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State-by-State Guide to Physician-Assisted Suicide


[Editor's Note: We do not recommend or refer specific physicians, counselors, organizations, or other experts on end-of-life issues.]


6 States and DC Have Legalized Physician-Assisted Suicide
(see section I below)
assisted suicide check mark legal
 
5 states (CA, CO, OR, VT, and WA) and DC legalized physician-assisted suicide via legislation
 
1 state (MT) has legal physician-assisted suicide via court ruling
 
   
44 States Consider Assisted Suicide Illegal
(see section II below)
assisted suicide x mark illegal
 
37 states have laws prohibiting assisted suicide
 
3 states (AL, MA, and WV) prohibit assisted suicide by common law
 
4 states (NV, NC, UT, and WY) have no specific laws regarding assisted suicide, may not recognize common law, or are otherwise unclear on the legality of assisted suicide.
 
   


0 Federal Laws on Euthanasia and Assisted Suicide
The federal government and all 50 states prohibit euthanasia under general homicide laws. The federal government does not have assisted suicide laws. Those laws are generally handled at the state level.
[Editor’s Note: On Jan. 13, 2014, Second Judicial Judge Nan G. Nash ruled that physicians who help competent terminally ill patients end their lives could not be prosecuted. The ruling applied only to Bernalillo County in New Mexico and was appealed by New Mexico Attorney General Gary King on Mar. 13, 2014. King also requested a stay of Judge Nash’s ruling. On Aug. 11, 2015, the New Mexico Court of Appeals struck down Judge Nash's ruling. The court's ruling makes physician-assisted suicide illegal in Bernalillo County and all of New Mexico.]






I. Six States with Legal Physician-Assisted Suicide
 
State Date Passed How Passed (Yes Vote) Residency Required? Minimum Age # of Months Until Expected Death # of Requests to Physician
1. California Sep. 11, 2015 ABX2-15 End of Life Option Act Yes 18 Six or less Two oral (at least 15 days apart) and one written
2. Colorado Nov. 8, 2016 Proposition 106, End of Life Options Act (65%) Yes 18 Six or less Two oral (at least 15 days apart) and one written
3. DC Oct. 5, 2016 B21-0038 Death with Dignity Act of 2016 (3-2) Yes 18 Six or less Two oral (at least 15 days apart) and one written
4. Montana Dec. 31, 2009 Montana Supreme Court in Baxter v. Montana (5-4) Yes * * *
5. Oregon Nov. 8, 1994
Ballot Measure 16 (51%)
Yes
18
Six or less
Two oral (at least 15 days apart) and one written
6. Vermont May 20, 2013 Act 39 (Bill S.77 "End of Life Choices") Yes 18 Six or less Two oral (at least 15 days apart) and one written
7. Washington Nov. 4, 2008
Initiative 1000 (58%)
Yes
18
Six or less
Two oral (at least 15 days apart) and one written




State and Relevant Physician-Assisted Suicide Law(s) Contact and Program Details
1. California

ABX2-12 End of Life Option Act

Signed into law: Oct. 5, 2015

"(a) Notwithstanding any other law, a person shall not be subject to civil or criminal liability solely because the person was present when the qualified individual self-administers the prescribed aid-in-dying drug. A person who is present may, without civil or criminal liability, assist the qualified individual by preparing the aid-in-dying drug so long as the person does not assist the qualified person in ingesting the aid-in-dying drug.

(b) A health care provider or professional organization or association shall not subject an individual to censure, discipline, suspension, loss of license, loss of privileges, loss of membership, or other penalty for participating in good faith compliance with this part or for refusing to participate in accordance with subdivision (e).

(c) Notwithstanding any other law, a health care provider shall not be subject to civil, criminal, administrative, disciplinary, employment, credentialing, professional discipline, contractual liability, or medical staff action, sanction, or penalty or other liability for participating in this part, including, but not limited to, determining the diagnosis or prognosis of an individual, determining the capacity of an individual for purposes of qualifying for the act, providing information to an individual regarding this part, and providing a referral to a physician who participates in this part. Nothing in this subdivision shall be construed to limit the application of, or provide immunity from."


[Note: California's law took effect on June 9, 2016.]
California Department of Health
Address: PO Box 997377, MS 0500 Sacramento, CA 95899-7377
Phone #: 916-558-1784
Website: California Department of Health


Patient eligibility:
  • 18 years of age or older
  • Resident of California
  • Capable of making and communicating health care decisions for him/herself
  • Diagnosed with a terminal illness that will lead to death within six months
  • Physically and mentally capable of self-administering the aid-in-dying drug

Physician protocol:
  • The attending physician must be licensed in the same state as the patient and have a current United States Drug Enforcement Administration (USDEA) certificate.
  • The physician's diagnosis must include a terminal illness, with six months or less to live.
  • The diagnosis must be certified by a consulting physician, who must also certify that the patient is mentally competent to make and communicate health care decisions.
  • If either physician determines that the patient's judgment is impaired, the patient must be referred for a psychological examination.
  • The attending physician must inform the patient of alternatives, including palliative care, hospice and pain management options.

