Who has the right to choose to die?  This has long been a complicated question for society, and as personal liberties have expanded in the United States, healthcare providers have been at the forefront of the conversation.  While the concept of physician-assisted dying, sometimes referred to as “death with dignity” or “medical aid in dying” has become more acceptable as an option for terminal or degenerative physical illnesses, professional healthcare organizations remain heavily engaged in the work of suicide prevention.  In expanding our understanding of personal rights and decisional capability, we have only recently considered the unique situations of those with serious/pervasive mental illness.  In this talk we will explore the history of attitudes around suicide/volitional death, identify differences in the application of the concept of “decisional capability,” and explore the role of healthcare providers in balancing respect for patient autonomy with respect for life.