The average age of individuals in the United States and worldwide is steadily increasing, resulting in an increase in the number of older, terminally ill adults who may seek counseling for end-of-life decisions. Euthanasia is one such end-of-life option that is emerging in the United States. Physician-assisted dying, currently the only legal form of active euthanasia in eight states and the District of Columbia, is a relatively new and often misunderstood end-of-life option. Although arguments continue about this issue, the American Mental Health Counselors Association has developed ethical codes to guide mental health counselors working with terminally ill clients making end-of-life decisions. The core moral and ethical principles of autonomy, beneficence, nonmaleficence, justice, fidelity, and veracity provide guidance for helping terminally ill clients explore end-of-life options that could include physician-assisted dying when it is a legally viable option. Additional recommendations are made for increasing intellectual and emotional competence regarding euthanasia.