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Model Ali Tate Cutler's grandmother is choosing to die on her own terms. Here's what you need to know about medically assisted death.

Ali Tate Cutler with her grandmother
Ali Tate Cutler has been posting about her grandmother's decision to chose medically assisted death. (alitatecutler via TikTok, Getty Images)

In a series of videos posted earlier this month, Victoria’s Secret model Ali Tate Cutler hangs out with her grandmother, known to her as “Bubbie,” taking her out to dinner, teaching her 2023 slang and asking for life advice. The reason for these sweet video posts is deeper than most grandparent content on social media: Bubbie has chosen to die by euthanasia following a terminal diagnosis, and the date is fast approaching.

Cutler’s posts highlight a controversial issue: the right to die by medical assistance in dying or MAID. Bubbie resides in Canada, where MAID is legal, and tells Cutler in one video that she has chosen death by physician injection.

Why Cutler is highlighting MAID

Cutler tells Yahoo Life that she was inspired by her grandmother, a former athlete, who not only lived well but chose to “die well.” Cutler says she is still afraid of death, but was profoundly affected by her grandmother making the decision on her own terms.

“When I saw her approach this imminent day with courage ... I just felt like that was the best gift I could have ever received because I truly saw a model of success when it comes to dying,” Cutler explains. “Before I had questions about the ethicality of all of this and now I feel pretty clear that the decision of what someone does with their body should absolutely be left up to them and them alone.”

The Love You Give podcast host has received lots of comments on her videos with Bubbie. While many are positive, some say her decision to support MAID is wrong, likening it to “putting down animals.”

Others criticize Cutler for bringing Bubbie onto TikTok (home of “get ready with me” videos) to discuss such a grim topic. Cutler, who says a core value within her family is “body sovereignty,” balks at the notion that she shouldn’t discuss her grandmother’s experience.

“Most people get their news and their information from social media,” she notes. “How do you want to talk about this? Would you like to about this by email? Small community groups? I'm not really sure. You can't win either way. But then sometimes, the negative feedback is just worth the conversation. And for me, this is an example of that.”

After all, Cutler says, “This is the human experience, we’re all going to go through this — so this is worth talking about.”

What is MAID, and how does it work?

MAID allows a person to end their life in order to limit their suffering. In 2016, the Parliament of Canada passed federal legislation that allows eligible Canadian adults to request medical assistance in dying.

“In order to qualify, a person needs to be 18 years or older,” explains Sarah Dobec, the communications specialist for Dying With Dignity Canada, a national organization that advocates for end-of-life rights and choice in Canada. “They would put in an official written request, on an official form, that they have witnessed by one person who cannot benefit from their death. Then, two independent physicians or nurse practitioners would see this person, either at home or in their medical office or, in some cases, over Zoom. They are assessed to ensure they have a grievous and irremediable condition, and they have to be experiencing some sort of physical or mental suffering from the illness, disease or disability.”

Currently, those solely suffering from mental health disorders (as opposed to physical conditions) are not eligible for MAID. That could change in March 2024. The delay, according to the federal government of Canada, is to ensure that physicians can develop the best standards and practices for those suffering from mental health conditions.

In order to request MAID in Canada, you also must be eligible for government health insurance, which means that tourists are barred.

If the person is approved by both physicians, they have as long as they wish to act on their choice — and some people never do, despite going through the approval process. Some individuals will never move on their MAID approval, Dobec says, but have it as an option should their suffering become unbearable.

Others who are suffering intolerably or who are terminal move more quickly on their chosen death date. However, Dobec stresses, they are asked for consent up until the last moment, meaning they can back out at any time.

In Canada, Dobec says that a majority of people choose to die by IV administered by a physician, though there is an oral option as well. The procedure can be conducted almost anywhere, and many physicians allow patients to choose where they want to spend their final moments. For those who choose the IV option, two IVs are put in a patient’s arm (one is a backup), which contain four drugs: one to put them to sleep, another to numb the veins to avoid pain, a third to calm the body and a fourth to stop the heart.

How does MAID work in the United States?

While Bubbie lives in Canada, Cutler is a resident of Texas, where MAID is not legal. At present, MAID is legal in Maine, New Jersey, Vermont, New Mexico, Montana, Colorado, Oregon, Washington, California and Hawaii, as well as in Washington, D.C.

The request process for MAID in the U.S. is similar to Canada’s — yet according to Anita Hannig, anthropologist and author of The Day I Die: The Untold Story of Assisted Dying in America, there is a key difference between choosing to die by MAID in the United States versus Canada.

In the U.S., “you have to be able to either drink or eat the medication or be able to push it through a feeding tube or a rectal catheter,” she says. “Either way, you have to be able to administer it yourself.”

This leads to issues with people who want to proceed with MAID but may have lost their mobility or ability to swallow.

“The laws in the United States are strict,” Hannig adds. “What sometimes happens is that people make that decision to go earlier than they would have chosen because they are afraid of losing that window of time where they can meet that criteria.”

The reason for this, Hannig says, is because lawmakers wanted to be clear that no one would be coerced into ending their life, and that “the final act was the expression of volition on the part of the patient.”

“I think in the media, it tends to be portrayed as kind of an easy way out and it definitely, at least in the United States, it’s not,” she notes. “There are lots of bureaucratic hurdles. You have to have a certain amount of financial and social capital to be able to access assisted death.”

Hannig notes that it can also be challenging emotionally as people often get pushback from their families when they choose MAID.

“I was often really surprised when I was in the room with people who were dying, who had chosen this path, with how peaceful and at times beautiful and almost wholesome these deaths were,” says Hannig. “While that’s not the case for everyone, there is this real power in choosing to go out on your own terms, like Cutler’s grandmother did, and have everyone come out and support you in that.”

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