New York’s Medical Aid in Dying Act: What the Governor’s Announced Deal Means for Patients and Families

By: Dana Walsh Sivak, Esq., with contributions by Michael B. Shapiro, Esq.

On December 17, 2025, Governor Kathy Hochul announced that a deal was reached with lawmakers to move forward with signing the Medical Aid in Dying Act into law. Hochul’s announcement paves the way for New York to join 12 other states (along with Washington, D.C.) that will now authorize medical aid in dying for certain terminally ill adults.

The Medical Aid in Dying Act, sponsored by Senator Brad Hoylman-Sigal and Assembly Member Amy Paulin, and passed by the state legislature earlier this year, aims to allow competent adult patients who have been diagnosed with a terminal illness and a prognosis of six months or less to live to request a prescribed medication intended to end life peacefully.

Polling conducted earlier this year shows majority support among New Yorkers for medical aid in dying, even as the policy remains deeply contested. Proponents have framed the bill as a compassionate option for those confronting the final stages of terminal disease, providing greater control over timing, setting, and symptom burden at life’s end. Opponents, including disability advocates and religious organizations, have argued that the policy is immoral, susceptible to abuse, and difficult to safeguard in practice. 

Key Safeguards Expected in the Negotiated Deal

While final statutory language has not yet been released, Governor Hochul’s announcement highlighted a number of additional “guardrails” that lawmakers and the Governor have agreed to incorporate in the new law in order to meaningfully address many of these concerns.  The additional requirements to be included in the final bill include:

• Residency Requirement: Access to medical aid in dying will be restricted to New York residents.
• Mandatory Waiting Period: Patients will be required to wait a period of 5 days between the date the prescription is written and filled.
• Specific Requirements for Medical Evaluation: Patients’ initial evaluation by a physician prescribing the medication will be required to be in person.
• Mandatory Mental Health Evaluation: Patients will be required to undergo a mental health evaluation by a psychologist or psychiatrist in order to confirm they are mentally competent to make the decision to utilize medical aid in dying.
• Restrictions on Oral Requests for Access to Medical Aid in Dying: Any oral request made by a patient to access this medication will be required to be recorded by video or audio. Additionally, any person who may benefit financially from the death of a patient will be disqualified under the law from serving as a witness to the oral request or as an interpreter for the patient.
• Opt-Out Allowance for Religious Care Providers: Hospice providers who are “religiously-oriented” will be permitted under the law to opt out of offering medical aid in dying to its patients if it conflicts with their religious beliefs.
• Violation Categorized as “Professional Misconduct”: The agreement calls for a violation of the Medical Aid in Dying Act to constitute “professional misconduct” under the New York State Education Law, creating an additional deterrent for those who may otherwise disregard the law’s safeguards and requirements.
• Effective Date of the Bill Extended Six Months: Under the agreement Hochul struck with lawmakers, the bill will not take effect until six months after it is signed. This, Hochul says, will allow the New York State Department of Health enough time to enact regulations required to implement the new law, and provide health care facilities sufficient opportunity to properly train and prepare their staff for how to lawfully provide this assistance to patients availing themselves of Medical Aid in Dying.

Practical Concerns and Need for Clarification Before Implementation

These additional requirements – which Hochul noted were “aimed at ensuring the integrity of the patient’s decision and the preparedness of medical institutions to appropriately administer medical aid in dying” – will need to be further clarified in the months to come, as some of these rules leave much room for interpretation. 

For example, the concept of any person who “may benefit financially from the death of a patient” being disqualified from serving as a witness to a patient’s oral request for medical aid in dying requires clarification to determine how expansive this category of individuals will be treated under this law. Arguably, this would include any individual who is a presumptive, or even potential, distributee of the patient, or beneficiary named in their estate planning documents. However, this could be interpreted more expansively, to include business partners, LLC owners, joint account holders, anyone sharing ownership of an asset which includes a right of survivorship, or individuals named as direct beneficiaries on retirement accounts or insurance policies. In some instances, these individuals may not know that they would have such an interest and will not know they are ineligible to serve in this role. 

While the rationale for this requirement makes sense, it also means that the testimony of family caregivers, who would perhaps be in the most likely position to have a meaningful conversation with the patient about their wishes concerning medical aid in dying, will not be afforded any credence in determining whether a patient requests access to this treatment option. 

