Based on this article:

by Karen Blanchette

As medical practice managers, you navigate complex ethical, legal, and operational challenges daily. One topic gaining attention is Medically Assisted Suicide, or Medical Aid in Dying (MAID), which is legal in a growing number of U.S. states and select countries worldwide. Understanding its legal status, implications for practice management, and global benchmarks can help you prepare your team for patient inquiries and ensure compliance with evolving regulations.

In the U.S., MAID—where a physician provides a terminally ill patient with a prescription for self-administered lethal medication—is legal in 11 jurisdictions: Washington, D.C., and the states of California, Colorado, Hawaii, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont, and Washington. Oregon led the way in 1994 with its Death with Dignity Act, followed by Washington in 2008 and others more recently, with New Mexico legalizing MAID in 2021. These laws typically require patients to be 18 or older, residents of the state, and diagnosed with a terminal illness with six months or less to live. Euthanasia, where a physician directly administers lethal drugs, remains illegal nationwide.

Data from Oregon, a pioneer in MAID, shows steady but limited use: in 2022, 278 patients used lethal prescriptions, representing 0.6% of total deaths. Across all U.S. jurisdictions allowing MAID, approximately 8,700 deaths have occurred since 1997, averaging about 300 annually. Cancer patients account for roughly 66% of MAID cases, followed by those with amyotrophic lateral sclerosis (ALS) at 8%. Practice managers in these states must ensure staff are trained on legal requirements, including patient eligibility, documentation, and reporting to state health authorities. For example, Oregon mandates detailed reporting to its Health Authority, a process that requires meticulous record-keeping to avoid penalties.

For practices in states where MAID is illegal (39 states as of 2025), managers should be prepared for patient inquiries, especially as 17 states, including New York and Florida, are considering MAID legislation. Staff training on compassionate communication is critical to address these sensitive discussions while adhering to state laws. Visit the PAHCOM Education Calendar and CEUs On-Demand for free training on patient communication and compliance, which can help your team navigate these conversations effectively.

Globally, MAID and euthanasia are legal in countries like Canada, Belgium, the Netherlands, and Switzerland, offering useful comparisons. In 2021, Canada reported 10,064 MAID deaths, accounting for 3.3% of all deaths, a sharp rise since legalization in 2016. The Netherlands, where both MAID and euthanasia are legal, saw 5.1% of deaths attributed to these practices in 2022. Belgium follows closely, with 2.6% of deaths in 2022 involving MAID or euthanasia. Switzerland, which permits only self-administered MAID, reported 1,196 assisted deaths in 2019, primarily among cancer patients.

These countries highlight stricter oversight and broader eligibility criteria than the U.S. For instance, Canada allows MAID for non-terminal but “grievous and irremediable” conditions, sparking debate among disability advocates. In contrast, U.S. laws are narrower, focusing on terminal illnesses. Globally, cancer remains the leading condition for MAID, accounting for up to 80% of cases, similar to U.S. trends. These benchmarks underscore the importance of clear policies and staff training, as patient demand may grow if U.S. laws expand.

For practices in MAID-legal states, compliance is paramount. Ensure your electronic health record (EHR) systems are configured to track MAID-related documentation securely. Train staff on state-specific protocols, such as obtaining two physician confirmations of eligibility. In states where MAID is illegal, focus on patient education and referral pathways to palliative care.

Cybersecurity is also critical, as sensitive MAID-related patient data requires robust protection. An HITCM-PP certification will prove a valuable asset when navigating privacy regulations, including HIPAA compliance, and can guide your team in safeguarding patient information. As public debate grows—49% of Americans support MAID legalization per Pew Research—practice managers must stay informed. Use The PAHCOM Forum to communicate directly with fellow members from within or outside of your state. Whether through PAHCOM or your specialty forums, networking within the professional community will help you stay ahead of regulatory changes.

Medically Assisted Suicide is a complex issue with evolving legal and ethical dimensions. By understanding U.S. laws and global trends, practice managers can prepare their teams to handle patient inquiries with compassion and compliance. Leverage professional association and specialty resources to strengthen your practice’s operational and ethical framework, ensuring you’re ready for this sensitive topic.

Sources: Statista, CDC, JAMA Internal Medicine, World Population Review

Karen Blanchette, MBA

Karen Blanchette is the Executive Director of PAHCOM. The PAHCOM collaborative network enables solo providers and small group physician practices to access focused information vital to managing their healthcare businesses effectively. Contact Karen at https://my.pahcom.com/contact-karen

Trained and professionally certified managers make a difference. Learn more about the CMM and HITCM-PP at https://my.pahcom.com/certifications.