Assisted suicide is mostly illegal in the U.S., but momentum for greater legalization appears to be growing. So, however, are concerns.
Euthanasia, the act of deliberately ending a person’s life to relieve suffering, is illegal in every state under general homicide laws. However, assisted suicide, suicides committed with the assistance of a physician, is legal in 10 states with several legislatures currently considering legalization.
By one measure, the timeline for legal assisted suicide in the U.S. began in 1994. That is when Oregon became the first state to allow assisted dying after 51% of the state’s voters passed Ballot Measure 16.
At the time, assisted dying was gaining attention due to the controversy surrounding Dr. Jack Kevorkian, who publicly advocated for patients’ rights to die by physician-assisted suicide. Kevorkian assisted in the deaths of at least 130 patients starting around 1990, and in 1999 he was convicted of second-degree murder and served eight years in prison.
States Begin to Act
However, support continued to grow for laws enabling compassionate death assistance for terminally ill people. In Washington, a group of physicians and three terminally ill patients challenged the state’s ban on assisted suicide. They claimed that assisted suicide was constitutionally protected by the Due Process Clause of the 14th Amendment.
The case made its way to the U.S. Supreme Court in 1997, when justices ruled unanimously against the plaintiffs, concluding that there is no federal constitutional right to physician-assisted suicide.
That settled the matter nationally, but states slowly began to take action. The first to do so, in 2008, was Washington. Voters passed a ballot initiative with 58% approval.
The following year, Vermont became the first state to legalize physician-assisted suicide through legislative action.
The assisted suicide laws go by different names. Four states call it Death With Dignity and two call it Medical Aid in Dying (MAID), but they all contain language about physicians’ or health care professionals’ roles in determining when a patient qualifies for assisted death.
The laws also all say that patients must be experiencing an irreversible condition that would, within reasonable medical judgment, result in death within six months. In addition, they specify that patients must be capable of making voluntary, informed health decisions and self-administer their prescribed doses.
The states that allow assisted deaths are:
CaliforniaColoradoHawaiiMaineMontanaNew JerseyNew MexicoOregonVermontWashington
Washington, D.C., also allows physician-assisted deaths.
Lawmakers in Connecticut, Indiana, New York, and Virginia are currently considering assisted-death bills, and there could be more.
Also, Oregon and Washington are considering expansions of their laws. A measure in Oregon would remove the residency requirement for recipients of assisted suicide. In Washington, a bill would expand the definition of who qualifies as a medical provider.
The ‘Slippery Slope’ Argument
Proponents argue that these laws enable acts of compassion in shortening the suffering that many people experience at the ends of their lives.
Opponents, however, argue that the normalization of physician-assisted suicide may create a slippery slope leading to euthanasia. These days, those opponents point to Canada as an example of where assisted-death laws can go.
In 2016, Canada passed a liberal, nationwide euthanasia law. Since then, troubling revelations have surfaced about doctors and health care workers recommending the procedure to people who may not have been considering it. Other stories came to light about people who sought assisted death because they were destitute and lacked adequate government support to live.
For the first three years, Canada’s law restricted its application to people with terminal illnesses. The law expanded in 2021 to include people with serious and chronic physical conditions even if they are not life-threatening. And now, Canada is considering expanding the reach of its euthanasia law to include people with mental illness, which puts it into a tiny handful of countries like Belgium and the Netherlands that allow medically assisted dying for people without terminal illnesses.
Many supporters of physician-assisted death in the U.S. agree that Canada has probably gone a bridge too far. It’s likely, however, that more states will pass laws to provide dignified deaths to dying people as long as necessary requirements and safeguards are in place, as they are in 10 states.
It’s safe to say, though, that full-blown euthanasia laws won’t be appearing any time soon.
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