Words carry weight at the end of life
If you have been reading about assisted dying, you have probably noticed how many different terms are in circulation: medical aid in dying, dying with dignity, assisted dying, AID, MAiD, VAD, PAD, VSED, Death with Dignity. The differences are not just style. Each term carries its own legal definition, cultural history, and emotional weight, and the right term depends on where you live, who you are speaking with, and what is actually being described.
This page is meant as a gentle orientation — not a legal guide. It is here to help you read with more confidence, support a loved one with more care, and (if you are training in this work) speak about it with precision.
The IEOLCA approach. Our primary term is medical aid in dying, with dying with dignity as a warm, person-centred alternative. We use regional terms (such as VAD or AID) when speaking about a specific country or jurisdiction. When supporting a person directly, we mirror the language they use for their own experience.
Each term, what it means, where it is used
Medical Aid in Dying (MAiD)
The primary term used in Canada and increasingly in international writing. Refers to the legally authorized pathway in which a clinician helps a person bring about their death using prescribed medications, where eligibility criteria are met.
Dying with Dignity
A warm, person-centred phrase used internationally to describe a death that aligns with someone's values, wishes, and sense of self. In the United States, "Death with Dignity" is also the formal name of the legislative framework in several states.
Aid in Dying (AID) / Death with Dignity
The terms most commonly used in the United States in jurisdictions where the pathway is legally authorized. Specific eligibility and process are governed by state law.
Voluntary Assisted Dying (VAD)
The formal term used in Australia and New Zealand. Each Australian state and the Aotearoa New Zealand framework have their own eligibility criteria and procedures.
Physician-Assisted Death (PAD)
Used more often in academic and clinical writing than in everyday conversation. Emphasizes the role of the physician in the process.
Assisted Dying
A broader, more general term sometimes used across regions. Useful as an umbrella, but less precise about which legal pathway is being referenced.
The terms above often refer to similar pathways, but they are not perfectly interchangeable. Each operates under specific national, state, or provincial law, with its own eligibility criteria and procedures. When precision matters — for example, in writing, advocacy, or training — using the term that matches the jurisdiction is the most respectful choice.
MAiD is not the same as VSED
One important distinction often gets blurred: medical aid in dying and VSED — voluntarily stopping eating and drinking — are not the same thing. They are sometimes mentioned in the same conversation, but they are distinct pathways with different legal, clinical, and practical considerations.
Medical Aid in Dying (MAiD)
Involves clinical assessment of eligibility and prescribed medication that ends life. Available only where it is legally authorized, and only under specific eligibility criteria.
VSED
A person, while still able to make the choice, decides to stop taking food and fluids. VSED does not involve medication to end life, and is legal in most places. It should always be supported by a clinical team for symptom management and comfort.
VSED can sit within end-of-life care for someone who is not eligible for MAiD, who lives in a jurisdiction where MAiD is not authorized, or who simply prefers this pathway for personal reasons. It is a fully separate consideration, and any decision about it belongs in conversation with a clinical team.
The law is local, and it changes
Whether an assisted death is legally available, who is eligible, and how the process works — all of this is determined by the law of the country, state, or province where the person lives. Laws also evolve, sometimes quickly.
A few practical realities to hold in mind:
- The legal framework in Canada (MAiD) is different from the United States (state-by-state Death with Dignity / AID laws), which is different from Australia and New Zealand (VAD), which is different from frameworks in parts of Europe
- Eligibility criteria can include things like residency, age, decision-making capacity, the nature of the condition, and timeline requirements
- Process requirements (waiting periods, number of assessments, who can provide) also vary by jurisdiction
This page is not legal or medical advice. Questions about eligibility, process, or access in your jurisdiction belong with the appropriate clinical team and, where relevant, a qualified legal advisor.
Using language well, especially with someone navigating this choice
For most readers — and for everyone doing doula work — the most important principle is simpler than the terminology itself.
Mirror the person's own language. If they say MAiD, you say MAiD. If they say dying with dignity, that is the term you use too. If they speak of an assisted death, follow them there. Their language for their own experience is the language that fits.
A few small habits make a real difference:
- Use the formal term that matches the jurisdiction when writing or speaking publicly
- Mirror the person's own term when supporting them directly
- Avoid loaded euphemisms or clinical distance — both can quietly create harm
- Do not equate VSED with MAiD; they are distinct
- Be careful with phrases like "choosing to die" — they can land harshly for families navigating an already difficult experience
Language is one of the few things you always have in this work. Using it with care is part of how respect shows up in the room.
Learn this work in depth
If you are drawn to supporting people through medical aid in dying, the IEOLCA MAiD Doula Support Training is a focused specialty program. For those newer to end-of-life work, our End-of-Life Doula Certification builds the foundation this specialty rests on.