Assisted Suicide in New York: Eligibility, Opt-Outs, Alternatives

Assisted suicide in New York is legal in a narrow set of circumstances as of February 2026, when Governor Hochul signed the Medical Aid in Dying Act into law. The statute lets a mentally capable, terminally ill adult resident request and self-administer prescribed medication to end their life, subject to several safeguards. The law does not take effect until roughly August 2026, six months after signing, to give the Department of Health time to write regulations and allow facilities to train staff.¹ Outside that framework, intentionally helping someone end their life remains a felony under New York Penal Law. New York is roughly the thirteenth state to permit medical aid in dying.

Who Qualifies Under the Medical Aid in Dying Act

The law applies to a very specific group of patients. All of the following must be true:

Two physicians confirm the patient has a terminal illness with a life expectancy of six months or less.
The patient is determined mentally capable of making an informed decision. A mental health evaluation by a psychologist or psychiatrist is required for every patient, not just those where capacity is in doubt.
The patient is a New York resident. Out-of-state patients cannot use the law.
The initial physician evaluation takes place in person.
The patient makes an oral request that is recorded by video or audio.

These safeguards came out of negotiations between Governor Hochul and the Legislature and make New York’s statute one of the more restrictive medical aid in dying laws in the country.¹

The Waiting Period and Self-Administration Rule

Once a physician writes the prescription, there is a mandatory five-day waiting period before it can be filled. The patient must then self-administer the medication. No physician, family member, or other person is permitted to deliver the dose.¹ That line is legally critical. Active euthanasia, in which someone else administers the lethal medication, is not authorized by this law and remains illegal.

Providers and Facilities Can Opt Out

No healthcare professional is required to participate. The statute protects the conscience rights of individual providers who object and allows religiously affiliated health facilities to decline to offer the service entirely. Religiously oriented home hospice providers may also opt out.¹ Patients in parts of the state served primarily by religiously affiliated hospital systems may need to search for a willing provider.

What Still Counts as a Crime

Everything outside the Medical Aid in Dying Act’s narrow pathway remains criminal. New York Penal Law Section 120.30, “promoting a suicide attempt,” makes it a Class E felony to intentionally cause or aid another person to attempt suicide.² A Class E felony carries a maximum sentence of four years in prison.³ A court can also impose a fine of up to $5,000 or double any financial gain from the offense, whichever is higher.⁴

This liability reaches anyone, including medical professionals, who helps someone end their life outside the Medical Aid in Dying Act. Sympathetic motives are not a defense. The statute makes no exception for family members acting out of love, and the Act’s protections apply only when every one of its procedural requirements has been met.

Death Certificates, Insurance, and Crossing State Lines

Medical aid in dying statutes, including New York’s, specify that using the law is not legally considered suicide. The death certificate lists the underlying terminal illness as the cause of death. This matters for life insurance. Most policies contain a suicide exclusion, typically covering the first two years, that allows the insurer to deny the death benefit if the insured dies by suicide. Because a MAID death is classified under the terminal illness, that exclusion should not apply.

One caution for anyone considering travel: if a patient obtains a prescription in New York but self-administers the medication in a state where medical aid in dying is not legal, New York’s protections may not follow. That state could classify the death as a suicide, with consequences for insurance payouts and other legal questions.

Separately, Medicare and Medicaid will not cover the cost of the prescription. Federal law prohibits federal funds from being used to pay for items or services whose purpose is to cause or assist in causing a person’s death.⁵ Patients should expect to pay out of pocket or through private insurance that chooses to cover it.

Legal End-of-Life Options That Don’t Involve MAID

Medical aid in dying is one option among several, and the alternatives below have been available in New York for decades. They do not require a terminal diagnosis of six months or less, do not require residency verification, and do not involve controlled substances.

Refusing Life-Sustaining Treatment

Every competent patient has the right to refuse any medical treatment, including treatment that keeps them alive. This covers ventilators, feeding tubes, dialysis, and any other intervention. Refusing treatment is not legally considered suicide, and healthcare providers who honor an informed refusal are protected from criminal and civil liability. The federal Patient Self-Determination Act requires every hospital that participates in Medicare or Medicaid to inform patients of this right and to help them create advance directives.

Health Care Proxy

A health care proxy appoints someone you trust to make medical decisions for you if you lose the ability to make them yourself. Under New York Public Health Law, the proxy takes effect only when your doctor determines you can no longer make your own decisions.⁶ Your agent can make all healthcare decisions on your behalf, including withdrawing life-sustaining treatment, unless you specifically limit that authority in the document.

To create a valid proxy, sign the document in front of two adult witnesses, who also sign. Notarization is not required. The person you name as agent cannot serve as a witness. If you are a hospital patient, you generally cannot appoint a hospital employee as your agent unless that person is a relative. A non-family member cannot serve as a health care agent for more than ten people at the same time.⁷

Living Will

A living will provides written instructions about your end-of-life wishes. Where a health care proxy delegates decision-making, a living will speaks for you directly. It takes effect when you have a terminal illness or are at the end of life and can no longer communicate. A standard New York living will addresses cardiac resuscitation, mechanical ventilation, and artificial nutrition and hydration.⁸ Having both documents gives the strongest protection: the proxy handles situations your living will did not anticipate, and the living will gives your agent clear guidance.

Palliative Care and Hospice

Palliative care manages pain and symptoms for people with serious illness and can be provided alongside curative treatment at any stage of disease. Hospice is a form of palliative care for patients expected to live six months or less who have chosen to stop pursuing curative treatment. Medicare Part A covers hospice for patients certified as terminally ill by both their attending physician and a hospice physician, with two initial 90-day benefit periods followed by unlimited 60-day periods as long as the patient continues to qualify.⁹ Electing hospice under Medicare means waiving Medicare coverage for curative treatment of the terminal condition, though Medicare still covers treatment for unrelated medical problems.

Voluntarily Stopping Eating and Drinking

Voluntarily stopping eating and drinking, often called VSED, is a choice some terminally ill patients make when other options feel inadequate. A competent person has the legal right to refuse food and water at any time, and the right of informed patients to refuse nutrition and hydration is well established. Death typically occurs within one to three weeks. Physicians and nurses can provide comfort care throughout the process, including medication to manage discomfort such as dry mouth or restlessness. VSED does not require a prescription, physician approval, or any formal legal process. It is physically difficult, and families generally benefit from professional support from hospice teams or palliative care specialists.

1
New York State. Governor Hochul Signs Medical Aid in Dying Act into New York State Law
2
New York State Senate. New York Penal Law 120.30 – Promoting a Suicide Attempt
3
New York State Senate. New York Penal Law 70.00 – Sentence of Imprisonment for Felony
4
New York State Senate. New York Penal Law 80.00 – Fine for Felony
5
Office of the Law Revision Counsel. 42 US Code 14401 – Findings and Purpose
6
New York State Department of Health. Health Care Proxy
7
New York State Senate. New York Public Health Law 2981 – Health Care Proxy
8
New York State Attorney General’s Office. New York State Living Will
9
Centers for Medicare & Medicaid Services. Hospice