What is Medical Aid in Dying?
All facts on this FAQ page are based on information provided by Death with Dignity National Center and/or Compassion and Choices. They are the two national organizations working toward passing medical aid in dying in all 50 states. They are valuable partners for state organizations like ours working on a more local level to build awareness, provide education, and inspire advocacy on this issue.
What is Medical Aid in Dying?
Medical aid in dying is the practice in which a mentally capable and terminally ill adult with less than six months to live has the option to request and obtain a prescription medication that will end their life. The process to obtain the prescription is strict with multiple safeguards. After obtaining the prescription a person may ingest the medication to die peacefully at the time and place that they choose. Medical Aid in Dying laws are sometimes referred to by the acronym MAID or as Death with Dignity laws. PLEASE NOTE: These laws are not available to those with dementia or Alzheimer’s disease. This may not be written into an Advance Directive.
How Does Medical Aid in Dying Differ from Euthanasia?
With medical aid in dying, the terminally ill person must take the medication themselves unaided and therefore, always remains in charge. Euthanasia is illegal in the United States and requires a third party to administer the medication.
What’s Wrong with Referring to Medical Aid in Dying as “Physician-Assisted Suicide?”
Factually, legally, and medically speaking, it is inaccurate to equate medical aid in dying with assisted suicide. A person who seeks medical aid in dying already has a terminal prognosis of six months or less to live. They are not choosing to die; a disease is taking their life. Further, medical aid in dying is not considered suicide—in any form—in the jurisdictions with a medical aid in dying law.
The American Association of Suicidology (AAS) states:
“In general, suicide and physician aid in dying are conceptually, medically, and legally different phenomena, with an undetermined amount of overlap between these two categories. The American Association of Suicidology is dedicated to preventing suicide, but this has no bearing on the reflective, anticipated death a physician may legally help a dying patient facilitate, whether called physician-assisted suicide, Death with Dignity, physician-assisted dying, or medical aid in dying. In fact, we believe that the term “physician-assisted suicide” in itself constitutes a critical reason why these distinct death categories are so often conflated, and should be deleted from use. Such deaths should not be considered to be cases of suicide and are therefore a matter outside the central focus of the AAS.“
The term “medical aid in dying” is the accepted language used in the healthcare and legal communities. It best defines the process in objective and respectful language.
Can’t people just kill themselves with a gun or drugs if they want to die?
Forcing a dying person to use illicit drugs or violence against themselves is cruel to the dying person and their family and friends. Terminally ill patients are often screened by their oncologist for depression and suicidal ideation. When needed, treatments can be provided in terms of medication and therapy. It does not change the course of their illness but can enhance their quality of life. Medical aid in dying laws include safeguards for patients by requiring clearance by two separate physicians. If there are any concerns about the patient’s mental capability the process is stopped and the patient is referred for a mental health evaluation. As a society, we must support suicide prevention efforts for anyone suffering from mental health issues.
Should we be worried that some might try to coerce sick, elderly, or disabled people to use medical aid in dying?
No. In the more than 40 combined years of experience with medical aid in dying in states where it is authorized, there has not been a single substantiated accusation of abuse or coercion.
Medical aid-in-dying laws make it a felony to coerce someone to request the medication or to forge a request. Under existing laws, two physicians must certify that the person’s request is informed and free of undue influence or coercion, and two witnesses who personally know the dying person must attest that the person is making a voluntary, informed decision and without undue influence or coercion.
Only the dying person may self¬-administer the medication; administration of the medication by any other person is a felony.
When there are so many pressing healthcare issues why should we focus on medical aid in dying when only a small percentage of people are going to use it?
In the states that have already authorized medical aid in dying, people report significant relief from worry about future physical and emotional pain just from knowing the option is there should they need it, regardless of whether they pursue it. In other words, the availability of this option significantly improves the quality of remaining life for people who are dying. Those living with terminal illnesses report that the availability of this option greatly lifts their mood and relieves anxiety. What’s more, multiple reports, polls, and studies have concluded that medical aid in dying promotes appropriate and increased hospice use, and results in greater knowledge about palliative, end-of-life, and hospice care, and better palliative care training of physicians.
What safeguards are in place to protect patients?
• Patients must meet stringent eligibility requirements, including being an adult, state resident, mentally competent, and having a terminal diagnosis with a 6-month prognosis as confirmed by two licensed physicians.
• Only the patient him or herself can make the oral requests for medication, in person. It is impossible to stipulate the request in an advance directive, living will, or any other end-of-life care document.
• The patient must make two oral requests, at least 15 days apart.
• The written request must be witnessed by at least two people, who, in the presence of the patient, attest that to the best of their knowledge and belief the patient is capable, acting voluntarily, and is not being coerced to sign the request. One of the witnesses cannot be a relative of the patient by blood, marriage or adoption; anyone who would be entitled to any portion of the patient’s estate; an owner, operator or employee of a health care facility where the eligible patient is receiving medical treatment or is a resident or the patient’s attending physician.
• The patient must be deemed capable to take (self-administer and ingest) the medication themselves, without assistance.
• The patient may rescind the request at any time.
• Two physicians, one of whom is the patient’s attending physician, familiar with the patient’s case, must confirm the diagnosis. Each physician must be licensed by the state to practice medicine and certified to prescribe medications.
• If either physician determines the patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment, they must refer the patient for evaluation by a state licensed psychiatrist or psychologist to determine their mental competency. Medication cannot be prescribed until such evaluation determines the patient is mentally competent.
• The attending physician must mail or hand-deliver the prescription to the pharmacy.
• The patient must wait 48 hours from their written request to fill their prescription.
• The request process must be stopped stop immediately if there is any suspicion or evidence of coercion.
• The physicians must meet strict reporting requirements for each request.
• Anyone who falsifies a request, destroys a rescission of a request or who coerces or exerts undue influence on a patient to request medication under the law or to destroy a rescission of such a request commits a Class A felony. The law also does not limit liability for negligence or intentional misconduct, and criminal penalties also apply for conduct that is inconsistent with it.
How does using a death with dignity law impact my health and life insurance?
Physician-assisted death statutes do not specify who must pay for the services. Individual insurers determine whether the procedure is covered under their policies, just as they do with any other medical procedure. Federal funding, including Medicaid and Medicare, cannot be used for services or medications received under these laws.
Physician aid in dying statutes specify that participation under them is not suicide. Therefore, your decision to use a medical aid in dying law to die peacefully in your sleep has no effect on your life, health, or accident insurance or annuity policy.
Are you the only organization currently advocating on behalf of the terminally ill for a law in Ohio?
Yes. Ohio End of Life Options is the only active organization raising awareness and providing education programs virtually and in person in all eighty-eight counties. At the Statehouse in Columbus, Ohio we actively communicate with legislators to provide accurate and transparent facts about medical aid in dying.
How are you funded?
Ohio End of Life Options is a 501c3 that is 100% privately funded by supporters who want to advocate on behalf of the terminally ill to pass a medical aid in dying law in Ohio. We do not receive any government funding.