Pharmacy Guidance
Medical Aid in Dying Act
Chapter 715 of the Laws of 2025 & Chapter 1 of the Laws of 2026
Purpose
This document summarizes the pharmacy related provisions contained in Public Health Law Article 28 F, Medical Aid in Dying (MAID), and is intended to guide pharmacists and pharmacies regarding participation, dispensing, patient interactions, protections and disposal requirements.
Why MAID applies to Pharmacists and Pharmacies:
The Act defines a health care provider as an individual licensed, certified or authorized by law to administer health care or dispense medication in the ordinary course of business or practice of a profession. Pharmacists and pharmacies are therefore included within the act and are required to comply with MAID provisions when participating.
Pharmacy Role in the MAID process:
The Act authorizes an attending physician, after all statutory requirements have been satisfied, to prescribe or order appropriate medication for a qualified individual. At the patient’s request, the physician may facilitate the filling of the prescription and delivery of medication to the patient.
A prescription for medication shall not be filled until five days, or the equivalent 120 hours, after the prescription has been written, unless the patient’s attending physician has medically confirmed that the qualified individual may, within reasonable medical judgment, die before the expiration of the waiting period identified herein, in which case, the prescription may be filled once the attending physician affirms that all other requirements pursuant to this article have been fulfilled. Such prescription must indicate the date and time that the prescription for medication was written and indicate the first allowable date and time when it may be filled.
Medication Administration:
- The medication prescribed under MAID is intended for self-administration by the qualified individual.
- No health care professional or other person may administer the medication to the patient.
- Self-administration is limited to the patient’s affirmative, conscious, and voluntary act of ingesting the medication.
- Self-administration does not include lethal injections or lethal infusion.
Pharmacist Participation:
- Participation by a pharmacist is voluntary.
- A pharmacist is not under any legal obligation or contractual duty to participate in providing medication under the Act.
When a health care provider, including a pharmacist, is unwilling to participate and a patient transfers care, relevant prescriptions must be transferred promptly pursuant to regulations promulgated by the Department of Health
.
Communication with Patients:
Pharmacists may also provide referrals to other pharmacists upon the patient’s request.
The patient request “to end my life” form specifically authorizes the attending physician to contact another physician or any pharmacist regarding the patient’s request.
Legal Protections for Pharmacists:
A pharmacist who acts with “reasonable good faith” under the Act, or who refuses to act under MAID, is protected from:
- Civil liability
- Administrative liability
- Criminal liability
- Professional disciplinary action
MAID expressly protects pharmacists who engage in discussion with patients regarding the risks and benefits of end-of-life options in circumstances covered by the Act.
The protections do NOT apply to:
- Negligence,
- Recklessness,
- Intentional misconduct, or
- Conduct that violates MAID – including helping a patient administer MAID medication.
Such conduct may still result in civil or criminal liability or professional misconduct.
Facility-Based Restrictions
Private health care facilities may prohibit prescribing, dispensing, ordering or self-administering medication under MAID when:
- The prohibition is based on formerly adopted policy.
- The policy is grounded in sincerely held religious beliefs or moral convictions central to the facility’s operating principles.
- The patient has been informed of the policy before admission or as soon as reasonably possible.
A pharmacist who works for or contracts with such a facility may be subject to facility sanctions if the pharmacist violates a properly established and communicated prohibition.
Coverage and Pharmacy Benefit Considerations:
MAID defines a third-party health care payer to include entities such as pharmacy benefit managers (PBMs) and third-party administrators.
The Act provides that:
- A third-party health care payer may not deny coverage for an otherwise covered service or item because a patient has or has not requested or used medication under the Act.
- Communications regarding the availability of medication under the Act may not be initiated by insurers or third-party health care payers unless requested by the patient or by the attending physician at the patient’s request.
- Communications may not combine a denial of treatment coverage with information regarding the availability of medications under MAID.
Medication Disposal Requirements:
After the death of the qualified individual, any person with custody or control of the unused medication prescribed pursuant to MAID must ensure proper disposal.
Unused medication must be:
- Delivered to the nearest facility that properly disposes of controlled substances; or
- Disposed of by lawful means in accordance with the Bureau of Narcotics Enforcement and Department of Health’s guidance and regulations health.ny.gov/professionals/narcotic/safe_disposal/ , or
- By guidelines of the federal Drug Enforcement Administration (DEA) approved take-back program.
A disposal facility must accept and dispose of medication delivered under this provision, regardless of whether the medication is classified as a controlled substance.
Compliance Considerations for Pharmacies:
Pharmacies that elect to participate should develop policies and procedures that address:
- Receipt and processing of prescriptions issued pursuant to MAID, including procedures to comply with the mandatory 5-day waiting period prior to dispensing.
- Documentation and records retention requirements consistent with applicable law.
- Staff education regarding voluntary participation rights.
- Procedures for declining participation.
- Coordination with prescribing physicians regarding medication fulfillment and delivery.
- Processes for responding to questions concerning disposal of unused medication.
- Policies addressing facility-based prohibitions where applicable.
Conclusion:
- Pharmacists are recognized as health care providers under MAID.
- Participation is voluntary.
- Good faith participation and good faith refusals are protected.
- Pharmacists may discuss end-of-life options and provide referrals.
- A prescription for medication shall not be filled until five days after the prescription has been written, unless a determination by the prescribing physician has found that the patient may not be alive in five days;
- The prescription must indicate the date and time that the prescription was written and indicate the first allowable date and time when it may be filled.
- Only the patient may self-administer the medication.
- Certain facilities may prohibit dispensing under specified conditions.
- Pharmacy benefit managers and third-party payers are subject to specific coverage and communications restrictions.
- Unused medication must be disposed of through approved mechanisms after the patient’s death.