How the process generally works
Multiple assessments. Time to change your mind.
The VAD process is deliberately careful. There are multiple steps, multiple doctors, and waiting periods. The person can withdraw their request at any point, for any reason or no reason.
The first request
The person makes a clear, voluntary request to a doctor. Doctors are not required to participate in VAD — if your doctor cannot or will not help, they should refer you to one who can, or to your state's VAD Care Navigator Service.
The first assessment
A trained "coordinating practitioner" assesses whether the person meets all the legal criteria. This includes confirming the diagnosis, prognosis, decision-making capacity, and that the request is voluntary and enduring.
The second assessment
A second independent "consulting practitioner" performs their own assessment. Both doctors must agree that the person is eligible for the process to continue.
A second formal request, then a final request
After a waiting period (usually a few days), the person makes a second request — often in writing, witnessed. Then, after another waiting period, a final request.
Permit and medication
A permit is issued and the medication is prescribed. The person can choose to self-administer the medication, or — in some circumstances and some states — have a doctor administer it.
You can stop at any point
See all 53 guides in Care & end of life →
From bluetulipco.com/library/end-of-life/the-process — printed 1 October 2026.
General information only — not a substitute for legal, medical, financial, or therapeutic advice. Read the full disclaimer.
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