Medical Aid In Dying In The United States
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Assisted suicide Assisted suicide is suicide undertaken with the aid of another person. The term usually refers to physician-assisted suicide (PAS), which is suicide that is assisted by a physician or other healthcare provider. Once it is determined that the p ...
is suicide with the aid of another person. In the United States, the term "assisted suicide" is typically used to describe what proponents refer to as medical aid in dying, in which terminally ill adults are prescribed and self-administer
barbiturates Barbiturates are a class of depressant drugs that are chemically derived from barbituric acid. They are effective when used medically as anxiolytics, hypnotics, and anticonvulsants, but have physical and psychological addiction potential as ...
if they feel that they are suffering significantly. The term is often used interchangeably with physician-assisted suicide (PAS), "physician-assisted dying", "physician-assisted death", "assisted death" and "medical aid in dying" (MAiD). Assisted suicide is similar to but distinct from
euthanasia Euthanasia (from el, εὐθανασία 'good death': εὖ, ''eu'' 'well, good' + θάνατος, ''thanatos'' 'death') is the practice of intentionally ending life to eliminate pain and suffering. Different countries have different eut ...
(sometimes called "mercy killing"). In cases of euthanasia, another party acts to bring about the person's death in order to end ongoing suffering. In cases of assisted suicide, a second person provides the means through which the individual is able to voluntarily end their own life, but they do not directly cause the individual's death. Physician-assisted suicide, or "medical aid in dying" is legal in eleven jurisdictions: California, Colorado, District of Columbia, Hawaii, Montana, Maine, New Jersey, New Mexico, Oregon, Vermont, and Washington. These laws (excluding Montana since there is no law) expressly state that "actions taken in accordance with
he Act He or HE may refer to: Language * He (pronoun), an English pronoun * He (kana), the romanization of the Japanese kana へ * He (letter), the fifth letter of many Semitic alphabets * He (Cyrillic), a letter of the Cyrillic script called ''He'' in ...
shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide, under the law". This distinguishes the legal act of "medical aid in dying" from the act of helping someone die by suicide, which is prohibited by statute in 42 states and prohibited by
common law In law, common law (also known as judicial precedent, judge-made law, or case law) is the body of law created by judges and similar quasi-judicial tribunals by virtue of being stated in written opinions."The common law is not a brooding omnipresen ...
in an additional six states and the District of Columbia. A 2018 poll by
Gallup Gallup may refer to: *Gallup, Inc., a firm founded by George Gallup, well known for its opinion poll *Gallup (surname), a surname *Gallup, New Mexico, a city in New Mexico, United States **Gallup station, an Amtrak train in downtown Gallup, New Me ...
displayed that a solid majority of Americans, with 72 percent in favor, support laws allowing patients to seek the assistance of a physician in ending their life. Nevertheless, assisted suicide remains illegal in a majority of states across the nation. In 2022, the state of Oregon ruled it unconstitutional to refuse assisted suicide to people from other states who are willing to travel to Oregon die that way, effectively giving out of state residents the opportunity to die by physician-assisted suicide. Before someone travels to Oregon to die by physician assisted suicide, those helping the patient travel to Oregon might be prosecuted for assisting a suicide. After the barbiturates are acquired, if the patient returns to their home state, those assisting with mixing the fatal dose of barbiturates may be prosecuted for assisting a suicide.


History


Early movements

The first significant drive to legalize assisted suicide in the United States arose in the early years of the twentieth century. In a 2004 article in the '' Bulletin of the History of Medicine'',
Brown University Brown University is a private research university in Providence, Rhode Island. Brown is the seventh-oldest institution of higher education in the United States, founded in 1764 as the College in the English Colony of Rhode Island and Providenc ...
historian
Jacob M. Appel Jacob M. Appel (born February 21, 1973) is an American author, poet, bioethicist, physician, lawyer and social critic.Nagamatsu, Sequoia "A Few Words with the Ubiquitous Jacob M. Appel" ''Prince Mincer'' Journal http://primemincer.com/ confirmed ...
documented extensive political debate over legislation to legalize physician-assisted death in Iowa and Ohio in 1906. In Ohio, the legislation was inspired by the campaign of heiress Anna Sophina Hall, whose mother had died a long, drawn-out, painful death from
liver cancer Liver cancer (also known as hepatic cancer, primary hepatic cancer, or primary hepatic malignancy) is cancer that starts in the liver. Liver cancer can be primary (starts in liver) or secondary (meaning cancer which has spread from elsewhere to th ...
. Despite Hall's efforts, the bill was rejected by the Ohio legislature by a vote of 79 to 23.


''Glucksberg v. Washington''

Dr. Harold Glucksberg, in 1994, along with four other physicians, three terminally ill patients, and Compassion and Dying, brought a case against the state of Washington for banning assisted suicide. The case was filed in District Court in 1994. Following a series of appeals, the U.S. Supreme Court decided in 1997 in a unanimous decision to uphold Washington's ban. They cited the Due Process Clause and argued that assisted suicide is not guaranteed as a fundamental liberty protected by due process. The case allowed individual states to decide independently on the medical aid-in-dying issue. It set the stage for legislative efforts on the state level to either permit or ban physician-assisted suicide.


Dr. Kevorkian

Assisted suicide in the United States was brought to public attention in the 1990s with the highly publicized case of Dr. Jack Kevorkian. Kevorkian assisted over 40 people in committing suicide in Michigan. His first public assisted suicide was in 1990, of Janet Adkins, a 54-year-old woman diagnosed with early-onset Alzheimer's disease in 1989. He was charged with murder, but charges were dropped on December 13, 1990, because there were no Michigan laws outlawing suicide or the medical assistance of it so he was not in violation of a law. In 1998, Kevorkian videotaped himself giving a man a lethal injection, with the patient's consent, and aired the tape on ''
60 Minutes ''60 Minutes'' is an American television news magazine broadcast on the CBS television network. Debuting in 1968, the program was created by Don Hewitt and Bill Leonard, who chose to set it apart from other news programs by using a unique styl ...
''. This was significantly different from previous cases, where it was always the patients themselves who reportedly completed the suicide process. He was found guilty of second-degree murder and served eight years of a 10–25 year sentence. He was released in 2007, and died on June 3, 2011.


