What Is Medical Aid in Dying? How It Differs From Euthanasia, Palliative Sedation, and Refusing Treatment

Few end-of-life topics are as personal, or as disputed. People searching for it may be facing a terminal diagnosis, supporting a loved one who is, or simply trying to understand the news. This guide explains what the term means, how it differs from related things, and where the disagreements lie. We describe the law and the positions people hold; we don’t tell you what to think.

What is medical aid in dying?

Medical aid in dying (MAID) is a practice that some U.S. states and the District of Columbia have authorized by law. A terminally ill adult who meets the legal requirements can ask a physician for a prescription for medication that the person can choose to take to end their life. Key features, using New York’s law as the Department of Health describes it:

• The person must be an adult, a resident of the state, with a medically confirmed terminal illness expected to cause death within six months, able to understand and make an informed decision, and able to self-administer the medication
• The request must come from the patient, not a health care agent, family member, or anyone else, and can’t be made in an advance directive
• The person can withdraw the request, decide not to take the medication, or change their mind at any time
• No one can qualify solely because of age or disability

Having the prescription doesn’t mean taking it. Oregon, which has published data since 1998, reported that of 560 people who received prescriptions in 2023, 337 (60%) died from taking the medication; others died of their illness or hadn’t taken it.

For who qualifies and how the process works, see who qualifies for medical aid in dying. For where it’s legal, see our dated state-by-state guide.

What is it called, and why does the name matter?

The name itself is part of the disagreement. The AMA’s Council on Ethical and Judicial Affairs has noted that the practice is called “assisted suicide,” “aid in dying,” or “death with dignity,” and that the terms carry different connotations; it observes that “aid in dying” invokes physicians’ commitment to succor and support. The AMA’s own ethics opinion uses “physician-assisted suicide.”

State laws use different names too, and several state that actions taken under the law are not suicide. New York’s law says a patient who requests medication isn’t considered suicidal and that self-administering the medication isn’t suicide for any purpose, and Oregon’s statute says actions under its act “shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide.” Opponents of the practice, and some faith traditions, use the terms “assisted suicide” or “physician-assisted suicide” and reject that distinction.

In this guide we use “medical aid in dying” as a descriptive term for the legal practice and use other terms when describing the people who use them.

How is it different from euthanasia?

In euthanasia, another person, such as a clinician, administers a drug that ends the patient’s life. In medical aid in dying, the patient must take the medication themselves. New York’s Department of Health says the law is clear that a health care professional or other person shall not administer the medication, and that a patient may use an assistive device but must perform a final, physical act. If a patient can’t self-administer, they can’t use the law. Neither the laws described here nor, as far as we found, any other U.S. state law authorizes euthanasia. In 1997, Congress’s federal funding law described assisted suicide, euthanasia, and mercy killing as criminal offenses throughout the United States.

How is it different from palliative sedation?

Palliative sedation uses medication to lower a dying person’s awareness when symptoms can’t be controlled any other way. The goal is to relieve suffering, not to cause death. See what is palliative sedation. The difference is in the intent, the process, and the usual timing: sedation is a symptom treatment for people who are already close to death, while MAID is a person’s choice to end their life.

How is it different from refusing or stopping treatment?

Patients have the right to refuse or stop treatment, including a ventilator, dialysis, or a feeding tube, even if death follows. This is legal everywhere, doesn’t need a special law, and is part of ordinary advance planning; see advance directives and DNR and POLST forms. Federal law on assisted suicide funding says it doesn’t affect decisions to withhold or withdraw treatment. Even most traditions that oppose MAID accept refusing treatment that is burdensome or disproportionate. See what different traditions teach.

A related but separate choice is voluntarily stopping eating and drinking. See what is VSED.

Who uses it?

Oregon’s published data give the most complete picture. In its 2025 annual report, 637 prescriptions were written, and 400 people died after taking the medication (a figure that may rise as records are finalized). Participants were most often 65 or older (88%) and white (94%), and about half had a bachelor’s degree or higher. The most common illness was cancer (61%), then neurological disease (14%) and heart disease (11%). Most were enrolled in hospice (92%) and died at home (80%). The three most frequently reported concerns were loss of autonomy (89%), decreasing ability to participate in activities that made life enjoyable (89%), and loss of dignity (65%). Oregon also reported that 24 of the 400 people who died in 2025 (6%) had lived more than six months after receiving their prescription, a reminder that prognoses are estimates. These are Oregon’s figures and can’t be assumed to hold for other states.

Why is it debated?

People of good will disagree, and the AMA’s own ethics code says “thoughtful, morally admirable individuals hold diverging, yet equally deeply held” views. In summary:

• Supporters argue that people with terminal illness should have the authority to decide how much suffering to endure and how their lives end, that the laws include safeguards, and that in states with long experience it is used by a limited number of people, most of whom are already in hospice (92% in Oregon in 2025)
• Opponents argue that ending a life is morally wrong or incompatible with medicine’s role as healer, that people could be subtly pressured to choose it, that disability-rights concerns about devaluing certain lives are serious, that diagnoses and prognoses can be wrong, and that the focus should be on better hospice and palliative care

Medical organizations differ. The American Medical Association opposes physician-assisted suicide in its Code of Medical Ethics, while saying that physicians who after moral consideration legally take part in jurisdictions where it’s allowed have not violated the Code. The American College of Physicians opposes it. The American Academy of Hospice and Palliative Medicine takes a position of “studied neutrality” on whether it should be legal, while stating concerns about making it part of routine medical practice, and the American Academy of Neurology is also described as taking studied neutrality. Faith traditions differ as well: most oppose it, and a few, such as the Unitarian Universalist Association and the United Church of Christ, support the right of terminally ill people to choose.

Federal law

Medical aid in dying is regulated by states. Under the Assisted Suicide Funding Restriction Act of 1997, federal funds, including Medicare, Medicaid, and veterans’ health care, can’t be used to provide or pay for health care items or services for the purpose of causing or assisting in causing death. CMS notes that the restriction doesn’t apply to items or services provided to relieve pain or discomfort, even if they may increase the risk of death, as long as they aren’t also provided to cause death.

What should I do if I’m facing this question?

• Talk with your care team, including a palliative care or hospice team, about your symptoms, your fears, and your options. Suffering often has treatable parts
• Ask what your state allows and which clinicians and facilities participate, since participation is voluntary and varies
• Talk with the people close to you, and put your wishes in writing. See goals of care
• If you are in distress or thinking about harming yourself outside of a legal medical process, please call or text 988 (the 988 Suicide & Crisis Lifeline), or call 911 in an emergency. Wanting relief from suffering is understandable, and help is available

Laws and professional positions on this subject change. This is general information, not medical or legal advice; your care team and your state’s health department can tell you what applies to you.