Who Qualifies for Medical Aid in Dying, and What Is the Process?

The rules for medical aid in dying (MAID) are written to be strict, and they vary by state. This guide describes the common pattern, then walks through New York’s process in detail because its Department of Health has published the clearest official explanation. For what MAID is and isn’t, see what is medical aid in dying, and for where it’s legal, see our dated state-by-state guide.

Who qualifies?

Laws share a general pattern, with differences in the details. In New York, a person must:

• Be 18 or older
• Be a resident of the state (the Department of Health says this means a place of abode in New York, not merely a mailing address, and patients attest to it)
• Have a medically confirmed terminal illness that is incurable and irreversible and will likely cause death within six months whether or not treatment is provided, as verified by two independent physicians
• Have decision-making capacity: the ability to understand and appreciate the nature and consequences, including benefits, risks, and alternatives, and make an informed decision
• Be able to self-administer the medication

Illinois’s law, according to the Associated Press and a law firm summary, has similar requirements: an adult Illinois resident with mental capacity and a terminal illness expected to cause death within six months, as confirmed by two doctors, who has been told about all end-of-life options such as hospice and palliative care. Oregon’s statute adds that no one qualifies solely because of age or disability, and Illinois’s enacted text says no person is a qualified patient solely because of advanced age, disability, or a mental health condition, including depression. The six-month prognosis is the same kind of estimate used for hospice eligibility; see what “terminal” means.

Not every state is the same. Residency rules, for example, differ: Oregon removed its requirement in 2023.

What is the process in New York?

New York’s Department of Health summarizes the steps. Other states’ steps differ in details such as timing and evaluations.

1. The patient makes an oral request to their attending physician. If the patient can’t speak, an alternative method of communication familiar to them can be used. The oral request must be recorded by audio or video and stored permanently in the medical record
2. The patient submits a written request on a state form, signed by the patient and witnessed by at least two disinterested adults who attest that the patient has decision-making capacity, is acting voluntarily, and isn’t being coerced. Witnesses can’t be relatives, people who would benefit from the estate, staff or owners of the facility where the patient is receiving care, domestic partners, health care agents, or agents under a power of attorney
3. The request must come from the patient. It can’t be made by a health care agent, surrogate, or anyone else, and it can’t be made in an advance directive
4. The attending physician and a consulting physician each examine the patient and confirm in writing the terminal illness and prognosis, the patient’s capacity, that the decision is informed, and that it is voluntary
5. A mental health professional, a psychiatrist or psychologist, evaluates the patient to determine whether they have decision-making capacity. If the professional finds the patient lacks capacity, the patient isn’t eligible. Other states’ rules on mental health evaluations differ, so check
6. The physician must give information about all end-of-life options, including hospice and palliative care, and must offer the patient the chance to rescind before any prescription is written
7. A five-day wait. A prescription can’t be filled until five days after it’s written, unless the physician medically confirms the patient may die before then
8. The patient decides whether and when to take the medication, and must do so without help from anyone else. The patient may use an assistive device but must perform a final physical act. If a patient can’t self-administer, they can’t use the law and should be given information about hospice and palliative care

The patient can withdraw the request, decline to take the medication, or change their mind at any time, and anyone who tries to coerce a patient into MAID may be prosecuted.

What else do families and patients ask?

Does the family have to be told? In New York the law doesn’t require patients to tell anyone, although the Department of Health recommends they talk with people close to them. Oregon’s law says the physician should recommend that the patient notify their next of kin.

Can a telehealth visit be used? In New York, the attending physician may waive the in-person exam only if requiring it would cause extraordinary hardship, such as undue pain or extraordinary expense or logistics; a physician outside New York may do a telehealth exam but must be licensed in New York.

Is it available to someone who has lost capacity, or through a proxy? No. New York’s law requires the patient to make the request, and if a patient becomes incapacitated and can’t perform the final act, they’re no longer eligible.

What if a clinician or hospital won’t take part? Participation is voluntary. In New York, a provider who doesn’t participate must arrange to transfer a patient who asks, a private hospital may adopt a written policy prohibiting it, pharmacies may refuse, and the state doesn’t keep a central list of participating providers. Finding a willing clinician often takes effort; start with your palliative care or hospice team. See hospice and medical aid in dying.

Who pays? Federal law bars federal funds, including Medicare and Medicaid, from paying for items or services for the purpose of causing or assisting in causing death. New York’s Department of Health says its Medicaid program doesn’t cover the prescription, and its law says health insurance benefits are otherwise unaffected. We didn’t find reliable national cost figures, so ask your care team and insurer.

What does the data show about who uses it?

Oregon’s published 2025 data are the most complete. Of the people who died after taking the medication, 88% were 65 or older, cancer was the most common illness (61%), 92% were enrolled in hospice, and the most frequently reported concerns were loss of autonomy, decreasing ability to participate in enjoyable activities, and loss of dignity. In 2023, about 60% of people who received a prescription died from taking it. See what is medical aid in dying for more.

What if I don’t qualify, or it isn’t available where I live?

• Hospice and palliative care can address pain, breathlessness, anxiety, and other symptoms, and don’t require giving up treatment you want. See when to consider hospice and palliative care eligibility and cost
• Palliative sedation is a symptom treatment for people close to death when symptoms can’t otherwise be relieved. See what is palliative sedation
• Refusing or stopping treatment is legal everywhere. See advance directives
• Voluntarily stopping eating and drinking is a separate choice that people have made, with clinical support. See what is VSED

What should I ask my care team?

• Is my prognosis likely to meet the legal definition, and how certain is it?
• Which clinicians and facilities here take part, and does my hospice or hospital have a policy?
• What are all my options for relief of symptoms, and have we tried them?
• Who would be involved, and who needs to know?

If you are struggling with hopelessness or thoughts of harming yourself, outside a legal medical process, please call or text 988, the Suicide & Crisis Lifeline, or call 911 in an emergency. Feeling overwhelmed by a serious illness is common, and a palliative care or mental health professional can help.

Eligibility rules and processes differ by state and change. This is general information, not medical or legal advice; your physician and your state’s health department can tell you what applies to you.