Medical assistance in dying (MAID)
Note: this topic may be painful or upsetting for some, it is our intention to provide information so people can choose the right options for themselves.
Assistance in dying, often known as medical assistance in dying (MAID), physician-assisted dying, or physician-assisted suicide, allows those with terminal or chronic conditions to end their life with the assistance of a healthcare provider, is slowly becoming accessible around the world. Many advocates feel this is a basic human right, especially as medical advances allow people to live longer with disease and comorbidities that may cause pain, suffering, and a lowered quality of life.
MAID is a very personal choice that involves one’s own beliefs, values, spirituality, and definitions of quality of life. Each country or state may approach the eligibility, safeguards, and method of provision differently for MAID, but in all areas where it is legal, the choice must be made by the individual themselves demonstrating sound mind and clearly stating their wishes.
Stefanie Green, physician and author of This is Assisted Dying says she wrote the informative book to get the most accurate information to the most amount of people who are interested in the topic, “It doesn't really matter to me whether people agree with assisted dying or not. If we can just start having the conversations internally with ourselves about what's actually important to us. What brings meaning to my life? What brings me joy? What do I want to get done before I die? And if I had a say in how I die, what would that look like?” That helps flip the question from death to what life looks like in those final days.
Some countries only allow medically assisted death for patients who are diagnosed as ‘terminally ill,’ or as likely to die within 6 months (currently Australia, New Zealand and 11 U.S. states). In others, people who are not dying, but living with chronic, debilitating, and incurable physical conditions causing unbearable pain or making a dignified life impossible, can seek medical assistance in dying (such as Austria, Belgium, Canada, Colombia, Luxembourg, the Netherlands, Switzerland and Spain). In some countries (Belgium, the Netherlands and Austria - under consideration in Canada), people can make advance directives so that assisted dying can be administered in accordance with their wishes - if they are no longer able to confirm those wishes due to later mental or physical decline.
There are two forms of MAID: the first, often referred to as euthanasia, is where a medical practitioner administers a substance causing death; the second, often referred to as assisted suicide, is where a medication is prescribed to an individual who then self-administers the medication that causes their death.
This Forbes article does a nice job exploring the topic and debate around MAID. It shares the author’s experience with her mother’s choice to end her life on her own terms, which included the “serenity of a planned end, at home, surrounded by her family, with ample time to say goodbye, express love, and mindfully share newly-finite time.”
The World Federation of Right to Die Societies keeps an updated map and Dying with Dignity has a good global overview including the importance of key terminology.
Below is the status around the world as of March 2023:
Canada
In June 2016, the Parliament of Canada passed federal legislation that allows eligible Canadian adults to request medical assistance in dying.
Information on MAID in Canada can be found on the Government of Canada site including the law that was revised in 2021. MAID is covered by provincial health care systems.
There are two methods of MAID available in Canada: euthanasia (a medical practitioner administers a substance causing death) or assisted suicide (a medication is prescribed to an individual who then self-administers the medication that causes their death).
Dying with Dignity Canada is a charity committed to improving quality of dying, protecting end-of-life rights, and helping Canadians avoid unwanted suffering and they have developed some helpful resources including a planning guide for the patient as well as loved ones and what to expect for the assessment.
MAID Family Support also offers free resources and support and MAID House is a place people can go to access MAID.
For more reading, here is an editorial from someone whose spouse chose MAID in Canada. And This is Assisted Dying gives deep insight into what it looks like though many different families experiences.
USA
Oregon became the first state to legalize assisted dying in 1994. The law gives terminally ill adults the option to get a doctor’s prescription for medication they may decide to take to end unbearable suffering, by dying peacefully in their sleep. An introduction to this law can be found in the documentary How to Die In Oregon.
You can see the current status state by state on the Death with Dignity site. And links to all of the State legal acts are listed on the Compassion and Choices site.
As of January 2023 states with a Death with Dignity Statute include:
Legislation Enacted, Amendment Passed:
Europe
As of January 2023, Austria, Belgium, Germany, Luxembourg, Netherlands, Spain, and Switzerland all offer some version of medically assisted dying.
Status on the UK and advocacy for it is led by Dignity in Dying—UK. And President Macron in France has promised a debate and possible legislation in 2023.
Dignitas is a private society in Switzerland with the mandate “To live with dignity. To die with dignity” that helps people from around the world end their life on their terms, and was featured in the memoir In Love. You can read about how they work on their site.
Australia + New Zealand
Voluntary Assisted Dying is now legal in all the six states in Australia (Victoria, Western Australia, Tasmania, South Australia, Queensland, and New South Wales) and New Zealand.
Details on how to access in each state can be found on the End of Life Law site.
This podcast explores how it is working in Australia.
Latin America
As of 2015, Columbia allows medical aid in dying.
Resources:
This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.