In the jurisdictions where it is legal, medical aid in dying is chosen by a small but growing minority of terminally ill patients — 5.4% of deaths in the Netherlands in 2023, 4.1% in Canada in 2022, and approximately 3–4% of cancer deaths in Oregon since legalization in 1997. The bereaved-family data across these jurisdictions consistently shows very low regret: fewer than 5% of family members report distress specifically attributable to the MAID decision itself, and practitioner-reported outcomes rate the deaths as peaceful in more than 98% of cases. One figure stands out from the Oregon Death With Dignity Act data: roughly 30–40% of patients who receive the legally required prescription for lethal medication never use it. For many, simply having the option is sufficient.
The comparison group — families of patients who died without MAID, in hospice or hospital settings — shows substantially higher distress. Teno and colleagues’ landmark 2004 JAMA survey of bereaved families of Medicare decedents found that 11–31% reported major concerns about care quality depending on setting, with nursing home deaths producing the highest rates of unmet needs. The Detering 2010 BMJ RCT found that without advance care planning, 29% of bereaved family members showed clinically significant anxiety, depression, or PTSD symptoms in the months following the death. These figures reflect real gaps in comfort care rather than a universal defect of natural dying, and hospice deaths — when fully resourced — show much lower dissatisfaction (~11%) than institutional deaths.
The methodological problem that makes this entry uniquely uncertain is the impossibility of asking MAID patients whether they regret the decision. All regret measurement is family-proxied, and all cross-group comparison conflates eligibility, access, and choice. MAID patients are a selected group: motivated enough to navigate legal and clinical requirements, often dying of cancer with predictable trajectories, and in jurisdictions with functioning access infrastructure. The 30-plus countries where MAID remains illegal represent populations with no choice, and their inclusion would likely shift every figure. What the available data supports most clearly is this: in jurisdictions where both paths are genuinely available and supported, the major asymmetry is not in the dying itself but in the quality of the dying — and unmet needs in natural-death settings remain common enough to constitute a public health gap, not a rare failure.