The debate in many countries prior to the introduction of a lawful assisted dying (AD) model focussed upon whether AD was morally right or wrong. There was less focus on how it impacts health care systems and health care professionals, or how patients and families navigate these systems. Yet the majority of laws permitting AD are medicalised, with clinical teams being directly involved in AD. In this chapter, we explore whether a de-medicalised, civic AD model involving third sector organisations (outside of health care) working with an external review panel, rather than a medicalised approach (within the health care system), should be considered. We use the term AD to encompasses a patient receiving medication to end their life which is either self-administered (assisted suicide - AS) or administered by someone else (euthanasia).