In New Jersey, individuals facing terminal illness or unbearable suffering have two options for death with dignity: Medical Assistance in Dying (MAiD) and Voluntarily Stopping Eating and Drinking (VSED).

Different than suicide and euthanasia, MAiD and VSED are processes that focus on empowering mentally competent people to have the control they want during the last days of their lives, before their illness overtakes them.

MAiD

First legalized in 1997 in Oregon, the MAiD statue enables patients to receive a prescription for life-ending medication they must self-administer.

The process is highly regulated and has strict eligibility requirements with built-in waiting periods. Within minutes after ingesting the medication, the person will fall into a deep sleep and then into a coma. Then anywhere from 30 minutes to a few hours later the heart will stop beating, the body will shut down, and the person will die peacefully.

Notably, many people who have chosen to hasten their death through MAiD have not filled nor taken their prescription ‘cocktail,’ But they said they felt comforted just having the autonomy to decide when they’ve “had enough” and a remedy available if they reach that point.

Physician-assisted death statutes do not specify who must pay for the services. Individual insurers determine whether they will cover the procedure, in line with their coverage of other medical procedure. Federal funding programs like Medicaid and Medicare cannot be used for services, or medications, received under these laws.

Physician aid-in-dying statutes specify that participating in Death with Dignity is not suicide, therefore death hastened under an aid-in-dying statute has no effect on life, health, or accident insurance or annuity policy.

VSED

VSED is an option by which an individual intentionally decides to cease all food and fluid intake to hasten the natural dying process. It can be chose by anyone, including those who may not qualify for MAiD, as there are no associated legal or medical requirements.

Natural death follows a gradual decline in health once food and hydration is stopped — several days or several weeks — as the timing is influenced by the person’s physical condition, age, illness, and other factors.

Since the timeframe is unpredictable, symptom-management to maximize comfort will be important. For some, VSED may be more peaceful than dying with MAiD, as the protracted decline under VSED allows time for the dying to let go and say goodbye to loved ones, giving all involved greater clarity about their decision, acceptance and closure.

MAiD became legal in NJ in 2019 and is legal in nine other states and the District of Columbia. VSED in legal in all 50 states. Support and assistance from family, hospice and/or an end-of-life doula can maximize physical and emotional comfort during either process chosen by the dying.