Medical Aid in Dying: Which States Allow It, How It Works, and What Families Need to Know

The short answer: Medical aid in dying (MAID) is legal in 10 U.S. states and Washington D.C. as of 2026. It allows terminally ill adults with a prognosis of 6 months or less to request a lethal prescription they self-administer. Each state has specific eligibility criteria, waiting periods, and safeguards. A death doula can support patients and families through the process in states where it is legal.

What Is Medical Aid in Dying?

Medical aid in dying (MAID) — also called physician-assisted death, death with dignity, or aid in dying — allows qualifying terminally ill patients to obtain a prescription for medication they self-administer to end their life peacefully. It is distinct from euthanasia, in which a physician administers the lethal medication. The patient must be able to self-administer: if they cannot do so when the time comes, the medication cannot be administered by anyone else.

States Where MAID Is Legal (as of 2026)

MAID is currently authorized in: Oregon (1997), Washington (2008), Montana (via court ruling, 2009), Vermont (2013), California (2016), Colorado (2016), Hawaii (2018), New Jersey (2019), Maine (2019), New Mexico (2021), and Washington D.C. (2017). Several other states have active legislation in progress. State laws vary in waiting periods (some require 15-day waiting periods), prescriber requirements, and whether telehealth requests are permitted.

Eligibility Requirements Across States

Despite variation, most MAID statutes share core requirements: (1) Adult (18+) and state resident; (2) terminal diagnosis with 6-month or less prognosis certified by two physicians; (3) mental competence and ability to self-administer; (4) voluntary, informed request made twice orally and once in writing; (5) waiting period between requests (7-20 days depending on state). Some states have reduced or eliminated waiting periods for patients with rapidly progressing disease.

The Role of a Death Doula in MAID

A death doula can be invaluable throughout the MAID process — but their role varies by state and individual practice. They may: help the patient navigate the eligibility and request process; facilitate family conversations about the decision; coordinate with the prescribing physician and pharmacy; provide emotional support for the patient choosing MAID and for family members who may have mixed feelings; be present at the death to provide witness and support; and provide grief support to survivors in the days and weeks after.

What Happens at the Death

Most MAID deaths occur at home. The patient self-administers a compounded oral or IV medication (typically DDMP2 or secobarbital). Death typically occurs within 30-60 minutes, though occasionally longer. A death doula present at the death can read poetry, play music, hold space in silence, and help family members through the experience. Many describe MAID deaths as peaceful and dignified — patients are often conscious until the final minutes.

If MAID Isn't Available in Your State

If you live in a state where MAID is not legal, there are still options for a peaceful, controlled death: palliative sedation (for refractory suffering), voluntarily stopping eating and drinking (VSED), and optimized hospice care. A death doula can help you understand and pursue these alternatives, and can support you whether or not MAID is an option.

Frequently Asked Questions

Is medical aid in dying legal in my state?

As of 2026, MAID is legal in Oregon, Washington, California, Colorado, Hawaii, Vermont, New Jersey, Maine, New Mexico, Montana (court ruling), and Washington D.C. Check your state's health department for the most current laws.

Can a death doula be present for a MAID death?

Yes — in states where MAID is legal, a death doula can be present to support the patient and family, provide witness, and offer emotional and spiritual support throughout the process.

What if I can't self-administer by the time I want to use MAID?

Current MAID laws require self-administration. If you lose the ability to self-administer, you cannot use MAID. This is one reason some patients choose to use it earlier than they might otherwise, while they still have capacity. VSED (voluntarily stopping eating and drinking) is an alternative that doesn't require self-administration.

Is MAID covered by insurance?

Coverage varies by state and insurer. Some states require Medicaid to cover MAID; commercial insurance coverage varies. The cost of the prescription ranges from $300-$500 in most states.

What is VSED and how is it different from MAID?

VSED (voluntarily stopping eating and drinking) is a legal option in all states in which a person with decision-making capacity chooses to stop all food and fluid intake. Death typically occurs within 1-3 weeks. A death doula and hospice team can provide full support throughout the VSED process.

Renidy connects grieving families with compassionate death doulas and AI-powered funeral planning tools. Try our free AI funeral planner or find a death doula near you.