Death with Dignity Challenges Our Fears, Not Our Values

While New York awaits Governor Hochul to sign the Medical Aid in Dying Act, Assembly Bill A.136 and Senate Bill S.138 in the 2025-2026 legislative session. Let’s discuss Death with Dignity, and how it is About Honoring a Dying Person’s Choice.

Few topics generate as much confusion, fear, and moral tension as Death with Dignity. Too often, it is casually labeled as “suicide,” dismissed as “euthanasia,” or framed as a slippery slope. These misunderstandings overlook a central and essential truth: the person choosing Death with Dignity is already dying.

Suicide, by definition, is the act of intentionally causing one’s own death and is typically associated with severe emotional distress, mental health conditions such as depression, feelings of hopelessness, or overwhelming life circumstances. Suicide is a major public health concern, and rightly so. It is understood as the result of complex psychological, social, biological, and environmental factors—not a single cause.

Death with Dignity is fundamentally different.

A person who chooses to pursue Death with Dignity is terminally ill, of sound mind, and facing a medically confirmed prognosis that death is imminent—generally within six months. This is not an impulsive act. It is not rooted in untreated mental illness. It is not about escaping life. It is about how a person dies when death is unavoidable.

In every U.S. state where Death with Dignity or medical aid-in-dying (MAID) laws exist, the process is deliberate and highly regulated. Multiple medical professionals must independently confirm that the individual is terminally ill and mentally capable of making their own medical decisions. The person must make the request themselves—clearly, consistently, and voluntarily. A legal guardian is not allowed to request the medication on someone’s behalf. This distinction is critical: choice and autonomy are the foundation of these laws.

Yet despite these safeguards, many people continue to equate Death with Dignity with suicide. This comparison ignores the reality of what end-stage illness often looks like.

Why would any person want their loved one to languish in pain, confusion, fear, or prolonged suffering when death is already certain? Why do we accept suffering as inevitable—or even virtuous—when medical science has given us the ability to alleviate it?

For years, people have openly said they were grateful they could stop their beloved pet from suffering at the end of life. We recognize that prolonging pain when there is no hope of recovery is cruel. Yet when it comes to humans—our parents, partners, siblings, and even our own adult children—we suddenly demand endurance at all costs. We tell people to “hang on,” even when hanging on means agony, terror, or the slow erasure of self.

Oregon was the first state to pass legislation allowing MAID in 1997 that followed a 1994 ballot measure it allows terminally ill, mentally competent adult residents with less than six months to live to voluntarily request and self-administer lethal medication prescribed by a physician. From 1997 through the end of 2024, a total of 3,243 have died in Oregon from self-administering the prescribe medication.

According to a Compassion & Choices MAID utilization report, more than one in four people — 26.57% — live in a jurisdiction where medical aid in dying is authorized. This does not include New York, as the Governor has yet to sign the bill, but has stated she would sign it in January of 2026. 

From 1997 through the end of 2024, a total of 3,243 have died in Oregon from self-administering the prescribe medication. We no longer must hypothesize about what will happen if this medical practice is authorized. We have almost 30 years of data since Oregon implemented its law in 1997 and years of experience from other authorized jurisdictions, including statistical reports from nine jurisdictions. This report is a compilation of data reports from the authorized jurisdictions that issue reports as of December 18, 2025.

Across the authorized jurisdictions that report data, 12,425 individuals to date have chosen to use medical aid in dying. While few people use the option, many gain peace of mind and comfort simply knowing it exists. Further, medical aid in dying creates a shift within our end-of-life care system to one that is resoundingly person-driven, leading to improvements in hospice care, palliative care, and pain and symptom management. We have reassuring data, strong public support, and evidence that medical aid in dying is a desirable and politically viable option.

End-stage dementia offers a particularly stark example. For many families, the final months or years involve profound loss of identity, fear, agitation, and suffering. The person who once expressed clear wishes about how they wanted to live and die may no longer be able to speak for themselves. Death with Dignity laws do not allow someone to choose aid-in-dying once they have lost mental competence—but those who receive a terminal diagnosis while still lucid may wish to plan ahead, to retain some measure of control while they still can.

This planning is not despair. It is clarity.

Religion often plays a role in opposition to Death with Dignity, and those beliefs deserve respect. Many faith traditions view intentional death as sinful, and for many individuals, that belief is deeply personal and sincerely held. Death with Dignity laws do not require anyone to violate their faith. They simply offer an option—one that can be declined for any reason.

What is troubling is when personal religious beliefs are used to deny others the right to choose differently. Death with Dignity is not mandatory. It is optional. It exists precisely because people’s beliefs, values, and tolerances for suffering differ.

Another common misconception is that Death with Dignity is the same as euthanasia. It is not.

Euthanasia involves a direct action by another person—typically a medical professional—who administers a substance to intentionally end a patient’s life. Laws governing euthanasia vary widely across countries and regions, and in most of the United States, euthanasia is illegal.

Death with Dignity laws are explicit: the patient must be able to self-administer the medication. No doctor, nurse, family member, or caregiver can give it to them. The individual must be mentally competent enough to understand the instructions and physically capable of carrying them out on their own. This requirement is not a loophole—it is a safeguard designed to ensure consent, autonomy, and agency.

What people think Death with Dignity allows is often very different from what the law actually permits. It does not allow someone to end their life because they are depressed, disabled, lonely, or poor. It does not allow family members to decide for someone else. It does not allow the state to deem a life “not worth living.”

It allows a dying person—after rigorous medical review, reflection, and confirmation—to decide how much suffering they are willing to endure at the very end of life.

At its core, Death with Dignity is about compassion, honesty, and respect for individual choice. It asks us to confront uncomfortable questions about death rather than hide behind fear or moral absolutism. It challenges us to distinguish between preventing suicide and prolonging suffering. 

In states without Medical Aid in Dying (MAID) laws, people facing unbearable end-of-life suffering sometimes feel forced to act on their own. Without medical guidance, these attempts often fail to provide the peace they are seeking.

My father lived in a state where MAID was not legal. After years of extreme pain, he reached a point where he could no longer endure it. He researched how to die peacefully in his sleep, but without medical oversight, the outcome was devastating. He suffered for 36 hours before his body finally gave out.

I knew what was happening and begged him to move to a state where MAID was an option, but his pain was too severe, and time was not on his side. When MAID is unavailable, the lack of choice does not prevent death—it only increases suffering and trauma for families.

Supporting Death with Dignity does not mean devaluing life. It means recognizing that life’s final chapter deserves the same respect as all the others.

We can oppose suicide while still honoring the right of a dying person to choose peace over prolonged pain. These positions are not contradictory. They are humane.

And perhaps the most important question is this: if you would not want to suffer needlessly at the end of your own life, why would you demand it of someone else?

Death with Dignity does not ask us to stop caring. It asks us to care enough to listen.