Understanding Medical Aid in Dying
The topic of Medical Aid in Dying (MAID) is deeply personal and often misunderstood. Here, I hope to clarify what medical aid in dying means, how it differs from other end-of-life practices, where it is legal, and key safeguards and eligibility criteria.
What Is Medical Aid in Dying?
Medical Aid in Dying is a legal process in which a mentally competent, terminally ill adult may obtain and self-administer prescription medication to end their life peacefully. The medication is provided by a physician or qualified healthcare provider.
In the United States, this practice may be referred to as physician-assisted death, physician-assisted suicide, or Death with Dignity, depending on local law. The person self-administers the medication without assistance.
It’s important to distinguish this from euthanasia, where someone else actively administers a lethal intervention to end a person’s life.
Medical Aid in Dying in the United States
In the U.S., medical aid in dying is determined at the state level and remains a patchwork of laws and legal interpretations.
Where MAID Is Legal
California
Colorado
Delaware
Hawaii
Maine
Montana
New Jersey
New Mexico
Oregon (no residency requirement)
Vermont (no residency requirement)
Washington
Washington, D.C.
Illinois has signed a law that will take effect in September 2026.
To stay informed about state legislation or learn how to get involved, visit the Death With Dignity website.
What Eligibility Looks Like
While specific requirements differ by state, most MAID laws require several eligibility criteria. The individual must be a legally competent adult, typically defined as 18 years or older, and able to make and communicate healthcare decisions independently at the time of the request.
Diagnosis: A confirmed terminal illness with a prognosis of six months or less to live.
Capacity: The individual must be mentally capable of making informed decisions.
Requests: Multiple oral and written requests must be made by the patient, often including at least two oral and one written request, usually separated by a minimum waiting period as defined by state law.
Self-Administration: The patient must be physically able to consume the prescribed medication on their own.
Every law also includes safeguards, such as independent confirmation of the terminal diagnosis by a second physician, requirements to verify the patient's mental capacity and voluntariness, mandatory reflection periods between requests, and the patient's ability to withdraw at any time.
Medical Aid in Dying Internationally
The attitudes and laws toward assisted dying practices vary, reflecting cultural, legal, religious, and ethical differences.
Some Countries With Legal Assisted Dying
Netherlands: Both euthanasia and physician-assisted suicide have been legal since 2002, under strict criteria.
Belgium: Legal for euthanasia since 2002, and includes provisions for non-terminal conditions.
Luxembourg: Permits both euthanasia and assisted suicide.
Spain: Legalizes euthanasia and assisted suicide when meeting eligibility criteria.
Switzerland: Medical Aid in Dying is legal. Organizations like Dignitas serve residents and non-residents.
Canada: Medical Assistance in Dying (MAiD) is legal and covers both assisted suicide and euthanasia when eligibility criteria are met.
Australia: Most states have laws permitting voluntary assisted dying for terminal or grievous diseases.
New Zealand: Legalized assisted dying.
Colombia: Court rulings allow euthanasia when meeting eligibility criteria.
Uruguay: Legalized euthanasia.
Medical aid in dying raises complex ethical questions about autonomy, medical professional roles, the value of life, suffering, and societal values. Medical associations may urge caution or oppose assisted dying, emphasizing the principle to “do no harm.” However, isn’t allowing someone to suffer doing harm?
Research indicates that even where MAID and euthanasia are legal, these options are rarely used, typically representing a small percentage of total deaths and most often involving patients with serious, progressive illnesses.
Research shows that even where MAID and euthanasia are legal, these options are rarely used, representing a small proportion of total deaths and most often involving patients with serious, progressive illnesses. Many patients who complete the process to obtain the medication do not take it. Having medication available can serve as a contingency plan, reducing anxiety and improving quality of life for some patients near the end of life.
A recommended film illustrating a personal experience with medical aid in dying is The Last Flight Home. Another film that explores individuals navigating Canada’s Medical Aid in Dying options is In My Own Time.
Medical aid in dying raises questions that weave through medicine, law, ethics, and dignity. Supporting patients and families through these decisions requires ongoing dialogue, legal clarity, and compassion.
