In countries where Medical Assistance in Dying (MAiD)(Euthanasia and Assisted Suicide) are available, suicide prevention helplines receive calls from people who are considering ending their life by MAiD, and who meet the legal criteria for access to MAiD’ often because they are suffering from a terminal illness. How should helplines respond to these calls? This presentation presents on the way calls are currently addressed and the concerns of helpline workers and their discomforts about taking these calls. T he objective is to consider current alternative practices and clarify the ethical, clinical and practical issues concerning suicide prevention with persons who are eligible for MAiD. Suicide prevention services are generally supposed to do their utmost to prevent suicides with all persons, regardless of the suicidal individual’s characteristics and reasons given for wanting to die. The assumption is that doing otherwise constitutes discrimination and that they would venture into an ethical morass if they attempt to determine whether some lives are more worthy of saving than others. However, when confronted with people in juridictions where MAiD has been legalized, as in Canada, helpline workers often express conflicted feelings and reactions sympathetic to the request, particularly when the caller presents compelling justifications for the benefits of ending a life which is described as having continued suffering associated with an uncurable degenerative or terminal illness. Are there some circumstances where we should abstain from preventing a death by suicide or even encourage people to seek to end their lives by MAiD? This presentation and explores alternative current practices and addresses if there are justified distinctions between how to respond to people requesting or considering requesting MAiD, and how to respond to suicidal individuals who present with a description of living a life of interminable suffering. We examine whether suicide is sometimes rational and without ambivalence, as well as how respect for autonomy may be balanced against obligations to protect vulnerable populations. We also examine some empirical evidence and arguments concerning access to MAiD for persons whose suffering is associated with a mental disorder.