Form MAID-4 Medical Aid in Dying for the Terminally Ill Act Medication Dispensing Record - New Jersey

What Is Form MAID-4?

This is a legal form that was released by the New Jersey Department of Health - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the MAID-4 medical aid in dying for the terminally ill act?
A: The MAID-4 Act allows terminally ill patients to request medication to end their lives.

Q: What is the purpose of the Medication Dispensing Record?
A: The Medication Dispensing Record is used to document the dispensing of medication to a terminally ill patient under the MAID-4 Act in New Jersey.

Q: Who can request medication under the MAID-4 Act?
A: Only terminally ill patients who meet specific criteria can request medication under the MAID-4 Act.

Q: What criteria must a patient meet to request medication under the MAID-4 Act?
A: The patient must be a New Jersey resident, have a terminal illness with a prognosis of six months or less to live, be mentally capable of making healthcare decisions, and make multiple requests for the medication.

Q: What is the process for requesting medication under the MAID-4 Act?
A: The patient must make two oral requests, at least 15 days apart, and one written request to their attending physician.

Q: Can a patient change their mind after making a request for medication?
A: Yes, a patient can change their mind at any time and withdraw their request for medication.

Q: Who can prescribe medication under the MAID-4 Act?
A: Only physicians licensed in New Jersey can prescribe medication under the MAID-4 Act.

Q: Is the MAID-4 Act legal in all states?
A: No, the MAID-4 Act is specific to New Jersey and may not be legal in other states.

Q: Are there any exceptions to the MAID-4 Act?
A: Yes, healthcare facilities and healthcare professionals can choose to not participate in the MAID-4 Act based on their moral or religious beliefs.