Axios Consulting LLC May 22, 2025
Why Some Americans Have to Travel Abroad for End-of-Life Options.
In a nation that prides itself on individual liberty, it is both tragic and ironic that many Americans are denied the autonomy to decide how and when they die. The case of our grandfather illustrates this painful contradiction. After enduring a long, degenerative illness that robbed him of independence and dignity, he was forced to travel to Switzerland to pursue a peaceful, medically supported death through Medical Aid in Dying (MAiD). He made this journey not by choice, but because the state he called home—New Hampshire—had failed to pass any MAiD legislation, unlike its neighbors, Vermont and Maine. Even if he had moved to one of those states, he still would not have qualified under their restrictive laws. His illness, while incurable and debilitating, did not meet the requirement of being “terminal within six months”—a standard that disqualifies countless Americans from accessing end-of-life options domestically.
His story is not unique. It exposes the legal and ethical inconsistencies surrounding MAiD in the United States and highlights why Switzerland remains one of the only destinations for Americans seeking compassionate, medically guided choices when none are available at home.
Switzerland’s approach to assisted dying is unique in the world. Since 1942, Swiss law has permitted assistance in dying, provided the person assisting has no selfish motives. Organizations like DIGNITAS operate within a clear legal framework, offering a structured, safe, and humane option for both Swiss citizens and foreigners. Critically, Switzerland does not impose a six-month terminal prognosis requirement. Instead, it recognizes that quality of life—not just length of life—matters. Patients suffering from degenerative, chronic, or neurological conditions can access support as long as they demonstrate mental capacity and freely choose their path.
Our grandfather was a thoughtful, well-informed man, who had long considered his options. Though he remained lucid, articulate, and emotionally balanced, his progressive neurological condition left him increasingly dependent and diminished. He did not qualify for MAiD in any U.S. state—not Oregon, California, Vermont, or Maine—because no doctor could state with confidence that he would die within six months. But in Switzerland, he was met with compassion and understanding. There, he was not a bureaucratic challenge to be rejected, but a person to be heard and respected. His decision was seen not as an act of despair, but of clarity and personal sovereignty.
This harsh reality confronts many Americans. As of 2025, only 11 U.S. states and the District of Columbia have legalized MAiD—and all impose narrow and often rigid requirements. Patients with Alzheimer’s, Parkinson’s, ALS, or early-stage dementia are frequently excluded, even though they may suffer for years without the ability to end life on their own terms. Moreover, even for those who qualify, the process can be grueling: multiple waiting periods, psychiatric assessments, and written and verbal requests—all while battling pain, fear, and emotional exhaustion. For those with cognitive decline, these hurdles are often insurmountable.
Our grandfather’s final journey also reveals the emotional burden placed on families. His decision to travel to DIGNITAS was not about escaping life but preserving dignity. The Swiss staff treated him with empathy, not suspicion. His family accompanied him not out of fear, but in solemn support of his right to choose. It was a peaceful end, grounded in love, consent, and respect—unlike the tragic, secretive, and often traumatic endings many Americans face when forced to take matters into their own hands, alone and without medical support.
That Americans must cross an ocean for this most personal of choices exposes a glaring failure in U.S. healthcare and policy. We celebrate freedom of speech, religion, and association—but deny freedom over our own death. Our family’s experience is a sobering reminder of how outdated laws can inflict needless suffering, even on those with the resources, education, and family support to seek alternatives.
This is why we founded Axios Consulting—to help others understand their options and, if necessary, help them navigate the complex process of seeking end-of-life care abroad. Until American laws evolve to reflect compassion, dignity, and personal agency, Switzerland will continue to serve as a refuge for those forced to leave home in order to die with grace.