Curious about MAID? Start here.

I offer this information not to convince anyone to choose MAID, but to provide curious people with reliable resources so they can better inform themselves.

The rules and process for aid in dying are constantly changing, and many are tied to residency. This page was published December 2024 and might not reflect the latest information. Please check with multiple sources to confirm that you are working with the most up-to-date information for where you live.

What is MAID, or Medical Aid in Dying?

Medical Aid in Dying, sometimes abbreviated as MAID, is an end-of-life option, governed by U.S. state legislation, that allows certain eligible people with terminal illness to voluntarily and legally request and receive a prescription medication from a physician to hasten their death in a peaceful, humane, and dignified manner. A legal prescription for life-ending medications in only available in states with aid in dying laws.

This support helps them die with less discomfort, anxiety, and unpredictability. This currently takes the form of a medical provider prescribing life-ending medications.

I’ve heard other terms used, do they describe something different?

You might also hear this form of support referred to by other names, including: Aid-in-Dying, Death with Dignity, Medical Assistance in Dying, Physician Aid in Dying, and Assisted Dying.

Different parts of the world might use other terms. For example, I'm based in California, and one of our hospices refers to this process as EOLA, which is the name of the California law that made Medical Aid in Dying legal in California (EOLA stands for End of Life Options Act).

I suspect that the terminology will continue to evolve as medical support, social awareness, and acceptance for this process continue to evolve.

The professionals in the field of End of Life care are working to establish standards for both process and language. While the terminology is not yet consistent, the following terminology is considered outdated, inaccurate, or misleading and should no longer be used: assisted suicide, euthanasia, doctor-assisted suicide, and physician assisted suicide.

Is this the same thing as Assisted Suicide or Euthanasia?

No. Aid in Dying is for people who are already dying. The eligibility process varies by state and by country, but in the US and Canada, one bedrock criteria is that the person applying must have a terminal diagnosis.

People choosing MAID are not choosing between living and dying. To be eligible for an Aid in Dying, someone must ALREADY be dying. A terminal diagnosis and <6 month prognosis is a steadfast eligibility requirement.

Why would someone choose this?

People who choose MAID are already dying. Every death is unique and the dying process for most deaths is unpredictable. Many people who choose Aid in Dying wish to reduce or avoid suffering physical and/or emotional suffering. Some choose it because they want to have control over how their ending might unfold.

Aid in dying support helps people die with less discomfort, anxiety, and unpredictability.

Where in the US is Aid in Dying legal?

According to Compassion and Choices, Aid in Dying is legal in 10 U.S. states and D.C.: California (2015), Colorado (2016), Hawaii (2019), Maine (2019), Montana (2009), New Jersey (2019), New Mexico (2021), Oregon (1994), Vermont (2013), Washington, D.C. (2017), Washington (2009)

Deathwithdignity.org has a tracker that shows the current status of aid in dying across the U.S.

What are the eligibility requirements?

Those interested in Aid in Dying must be eligible and must qualify to be prescribed Aid in Dying medications.

Generally, to become legally eligible for medical aid in dying, you must:

  • Be at least 18 years old

  • Have been diagnosed with a terminal condition with less than six months left to live. This means your disease cannot be cured or reversed and is expected to result in death within six months. You might hear this referred to as a prognosis of six months or less (as estimated by two doctors).

  • Have the capacity to make medical decisions and not have impaired judgment due to a mental disorder

  • Have the physical ability to self-ingest aid-in-dying medications independently via mouth, feeding tube, ostomy, or rectal catheter (no IV meds can be used)

  • Meet residency requirements of a state where MAID is legal (or you can move to Vermont or Oregon or establish residency in an aid-in-dying state)

  • Apply for legal eligibility, which consists of making direct, uncoerced requests to medical doctors who then evaluate and confirm that you meet these criteria.

If you are found eligible and complete all the necessary steps, you can proceed and take the medications to die if you choose to, but you are never required to, even after your receive the medications. If you are not found eligible, you may request to be closely monitored and re-evaluated if your condition changes, ideally through the same MDs who initially evaluated you.

What else should I know?

  • You must be able to ingest about 4 to 6 ounces of liquid by mouth or feeding tube in a relatively short amount of time. The medication results in sleep, usually within a few minutes, followed by death within a few hours.

  • Eligibility does not require proof of suffering or exact planning for self-ingestion.

  • There are legally mandated waiting periods between verbal requests, and some states require a written request.

  • Eligibility details differ by state and can take weeks to months—states have different waiting periods and residency requirements, e.g. Some states require two doctors to sign off, while New Mexico requires only 1 if patient is in hospice.

  • It can take 2 to 4 days to get the medication once the prescription has been written.

  • It’s up to you to figure out how to pay for aid in dying care; aid in dying drugs are generally not covered by medicare or insurance.

  • Remember, you have the right change your mind about taking the medications at any time, even after obtaining them. You always have the right to stop the process at any time.

  • No one should administer these drugs to you. Another person may assist in preparing the medication for you to take. However, if you decide to take them, you must ingest them on your own.

  • Death is a dynamic process, and things change quickly. For this reason, if MAID is something being considered, it’s important to get started on the application process as early as possible, even if there are no specific plans for when or if the meds will be taken. If circumstances change and you do not meet eligibility criteria, you will no longer qualify to receive Aid in Dying medications.

  • Aid in Dying medications cannot be ingested in public places, eg on a public beach. Please seek additional guidance around safe ingestion.

How does it work?

