Medical aid in dying, or MAiD, is a medical practice that provides a terminally ill, mentally capable adult with a life expectancy of six months or less the option to request a prescription for medication they can self-ingest to die peacefully in their sleep. It is legal in 10 states and the District of Columbia, with many additional states repeatedly introducing legislation to legalize this option. People often use the terms “physician-assisted suicide” and “euthanasia” interchangeably, although they are not the same. MAiD is the term preferred by leading medical associations, replacing “physician-assisted suicide.” Neither term is interchangeable with “euthanasia,” which refers to a practitioner administering the means of death, rather than the patient self-administering. While specific rules are different in different states, MAiD is always a highly regulated process that includes multiple doctor approvals and a waiting period.

I had the honor of accompanying a medical aid in dying patient in Washington D.C., along with an experienced doula who has supported many MAiD patients. The patient, “Sandy,” had stage 4 lung cancer and had opted to forego typical cancer treatments. Her husband had died several years previously, she lived alone, and she didn’t want to suffer with cancer treatment and a prolonged death, so she opted to choose when and how to end her life. She chose a beautiful day in June, and invited her three closest friends to be with her.

When we arrived at her apartment, Sandy was resting while her friends were recovering from an evening of celebration and joy that they had shared with her. We chatted with them and explained how the process would work. One friend, “Ben,” commented that his religious beliefs didn’t allow him to be in the room while Sandy ingested the medication, but that he wanted to support her and would be with her at the end. After an hour or so of talking and reflecting, Sandy was ready.

As doulas, our role was to mix the medication, which is an extremely high-dose cocktail that sedates the patient and stops the heart, usually within two hours after ingestion. It is very bitter-tasting, so it is usually mixed with apple juice and frequently chased with fruit sorbet. Sandy had been advised about the taste, and instead of sorbet she chose to follow the cocktail with a shot of her favorite tequila. With her friends gathered around, she ingested the cocktail in the required two minutes, took a shot of tequila, and quickly slipped into a peaceful sleep. Over the next two hours, we sat with Sandy and her friends while they shared stories, tears, and laughter. Once she passed, we were able to help with some of the logistics so that her friends could be present with their own loss and grief.

It was a beautiful and sacred experience to be present for Sandy and her friends. She was able to make the choice of how and when to end her life, and they were able to participate with her in her final moments. While she could have chosen to pursue cancer treatment or hope for the best, Sandy was able to leave her life on her own terms.

Not even a week later, my cat Isabel, who was 15 and had been struggling with various elder cat ailments for several years, began to act strangely. She stopped eating and started hanging out in unusual places, obviously not feeling well. I took her to the urgent care vet, who ran tests and told me that she was in end stage kidney failure. She said she would treat her if I wanted but didn’t see any hope for recovery. I didn’t hesitate—after many tears and consultation with my absent kids, I told her that we were ready to say goodbye to Isabel. This was where doula training came in handy; I reminded myself that she needed me to be there for her in her last moments and hugged her on my lap while the vet administered the medication. She went peacefully and knowing she was loved. I asked the vet if this was the least favorite part of her job, and she replied that it actually wasn’t at all—she was proud to be able to alleviate suffering in animals that didn’t have hope for recovery. Her words resonated with me, and I realized that this had similarities to my work as a doula.

After this incredibly emotional week, I’ve been reflecting on what it all means. While it might be offensive to some to compare the death of a human to the death of a pet, I believe it all boils down to reducing suffering. We have the medical and legal (in some places) tools to offer these choices, which in no small measure offers dignity to people who don’t have much of that left. If we’re willing to do this for our pets, it seems like we should do the same for ourselves and our loved (human) ones.