Brittany Maynard

In 2014, the death of Brittany Maynard, an advocate for the legalization of aid in dying, from
brain cancer A brain tumor occurs when abnormal cells form within the brain. There are two main types of tumors: malignant tumors and benign (non-cancerous) tumors. These can be further classified as primary tumors, which start within the brain, and secondar ...
led to renewed debate in the United States over assisted suicide, and was cited as being responsible for bills in several states on the topic. Her home state of California, which she left to reside in Oregon to access its Death With Dignity Act, became the fifth state to authorize aid in dying, in 2015.


Jurisdictions where assisted suicide is authorized


California

In 1992, the group Californians Against Human Suffering proposed Proposition 161 to allow patients with less than six months to live the right to receive assistance from physicians in dying. This proposition offered more safeguards against abuse by physicians than Washington's Initiative 119, such as special protections for patients in
nursing Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health ...
facilities. This measure failed to pass with 46 percent of the vote. Subsequent efforts were tried to pass assisted death legalization through the California State Legislature in 1999, 2005, and 2006, all of which failed. The California legislature passed the California End of Life Option Act, a bill legalizing the practice in September 2015, and the bill was signed into law by
Governor A governor is an administrative leader and head of a polity or political region, ranking under the head of state and in some cases, such as governors-general, as the head of state's official representative. Depending on the type of political ...
Jerry Brown Edmund Gerald Brown Jr. (born April 7, 1938) is an American lawyer, author, and politician who served as the 34th and 39th governor of California from 1975 to 1983 and 2011 to 2019. A member of the Democratic Party, he was elected Secretary of S ...
on October 5, 2015, making California the fifth state to authorize medical aid in dying and the second to do so through the legislature. The Act began implementation on June 9, 2016. The law went into effect in June 2016. In May 2018, Judge Daniel A. Ottolia of the Superior Court of Riverside County ruled that the method of enacting the law was unconstitutional, but the law was reinstated by a state appeals court the following month.


Colorado

Representatives
Lois Court Lois Court is a former legislator in the U.S. state of Colorado. Initially elected to the Colorado House of Representatives as a Democrat in 2008, Court represented House District 6 from 2009 through 2016, and was elected to the Colorado Senate ...
and
Joann Ginal Joann Ginal is an American politician who serves in the Colorado Senate from the 14th district since 2019, as a member of the Democratic Party. Before her tenure in the state senate she served in the Colorado House of Representatives from the 5 ...
introduced assisted suicide legislation in 2015 in the Colorado House. The bill was voted down in committee 8–5. In April 2016, Julie Selsberg and Jaren Ducker filed an initiative with the secretary of state seeking to authorize medical aid in dying in November 2016 through the ballot process. On November 8, 2016, Colorado voters passed Proposition 106 making assisted death legal among patients with a terminal illness.


District of Columbia

In January 2015, D.C. Council member Mary M. Cheh introduced the Death with Dignity Act of 2015. On October 5, 2016, the D.C. Committee on Health and Human Services voted 3–2 for the Death with Dignity Act. On November 1, 2016, the D.C. Council voted 11–2 to advance the Death with Dignity Act. It then went through another vote in the council and the Mayor's office. Mayor Bowser signed the bill on December 23, 2016. After the-30 day U.S. Congress review mandated by the federal Home Rule Act, and following the inability of Congressional Republicans to block the bill, the law went into effect on February 18, 2017, with D.C. becoming the seventh jurisdiction in the U.S. to legalize this.


Hawaii

Since 2019, Hawaii has legally allowed assisted dying, based on the Oregon and Washington state models. Governor
David Ige David Yutaka Ige (; born January 15, 1957) is an American politician and engineer who served as the eighth governor of Hawaii from 2014 to 2022. A Democrat, he served in the Hawaii State Senate from 1995 to 2014 and the Hawaii House of Represen ...
signed a medical aid-in-dying law on April 5, 2018. The law has safeguards to protect against abuse, including two health care providers being required to confirm a patient's diagnosis, prognosis, his or her ability to make decisions, and that the patient's request is voluntary; as well as a counselor being required to determine that the patient does not have conditions that may interfere with decision-making, such as untreated depression. The law requires that the patient must make two oral requests for the life-ending medication, with a 20-day waiting period in between, and sign a written request witnessed by two people, one of whom cannot be a relative. Criminal penalties apply to anyone attempting to coerce people into obtaining life-ending medication or tampering with said patient's request.


Maine

The Maine Death with Dignity Act was introduced in the state legislature in 2019 by Representative
Patricia Hymanson Patricia Hymanson is an American physician and politician from Maine. Hymanson, a Democrat from York, Maine, has served in the Maine House of Representatives since December 2014. She has also served on the York School Committee, including as c ...
(D-York). The bill passed in the House by 73 to 72 and in the Senate by 19 to 16. On June 12, 2019, Governor
Janet Mills Janet Trafton Mills (born December 30, 1947) is an American politician and lawyer serving as the 75th governor of Maine since January 2019. She previously served as the Maine Attorney General on two occasions. A member of the Democratic Party ...
signed the Maine Death with Dignity Act into law making
Maine Maine () is a state in the New England and Northeastern regions of the United States. It borders New Hampshire to the west, the Gulf of Maine to the southeast, and the Canadian provinces of New Brunswick and Quebec to the northeast and north ...
the ninth jurisdiction to legalize assisted suicide in the United States.


