Poison Pill? Experts Weigh the Ethics of Prescribed Lethal Drugs That End Patients’ Lives

Jul 15

*Disclaimer: This article refers to medical aid in dying, or MAID, which some people refer to as assisted suicide or physician-assisted suicide. The content may not be appropriate for all audiences.

Let’s say you go to the doctor seeking relief from a nagging problem – like a cough that won’t go away, for example. Tests reveal you have a progressive illness and six months or fewer to live. Your throat tightens. You develop what feels like a lump in the throat. You can barely speak as you struggle to digest what your health care practitioner has just told you.

Depending on whom you are and your value system, perhaps you choose to live out your remaining days in the company of family and friends, while you get your affairs in order, and forego invasive medical treatment. Perhaps you check off items on your bucket list of things to do while you still can and live life to the fullest with whatever time you have left.

Or, depending on where you live and your circumstances, maybe you feel you don’t want to suffer or be in debilitating pain. You ask your doctor or nurse practitioner to prescribe lethal doses of drugs for you – if it is legally within their scope of practice in your jurisdiction.

If approved to do so and you voluntarily decide to self-administer the prescription – you would do so with the full awareness that when the drugs take effect in your system, they will end your life.

This action has been termed medical aid in dying, known as MAID, or “Death with Dignity,” by advocates. Critics contend MAID is assisted suicide, or physician-assisted suicide. They have said the words “medical aid in dying” are misleading on the grounds they sanitize the issue to make it more acceptable to the general public. The word suicide has a negative connotation to it.

The debate over assisted death

Hospice volunteer and end-of-life activist Chris Palmer is the author of the book, “Achieving a Good Death: A Practical Guide to the End of Life.” Palmer says in his book that MAID is a “thoughtful, rational response to avoid further suffering from severe conditions.”

In a lengthy interview, Palmer also said, “I feel that if somebody is suffering unbearably, if they're suffering intractable pain, then they have a right to hasten their death … but what we're talking here is about dying with dignity, about having some choices at the end of life.”

Palmer went on to say that while everyone is entitled to their opinion on this issue, “My position is that people should be allowed to hasten their death if they are close to death anyway, and the choice is not between living and dying, it’s between dying this way or dying that way.”

He made a distinction between people who choose doctor-assisted death if they have weeks left to live, as opposed to those who possibly had a long life ahead of them but instead chose conventional suicide and died violently.

In the United States, doctor-assisted death has been authorized in the District of Columbia and 13 states.

They include New York, where the practice becomes legal August 5, 2026, and Illinois, where it takes effect in September 2026.

Illinois Governor J.B. Pritzker signed the state’s law in December 2025, even though U.S.-born Pope Leo asked that the governor not do so. The pope once lived in Illinois and voiced disappointment over the state’s decision to approve the legislation, nicknamed “Deb’s Law,” after a resident with a rare, aggressive form of cancer (neuroendocrine carcinoma).

The Roman Catholic Church opposes euthanasia and assisted suicide, saying, “They are always the wrong choice.” The Church believes in the sanctity of life.

When the Illinois measure takes effect, getting a prescription to take lethal drugs will be the law in nearly one out of three U.S. jurisdictions.

The consequences, according to opponents

The New York-based, non-partisan Patients’ Rights Action Fund, or PRAF, opposes these laws, saying they are dangerous, discriminatory, and open the door to abuse and coercion.

PRAF has filed suit challenging the constitutionality of such legislation in states that include California, Colorado, Delaware, Illinois, and New York. The single-issue organization says suicide is not medical treatment and has voiced concerns over how the laws could impact the poor, people with disabilities, the elderly, the infirm, or even people with depression, which is treatable.

“The basis of our challenge is that the prescribing of these drugs is a violation of the Americans with Disabilities Act, because by description in the ADA, a person that is in a terminal condition fits the description of a person with a disability ..., said Barbara Lyons, PRAF’s special projects coordinator.

“And then we also are claiming that it violates various aspects of the federal Constitution,” she added. She said the practice disrupts the doctor-patient relationship and destroys the practice of medicine because medicine is thought of as a “healing when possible, do no harm practice.”

Lyons also described the phrase medical aid in dying as “a made-up term that does not have any value in both the legal context or in the medical context ….”

She added, “The American Medical Association studied the terminology and decided that medical aid and dying was so broad that it could encompass both palliative care and euthanasia, and so they stated that physician-assisted suicide is the proper term to use in discussing the topic.” The AMA opposes assisted suicide.

The illegality of euthanasia

With euthanasia, a medical professional such as a doctor intentionally administers lethal drugs to someone to end that person’s life. Euthanasia is against the law in the U.S.

In 1998, euthanasia proponent and Michigan pathologist Dr. Jack Kevorkian filmed himself administering a lethal injection to a terminally ill man with Lou Gehrig’s disease. The tape was later broadcast on the CBS television network.

In 1999, Kevorkian, known as “Dr. Death,” was convicted of second-degree murder in the case and sentenced to 10-25 years in prison. He was released after eight years. Kevorkian died due to illness in 2011, not by his hand.

Separately, there have been well-known instances of other people who have taken advantage of aid in dying laws to end their lives with prescription drugs.

