What Is Medical Aid in Dying and Which States Allow It?
By CRYSTAL BAI •
The short answer: Medical aid in dying (MAID) — also called physician-assisted death, death with dignity, or assisted dying — is the practice of a physician prescribing a lethal medication that a terminally ill patient can self-administer to end their life. It is legal in 10 US states and Washington DC as of 2025, and requires strict eligibility criteria: terminal illness, prognosis of 6 months or less, mental competence, and self-administration.
What Medical Aid in Dying Is — and Is Not
MAID is a practice in which an eligible patient requests and receives a prescription for a medication they can self-administer to end their life at a time of their choosing. Crucially:
- The patient must self-administer — no one else can administer the medication
- It is not euthanasia (where a physician or other person administers the medication)
- It is not assisted suicide in the criminal sense — it requires physician authorization and strict medical criteria
- It is distinct from palliative sedation (which aims to reduce suffering but does not intentionally end life)
States Where MAID Is Legal (as of 2025)
| State | Law Name | Year Enacted |
|---|---|---|
| Oregon | Death with Dignity Act | 1997 |
| Washington | Death with Dignity Act | 2008 |
| Montana | (Court ruling, not statute) | 2009 |
| Vermont | Patient Choice and Control at End of Life Act | 2013 |
| California | End of Life Option Act | 2015 |
| Colorado | End-of-Life Options Act | 2016 |
| Hawaii | Our Care, Our Choice Act | 2019 |
| New Jersey | Aid in Dying for the Terminally Ill Act | 2019 |
| Maine | Death with Dignity Act | 2019 |
| New Mexico | Elizabeth Whitefield End of Life Options Act | 2021 |
| Nevada | End of Life Options Act | 2023 |
| Washington DC | Death with Dignity Act | 2017 |
Eligibility Requirements (Common Across States)
- Adult (18+) resident of the state
- Terminal illness with prognosis of 6 months or less, certified by two physicians
- Mental competence to make and communicate healthcare decisions
- Ability to self-administer the medication
- Two oral requests and one written request (waiting period between requests varies by state)
What MAID Is Not
MAID does not override other end-of-life options — patients who qualify can still choose hospice, palliative care, or standard medical care. Choosing to explore MAID does not commit a patient to using it — many patients get the prescription and never use it, finding that having the option provides peace of mind and control.
Frequently Asked Questions
What is the difference between MAID and euthanasia?
In MAID, the patient self-administers the medication — no one else administers it. In euthanasia, a physician or other person administers a lethal medication to the patient. MAID is legal in 10+ US states; euthanasia is not legal in any US state.
Can I use MAID if I'm not from a state where it's legal?
Generally no — all state MAID laws require residency in that state. Some states have removed waiting period requirements, making brief residency more feasible, but legal advice is needed for specific situations.
Does MAID affect life insurance?
Most life insurance policies issued after 1997 (when Oregon's law took effect) explicitly cover MAID in states where it is legal. The death certificate typically lists the underlying terminal illness as cause of death, not the medication. Consult your specific policy and insurer.
Is MAID compatible with hospice?
Yes. Most hospice organizations in states where MAID is legal support patients who choose this option. Some hospice organizations — particularly Catholic-affiliated ones — may not participate. Patients should ask their hospice provider's policy.
How does a death doula support a patient using MAID?
A death doula can help with advance planning, facilitate family conversations about the decision, help plan the circumstances and setting for the death, and provide emotional support throughout the process. They do not administer the medication.
Renidy connects grieving families with compassionate end-of-life professionals. Find support near you.