Physician-assisted suicide is a medical practice where a qualified healthcare professional aids a terminally ill patient who wishes for their life to end.  Physician-assisted suicide is considered when a patient is suffering from a terminal illness, experiencing unbearable pain, and has a limited life expectancy.  Eligibility criteria for physician-assisted suicide typically include being diagnosed with a terminal illness with a prognosis of six months or less to live, being mentally competent to make medical decisions, and voluntarily requesting assistance in dying.

The assistance can come in the form of prescribing lethal medication or providing information on how to obtain and use such medication.  While the exact drugs and dosages may vary, one of the most common drug combinations includes a mixture of a barbiturate and a muscle relaxant.  The barbiturate acts as a sedative that induces unconsciousness, and the muscle relaxant causes paralysis and stops breathing.

Physician-assisted suicide is a widely debated topic.  Advocates argue that physician-assisted suicide provides individuals with autonomy and the ability to end their suffering with dignity.  Those who condemn physician-assisted suicide argue that it raises ethical implications, the potential for abuse, and threatens the value of life. 

Physician-assisted suicide is legalized in several countries and jurisdictions.  The Netherlands was one of the first countries to legalize euthanasia and allows physician-assisted suicide only under strict conditions, including the patient’s voluntary request, unbearable suffering without hope of improvement, and consultation with at least one other independent physician.  Other countries such as Belgium, Luxembourg, Canada, Switzerland, and Germany also allow physician-assisted suicide under strict conditions. 

As of 2024, physician-assisted suicide is legal in nine U.S. states and the District of Columbia.  Each state has its own set of laws and regulations that govern the practice.  Oregon was the first state to legalize physician-assisted suicide when the state passed the Death with Dignity Act in 1994. The law allows terminally ill patients with a prognosis of six months or less to request and receive a prescription for medication to end their lives.  Washington legalized physician-assisted suicide through a voter-approved initiative in 2008. The Washington Death with Dignity Act is similar to Oregon’s law and allows terminally ill patients to request medication to end their lives.

Vermont became the first state to legalize physician-assisted suicide through legislation rather than a voter initiative. The Patient Choice and Control at End of Life Act, passed in 2013, allows terminally ill patients to request medication to end their lives.  California legalized physician-assisted suicide with the End of Life Option Act, which took effect in 2016. Like Oregon and Washington, the law allows terminally ill patients to request medication to end their lives.  Colorado voters approved Proposition 106, the Colorado End-of-Life Options Act, in 2016. This law allows terminally ill patients with a prognosis of six months or less to request medication to end their lives.

Hawaii passed the Our Care, Our Choice Act in 2018, legalizing physician-assisted suicide for terminally ill patients with a prognosis of six months or less. The law took effect in 2019. New Jersey passed the Medical Aid in Dying for the Terminally Ill Act in 2019, allowing terminally ill patients with a prognosis of six months or less to request medication to end their lives.  Maine voters approved the Death with Dignity Act in 2019, legalizing physician-assisted suicide for terminally ill patients with a prognosis of six months or less. New Mexico’s Elizabeth Whitefield End-of-Life Options Act was effective in 2021. Additionally, Washington D.C. has also legalized physician-assisted suicide with the passage of the D.C. Death with Dignity Act in 2016.  Efforts to legalize physician-assisted suicide continue in several states across the country; however, progress is often slow and faces opposition from religious groups and medical associations.

While legal challenges to physician-assisted suicide have occurred, Courts in states where it is legal have upheld the right to physician-assisted suicide under certain circumstances.  Additionally, in Montana, there is currently no death with dignity statute; however, the end-of-life option is legal through a state supreme court ruling. Public opinion on physician-assisted suicide varies, however, polls show a majority of Americans support the right to die when an individual is facing a terminal illness and experiencing severe suffering.

For more information on state statutes and requirements, check out https://worldpopulationreview.com/state-rankings/assisted-suicide-states

If you would like to read more about physician-assisted suicide, ask a Library Research Fellow, a law librarian, or here are books in the Sol Blatt, Jr. Law Library Collection:

• Physician-assisted dying : the case for palliative care and patient choice / edited by Timothy E. Quill and Margaret P. Battin. General collection R726 .P59 2004.
• Physician-assisted dying : the case for palliative care and patient choice / edited by Timothy E. Quill and Margaret P. Battin. General collection R726 .P59 2004.

Allyson Carswell

Sol Blatt, Jr. Law Library Research Fellow
Student Ambassador
Associate Justice of External Competitions, Moot Court Executive Board
Juris Doctor Candidate, May 2024 Charleston School of Law