Montana

Aid in dying is legal in Montana through a state supreme court decision. In ''
Baxter v. Montana ''Baxter v. Montana'', is a Montana Supreme Court case, argued on September 2, 2009, and decided on December 31, 2009, that addressed the question of whether the state's constitution guaranteed terminally ill patients a right to lethal prescript ...
'' (2009) the
Montana Supreme Court The Montana Supreme Court is the supreme court, highest court of the state court system in the U.S. state of Montana. It is established and its powers defined by Article VII of the 1972 Montana Constitution. It is primarily an appellate court wh ...
ruled in a 5–2 decision that state law allows for terminally ill Montanans to request lethal medication from a physician under existing statutes, in 2009. The Attorney General of the state of Montana sought an appeal from the Montana Supreme Court, but the court, by a decision of five to two, affirmed the lower court's ruling on the state law. The Court did, however, limit the scope of the decision by not determining if the state's constitution protected the right.


New Jersey

A
New Jersey New Jersey is a state in the Mid-Atlantic and Northeastern regions of the United States. It is bordered on the north and east by the state of New York; on the east, southeast, and south by the Atlantic Ocean; on the west by the Delaware ...
Assembly committee voted in favor of assisted suicide legislation, and the full state Assembly voted on Assemblyman John Burzichelli's bill, known as A 2270, the New Jersey Death with Dignity Act, on November 13, 2014, although the bill failed to receive a vote in the Senate. The bill would have required patients with a terminal disease to first verbally request a prescription from their attending physician, followed by a second verbal request at least 15 days later and one request in writing signed by two witnesses. In addition, the attending physician would have to offer the patient a chance to rescind their request. Governor Chris Christie, at the time the bill was going through a legislative review and voting, vowed to veto any bills related to allowing assisted suicide. State Senator Nicolas Scutar introduced the Aid in Dying for the Terminally Ill Act in January 2018. The bill was passed on the State Assembly on March 25, 2019, and it was signed by Governor Phil Murphy on April 12, 2019, making New Jersey the 7th state to legalize assisted suicide. The law went into effect on August 1, 2019.


New Mexico

A New Mexico court legalized the practice in Bernalillo County in January 2014; this decision was overturned on August 11, 2015, which upheld the state's ban on assisted suicide. On April 8, 2021, Governor Michelle Lujan Grisham signed the Elizabeth Whitefield End-of-Life Options Act into law after the bill passed the New Mexico Legislature, legalizing assisted suicide in the state. The law allows for terminally ill patients with six months or less to live to request lethal medication. Two medical experts are required to agree on the patient's diagnosis and the patient must pass a mental competency screening in order to receive lethal medication. There is a 48-hour waiting period, after which the patient must take the medication themselves. The law took effect on June 18, 2021.


Oregon

Oregon voters first approved the Death with Dignity Act (DWDA) by general election in November 1994 by a margin of 51% to 49%. Ballot Measure 16, a citizen initiative sponsored by Oregon Right to Die Political Action Committee, asked if terminally ill patients with less than six months to live should be able to receive a prescription for lethal drugs and included many provisions to protect against misuse, such as two oral requests and a written request from the patient. The patient must also be referred to
counseling Counseling is the professional guidance of the individual by utilizing psychological methods especially in collecting case history data, using various techniques of the personal interview, and testing interests and aptitudes. This is a list of co ...
if a mental illness is suspected. The law went into effect in October 1997 after an injunction delayed implementation. In November 1997, Measure 51 was placed on the general election ballot to repeal the Act. Voters chose to retain the Act by a margin of 60% to 40%. Data from the Oregon Health Authority, which publishes annual reports on the state's first-in-the-nation assisted death law, show that approximately two-thirds of patients who receive prescriptions for lethal drugs take them.


Challenges


=''Lee v. State of Oregon''

= In December 1994, doctors and patients argued that the DWDA violated the U.S. Constitution's first and fourteenth amendments in ''Lee v. Oregon''. U.S. District Court Judge Michael Hogan placed a temporary injunction, that he later made permanent, on the Act. In February 1997, the Ninth Circuit Court of Appeals ruled to dismiss the challenge to the Death with Dignity Act.


=''Measure 51, Oregon repeal of Death with Dignity''

= In 1997, Measure 51 was placed on the November ballot. It failed, and 60% of Oregon voters, more than the original 1994 vote, expressed their support for the Death with Dignity Act.


=''Oregon v. Ashcroft''

=
U.S. Attorney General The United States attorney general (AG) is the head of the United States Department of Justice, and is the chief law enforcement officer of the federal government of the United States. The attorney general serves as the principal advisor to the p ...
John Ashcroft issued a directive in 2001 to prevent the Oregon Death With Dignity Act from being implemented. The state of Oregon successfully sued and proceeded with implementation.


Vermont

In May 2013, the
Vermont Legislature The Vermont General Assembly is the legislative body of the state of Vermont, in the United States. The Legislature is formally known as the "General Assembly," but the style of "Legislature" is commonly used, including by the body itself. The G ...
passed the Patient Choice and Control at End of Life Act. Governor
Peter Shumlin Peter Elliott Shumlin (born March 24, 1956) is an American politician from Vermont. A member of the Democratic Party, he served as the 81st governor of Vermont from 2011 to 2017. He was first elected to the office in 2010, and was reelected to a ...
signed it into law. The law is based on, but is less restrictive than, the Oregon model. Vermont was the first state to pass an assisted death law through the legislative process. In January 2013 the act was introduced to the Senate, and in May 2013 it was passed by both the house and senate. Vermont residents 18 years old or older who are mentally capable adults with a terminal illness and a prognosis of six months or less to live can make an oral request and obtain a lethal dose of medication from a physician to hasten their death. The bill requires a second opinion, written and oral requests, and other provisions.


Washington

In 1991, a ballot question asked if terminally ill adults should be allowed to receive physician aid-in-dying. The initiative failed, receiving 46 percent of the vote. Washington voters approved the Death with Dignity Act by general election in November 2008 by a margin of 58% to 42%. "This measure would permit terminally ill, competent, adult Washington residents medically predicted to die within six months to request and self-administer lethal medication prescribed by a physician. The measure requires two oral and one written request, two physicians to diagnose the patient and determine the patient is competent, a waiting period, and physician verification of an informed patient decision. Physicians, patients, and others acting in good faith compliance would have criminal and civil immunity."