Aid in Dying involves taking a specific mix of drugs that have been prescribed by an Aid in Dying doctor. Each drug is included in the mix for distinct reasons. This mix of aid in dying drugs is constantly changing based on feedback from patients, care providers, and observers within the Aid in Dying community. As of December 2024, the current mix is designed for sedation, as well as respiratory and cardiac suppression.

These medications will make you go to sleep. This isn’t a euphemism; the drugs will first make you fall asleep and then you will die because your heart and lungs will stop. Once you are unconscious, there is no suffering. Although the underlying disease process might create pain or discomfort for the dying person, there is no pain associated with the Aid in Dying process. If pain is present from the underlying disease process, hospice can provide support for pain management up until the ingestion moment.

How do you ensure that someone isn't being forced to make this choice?

Choosing Aid in Dying is a big decision. The process involves a number of checks to ensure that the decision is not made lightly. It’s important that this process is entered into entirely by choice and free from coercion, so don’t be surprised if various members of the care team ask questions to confirm that this is what is wanted and that the person choosing this really wants this. Some might interpret this as badgering or even judgment. It can be possible to have the care team coordinate conversations about aid in dying so the person doesn’t feel constantly questioned, but end of life care can involve multiple people, so despite best efforts, questioning can feel redundant. Knowing this might help the person be more emotionally prepared for these multiple checks.

What are some reliable resources where I can learn more about Aid in Dying?

  • American Clinicians Academy on Medical Aid in Dying (formerly known as ACAMAID) is a donation-funded group whose mission is to make clinical information about medical aid in dying available to all clinicians. The Academy develops, improves, and supports best practices for the care of patients considering or completing Aid in Dying.

  • End of Life Choices California (EOLCCA) is a California-based group that provides comprehensive end-of-life support, including guidance on legal options, one-on-one volunteer support, and assistance with advance care planning. Their site has a number of helpful resources around End of Life choices, including links to videos and movies, medical aid in dying support, and a support hotline. There are other organizations like this specific to the other states that have legalized aid in dying. Since state laws are always changing, google might be helpful to find yours.

  • Compassion and Choices is a nonprofit working to improve care, expand options and empower everyone to chart their end-of-life journey. They are a lobbying and education group leading the effort to authorize, implement, and defend medical aid in dying so all qualifying people get the end-of-life care they want. Their site has great resources on end of life planning and options.

  • Death With Dignity is a national nonprofit organization focused on end-of-life advocacy and policy reform. They promote medical aid-in-dying laws and support nationwide improvements in end-of-life care.

  • While the Coalition for Compassionate Care of California does not take a position on Aid in Dying, it does provide information in support of people trying to live their best lives with serious illness.

Do you have any resources that might help with talking with a child or teen about an adult’s decisions to use MAID?

While the following are all specific to Canada, they might be a helpful starting place:

I’m a patient considering medical aid in dying. How can I find a doctor to help me?

Finding participating physicians can be difficult. The American Clinicians Academy on Medical Aid in Dying provides a Patient-to-Doctor Referral System. Use that link to learn more or to complete an intake to participate. This referral system can help connect you to clinicians who can evaluate patients for legal eligibility for medical aid in dying. They do not provide direct patient care but are there to support you with information and connect you with clinicians in your area who can evaluate you and provide aid-in-dying care. Once they identify possible providers, they will email you as quickly as possible, usually within 48 hours. They may need further information, so after submitting, please check your emails often for a response. 

I received a diagnosis for a condition that involves a slow deterioration, like dementia, Alzheimer's, or ALS, am I eligible?

This is a tricky area because disease progression can be so individualized. The eligibility criteria for MAID can sometimes conflict with the timelines involved in some of these diseases. When a patient is not within the 6 month window, they have to become eligible for Aid in Dying, and that takes time. For example, by the time someone is within 6 months of End of Life with dementia, they might not have the cognitive capacity to willingly choose MAID. And with diseases involving a loss of physical mobility, it can be challenging for the person to take ownership of the ingestion process, which is an absolute requirement for eligibility. If this might describe your circumstances, check the resources above for more options. 

Is Aid in Dying my only option if I don’t want to suffer at the end of my life?

Aid in dying isn’t the only way to die, and it’s not the only way to assert some measure of control over your pain, suffering, or speed of dying. zAn End of Life doula and many hospice staff can guide you through dying to support a peaceful death.

Hospice is designed to keep you clean, safe, and comfortable (pain-free). A doula can also support this to some degree and can provide emotional and spiritual support, as well as enable reflection, processing, and the creation of legacy projects. I encourage you to utilize some of the many end of life support resources that are available.

Death is not inherently painful. Dying doesn’t have to involve suffering. You don’t have to go through this alone.

Where can I watch videos and documentaries to learn more about the Aid in Dying process? Do you have any specific recommendations?

Our society is not very death literate. I encourage you to learn as much as you can about the options available at the end of life. End of Life Choices has pulled together a rich collection of independently-produced videos and documentaries about MAID and other end of life options.

Here are a few places you might start:

Websites for CA-based Healthcare Organizations:

Has someone you care about chosen MAID?

My heart is with you. Losing a loved one is rarely easy, even if they were suffering. An Aid in Dying death can be especially difficult for family members who feel that they cannot talk openly about how their loved one has died. This can be true for any death that might be considered taboo in some way. There are specific support groups for family and friends of people who have chosen MAID. Reach out to your local hospice to inquire about whether they offer this kind of group. Some aid in dying support groups meet virtually, which helps extend this important support option to a wider geographic range. If your hospice doesn’t know of any MAID-specific support groups, feel free to contact me directly. I’m happy to help you find a safe and understanding group to support you.