What Is the Difference Between MAID and Euthanasia?

Patients who opt for Medical Aid in Dying (MAID) are provided with specific prescription medications that will be self-administered when the patient is ready to die, whereas euthanasia is differentiated by these medications being administered by a physician or healthcare staff. Euthanasia is illegal in the United States, and as of 2023, MAID is currently legal in 11 states and continues to receive advocacy in states where access is restricted. Another distinguishing factor is that there is only one type of MAID, but there are many different types of euthanasia and practices that are categorized as euthanasia. 

It is important to understand that the decision to withhold or withdraw life-sustaining interventions is not the same as euthanasia or MAID. Deciding to stop treatment is a common occurrence in healthcare, but the element of life-sustaining interventions is often unique to emergencies or end-of-life care scenarios. If the intervention no longer benefits the patient, doesn’t improve the patient’s quality of life, or no longer meets care goals, it is deemed appropriate to withdraw. If the patient has decision-making capacity, understands the outcome of their decision, and states that they no longer wish to receive the intervention, this also justifies the decision to withdraw. However, if the patient doesn’t have decision-making capacity, the decision may be made according to indications in an advance directive or transitioned to the patient’s surrogate in the absence of these documents. 

In contrast, specific criteria must be met to be eligible for MAID. Individuals must be at least 18 years of age or older, terminally ill with a prognosis of six months or less to live, have the capacity to make their own healthcare decisions and have the ability to self-administer the prescribed medication. If someone does not meet all four of these criteria, they are deemed ineligible and exceptions cannot be made. Since euthanasia is illegal in the United States, criteria are not used to determine eligibility, but rather to discern whether a patient’s death resulted from an illegal practice rather than natural causes. In other countries, euthanasia is only legal if physicians have fully adhered to the laws pertaining to the termination of life within the region.

MAID and euthanasia differ fundamentally in method, legality, and the level of involvement between the patient and the physician. Despite these differences, most people become interested in MAID or euthanasia for similar reasons. Many people fear the dying process and have concerns surrounding reduced quality of life, poor pain management, loss of bodily function, or lack of dignity as they become more reliant on others for care. Some individuals request MAID or euthanasia because it provides them with a sense of control regarding when and how they will die. Rationale varies based on each person’s values, preferences, and concerns pertaining to the end of life.  

As the societal conversation around end-of-life care continues to evolve, it’s crucial to understand the differences regarding MAID, euthanasia, and their implications in order to maintain informed and respectful discussions about these deeply personal decisions. Legislation and policies pertaining to MAID will continue to change as advocacy and the landscape surrounding end-of-life care continue to evolve and shift with the healthcare sector. Maintaining awareness of these changes and engaging in more open dialogues to reduce stigma can have a significant role in ensuring that patients with these wishes are understood, respected, and acknowledged appropriately. 

Sources 

“Reasons for requesting medical assistance in dying”. Canadian Family Physician. https://pmc.ncbi.nlm.nih.gov/articles/PMC6135145/ 

“Medical Aid in Dying”. Compassion & Choices. https://compassionandchoices.org/our-issues/medical-aid-in-dying/