Medical aid in dying (MAID) is a practice in which a terminally ill patient, with full mental capacity, requests and receives medication from a physician that they can use to end their own life at a time of their choosing. It is legal in a growing number of countries and US states, but the laws — and the terminology — vary considerably.
This guide explains what MAID is, how it differs from related concepts like euthanasia and palliative sedation, who qualifies, and where it is legal.
Key Terms — What's the Difference?
| Term | Who Administers | Legal Where? |
|---|---|---|
| Medical Aid in Dying (MAID) | Patient self-administers prescribed medication | US states with Death with Dignity laws, Canada, New Zealand, Australia |
| Euthanasia | Physician administers the the medication | Netherlands, Belgium, Luxembourg, Spain, Colombia, Canada |
| Assisted Suicide | Patient self-administers; physician or organization provides means | Switzerland (Dignitas/Exit), Austria, Germany |
| Palliative Sedation | Physician administers sedation to relieve suffering | Legal in most countries — does not intentionally hasten death |
| Voluntary Stopping of Eating and Drinking (VSED) | Patient's own choice to stop eating/drinking | Legal everywhere — not considered assisted dying |
Who Qualifies for MAID?
Eligibility criteria vary by jurisdiction, but common requirements across most US states include:
- Terminal diagnosis — most US states require a prognosis of 6 months or less to live
- Adult age — typically 18 or older (Belgium and Netherlands allow minors under specific circumstances)
- Mental competence — the patient must be able to make and communicate healthcare decisions at the time of each request
- Voluntary request — the request must not be the result of external pressure
- Residency — most jurisdictions require state or national residency (Switzerland and Oregon, since 2023, are exceptions)
- Multiple requests — usually two oral requests plus a written request, often with a waiting period between them
What Happens in Practice?
In US states with Death with Dignity laws, the process typically works as follows:
- The patient discusses their wish to access MAID with their attending physician
- The physician confirms terminal diagnosis, prognosis, and decision-making capacity
- The patient makes a first oral request; a waiting period begins (48 hours to 20 days depending on the state)
- The patient makes a second oral request and submits a written request signed by witnesses
- A second physician confirms eligibility
- A prescription is issued for a self-administered life-ending medication
- The patient fills the prescription and may take it at any time and place of their choosing, or never — many patients die naturally before using it
Studies consistently show that for many patients, simply having the prescription provides psychological comfort, regardless of whether they ultimately use it.
Common Misconceptions
- "It's the same as suicide." Advocates and most legal frameworks distinguish MAID from suicide: it occurs in the context of terminal illness, not untreated mental illness or situational crisis.
- "Doctors are forced to participate." All laws include conscience clauses allowing physicians to decline on moral or religious grounds, with a duty to refer the patient to another provider.
- "It's a slippery slope." Oregon's 25+ years of data show no evidence that the pool of patients has expanded beyond terminally ill adults since the law took effect.
- "It undermines palliative care." States with MAID laws have simultaneously seen growth in palliative care access; the two are not mutually exclusive.
Where Is It Legal?
Approximately 12 countries and 11 US states plus Washington D.C. now permit some form of medically assisted dying. See our full guides:
- World Directory — all countries
- US State-by-State Guide
- Canada MAID Guide
- Switzerland — Dignitas & Exit
Resources
- Death with Dignity National Center — deathwithdignity.org
- Compassion & Choices — compassionandchoices.org
- World Federation of Right to Die Societies — wfrtds.org
- American Academy of Hospice and Palliative Medicine — aahpm.org