Dr. Cynthia Chatterjee had long opposed medical aid in dying—until she watched her father suffering from terminal cancer. His pain was unbearable. But in his final moments, there was peace.
Three minutes after taking the medication he knew would end his life, her father fell asleep, she recalled. Within 15 minutes, he died.
“There was no struggling or gasping for breath, which had been his greatest fear,” she said. “I came away from my father’s death wishing that everyone could have the opportunity to have such a peaceful passing.”
In most of America, that option doesn’t exist. However, there is a growing conversation across the country. Lawmakers in 25 states have filed legislation related to the practice, though not all are considering legalization bills.
The practice, which allows doctors to prescribe life-ending medication to terminally ill patients, is currently legal in 10 states and Washington, D.C. Oregon became the first state to legalize it in 1997 under its Death With Dignity Act. The other states are California, Colorado, Hawaii, Maine, Montana, New Jersey, New Mexico, Vermont and Washington.
A 2022 study published in the Journal of the American Geriatrics Society said 5,329 people died using medical aid in the United States from 1998 to 2020. During that time, 8,451 people requested and received a prescription for the medication. About 22% of Americans—74 million people—live in jurisdictions where assisted dying is legal, the study found.
This year, 27 bills were proposed in legislatures to legalize assisted dying in 18 states. This has been common over the years, as similar bills have failed to make it through the legislative process.
In states where physician-assisted dying is legal, safeguards are in place. Generally, a patient must be an adult with a terminal diagnosis and have less than six months to live, confirmed by at least two physicians. The patients must make multiple verbal and written requests and undergo a waiting period, which varies by state. There are also safeguards to prevent coercion and ensure the patient is capable of making decisions independently.
Some states are looking to legalize the practice
In 2024, 71% of Americans believed doctors should legally be able to end the life of a patient who has an incurable disease if the patient or …
Strong political will exists in Illinois, Delaware and New York to move legislation legalizing assisted dying forward, according to Elizabeth Armijo, national director of legislative advocacy at Compassion & Choices.
In Illinois, a measuresponsored by Sen. Linda Holmes and several other senators proposes safeguards such as dual physician assessments and mandatory counselling sessions for the patient.
“Losing someone you love is tough. Watching someone you love suffer is worse,” Holmes said during a committee hearing as she talked about witnessing her parents struggle with cancer. The bill is awaiting a full hearing in the Senate. The deadline for a third reading is May 23.
In New York, Assemblywoman Amy Paulin and Sen. Brad Hoylman-Sigal have reintroduced a bill supported by 72% of New Yorkers, a poll by interest groups Death With Dignity and the Completed Life Initiative found, including majorities across political and demographic groups.
“Support has continued to grow among New Yorkers for this compassionate end-of-life option,” Paulin said in a statement, according to City and State New York.
Jonathan Thaler, whose mother died in New Jersey, has been a vocal supporter of the bill, which as of May 16 had passed the Assembly and awaited a vote in New York’s Senate.
“When speaking about her coming death, my mother said, ‘Make sure that we use the right terms. I am not committing suicide; I am using medical aid in dying,’” he said in January. “Mom died peacefully and gracefully, surrounded by her loved ones, after living a full life. Governor Hochul, you have the opportunity to provide a true blessing to the people of New York.”
Dr. Jeremy Boal, former chief clinical officer at Mount Sinai, supports the bill as both a physician and as someone who witnessed medical aid in dying firsthand. “If this law is passed, not one more person will die as a result of its passage. But many fewer will suffer. Of that I am confident. Medical aid in dying is a blessing for all of us,” he said in January.
In Delaware, the medical aid in dying bill passed the House in March and the Senate on April 17. The bill, which allows people who have fewer than six months to live, awaits action by Gov. Matt Meyer. A similar bill passed last year was vetoed by the former governor.
Lawmakers in Massachusetts are also taking another attempt at the legislation; a new rule sets a deadline of June 1 to take a call on the bill.
“Seventy-nine percent of residents support it,” said Melissa Stacy, New England campaign manager for Compassion & Choices. “We have 30 years of data from Washington and Oregon showing that the safeguards work.”
Massachusetts Sen. Jo Comerford, who introduced the bill, said it “offers a compassionate option to allow mentally capable patients with terminal diagnoses to choose a peaceful, humane death with dignity.”
In Tennessee, attempts to legalize medical aid in dying have failed repeatedly. This year, House Democrat Rep. Bob Freeman introduced the Dignity in Death bill, which died in the committee. In Arizona, two Death with Dignity bills were introduced by Democrats but failed to advance to committee hearings. It was the 11th time a similar bill had been introduced since 2003 without any movement.