Other jurisdictions


Alaska

In 1999, two terminally ill patients, Kevin Sampson and Jane Doe, sued for an order to exempt their physicians from being charged with manslaughter for assisting them in dying. The superior court ruled against them, and they appealed to the Alaska Supreme Court. This court upheld the previous ruling with the reasoning that the Alaska Constitution's right to privacy and liberty does not allow terminally ill patients to be assisted by physicians in dying. More recently, Representative
Harriet Drummond Harriet A. Drummond (born 1952) is an American politician and a Democratic member of the Alaska House of Representatives since January 18, 2013 who has represented District 16. She ran to represent District 17 in the Alaska legislature and lost ...
(D-Anchorage) has twice introduced legislation to legalize physician assisted suicide: first in 2015 and again in 2017. In each case, the act was heard in the House Health & Social Services Committee, then was rolled over to the session for the subsequent year. In 2018, the House Health & Social Services Committee passed the bill 3 to 2, with 2 abstentions, sending it to the Judiciary Committee, where it stalled again.


Arizona

Arizona's state legislature has heard bills to legalize physician assisted suicide and patient-controlled pain medication dosing numerous times since 2003. Each year from 2017 to 2020, companion bills for assisted suicide were simultaneously introduced in the House and Senate, but failed to advance. In 2017, the legislature passed a related law, SB 1439, Prohibition on Discrimination Against Health Care Entities, which prohibits discrimination against medical care providers who opt out of providing assistance in dying, should such care ever be legalized. It was subsequently signed by the Governor on March 24, 2017. In Arizona, the city of Bisbee became the first municipality in the state to approve an aid in dying resolution, although the vote is not legally binding. The resolution states that the city of Bisbee: * Respects the diversity of perspectives of its citizens, * Supports equal protection within the diversity of perspectives on end-of-life decisions, * Recognizes the practice of Aid in Dying as a legitimate individual liberty, * And, while not a legally enforceable document, urges prosecutorial discretion by the Cochise County Attorney in de-prioritizing cases involving prosecution of a person who has supported, been present, or facilitated a loved one to advance the time of his or her imminent death when facing intolerable suffering.


Connecticut

Legislation to legalize assisted suicide was first introduced in Connecticut in 1995, when Oregon considered its own policy. Similar bills have had a public hearing in seven of the last eight years (2013-2020, excepting 2016), but they consistently died in committee without coming to a vote. HB-06425, An Act Concerning Aid In Dying For Terminally Ill Patients, was evaluated by the Connecticut Public Health Committee March 5, 2021 with a 24–9 vote to send to the assembly floor, however was then referred to the Judiciary Committee and subsequently tabled.


Florida

''Krischer v. McIver'' was a case brought to the Florida Supreme Court in 1997 by the Florida chapter of the Hemlock Society in an attempt to overturn the state's anti-assisted suicide law. The question was if AIDS patient Charles Hall had this right, and the case was appealed to the Florida Supreme Court. This court upheld the constitutionality of Florida's law against assisted suicide.Marker, Rita L. (2009).
Assisted Suicide: The Continuing Debate
. International Task Force 1–18. March 1, 2009.
In 2020, State Senator Kevin Rader (D-29) introduced the first ever Florida bill to legalize physician assisted suicide, SB 1800, the Florida Death with Dignity Act. The bill was indefinitely postponed and withdrawn from consideration on March 14, 2020.


Maryland

The Maryland legislature has considered and rejected bills on physician-assisted death many times, beginning in 1995. From 2015 to 2017, an End of Life Option Act was introduced each year, but each year withdrawn without a vote. In 2019, the reintroduced act was brought to a vote. It passed the House 74–66, but failed in the Senate with a tie 23–23. In 2020, the act was once again introduced but subsequently set aside due to the COVID-19 pandemic. Governor
Larry Hogan Lawrence Joseph Hogan Jr. (born May 25, 1956) is an American politician and businessman serving as the 62nd governor of Maryland since 2015. A moderate member of the Republican Party, he was secretary of appointments under Maryland governor Bo ...
, whose term in office will end in 2023, has suggested in the past that he would oppose the legislation, but indicated in 2020 that his personal battle with cancer had changed his perspective and that he was now "open to both sides of the issue".


Massachusetts

The
Massachusetts Death with Dignity Initiative The Massachusetts "Death with Dignity" Initiative, also known as Question 2, appeared on the November 6, 2012 general election ballot in the state of Massachusetts as an indirect initiated state statute to allow physician-assisted suicide. The ...
, a ballot measure to legalize aid in dying, was narrowly defeated in the 2012 general election, with 51% of voters against the proposal. A poll taken by the ''Boston Globe'' and the University of New Hampshire between September 21 and 27, 2012, found Massachusetts residents supporting Question 2 68%, with 20% opposed. Another public poll by the University of Massachusetts and YouGov American found similar results as late as October 8 with 65% in support and 19% opposed. Legislation to legalize physician assisted suicide was introduced numerous times in the Massachusetts House both before and after the ballot initiative, in 1995, 1997, 2009, 2011, 2012, 2013, and 2015. None of these bills moved out of committee. In 2017, companion bills in the House and Senate were introduced on the issue, with 44 and 11 cosponsors on the respective bills, but died in committee after a joint public hearing. In 2019, a similar pair of bills was introduced by an expanded coalition of 67 cosponsors in the House and Senate. An amended version of these bills, the Massachusetts End of Life Options Act, advanced from the Joint Committee on Public Health on May 29, 2020, to the Joint Committee on Healthcare Financing, where it failed to receive a vote before the end of the 2020 legislative session on December 31. A 2019 poll of 500 residents conducted by the Boston Globe and Suffolk University, released in 2020, found that 70% of Massachusetts residents agreed that "the terminally ill houldbe permitted to end their own lives with the help of a doctor, also known as medical aid in dying." Support for assisted suicide was similar across broad geographic regions, age brackets, and genders, but varied more by race, with stronger support among White (73%) and Black (64%) respondents, and less support from Hispanic/Latino (50%) and Asian (52%) respondents. The overall margin of error was reported as ±4.4, but higher for smaller subgroups.


