With 25 years in end-of-life care and firsthand experience with death, dying, and MAiD, David Maginley explores the unaddressed issues at the heart of our effort to control the final human experience. What drives most requests for Medical Assistance in Dying (MAiD)? Surprisingly, it’s not physical pain but existential distress—the fear of suffering, the loss of dignity, and the struggle to find meaning and purpose as life draws to a close. Yet these very struggles are functional in a process few recognize: the deconstruction of the personal self (the ego), which prepares us for our final and most significant state of being—transcendence. In Early Exits , David Maginley offers a radical reinterpretation of MAiD as an attempt to preserve the ego in the face of this transformation. This is a reflection of our culture’s spiritual poverty and reveals MAiD as a medical procedure being used to treat what is, fundamentally, a spiritual condition. E arly Exits goes beyond discussions of autonomy, ethics, and dignity to explore the fundamental human experience of dying. Each chapter begins with a real-world case example and ends with practical tools to help readers live—and die—more fully informed. Drawing on decades of research into end-of-life phenomena and over 25 years of experience providing spiritual care to cancer and palliative patients, Maginley illuminates the inner dimensions of dying and how to address the distress that drives MAiD requests. With compelling research, personal stories, and profound spiritual insights, Early Exits reframes dying as a transformative process that leads us beyond grief and despair to a state of grace and growth. Central topics explored: Existential Distress and MAiD : Why existential suffering—not physical pain—is at the heart of requests for assisted death, and how to best address it. - Spiritual Dimensions of Dying : How the deconstruction of identity accelerates spiritual growth and calibrates us for transcendence. - The Role of Healthcare Providers : The importance of addressing both physical and psycho-spiritual needs in palliative care. - Nearing-Death Awareness and Terminal Lucidity : The phenomena of expansive consciousness, mystical awareness, and soulful clarity experienced by most dying people, regardless of culture or belief. Maginley’s insights are shaped not only by decades of experience supporting those facing mortality but also by his own journey as a four-time cancer survivor. Whether you are navigating a terminal diagnosis, supporting a loved one, or providing care as a professional, this book offers hope and clarity. Early Exits is an essential resource for understanding—and transforming—the most profound and ultimate event in life. It offers a way forward to a better society, a better tomorrow, and a better end to our days. Early Exits is a milestone that will bring comfort to many and may change the way we think about end-of-life care. This thought-provoking and, ideally, conversation-provoking book should be required reading for anyone dealing with or anticipating the process of dying. - Bruce Greyson, MD Carlson Professor Emeritus of Psychiatry & Neurobehavioral Sciences Division of Perceptual Studies, University of Virginia Health System This is a well-informed, honest, and deeply spiritual alternative to the materialistic, individualistic, and autonomy approaches to death and dying. The narratives are impressive, as is the author's courage to swim against the current. - Theo A. Boer, PhD Universitair Docent Ethiek, Protestantse Theologische Universiteit Groningen, Netherlands Center for Bioethics and Health Law of Utrecht University Early Exits is a masterfully argued, well-written, compassionate, and provocative book on a contested issue that will likely continue to be debated. - David Pfrimmer, PhD Professor Emeritus for Public Ethics Martin Luther University College An honest and thought-provoking review of MAiD in Canada, urging readers to consider our approach to living, dying, suffering, and reality itself. This is an immensely significant work that contributes to our ongoing societal dialogue on the dying process. I highly recommend this book to anyone who recognizes the importance of embracing life fully, including its inevitable end. - Kristine Lund, PhD, RP Professor, Spiritual Care and Psychotherapy Clinical Director, Delton Glebe Counselling Centre David offers a non-judgmental exploration that is both well-researched and deeply heartfelt. His extensive background in working with dying individuals shines through in this remarkable book, overflowing with invaluable insights and resources. This is a thought-provoking and enriching read, shedding light on the profound challenges of transitioning with grace and dignity. Magnificent! - Rebecca Austill-Clausen MS, OTR/L, FAOTA Ethics Committee, International Association for Near-Death Studies This book arrives at a crucial moment as MAiD is increasingly adopted. It offers a thoughtf