Physician-assisted dying (PAD) is now legal in several states, as well as some foreign countries. The primary arguments to justify the practice include autonomy, compassion, justice, non-abandonment, and transparency. Counterarguments include the wrongness of killing, the impact on the physician-patient relationship, potential exploitation of the vulnerable, and the slippery slope. While some oppose the practice on religious or purely moral grounds, a compelling public policy argument can be made against it without holding that every possible case of PAD is “immoral.” If the sole consideration is patient autonomy and relief of suffering, assisted dying could be offered without physician involvement,as is the case in some other countries. Without the imprimatur of the medical profession, however, PAD may not achieve the societal acceptance that advocates seek.