New York

In 1994, a suit was filed in New York claiming that the anti-assisted suicide statute was a violation of equal protection and liberty guarantees of the Fourteenth Amendment. This claim was rejected by the District Court on the basis that there is no right to assisted suicide given by the U.S. Constitution. In 1996, the
U.S. Court of Appeals The United States courts of appeals are the intermediate appellate courts of the United States federal judiciary. The courts of appeals are divided into 11 numbered circuits that cover geographic areas of the United States and hear appeals fro ...
overturned this ruling with the reasoning that the criminalization of assisted suicide violates the Equal Protection Clause. However, the U.S. Supreme Court unanimously reversed the U.S. Court of Appeals decision in ''
Vacco v. Quill ''Vacco v. Quill'', 521 U.S. 793 (1997), was a landmark decision of the Supreme Court of the United States regarding the right to die. It ruled 9-0 that a New York ban on physician-assisted suicide was constitutional, and preventing doctors from a ...
,'' 521 U.S. 793 (1997). In February 2015, New York state senators
Brad Hoylman Brad Madison Hoylman (born October 27, 1965) is an American Democratic politician. First elected in 2012, Hoylman represents the 27th District in the New York State Senate, covering much of Lower and Midtown Manhattan in New York City. He is C ...
and Diane Savino introduced a "Death With Dignity Act" to allow physician-assisted suicide in the state. On September 7, 2017, in ''Myers v. Schneiderman'', the New York Court of Appeals held that terminally-ill persons did not possess a right to physician-assisted suicide under the New York State Constitution.


Nevada

In May 2017, a bill was passed by the state senate, which sought to legalize physician-assisted suicide. However, when passed to the Nevada Assembly, the Committee on Health and Human Services chose not to advance the bill. Similar legislation was reintroduced at the next legislative session, which took place in 2019. Although it once again passed out of committee, it was not brought to a full Senate vote before the deadline.


Tennessee

Tennessee Tennessee ( , ), officially the State of Tennessee, is a landlocked state in the Southeastern region of the United States. Tennessee is the 36th-largest by area and the 15th-most populous of the 50 states. It is bordered by Kentucky to th ...
's legislature first debated legalizing assisted suicide in 2015. In the following year, a prominent Tennessee political figure, John Jay Hooker, took the cause to the courts by filing a lawsuit asking for physician assisted suicide. The case was in the appeals process when Hooker died of cancer on January 24, 2016. A pair of companion bills to legalize the practice were introduced in the Tennessee House and Senate in 2017, but did not advance.


State power to allow and regulate

States have the power to regulate, allow or prohibit assisted suicide. In 1997, in the cases of ''
Washington v. Glucksberg ''Washington v. Glucksberg'', 521 U.S. 702 (1997), was a landmark decision of the U.S. Supreme Court, which unanimously held that a right to assisted suicide in the United States was not protected by the Due Process Clause. Background Dr. Harold ...
'' and ''
Vacco v. Quill ''Vacco v. Quill'', 521 U.S. 793 (1997), was a landmark decision of the Supreme Court of the United States regarding the right to die. It ruled 9-0 that a New York ban on physician-assisted suicide was constitutional, and preventing doctors from a ...
'', the U.S. Supreme Court ruled unanimously that there is no Constitutional right to assisted suicide, and that states therefore have the right to prohibit it. Advocates of assisted suicide saw this as opening the door for debate on the issue at the state level. ''
Gonzales v. Oregon ''Gonzales v. Oregon'', 546 U.S. 243 (2006), was a landmark decision of the US Supreme Court which ruled that the United States Attorney General cannot enforce the federal Controlled Substances Act against physicians who prescribed drugs, in com ...
'' was brought to the United States
Supreme Court A supreme court is the highest court within the hierarchy of courts in most legal jurisdictions. Other descriptions for such courts include court of last resort, apex court, and high (or final) court of appeal. Broadly speaking, the decisions of ...
in 2006. The court ruled that the United States Attorney General could not enforce the federal Controlled Substances Act against physicians who prescribed drugs, in compliance with Oregon state law, for the assisted suicide of the terminally ill.


In practice

Health departments in Oregon and Washington State publicly report yearly on the use of assisted death; as required in their respective statutes. A documentary was produced in 2011 called ''
How to Die in Oregon ''How to Die in Oregon'' is a 2011 American documentary film produced and directed by Peter Richardson (filmmaker), Peter Richardson. It is set in the U.S. state of Oregon and covers the state's Oregon Death with Dignity Act, Death with Dignity A ...
'' which follows a woman who uses assisted death and interviews her family and interviews opponents of the law.


Controversy

People disagree about what the practice of helping a terminally ill or disabled person die by suicide should be called. Proponents like to call the practice "medical aid in dying" because they do not believe that killing oneself under those circumstances is wrong or unhealthy. Opponents tend to prefer the term "physician-assisted suicide (PAS)", which employs the technical terms for self (sui) killing (cide). They feel that PAS is the most accurate monker for the act of helping anyone end their own life. Like all heated debates, terms for the latter practice are subject to
political framing In the social sciences, framing comprises a set of concepts and theoretical perspectives on how individuals, groups, and societies organize, perceive, and communicate about reality. Framing can manifest in thought or interpersonal communicati ...
. Proponents are more likely to use terms like "physician-assisted dying", "physician-assisted death", "aid in dying", "death with dignity", "right to die", "compassionate death", "compassionate dying", "end-of-life choice", and "medical assistance at the end of life". Opponents do not view the latter practice as a legitimate medical procedure, hence they regard the aforementioned labels as euphemisms and use the term "
assisted suicide Assisted suicide is suicide undertaken with the aid of another person. The term usually refers to physician-assisted suicide (PAS), which is suicide that is assisted by a physician or other healthcare provider. Once it is determined that the p ...
". Controversy concerning the legalization of this practice typically arises from concerns regarding its intersection with manipulative circumstances or family members; inaccurate prognoses, the accuracy of death certificates, unequal access to healthcare, financial problems, the
Werther Effect ''Werther'' is an opera (''drame lyrique'') in four acts by Jules Massenet to a French libretto by Édouard Blau, Paul Milliet and Georges Hartmann (who used the pseudonym Henri Grémont). It is loosely based on Goethe's epistolary novel ''The So ...
, advocacy for the practice's expansion to those with disabilities, the deaths of disabled persons in places like Canada that have occipital because of a lack of social support, evidence of abuse in other jurisdictions where PAS is authorized and
ableism Ableism (; also known as ablism, disablism (British English), anapirophobia, anapirism, and disability discrimination) is discrimination and social prejudice against people with Disability, disabilities or who are perceived to be disabled. Ableis ...
in general. Opponents view these factors as legitimate reasons to keep physician assisted suicide illegal.


