Medical Aid in Dying: Misconceptions Fueled by Misinformation and Uncertainty

Public misunderstanding about medical aid in dying falls into two distinct categories, according to recent research from Rutgers Health. The study reveals that Americans’ knowledge gaps about this end-of-life option are driven by different factors, with important implications for public health education.

Published in the Journal of General Internal Medicine, the research distinguishes between misinformation and uncertainty regarding medical aid in dying (MAID) – a practice that allows terminally ill, mentally capable adults to self-administer prescribed medication to hasten death.

“Treating MAID knowledge as a single ‘informed versus uninformed’ issue would be a big miss,” explained Elissa Kozlov, assistant professor at Rutgers School of Public Health and the study’s lead author. “Our findings show that being wrong may reflect belief-protecting reasoning, not simply a lack of information.”

The research team analyzed survey responses from more than 3,200 U.S. adults, comparing those who gave incorrect answers about MAID’s legality with respondents who admitted uncertainty. A clear pattern emerged: individuals with strong ideological positions – particularly those opposing medical aid in dying on moral grounds or those highly engaged in religious activities – were more likely to be incorrect than uncertain about the law.

This suggests that misinformation often stems from “motivated reasoning,” a psychological process where people interpret information in ways that align with their existing beliefs and values.

By contrast, uncertainty about MAID’s legal status was more strongly associated with structural barriers. Respondents with lower educational attainment or experiencing financial insecurity were significantly more likely to answer “don’t know” rather than provide incorrect information.

Currently, medical aid in dying is legal in 13 states, including New Jersey, and Washington D.C., meaning approximately one in four Americans lives in a jurisdiction where the practice is permitted. However, the researchers note that legal availability does not automatically translate to informed or equitable access.

“That distinction matters,” Kozlov emphasized. “People who don’t know may benefit from straightforward education, but people who are misinformed may need tailored approaches that acknowledge their values while presenting accurate information.”

The findings come as discussions around end-of-life autonomy and medical aid in dying continue to evolve across the United States. Several states are considering legislation that would expand access to this practice, highlighting the importance of accurate public understanding.

The research team recommends a two-track approach to public education: conventional health literacy strategies to address uncertainty, coupled with values-aligned messaging delivered by trusted messengers to counter misinformation. This differentiated approach acknowledges that simply providing information is unlikely to change minds among those whose misconceptions are rooted in deeply held beliefs.

The subject of medical aid in dying remains contentious in American society, with advocacy groups, religious organizations, and medical associations taking various positions. Proponents argue it provides dignity and autonomy for terminally ill patients, while opponents raise concerns about potential abuses and ethical implications.

Kozlov and her colleagues plan to build on this research by examining how confident people are in their understanding of MAID, where they obtain information about the practice, and how firmly they hold related beliefs. They also intend to test communication-based interventions to determine effective approaches for improving public understanding, regardless of an individual’s moral views.

As medical aid in dying becomes available to more Americans, this research underscores the importance of nuanced communication strategies that account for both structural inequities and ideological differences in how the public processes information about end-of-life options.