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Why Medical Aid in Dying and Assisted Suicide are not the same thing
Episode 31
Charles just turned 90, and he’s asking a question many of us wonder about but rarely say out loud: “What are my options if I want to die with dignity?”
In this Tuesday Triage, Jill unpacks what medical aid in dying really means, how it differs from assisted suicide, and what the law says for families navigating these difficult conversations. With legal insights and examples from California’s End of Life Option Act, this episode shines a light on a topic often tucked away in silence.
What We Discussed
A personal connection: Jill shares her mom’s story of living with progressive supranuclear palsy (PSP), a rare degenerative brain disorder. She recalls the moments of fear and uncertainty, the independence her mom held onto, and why conversations about dying with dignity are deeply personal for her.
Charles’ question: At 90 years old, Charles asked his daughter, and through her, Jill, what options exist for someone who wants to die with dignity. His willingness to ask reflects the questions many people carry silently, often Googling late at night but rarely discussing openly.
Defining medical aid in dying: Jill explains that medical aid in dying is a regulated medical practice that allows a mentally competent adult with a terminal diagnosis of six months or less to request a prescription to peacefully end their life. She emphasizes that it is not the same as assisted suicide, euthanasia, or mercy killing.
Where it’s legal and what’s pending: Eleven states and Washington, D.C. currently permit medical aid in dying, while 18 others have pending or recently introduced legislation. Jill highlights the significance of these legal shifts for families who may face these decisions in the future.
California’s End of Life Option Act: Jill uses California as a case study to explain how the process works in practice. Key points include:
- Eligibility: Adults 18+, California residents, with terminal illnesses expected to result in death within six months.
- Requests: Two oral requests at least 48 hours apart, plus a written request signed in the presence of two witnesses.
- Safeguards: Physicians must confirm the patient’s capacity and voluntariness, and participation by doctors is voluntary.
- Self-administration: Only the patient can administer the medication; family or physicians may help prepare it but cannot administer it.
- Residency proof: California requirements include a state ID, voter registration, property ownership, or tax returns.
Protections for families and insurance: The law makes clear that using medical aid in dying does not affect life insurance, health insurance, or annuities. Death through medical aid in dying is legally recognized as a natural result of the underlying disease, not suicide. Family and friends cannot be held civilly or criminally liable for being present, as long as the patient self-administers the medication.
The importance of terminology: Jill explains why she avoids terms like “assisted suicide” or “euthanasia” and highlights Section 443.18 of the California law, which explicitly rejects those labels. This distinction matters, because medical aid in dying is not about choosing whether to die, but about how to face a death that is already imminent.
The bigger picture: Beyond the legal details, Jill explores what these laws mean for agency, dignity, and conversations about the end of life.
Resources and Links
- Death Readiness Services – Learn how Jill helps families prepare and stay organized
- Text of Published on 17 hours ago