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American Academy of Aid in Dying Medicine

Legalizing Medical Aid in Dying 
By Chris Palmer, Vice President, Hemlock Society of San Diego

Medical Aid in Dying (MAID) refers to the practice where terminally ill patients who have been deemed mentally competent and are expected to live six months or less can voluntarily request and self-administer prescribed lethal medications to end their suffering. This practice is designed to offer a dignified, controlled end to patients who face unbearable anguish that even optimal hospice care cannot alleviate.

Why Legalizing MAID Is Crucial 

  1. Compassionate Care for Terminal Patients: MAID provides a compassionate choice for patients in the final stages of terminal illness. It offers an escape from extreme pain and suffering, granting patients the autonomy to end their lives in a dignified and peaceful manner. This option is particularly crucial for those whose pain management needs cannot be fully met through existing medical interventions.
  2. Ethical and Controlled Approach: Evidence from the 11 US jurisdictions where MAID is legal, including Washington D.C., demonstrates that MAID is a safe, ethical, and beneficial option. It operates under strict regulations that ensure it is a patient-driven decision, safeguarding against potential abuses and ensuring that it is used appropriately.
  3. Public and Professional Support: Most Americans and healthcare professionals support the legalization of MAID. This public backing reflects a societal acknowledgment of the importance of personal choice and humane treatment at the end of life. Legalizing MAID would align state laws with the values and wishes of its people.
  4. Enhancing Patient Autonomy: MAID recognizes the right of individuals to make informed decisions about their bodies and end-of-life care. By legalizing MAID, residents would are empowered to have greater control over the circumstances and conditions of their dying, respecting their inherent dignity.
  5. Complementing Existing End-of-Life Options: People in the U.S. currently have the right to refuse or withdraw life-sustaining treatments, use voluntarily stopping eating and drinking (VSED), use voluntary assisted dying (VAD) in Switzerland, opt for palliative sedation, or seek support from Final Exit Network’s Exit Guides Program (www.finalexitnetwork.org). MAID would be an additional option, giving patients and their families more choices to consider what best aligns with their values and needs.

The Challenge with Dementia and MAID

Many Americans harbor a deep fear of living with late-stage dementia, a condition that slowly strips away cognitive functions, leading to a loss of self and autonomy. Medical Aid in Dying (MAID) currently does not cater to the needs of dementia patients primarily because eligibility requires that a patient be both terminally ill within six months and mentally competent to make decisions about their care. Unfortunately, by the time a dementia patient is considered terminally ill, they often no longer possess the mental capacity required to consent to MAID.

Conclusion

The legalization of MAID would not lead to more deaths but would instead offer a more peaceful, dignified death for those already near the end of their lives. It is a patient-centered, ethical approach that respects individual dignity and alleviates suffering. As debates continue and legislative efforts evolve, it is essential to focus on the compassionate aspects of MAID and the autonomy it provides to terminally ill patients. Everyone deserves the right to choose a peaceful end, and MAID can provide this choice.

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