Physician-assisted death is when someone with a terminal illness requests a prescription for a lethal dose of medication. People may choose to die on their own terms to feel a sense of control over their situation and put an end to extreme pain.

Physician-assisted death goes by a number of different names, including:

  • physician aid in dying
  • medical aid in dying
  • death with dignity
  • assisted medical suicide (but many people believe the practice shouldn’t be considered suicide)

This practice is very controversial. Only a handful of countries and U.S. states have passed legislation allowing physician aid in dying.

People who support it say everyone deserves the autonomy to choose when their life ends. Meanwhile, opponents say physicians who intentionally cause death are working outside their role as healers.

Read on for more details on physician-assisted death, including where it’s legal and the controversies around the practice.

Eligibility criteria for physician-assisted death vary depending on location.

People considering this option in the United States must:

  • Have a terminal illness: In this case, “terminal” means you have 6 months or less to live. According to data from Oregon, common diagnoses include cancer, neurological disease, and heart disease.
  • Be 18 years or older: Children can’t request medical aid in dying.
  • Have the ability to make healthcare decisions: You need to have the ability to make your own healthcare decisions and communicate them. No one else can request medical aid in dying for you.
  • Have the ability to consume medication: You must be able to take the medication yourself. No U.S. states allow doctors to administer lethal medication directly. They can only prescribe the medication.

Before requesting medical aid in dying, you will need to:

  • consult multiple physicians
  • make oral and written requests, with a waiting period between these requests
  • fill out legal paperwork

If the physicians approve your requests, you will receive a prescription for lethal medication, which often involves a combination of sedating drugs, like barbiturates and morphine sulfate.

Receiving the medication doesn’t mean you have to take it — you can always change your mind. Among people who receive a prescription, roughly 30% decide not to take it.

If you do decide to take it, you’ll fall unconscious within about half an hour. Death often follows within several hours, though in some cases it may take a few days.

Currently, physician-assisted dying is legal in these countries:

  • Australia
  • Austria
  • Belgium
  • Canada
  • Colombia
  • Germany
  • Luxembourg
  • Netherlands
  • Spain
  • Switzerland
  • United States

In the United States, it’s also legal in:

  • California
  • Colorado
  • District of Columbia
  • Hawaii
  • Maine
  • Montana
  • New Jersey
  • New Mexico
  • Oregon
  • Vermont
  • Washington

Physicians are never required to offer aid in dying if they have ethical objections. At the same time, they can’t prevent their patients from seeking doctors who do offer this aid.

People may support this practice for reasons of:

  • Personal autonomy: Supporters believe every person has the right to control their own body, including when that body dies.
  • Quality of life: Some people with a terminal illness may consider their life no longer worth living, especially if they experience extreme pain and discomfort. They may prefer a relatively quicker death before their condition gets any worse.
  • Harm reduction: Some terminal illnesses cause pain and discomfort that medication can’t do much to ease. Supporters believe no one should have to live in a state they find unbearable.

People may oppose this practice for reasons of:

  • Inherent value of life: Opponents believe it’s unethical to die intentionally, no matter the reason.
  • Potential coercion: Some people believe a person’s family could pressure them to request aid in dying to prevent further medical expenses. This may especially be the case if they lack access to affordable treatments to manage their health concerns.
  • Complications: Due to a lack of reporting, it’s difficult to know how safe the medications are. Some people experience significant nausea and vomit the medication back up. Rarely, some people regain consciousness after taking the medications.

Canada’s medical assistance in dying (MAID) program allows both self-administered and clinician-administered methods of death. Its eligibility criteria are much broader than similar programs in other countries.

As of March 2021, you do not need to have a terminal illness to qualify for MAID. Instead, your medical condition must be “grievous and irremediable.” In other words, it meets all of these criteria:

  • It’s a serious illness, disease, or disability.
  • It has caused advanced decline that can’t be reversed.
  • It causes severe physical or mental suffering that can’t be relieved by any methods you deem acceptable.

Beginning in March 2023, people with mental health conditions will be eligible for MAID if they meet the above criteria.

International debate

Human rights experts from the United Nations have expressed concerns that the MAID program will encourage older adults and people living with disabilities to opt for premature death.

Opponents believe people whose conditions could improve with treatment and better living conditions may instead choose MAID because they lack other options.

Indeed, there are cases of Canadians with disabilities pausing or canceling their request for MAID upon receiving accessible housing.

Supporters of MAID counter that people living with ongoing emotional distress and suffering deserve the same options for relief as people who experience physical pain and distress due to terminal illnesses.

Physician-assisted death, also called medical aid in dying, is when an adult with a terminal illness takes a prescribed drug to end their life at the time of their choosing.

The practice is legal in certain countries and U.S. states, although eligibility criteria differ by location.

Physician-assisted death is an ethically and philosophically complicated subject. If you’d like to learn more about all sides of this issue, these resources offer a variety of viewpoints:

Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.