Debate over whether assisted suicide/MAiD is suicide

Suicide refers to the act of taking one's own life. Opponents feel that this term is appropriate to describe assisted death, because of the social and personal dynamics that can pressure someone into choosing death. Opponents also cite the fact that oncologists and other non-psychiatric physicians responsible for referring patients for counseling are not trained to detect complex, potentially invisible disorders like clinical depression. Proponents feel that "medical aid in dying" differs from suicide because a patient must be confirmed by two physicians to be terminally ill with a prognosis of 6 months or less to live and must also be confirmed by two physicians to be mentally capable to make medical decisions. That is why proponents support death certificates that list their underlying condition as the cause of death. According to the proponents, suicide is a solitary, unregulated act whereas aid in dying is medically authorized and is intended to allow for the presence of loved ones. Proponents define "suicide" as an irrational act committed in the throes of mental illness. They assert that the latter act is fundamentally distinct from the practice that they are advocating, as it is intended to be a measured act. In contrast, opponents feel that this characterization of suicide is erroneous. They point out that people commit suicide for political reasons, for the same reasons that proponents cite as rational justifications for assisted death, and that mentally ill people who become terminally ill may experience assisted death as a potential "out" in regard to suicidal ideation that they had previously fought. Moreover, they argue that the highly publicized deaths of assisted death advocates are political acts.


Assisted suicide versus euthanasia

In the United States, assisted death is a practice by which a terminally ill person who is believed to be of sound mind and has a prognosis of six months or less requests, obtains and – if they feel their suffering has become unbearable – self-administers barbiturates to end their life.
Euthanasia Euthanasia (from el, εὐθανασία 'good death': εὖ, ''eu'' 'well, good' + θάνατος, ''thanatos'' 'death') is the practice of intentionally ending life to eliminate pain and suffering. Different countries have different eut ...
, which is practiced in Canada, Belgium, Colombia and the Netherlands, is a practice in which another person (generally a physician) acts to cause death. Euthanasia is illegal in the United States, whereas assisted death is currently authorized in ten states and the District of Columbia.


Public opinion

Public support for assisted death ranges from around 45% to 75% depending on how in-depth the questions are and how they are phrased. For instance, in "The Murky Issue of Whether The Public Supports Assisted Dying", reporter Katherine Sleeman noted: "Not surprisingly, the acceptability of assisted dying varies according to the precise context ... a ComRes/Care poll in 2014 found that 73% agreed with the legalization of a bill which enables, "Mentally competent, adults in the UK who are terminally ill and have declared a clear and settled intention to end their own life, to be provided with assistance to commit suicide by self-administering lethal drugs." But 42% of these same people subsequently changed their minds when some of the empirical arguments against assisted dying were highlighted to them-such as the risk of pressure on people to end their lives so as not to be a burden on loved ones."


Gallup

In a May 2020 Gallup poll, 74% of U.S. adults say doctors should be allowed to end the life of a patient with an incurable disease "by some painless means" if the patient and the patient's family requests it." In a May 2016 Gallup poll, 69% of Americans said they agree that "when a person has a disease that cannot be cured...doctors should be allowed by law to end the patient's life by some painless means if the patient and their family request it." The fact that the caveat in this poll is incurable illness rather than terminal illness represents one of the opponents' primary objections to assisted death. In a May 2015 Gallup survey, 68% of Americans agreed that "individuals who are terminally ill ... have the right to choose to end their own life." A 2014 Gallup survey found that 69% of Americans think that doctors should be allowed by law to end the life of a patient who has a disease that cannot be cured "by some painless means if the patient and their family request it."


Other surveys

In 2014, a Harris Poll found that 74% of Americans agree that "individuals who are terminally ill ... have the right to choose to end their own life." 17,000 U.S. doctors representing 28 medical specialities were surveyed by Medscape on end-of-life issues. The survey found that 54% of doctors believe assisted suicide, or medical aid in dying, should be available as an end-of-life option.


Advocates


Religious leaders

*
Desmond Tutu Desmond Mpilo Tutu (7 October 193126 December 2021) was a South African Anglican bishop and theologian, known for his work as an anti-apartheid and human rights activist. He was Bishop of Johannesburg from 1985 to 1986 and then Archbishop ...
*
George Carey George Leonard Carey, Baron Carey of Clifton (born 13 November 1935) is a retired Anglican bishop who was the Archbishop of Canterbury from 1991 to 2002, having previously been the Bishop of Bath and Wells. During his time as archbishop the Ch ...


