On April 5, 2018, Hawaii became the eighth jurisdiction in the United States to affirmatively authorize medical aid in dying (MAID). The Our Care, Our Choice Act (OCOCA), which takes effect on January 1, 2019, permits Hawaii physicians to write a lethal prescription for a mentally capacitated, terminally ill adult patient that the patient may later self-administer to end his or her life. The Hawaii OCOCA exemplifies a growing national trend toward expanding end-of-life liberty. Half of the eight states to legalize MAID did so in only the past three years.