Medical aid in dying (MAID) is a patient-centered approach to end-of-life care that empowers dying patients to be in charge of their own medical decisions, prioritizing their comfort, dignity, and autonomy. This peaceful end-of-life option allows qualified, terminally ill patients to legally and voluntarily request prescribed medications from their licensed healthcare provider to die at the time and place of their choosing, in a manner that aligns with their values and wishes.
Who can qualify for MAID?
For someone to be eligible for MAID, they need to meet each of the following requirements:
- Terminally ill, with a diagnosis of six months or less to live
- Mentally capable of making and communicating healthcare decisions
- Physically capable of self-administering and ingesting the medication
- Physically in a state/jurisdiction with an existing MAID law*
- At least 18 years old
*Most states/jurisdictions with existing MAID laws require patients to be residents. However, there are some states/jurisdictions that allow qualified patients to come and use MAID, as long as they are working with licensed healthcare providers in the state/jurisdiction where they will be receiving MAID. For more information about the eligibility criteria and MAID status in each state or jurisdiction, visit our MAID Map.
What if someone doesn’t qualify for MAID?
Not everyone qualifies for MAID. Even if someone doesn’t qualify, they may find it valuable to have a conversation with a licensed healthcare provider to learn about other end-of-life options that they may be interested in pursuing instead.
What is the difference between MAID, euthanasia, and “assisted suicide”?
Different terms are often used when discussing end-of-life options, including “euthanasia” and “assisted suicide.” In the U.S., MAID allows eligible, terminally ill adults to request and self-administer medications prescribed by their healthcare providers to bring about a peaceful death. With MAID, patients remain in total control.
Euthanasia, in contrast, is a separate practice, where a healthcare provider administers the life-ending medications to the patient. Euthanasia is not legal anywhere in the U.S. for humans.
Additionally, the term “assisted suicide” is also an inaccurate way to describe MAID. Individuals who pursue MAID are already facing an incurable, terminal illness, and their approaching death is inevitable. MAID is a regulated medical process that requires multiple evaluations by licensed healthcare providers to confirm eligibility and ensure that the process is fully voluntary and without coercion.
When is the right time to start talking with doctors about MAID?
If a terminally ill patient is interested in learning more about MAID, it’s vital to reach out to a licensed healthcare professional as early as possible. Some patients who qualify for MAID wait too long and become unable to complete the process. For example, someone with ALS might qualify for MAID only for a short window of time. If they wait too long, their motor capabilities might deteriorate so much that they can no longer physically self-administer the MAID medications, making them ineligible to qualify for this option.
How does a patient get approved for MAID?
In order to qualify for MAID, a patient needs two licensed healthcare providers to confirm their eligibility. The first clinician will have to confirm that the patient meets each of the MAID qualifications, including giving the patient a prognosis as terminally ill with six months or less to live. A second consulting provider will also need to confirm that the patient meets these qualifications. The first clinician will be the one to write the prescription at the end of the process.
If a patient doesn’t know who to reach out to, a good starting place is to connect with a primary care physician. A primary care physician may be able to refer the patient to a second consulting provider, or there may be specialists on the patient’s broader healthcare team that would be willing to help. Depending on the jurisdiction, various licensed healthcare providers are allowed to provide MAID services, including physicians, physician assistants, or nurses. Some states/jurisdictions require in-person appointments, while others allow telehealth appointments. To learn more about the specifics of your state or jurisdiction’s MAID law, visit our MAID Map here.
How long does the approval process take from start to finish?
To get approved for MAID, a patient has to meet with their licensed healthcare providers multiple times. It can happen relatively quickly, but it can sometimes take a couple of months. Since the timeline depends on which state or jurisdiction the patient is in, it’s important to check out the timeline requirements first. (For reference, many states have an initial 15-day waiting period after the first request for MAID and then another 48-hour waiting period to get the prescription filled. Some states will waive waiting periods if a patient is likely to die before the waiting period can be fulfilled.)
What if a patient changes their mind?
A patient can decide at any point to stop the process, even if they have already been prescribed the medications. Some people find peace and comfort knowing that they have MAID as an option, even if they do not end up taking the MAID medications. Every jurisdiction with a MAID law has safeguards in place to protect the patient from coercion or abuse.
What happens when a patient takes the MAID medications?
Licensed medical providers will generally prescribe a compound medication for their approved patient to take. The patient needs to ingest the medications on their own, without help from anyone else. The most common way to take the medications is by mouth. If the patient has trouble swallowing, other ways to ingest the medications are by feeding tube, ostomy, or rectal administration.
After the patient takes the medications, they will soon enter a state of sleep. Once they’re asleep, they will usually die within 1-2 hours. The time it takes for the medications to work can vary depending on the underlying health conditions of the patient.
Is MAID covered by health insurance?
Patients should check with their specific health insurance carrier to see if they cover MAID medications and related services. Patients are not able to use federal funding, including Medicare and Medicaid, for MAID services or medications.
More resources on MAID
Below are some more resources about MAID that patients and loved ones might find helpful as they consider this end-of-life option.
The Completed Life Initiative does not provide direct patient healthcare or legal services. We help individuals navigate their end-of-life choices with dignity and autonomy, in consultation with each patient’s licensed care team.