Physician-assisted suicide is the practice in which a doctor provides a terminally ill patient with the means to end their own life, typically by prescribing a lethal dose of medication that the patient takes independently. The American Medical Association defines it as occurring “when a physician facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act.” The critical distinction is that the patient, not the doctor, performs the final act.
Why the Terminology Is Shifting
You’ll increasingly see the phrase “medical aid in dying” used instead of “physician-assisted suicide,” and that shift is deliberate. Organizations including the American Public Health Association, American Psychological Association, and American Academy of Hospice and Palliative Care have formally rejected the term “physician-assisted suicide” in favor of “patient-directed dying” or “physician aid in dying.”
The reasoning centers on what the word “suicide” implies. People who attempt suicide are generally treated as having impaired decision-making, and healthcare providers often intervene with life-sustaining treatments, sometimes involuntarily. Advocates for the terminology change argue that a terminally ill person with a six-month prognosis making a rational, autonomous decision to control the timing of an inevitable death is fundamentally different from someone experiencing a mental health crisis. The word “suicide” conflates the two situations in ways that can stigmatize dying patients and their families.
Critics of the newer term point out that “physician aid in dying” is vague enough to encompass practices like euthanasia, where a doctor directly administers the lethal medication, which falls outside what U.S. laws actually permit. Both terms remain in wide use, and the language someone chooses often signals their position on the practice itself.
How It Differs From Euthanasia
The line between physician-assisted suicide and euthanasia comes down to who performs the final act. In physician-assisted suicide, the doctor writes a prescription and the patient decides whether, when, and how to take it. In euthanasia, the doctor directly administers the lethal medication, typically through an injection. U.S. laws exclusively authorize the first model: the patient must self-administer. The AMA considers euthanasia “fundamentally incompatible with the physician’s role as healer.”
Some countries blend both approaches. In Canada, medical assistance in dying includes both physician-administered and self-administered options. In the Netherlands, Australia, Luxembourg, and New Zealand, both forms are legal as well. The United States, Austria, and Switzerland permit only self-administration. Belgium, Colombia, and Spain permit only euthanasia.
Who Is Eligible
Every U.S. jurisdiction that permits this practice follows a similar framework. To qualify, a person must be at least 18 years old, a resident of the state, diagnosed with a terminal illness that gives them a life expectancy of six months or less, and mentally capable of making their own medical decisions. The mental competency requirement is central: you must be able to understand your diagnosis, your prognosis, the alternatives (including palliative care and hospice), and the consequences of taking the medication.
If either of the two required physicians has any doubt about your decision-making capacity, they can refer you to a mental health specialist for evaluation before the process moves forward.
The Request Process
The safeguards built into U.S. laws require multiple steps spread over a minimum timeframe. Using California’s End of Life Option Act as a representative example, the process works like this:
- Two verbal requests: You must ask your prescribing physician on two separate occasions, with at least 48 hours between requests.
- A written request: You complete an official aid-in-dying form, signed by you and two witnesses, and submit it to your doctor.
- Two physician confirmations: Your attending physician makes the initial determination that you have a terminal disease and are making an informed decision. A second, independent consulting physician then examines you, reviews your medical records, and confirms the diagnosis, prognosis, and your capacity to make this choice.
At every stage, you can withdraw your request. The medication sits in your possession, and many people who receive a prescription never take it. Oregon’s data illustrates this clearly.
What the Data Shows
Oregon’s Death with Dignity Act, enacted in 1997, provides the longest track record in the United States. In 2024, 607 people received prescriptions under the law. Of those, 333 (55%) died from ingesting the medication. Another 96 people (16%) never took the pills and eventually died of their underlying illness. For the remaining 29%, follow-up information was still pending at the time of reporting.
The gap between prescriptions written and medications actually taken is a consistent pattern across all years of Oregon’s data. For many patients, simply having the prescription provides a sense of control over an otherwise uncontrollable situation, even if they ultimately choose not to use it.
Where It Is Legal in the U.S.
As of 2026, medical aid in dying is authorized in 14 U.S. jurisdictions: California, Colorado, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Montana, New Jersey, New Mexico, New York, Oregon, Vermont, and Washington. Oregon was the first, and most subsequent states modeled their laws on its framework. Montana’s authorization came through a court ruling rather than legislation, which makes its legal framework somewhat different from the others.
Internationally, 12 countries have regulated some form of assisted dying. The specific rules vary widely. Switzerland has permitted assisted suicide since 1942 and is notable for allowing non-residents to access the practice, which no U.S. state does. Canada’s program is among the broadest, covering both physician-administered and self-administered options.
The Role of Each Physician
Two doctors are involved by law, and their roles are distinct. The attending physician is your primary point of contact. They confirm your terminal diagnosis, discuss your prognosis, ensure you understand all available alternatives including pain management and hospice care, and ultimately write the prescription if all criteria are met.
The consulting physician serves as an independent check. They separately examine you, review your medical records, and must independently verify the diagnosis, the six-month prognosis, and your mental capacity. The two physicians cannot simply rubber-stamp each other’s findings. If either physician is uncertain about your mental state, the process pauses until a mental health professional completes an evaluation. Neither physician is required to participate. Doctors who object on moral or ethical grounds can decline, and many hospitals and health systems have policies allowing individual clinicians to opt out.