II. Types: Medical Aid in Dying (MAID)
- Patient self-administers a cocktail of medications that result in a humane death
- Intended to avert a more inhumane death (e.g. rapidly progressive ALS)
- Patient must physically take the medication themselves
- Not considered Suicide (by law) and does not invalidate life insurance
- Cause of death listed as the terminal illness from which they suffer
- Laws in U.S. (vary by state) and internationally (vary by country) allow for MAID
- Eligibility Criteria
- Two independent physician assessments (including decision making capacity)
- Adult age >=18 years old
- U.S. State resident (where the MAID law applies, exceptions: Vermont, Oregon)
- Life Expectancy <=6 months
- Medical safeguards
- Other specialties are consulted (e.g. hematology and oncology, Palliative Care)
- Patient must demonstrate decision making capacity at all evaluation visits
- Process is 100% voluntary and must be understood as such by patient and all involved
- Requires a signed consent with 2 witnesses
III. Types: Voluntarily Stopping Eating and Drinking (VSED)
- Patient chooses to not eat or drink
- Considered legal in all U.S. states
- Alternatively, forced feeding, may be considered battery
- Typically results in death within 7-10 days
- Duration varies by underlying comorbidity and health status
- Requires additional support (e.g. Hospice)
- Some symptoms of initial Dehydration are initially distressing
- Timeline of findings
- Day 0-1: Patient is awake and interacts with others
- Day 2-3: Generalized weakness and Light Headedness
- Day 4-6: Progressive Somnolence to coma
IV. Types: Palliative Sedation
- Occurs in ICU or inpatient Hospice
- Continuous sedating medications (e.g. Anxiolytics, Opioids) are used to maximize patient comfort and ease suffering
- Comfort is the key focus and require a deeper sedation to achieve relief
- Medications are not intended to end life
V. Resources
- Academy of Aid-In-Dying Medicine (AADM)
VI. References
- Morrison and Uslander (2026) Dying with Dignity, EM:Rap, accessed 7/3/2026