Which States Allow Medical Aid in Dying and How Does It Work?

The short answer: As of 2026, medical aid in dying (MAID) is legal in 10+ states including Oregon, Washington, California, Colorado, Vermont, Hawaii, New Jersey, Maine, New Mexico, Montana, and Washington D.C. Requirements typically include terminal illness with 6-month prognosis, two oral requests, a written request, and approval from two physicians.

Medical Aid in Dying (MAID): A State-by-State Guide

Medical aid in dying — also called Death with Dignity or physician-assisted death — allows qualifying terminally ill adults to request a prescription for life-ending medication that they can self-administer. It is distinct from euthanasia (where a physician administers the medication). As of 2026, MAID is authorized in a growing number of U.S. states.

States Where Medical Aid in Dying Is Legal

Oregon — Death with Dignity Act (1997, first in the nation)

Washington — Death with Dignity Act (2009)

Vermont — Patient Choice and Control at End of Life Act (2013)

California — End of Life Option Act (2016)

Colorado — End of Life Options Act (2016)

Washington D.C. — Death with Dignity Act (2017)

Hawaii — Our Care, Our Choice Act (2019)

New Jersey — Aid in Dying for the Terminally Ill Act (2019)

Maine — Death with Dignity Act (2019)

New Mexico — Elizabeth Whitefield End-of-Life Options Act (2021)

Montana — Authorized by court ruling (Baxter v. Montana, 2009) rather than legislation; status is somewhat uncertain

Standard Eligibility Requirements

While specific requirements vary by state, most MAID laws require:

• Adult (18+) residing in the state where MAID is legal
• Terminal illness with prognosis of 6 months or less to live
• Mental capacity to make and communicate healthcare decisions
• Ability to self-administer the medication (some states have removed this requirement)
• Two oral requests to a physician (separated by a waiting period, varying by state)
• One written request signed by two witnesses
• Approval from a second physician or other healthcare provider
• Mental health evaluation may be required if capacity is in question

What MAID Is Not

MAID is not euthanasia — the patient must self-administer the medication. It is not available to people with non-terminal illness, disability alone, or mental illness without a terminal diagnosis. It is not a suicide — MAID deaths are classified as deaths from terminal illness on death certificates in most states.

The Process of Requesting MAID

1. Consult with your primary physician or specialist about your prognosis and eligibility
2. Make first oral request
3. Wait the required waiting period (often 15 days, though some states have reduced or eliminated this)
4. Make second oral request
5. Complete written request with two witnesses
6. Receive second physician opinion
7. Prescription is filled at a pharmacy
8. Patient self-administers at a time and place of their choosing, surrounded by loved ones if desired

Support for MAID Patients and Families

Death doulas and end-of-life support organizations can provide emotional support throughout the MAID process — helping with decision-making, family conversations, and being present if desired. Organizations like Death with Dignity National Center and Compassion & Choices provide guidance, advocacy, and referrals to supportive providers.

Physician Conscientious Objection

Physicians may legally refuse to participate in MAID based on personal or religious objections. However, in states with MAID laws, healthcare systems may be required to refer patients to willing providers. Patients who encounter refusal should contact Compassion & Choices for help finding a willing provider.

Frequently Asked Questions

What states allow medical aid in dying?

As of 2026, medical aid in dying is legal in Oregon, Washington, Vermont, California, Colorado, Washington D.C., Hawaii, New Jersey, Maine, New Mexico, and Montana (via court ruling). Several other states have pending legislation. The legal landscape continues to evolve.

What is the difference between medical aid in dying and euthanasia?

In medical aid in dying, the patient self-administers the life-ending medication — the physician only prescribes it. In euthanasia (illegal in the U.S.), the physician administers the medication directly. MAID laws require the patient to be physically capable of self-administering.

How do you qualify for medical aid in dying?

Typical requirements include: being 18+ and a resident of a MAID-legal state, having a terminal illness with 6 months or less to live, having mental capacity to make healthcare decisions, and completing the multi-step request process (two oral requests, one written request, second physician approval). Requirements vary by state.

Does insurance cover medical aid in dying medication?

Some insurance plans, including Medicaid in certain states and some private insurers, cover the cost of MAID medication. The medication itself (typically secobarbital or a multi-drug protocol) can cost $500–$1,000. Contact your insurer and your state's MAID program for specific coverage information.

Can a doctor refuse to provide medical aid in dying?

Yes. Physicians may refuse to participate in MAID based on personal, moral, or religious objections — this is called conscientious objection. However, in most MAID-legal states, healthcare systems must refer patients to willing providers. Compassion & Choices can help patients find supportive providers.

Renidy connects grieving families with compassionate death doulas and AI-powered funeral planning tools. Try our free AI funeral planner or find a death doula near you.