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On the Brain
August 24, 2020

Medical Aid in Living

Author Affiliations
  • 1Department of Neurology, University of Rochester Medical Center, Rochester, New York
  • 2Department of Medicine, University of Rochester Medical Center, Rochester, New York
JAMA Neurol. Published online August 24, 2020. doi:10.1001/jamaneurol.2020.2915

In November 2016, Colorado voters passed Proposition 106, the Colorado End of Life Options Act, by a nearly 2-to-1 margin.1 Colorado thus became the fourth US state to have a medical aid in dying (MAID) law. As with other MAID laws, the Colorado law allows an “eligible terminally ill individual with a prognosis of six months or less to request and self-administer medical aid-in-dying medication in order to voluntarily end his or her life”2; allows physicians to prescribe these medications2; and provides additional regulations, such as the process of determining eligibility (eg, a determination must be made by 2 physicians or include an assessment of capacity).

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    1 Comment for this article
    MAID as an End of Life Option
    Michael McAleer, PhD(Econometrics),Queen's | Asia University, Taiwan
    The sensitive message from a caring neurologist on medical aid in living is reminiscent of the final words of The Last Samurai, where the Emperor Meiji asks Nathan Algren about the warrior Katsumoto: "Tell me how he died", to which the response is: "I will tell you how he lived".

    The medical aid-in-dying (MAID) law enables terminally ill patients with a prognosis of six months or less to request medication to voluntarily end their lives as an end of life option.

    Some terminal illnesses may provide clear indications of longevity, but others might be more opaque about the
    expected time to the end of life.

    How accurate is the prognosis of six months for all illnesses and all patients, especially regarding the possible feedback effect of admission to a MAID program on the prognosis?