One person who took a lethal cocktail was a 29-year-old California teacher by the name of Brittany Maynard, who had an aggressive form of brain cancer. At the time, California did not have a MAID law, so the terminally ill Maynard and her husband moved to Oregon – the first state with a Death with Dignity Act. The measure has been in effect since 1997. Maynard died there in November 2014. California later passed an End of Life Option Act. It went into effect in 2016, while a revised version took effect in 2022.

Another person was award-winner American actor Rene Auberjonois, whose career spanned movies, theater and television. The star of television shows that included “Star Trek: Deep Space Nine,” “Benson,” and “Boston Legal,” opted to take advantage of the California law due to metastatic lung cancer. Auberjonois died in December 2019 at age 79.

Public opinion

How does the public feel about the issue of getting a prescription to die?

According to a survey published in March 2026 by the Pew Research Center in Washington, DC, about six in 10 Americans had no moral objections to seriously ill individuals getting a doctor’s help to end their lives. Thirty-five percent of those polled said it was morally wrong.

In August 2024, Gallup released the results of a survey that said most Americans favor legal euthanasia, with a smaller majority in support of doctor-assisted suicide. Separately, it said Americans living in regions that permitted doctor-assisted suicide were “also among the most likely to say it is moral.”

An article published in February 2025 in JAMA Network says medical aid in dying has been used by “a largely White, educated population.”

Lyons said answers to poll questions depend on how they are worded.

“The poll data is supposedly favorable when you ask a question that says, ‘Do you think people should be able to take have a doctor's assistance to die a peaceful death? But I mean you can see … variations of that question, you could see where the numbers go up,” she said.

An ethical issue

Dr. Lydia Dugdale is the director of the Center for Clinical Medical Ethics at Columbia University in New York City. The medical doctor and ethicist said the laws raise various concerns.

In a May 11, 2025 article for The New York Times, Dugdale wrote that the New York bill “defines aid in dying” as a medical practice. If a patient qualifies, a doctor can prescribe a lethal dose of drugs that the patient may self-administer to end his or her life. Labeling this a medical practice confers a kind of legitimacy on what is also, more accurately, physician-assisted suicide.”

In an interview, Dugdale disagreed with those who say that in every jurisdiction where this is legal, there have been no abuses. She said, “There are a few problems with that statement. One is that the death certificate does not report that lethal ingestion or lethal injection in jurisdictions where it's legal is the reason for death, so we don't have an accurate public record of people dying in this way. There's also no required follow-up for reporting sort of the circumstances … .”

In March 2026, a 31-year-old woman with severe mental illness checked into an Oregon hotel room, where she ended her life with prescribed lethal drugs. The woman, Eileen Mihich, had fraudulently obtained the drugs from a pharmacy in neighboring Washington state, although she did not live there. Neither was she terminally ill.

Separately, Dugdale said insurers “are going to be much more inclined to authorize drugs to hasten death than they are going to be to authorize million-dollar drugs to delay death for complicated autoimmune or other conditions.”

Dugdale wrote the book, “The Lost Art of Dying: Reviving Forgotten Wisdom.” Her work, which draws on science and philosophy, looks to the past for meaning on living well and dying well.

Palmer, for his part, denied that aid in dying laws promote a culture of death.

“No, we are very focused on life. I mean, we want people to live full, fulfilling lives, right up, right up to the end.” He said many people who purchase the lethal drugs don’t actually end up taking them, but “are hugely relieved knowing that if they want them, they can take them.”

Elsewhere, in Canada, such laws have been on the books since June 2016. Getting a doctor’s help in dying there is known as Medical Assistance in Dying (shortened to MAID or MAiD). According to the Canadian government, its Criminal Code allows this only “under very specific circumstances and rules” and with certain safeguards in place.

Of the practice there, Dugdale said, “And in Canada, you know, in 2024, 16,499 people died by MAID; the vast majority preferred lethal injection, where the doctor just runs the IV into the vein, and they die, and the doctor basically kills the patient. They prefer that to having to take the pills themselves and kill themselves.”

Some form of aid in dying is also authorized in at least eight European countries.

Regardless of where anyone stands on this debate, one thing is certain: This is a difficult topic that is very personal. Everyone will have an opinion on it.

Suicidal thoughts or actions (even in very young children, older adults, and people with life-threatening illness/disability) are a sign of extreme distress and should not be ignored. If you need or someone you know needs immediate help, call or text the  Suicide & Crisis Lifeline  at  988. Learn more  about ways you can help someone who might be at risk for self-harm.

Sources

“Achieving a Good Death: A Practical Guide to the End of Life,” by Chris Palmer

https://www.biography.com/scientists/jack-kevorkian

https://compassionandchoices.org/wp-content/uploads/2024/03/2021-Summer-Magazine-online-FINAL.pdf

https://www.cdph.ca.gov/Programs/CHSI/CDPH%20Document%20Library/CDPH_End_of_Life%20_Option_Act_Report_2022_FINAL.pdf

https://www.canada.ca/en/health-canada/services/health-services-benefits/medical-assistance-dying.html

https://www.dignityindying.org.uk/assisted-dying/assisted-dying-around-the-world/europe/

https://code-medical-ethics.ama-assn.org/ethics-opinions/physician-assisted-suicide

https://compassionandchoices.org/stories/brittany-maynard/

https://thehill.com/opinion/healthcare/5850802-lax-safeguards-assisted-suicide/

https://patientsrightsaction.org

https://news.gallup.com/poll/648215/americans-favor-legal-euthanasia.aspx