient’s written request.

I suspect that, over the course of time, we will learn that this additional mental health practitioner evaluation is not necessary in the case of every single patient. We may ultimately conclude that the original language in the law—that allowed the attending and consulting physicians to use their best medical judgment to determine whether an additional mental health assessment is necessary—is the more prudent approach.

Second, I am concerned that the New York residency requirement for MAID will be another obstacle to patients receiving end-of-life care. This may prove to be a particular concern for patients who are lifelong New Yorkers but who moved south in their retirement years to enjoy a warmer climate. Many snowbird states do not currently permit MAID, leaving former New York State residents unable to access this option. Oregon and Vermont originally had residency requirements, but then removed them. I am hopeful that after we have some experience under our belt that the governor and the legislature may reconsider New York’s residency requirement.

What does this mean for healthcare professionals in the state? Detractors of the law said it could force doctors to perform services that are against their religious beliefs. Is that the case?

D. H. The single most important insight I can share is that the New York medical aid in dying law does not create a single obligation for any practitioner that they don’t already have. No medical professional is obligated under this law to participate in either evaluating a patient for MAID or writing a prescription for MAID drugs.

However, it is my ethical and legal judgement that all clinicians in New York have a professional obligation to inform patients of available treatment options and provide referrals for information about types of care that the practitioner does not provide. They are also obligated to forward copies of patient medical records to subsequent care providers. That obligation is as real for end of life care as it is for any other form of care. It is incumbent upon all healthcare organizations to inform their patients and their employees of what services are available and what services, including end of life care, require referrals to other institutions. This has been true in hospitals for generations.

Historically, data from other states shows that utilizing MAID heavily skews towards a wealthier demographic. What can be done to ensure that MAID doesn’t become a privilege in New York only accessible to those with the resources to navigate our complex medical system?

D. H. It is impossible to judge how many New Yorkers from medically underserved and economically disadvantaged groups will actually want access to MAID, even now that it is legalized and made available to all New Yorkers. The initial data suggests that MAID is being sought by patients from various socio-economic groups. One of the steps being taken by the New York State MAID Implementation Work Group is outreach to historically marginalized and medically underserved communities, including communities of color, to facilitate awareness of and access to health centers that can provide end-of-life care to those who are economically constrained.

Some steps that are being implemented by the New York State MAID Implementation Work Group include creating a robust social media presence for information about MAID, a referral network for clinicians who have extra patient consultation capacity, and organizational purchasing of the component medications required for MAID to reduce the cost to each individual patient. Once we have a better appreciation of the number of individuals seeking MAID in New York from across the socio-economic spectrum, we will be in a position to evaluate what additional steps are needed. We are also looking at ways to help reduce the cost of the MAID medications.