Similarly, the five-day mandatory waiting period – presumably added to ensure that patients take the necessary time to consider the gravity of their decision – may cause some patients to suffer for a prolonged time period, perhaps in significant pain, simply to fulfill this requirement. 

Likewise, while the residency requirement aims to avoid having people from outside of the state travel to New York for the purpose of accessing this treatment option, the current guidelines for establishing residency in New York are not particularly stringent.  In some cases, a person can establish residency in New York after a period of one day, provided they intend to make New York their home on a permanent basis. Therefore, the residency requirement, including the duration of time an individual must be present in the state to establish residency and the means of proving this, may need further clarification.

The religious “opt out” provision for providers also has potential ramifications – and practical barriers – for patients who may wish to access medical aid in dying. As many hospice providers are affiliated with a specific religion, it will be important for patients who would consider medical aid in dying to investigate whether their hospice provider opposes this treatment option on religious grounds. For patients relocating to a hospice facility from a hospital, there may be instances where limited availability of nearby hospice facilities without a religious affiliation could impact a patient’s practical ability to access this treatment.  In inpatient hospice wings within religiously-affiliated hospitals, patients who wish to have this option made available to them may have to transfer hospitals, which may or may not be medically practicable. Further, while Hochul’s commentary regarding religious opt-out provisions focused on religiously-affiliated hospice providers, it is likely that some providers in other medical care settings may object to prescribing or administering medications for medical aid in dying for patients based on their own religious beliefs.

Impact on Elder Law and Estate Planning

Elder law and estate planning attorneys will need to consider how this new law may impact the way they help clients navigate the process of planning for their future, including with respect to advance directives.

While, currently, the execution of a health care proxy allows an individual to confer the authority to make a host of important medical decisions on their behalf if they one day cannot – including end-of-life decisions – this law does not appear to permit anyone but the patient to request medical aid in dying. A health care agent would therefore be unable to authorize or access this treatment option on the patient’s behalf. Clients should be informed of this when executing advance directives so that they understand the limitations of a health care proxy in this context, and can make medical decisions accordingly if they are later faced with a terminal illness.

Additionally, clients should be made aware of the prohibition against individuals who stand to benefit financially from the death of a patient serving as a witness to a patient’s oral request for medical aid in dying – if nothing else, so that the client is aware of the potential consequence of including that individual in his or her will, or otherwise providing for an individual in his or her estate plan. While it is unlikely that a client would opt to exclude a loved one from his or her will on the basis of this concern, it should be shared with clients so that they can take additional steps to prepare alternate ways of conveying and recording their consent, at a future time, if access to medical aid in dying as a treatment option is particularly important to the client.

Legal Considerations for Health Care Providers

As the final form of this legislation takes shape, it will be important for health care facilities and medical providers who may, at times, care for terminally ill patients to enact policies and procedures that comply with this new law. It will require training for providers, as well as evaluation of whether the facility can opt out of offering this treatment option on religious grounds.

What this Could Mean for Older Adults and Caregivers

The Medical Aid in Dying Act is slated to be signed into law in January 2026, and will take effect six months after it is signed. It is likely that additional information will be shared prior to the effective date that will add much-needed clarity to some of these important issues and questions.

If you or a loved one is facing a terminal diagnosis, it will be important to understand the eligibility criteria, the documentation and evaluation steps, waiting periods, and how this option interacts with existing advance care planning, palliative care, hospice, and pain management.

Our Elder Law Attorneys Can Help You Navigate These Important Changes

Falcon Rappaport & Berkman’s Elder Law Practice Group focuses on helping clients navigate end-of-life planning, and other aspects of elder law planning, with clarity and dignity. As the state releases final statutory language and any implementing guidance, we can help ensure your advance directives, health care proxies, and related planning documents align with your goals, values, and the new legal framework. Contact FRB’s elder law attorneys today to learn how we can help.

DISCLAIMER: This post is for general informational purposes only and does not constitute legal advice. Each situation is unique, and decisions about end-of-life care should be made in consultation with your medical providers and legal counsel who can advise on your specific circumstances. This summary is not legal advice and does not create any attorney-client relationship. This summary does not provide a definitive legal opinion for any factual situation. Before the firm can provide legal advice or opinion to any person or entity, the specific facts at issue must be reviewed by the firm. Before an attorney-client relationship is formed, the firm must have a signed engagement letter with a client setting forth the Firm’s scope and terms of representation. The information contained herein is based upon the law at the time of publication.