Actors

* Patrick Stewart *
Leonard Nimoy Leonard Simon Nimoy (; March 26, 1931 – February 27, 2015) was an American actor, famed for playing Spock in the ''Star Trek'' franchise for almost 50 years. This includes originating Spock in the original ''Star Trek'' series in 1966, then ...
*
Olympia Dukakis Olympia Dukakis (June 20, 1931 – May 1, 2021) was an American actress. She performed in more than 130 stage productions, more than 60 films and in 50 television series. Best known as a screen actress, she started her career in theater. Not lon ...
*
Elliott Gould Elliott Gould (; né Goldstein; born August 29, 1938) is an American actor. He began acting in Hollywood films during the 1960s. Elliott's breakthrough role was in the ''Bob & Carol & Ted & Alice'' (1969), for which he received a nomination f ...
*
Montel Williams Montel Brian Anthony Williams (born July 3, 1956) is an American television host, actor and motivational speaker. He is known for hosting the long-running daytime tabloid talk show ''The Montel Williams Show'', which ran in syndication from 1991 ...
* Florence Henderson


Public personalities

* George Will *
Derek Humphry Derek Humphry (born 29 April 1930) is a British-born American journalist and author notable as a proponent of legal assisted suicide and the right to die. In 1980, he co-founded the Hemlock Society and, in 2004, after that organization dissolv ...
* Jack Kevorkian * Diane Rehm *
Brittany Maynard Brittany Lauren Maynard (November 19, 1984 – November 1, 2014) was an American activist with terminal cancer who decided that she would end her own life "when the time seemed right." She was an advocate for the legalization of assisted suicide ...
* Philip Nitschke *
Jeanne Phillips Jeanne Phillips (; born 1942), also known as Abigail Van Buren, is an American advice columnist who has written for the advice column '' Dear Abby'' since 2000. She is the daughter of Pauline Esther Phillips, who founded ''Dear Abby'' in 1956 ...
*
Betty Rollin Betty Rollin (born January 3, 1936, in New York City) has been an NBC News correspondent and author. Rollin's reports have won both the DuPont and Emmy awards. She now contributes reports for PBS's Religion and Ethics News Weekly. Rollin is a gr ...
* Jane E. Brody * Dolores Huerta


Opponents


Public personalities

*
Dean Koontz Dean Ray Koontz (born July 9, 1945) is an American author. His novels are billed as suspense thrillers, but frequently incorporate elements of horror, fantasy, science fiction, mystery, and satire. Many of his books have appeared on ''The New Y ...
*
Charles Krauthammer Charles Krauthammer (; March 13, 1950 – June 21, 2018) was an American political columnist. A moderate liberal who turned independent conservative as a political pundit, Krauthammer won the Pulitzer Prize for his columns in ''The Washington ...


Politicians

*
Victoria Reggie Kennedy Victoria Anne Kennedy (née Reggie; born February 26, 1954) is an American diplomat, attorney and activist who has served as the List of ambassadors of the United States to Austria, United States Ambassador to Austria since 2022. She is the wid ...
*
Ralph Nader Ralph Nader (; born February 27, 1934) is an American political activist, author, lecturer, and attorney noted for his involvement in consumer protection, environmentalism, and government reform causes. The son of Lebanese immigrants to the Un ...
* Denise Provost


Lawyers

*
Wesley J. Smith Wesley J. Smith (born 1949) is an American lawyer and author, a Senior Fellow at the Discovery Institute's Center on Human Exceptionalism, a politically conservative non-profit think tank. He is also a consultant for the Patients Rights Council. S ...
* Harriet McBryde Johnson *
Shain Neumeier Shain A. Mahaffey Neumeier (born 1987) is an American Societal and cultural aspects of autism, autistic and nonbinary transgender attorney from Los Angeles, California. Neumeier advocates against coercive and Involuntary commitment, forced treatm ...


Doctors

* Ira Byock


Activists

* Ari Ne'eman *
Marilyn Golden Marilyn Golden (March 22, 1954 – September 21, 2021) was an American disability rights activist, most notably in the area of transportation. For many years she was a Policy Analyst at the Disability Rights Education and Defense Fund (DREDF). She ...
*
Lydia Brown Lydia X. Z. Brown (born 1993) is an American autistic disability rights activist, writer, attorney, and public speaker who was honored by the White House in 2013. They are the chairperson of the American Bar Association Civil Rights & Social J ...
*
Dominick Evans Dom Ławniczak Evans is a Polish-Irish-American filmmaker, streamer, public speaker, and social activist who focuses on LGBT rights and disability rights. Early life Evans was born in Toledo, Ohio to a Polish-American father, David Ławniczak ( ...
*
Corbett O'Toole Corbett O'Toole (born 1951) is a disability rights activist. She had polio as a child. She ran the Disabled Women's Coalition office with Lynn Witt in the 1970s. She worked as a staff member at the Center for Independent Living in Berkeley from ...
* Alice Wong (disability rights activist)


Actors

*
Liz Carr Liz Carr is an English actress, comedian, broadcaster and international disability rights activist. Early life and education Carr was born 21 April 1972 in Port Sunlight and grew up in Bebington, Merseyside. She attended Upton Hall School FCJ i ...
* Martin Sheen


Academics

*
Rosemarie Garland-Thomson Rosemarie Garland-Thomson is Professor of English at Emory University with a focus on disability studies and feminist theory. Her book ''Extraordinary Bodies'', published in 1997, is a founding text in the disability studies canon. Garland-Thomson ...
* Paul K. Longmore *
Adrienne Asch Adrienne Asch (September 17, 1946 – November 19, 2013) was a bioethics scholar and the founding director of the Center for Ethics at Yeshiva University in New York City. She was also the Edward and Robin Milstein Professor of Bioethics at the ...