States are looking to amend existing laws
Washington state Rep. Strom Peterson, a Democrat from Edmonds, introduced legislation to expand access to the state’s Death With Dignity Act by reducing mandatory waiting periods for patients in severe decline.
State law currently allows terminally ill patients to request life-ending medication but stipulates patients must make two verbal requests to die during interviews with physicians, separated by a seven-day waiting period and followed by a written request.
This year’s bill sought to shorten the waiting period in certain cases, providing streamlined access to patients in extreme pain and at risk of soon losing cognitive or physical ability. The bill failed to make it out of committee this year, but Peterson said he plans to introduce it again next year.
His motivation for sponsoring the bill is personal. After witnessing his mother’s smooth experience with New Mexico’s more flexible aid-in-dying laws, Peterson saw the need for changes to Washington’s law.
New Jersey is making similar attempts to remove waiting periods. Advocates argue that existing waiting periods can unnecessarily prolong suffering. Oregon and Vermont are also considering legislation to allow certified physician assistants and nurse practitioners to participate in the assisted-dying process. Supporters say this would enhance accessibility and address physician shortages.
Opposition to the issue
Jessica Rodgers, coalition director at Patients Rights Action Fund, is firmly against medical aid in dying measures. Her personal experience of caring for her terminally ill mother profoundly shaped her advocacy against physician-assisted dying. Chief among her concerns is fear that legalizing assisted death creates a lower standard of care for the terminally ill.
“Instead of coming around them and providing support, states where this is legal have a policy saying, ‘This is a valid reason for you to kill yourself,'” Rodgers said.
The Illinois bill has also faced significant criticism.
“I have a problem with the vulnerable people that we’re putting at risk by allowing active participation in death by allowing doctors and the government essentially to allow who decides who dies and when. I think that’s unacceptable,” Dr. Kevin Garner, a physician from Granite City, said during an Illinois Senate committee hearing.
In Massachusetts, the bill has not passed despite being discussed in the Legislature for 13 years, largely due to lobbying efforts from opposition groups.
“The majority of people choose this option not because of pain but because they feel like a burden on society,” said John Kelly, director of Second Thoughts Massachusetts.
One of the biggest concerns, according to opponents, is that errors could happen while treating terminally ill patients. Anita Cameron, director of minority outreach for a disability rights group that opposes medical aid in dying, narrated the story of misjudgment by the doctor in her mother’s case.
“The doctor told my mom she was going to die very soon, and she was convinced she was dying soon and hence wanted to opt for physician-assisted suicide. However, luckily, she didn’t and lived for 12 years,” Cameron said. “A lot of times such misjudgments happen, and it is very concerning.”
Health care groups weigh in
The American Academy of Hospice and Palliative Medicine maintains a neutral stance on the issue but raises concerns about potential impacts on medical integrity. In contrast, organizations such as the American College of Legal Medicine and the American Public Health Association support medical aid in dying, emphasizing the importance of strict safeguards.
Supporters faced a potential setback in Montana, where Senate Bill 136, introduced by Sen. Carl Glimm would have invalidated patient consent as a defense in physician-assisted death cases.
“Physicians should not be helping people commit suicide,” said Sen. Carl Glimm, whose bill would have criminalized the practice. “It endangers the weak and vulnerable. It corrupts the practice of medicine. It compromises the family and betrays human dignity.”
Supporters of the bill said it could help reduce the suicide rate in Montana, which ranked first in the nation in 2022, according to data from the Centers for Disease Control. But opponents fear it will drive suffering patients into silence—or worse, despair.
A lot of opposition is deeply rooted in the belief that improving health care is the solution and not choosing to die.
“Instead of legalizing physician-assisted suicide, the state should work on improving palliative care for terminally ill people,” said John Kelly, New England regional director for the advocacy group Not Dead Yet.
Supporters believe that patients deserve control over their lives. “It’s something that always has to be driven by the patient. The patient initiates that conversation and that discussion,” said Geoff Sugerman, a national policy advisor for Death With Dignity.
Armijo also underscored the deeply personal nature of these decisions: “It’s about having the autonomy to make personal decisions for yourself at the end of life. You’ve made decisions about everything else in your life, and this shouldn’t be any different.”
TheStatehouseFile.com is publishing this article as part of the Statehouse Reporting Project, a collaborative effort by collegiate journalism programs operating in statehouses across the country.
Emma Schwichtenberg from the University of Washington, Natanya Friedheim from the University of Missouri and Erin Bruce from Franklin College contributed to this story.