Supportive organizations

* American College of Legal Medicine *
American Medical Student Association The American Medical Student Association (AMSA), founded in 1950 and based in Washington, D.C., is an independent association of physicians-in-training in the United States. AMSA is a student-governed national organization.They have a membership ...
* American Medical Women's Association * American Public Health Association * Coalition for Liberty & Justice *
Compassion and Choices Compassion & Choices is a nonprofit organization in the United States working to improve patient autonomy and individual choice at the end of life, including access to medical aid in dying. Its primary function is advocating for and ensuring acce ...
*
Death with Dignity National Center Death with Dignity National Center is a 501(c)(3) nonpartisan nonprofit organization, headquartered in Portland, Oregon, that has led the legal defense of and education about Death with Dignity laws throughout the United States for more than ...
* GLMA: Health Professionals Advancing LGBT Equality *
National Association of Social Workers The National Association of Social Workers (NASW) is a professional organization of social workers in the United States. NASW has about 120,000 members. The NASW provides guidance, research, up to date information, advocacy, and other resources f ...
*
Older Women's League OWL - The Voice of Women 40+ was founded as the Older Women's League by Tish Sommers and Laurie Shields, following the White House Mini-Conference on Older Women in Des Moines, Iowa in October 1980. The conference, called "Growing Numbers, Growing ...
* American Nurses Association of California * End of Life Washington * Oregon Hospice and Palliative Hospice Association * Triage Cancer


Neutral organizations

*
American Academy of Hospice and Palliative Medicine The American Academy of Hospice and Palliative Medicine (AAHPM) is a professional organization for physicians specializing in Hospice and Palliative Medicine, headquartered in Chicago, Illinois. Membership is open to all health care providers com ...
* American Society of Health-System Pharmacists *
American Psychological Association The American Psychological Association (APA) is the largest scientific and professional organization of psychologists in the United States, with over 133,000 members, including scientists, educators, clinicians, consultants, and students. It ha ...
* American Pharmacists Association * Coalition for Compassionate Care of California * California Hospice and Palliative Care Association * California Medical Association *
Colorado Medical Society The Colorado Medical Society (CMS) is the largest group of organized physicians in Colorado. This nonprofit organization is composed of physicians, residents and medical students. It was founded in 1871 to promote the art and science of medicine ...
* Hospice and Palliative Care Council of Vermont * Kokua Mau (Hawaii) * Missouri Hospice and Palliative Care Association * Oncology Nursing Association * Vermont Psychiatric Association *
Washington State Medical Association The Washington State Medical Association (WSMA) is a professional organization providing tangible support of medical practice and access to physician services; promoting quality, cost effective care; and being a respected voice in the public are ...
* Washington State Psychological Association


Opposing organizations

*
American Medical Association The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's state ...
* National Spinal Cord Injury Association *
World Association of Persons with Disabilities In its most general sense, the term "world" refers to the totality of entities, to the whole of reality or to everything that is. The nature of the world has been conceptualized differently in different fields. Some conceptions see the worl ...
*
American Association of People with Disabilities The American Association of People with Disabilities (AAPD) is a 501(c)(3) non-profit organization which advocates for the legal rights of people with disabilities.Imparato, Andrew J. 2005. "AAPD In Its Second Decade," ''AAPDnews'' (Spring 2005), ...
* Euthanasia Prevention Coalition *
National Council on Disability The National Council on Disability (NCD) is an advisory agency on disability policy in the United States for all levels of government and for private sector entities NCD is an independent agency of the United States government headquartered in ...
*
ADAPT ADAPT (formerly American Disabled for Attendant Programs Today) is a United States grassroots disability rights organization with chapters in 30 states and Washington, D.C. They use nonviolent direct action in order to bring about disability just ...
* National Council on Independent Living * Patients Rights Action Fund * LULAC *
Not Dead Yet Not Dead Yet (NDY) is a United States disability rights group that opposes assisted suicide and euthanasia for disabled people. Diane Coleman, JD, is the founder and president of this national group. Stephen Drake, a research analyst with NDY, ...
*
Disability Rights Education and Defense Fund The Disability Rights Education and Defense Fund (DREDF), located in Berkeley, California, and Washington, DC, USA is a national cross-disability civil rights law and policy center directed by individuals with disabilities and parents who have chi ...
*
Arc of the United States The Arc of the United States is an organization serving people with intellectual and developmental disabilities. The organization was founded in the 1950s by parents of people with developmental disabilities. Since then, the organization has estab ...
* TASH *
American Nursing Association The American Nurses Association (ANA) is a 501(c)(6) professional organization to advance and protect the profession of nursing. It started in 1896 as the Nurses Associated Alumnae and was renamed the American Nurses Association in 1911. It is ba ...
* Autistic Women & Nonbinary Network *
American College of Physicians The American College of Physicians (ACP) is a national organization of internists, who specialize in the diagnosis, treatment, and care of adults.Sokanu "What is an Internist?" Retrieved October 20, 2014 With 161,000 members, ACP is the largest ...
*
Roman Catholic Church The Catholic Church, also known as the Roman Catholic Church, is the largest Christian church, with 1.3 billion baptized Catholics worldwide . It is among the world's oldest and largest international institutions, and has played a ...
*
Islamic Medical Association of North America The Islamic Medical Association of North America ("IMANA") is one of the largest faith-based medical groups in the world and is the largest Muslim medical organization in North America. It was founded in 1967 in Illinois and is a non-profit 501(c ...
*
World Medical Association The World Medical Association (WMA) is an international and independent confederation of free professional medical associations representing physicians worldwide. WMA was formally established on September 18, 1947 and has grown to 115 national m ...
* International Task Force on Euthanasia and Assisted Suicide (Patients Rights Council)


See also

* ''
Baxter v. Montana ''Baxter v. Montana'', is a Montana Supreme Court case, argued on September 2, 2009, and decided on December 31, 2009, that addressed the question of whether the state's constitution guaranteed terminally ill patients a right to lethal prescript ...
'' *
Euthanasia in the United States Euthanasia is currently illegal in all 50 states of the United States. Assisted suicide is legal in 10 jurisdictions in the US: Washington, D.C. and the states of California, Colorado, Oregon, Vermont, New Mexico, Maine, New Jersey, Hawaii, and ...
* Oregon Death with Dignity Act *
Suicide in the United States Suicide in the United States is a major national public health issue. The country has one of the highest suicide rates among wealthy nations. In 2020, there were 45,799 recorded suicides, up from 42,773 in 2014, according to the CDC's Nat ...
* Washington Death with Dignity Act


References


External links


Official Oregon Health Authority page on the DWDA
with Annual Reports
Official Washington State Department of Health page on the DWDA
with Annual Reports
Annotated Legal Cases on Physician-Assisted Suicide in the USA
{{Death Palliative care in the United States