Patient request timeline:
  • First oral request to physician
  • 15 day waiting period
  • Second oral request to physician
  • Written request to physician

Other:
  • Use of the law cannot affect the status of a patient's health, life, or annuity insurance policies.
  • Physicians and health care systems are not obligated to participate.
  • Translators should be made available for non-English speakers.
  • Pharmacists are also protected from prosecution for filling aid-in-dying prescriptions.
2. Colorado

Proposition 106: End of Life Options Act

Voted on Nov. 8, 2016

"(1) An adult resident of Colorado may make a request, in accordance with sections 25-48-104 and 25-48-112, to receive a prescription medical aid-in-dying medication if:

(a) The individual's attending physician has diagnosed the individual with a terminal illness with a prognosis of six months or less;

(b) The individual's attending physician has determined that the individual has mental capacity; and

(c) The individual has voluntarily expressed the wish to receive a prescription for medical aid-in-dying medication;

(2) The right to request medical aid-in-dying does not exist because of age or disability."


[Note: Colorado's law will take effect in Jan. 2017]
Colorado Department of Public Health & Environment
Address: 4300 Cherry Creek Drive, Denver, CO 80246
Phone #: 303-692-2000
Email: [email protected]
Website: CDPHE website


Patient eligibility:
  • 18 years of age or older
  • Resident of Colorado
  • Capable of making and communicating health care decisions for him/herself and has made the request voluntarily
  • Diagnosed with a terminal illness that will lead to death within six months

Physician protocol:
  • The physician's diagnosis must include a terminal illness with six months or less to live and that the patient is mentally capable of making an informed decision and is making that decision voluntarily.
  • The physician must request that the patient demonstrate Colorado residency.
  • The patient must be referred to a consulting physician to confirm the diagnosis and competency.
  • The physician must discuss with the patient his or her medical diagnosis and prognosis of six months or less to live; feasible alternative or additional treatment; the risks of taking aid-in-dying medication; and the possibility that a patient may fill the aid-in-dying medication prescription but choose not to use it.
  • The physician must refer the patient to a licensed mental health professional.
  • The physician must request that the patient notify his or her next of kin about the prescription request.
  • The patient must be informed that the medication should be taken in a private place with another person present.

Patient request timeline:
  • First oral request to physician
  • 15 day waiting period
  • Second oral request to physician
  • Written request to physician

Other:
  • Use of the law cannot affect the status of a patient's health or life insurance policies.
  • Physicians and health care systems are not obligated to participate.

3. DC

DC ACT 21-577 Death with Dignity Act of 2016

Signed into law: Dec. 19, 2016*

"To provide procedures and requirements regarding the request for and dispensation of covered medications to qualified patients seeking to die in a humane and peaceful manner, to define the duties of attending physicians and consulting physicians, to provide for counseling of patients and family notification, to require informed decisions-making and waiting periods, to require reporting from the Department of Health, to outline the effect of the act on contracts, wills, insurance, and annuity policies, to provide for immunities, liabilities, and exceptions, to provide an opt-out provision for health care providers, to provide for claims against a qualified patient's estate for costs incurred by the District government when a qualified patient ingests a covered medication in public, and to establish criminal penalties."


*[Note: DC laws are subject to Congressional oversight. The Death with Dignity Act of 2016 was submitted to Congress for a 30-day review on Jan. 6, 2017. Representative Brad Wenstrup (R-OH) and Senator James Lankford (R-OK) submitted disapproval resolutions to the House and Senate respectively on Jan. 12, 2017 that would bar the law. However, the resolutions did not come up for a full vote of the House or the Senate within 30 working days, making the law effective as of Feb. 18, 2017.]
DC Department of Health
Address: 899 North Capitol Street, NE, Washington, DC 20002
Phone #: 202-442-5955
Email: [email protected]
Website: DC Department of Health website


Patient eligibility:
  • 18 years of age or older
  • Resident of the District of Columbia
  • Capable of making and communicating health care decisions for him/herself
  • Diagnosed with a terminal illness that will lead to death within six months

Physician protocol:
  • The attending physician must be licensed in DC.
  • The physician's diagnosis must include a terminal illness with six months or less to live.
  • The diagnosis must be certified by a consulting physician, who must also certify that the patient is mentally competent to make and communicate health care decisions.
  • If either physician determines that the patient's judgment is impaired, the patient must be referred for a psychological examination.
  • The attending physician must inform the patient of alternatives, including palliative care, hospice and pain management options.


Patient request timeline:
  • First oral request to physician
  • Written request to physician before second oral request and at least 48 hours before the medication is dispensed
  • Second oral request to physician made at least 15 days after the first oral request

Other:
  • Use of the law cannot affect the status of a patient's health, life, or annuity insurance policies.
4. Montana

Montana First Judicial District Court: Baxter v. Montana

Decided: Dec. 5, 2008 in favor of plaintiffs

The plaintiffs (four Montana physicians, Compassion and Choices, and Robert Baxter, a 76 year old truck driver from Billings dying of lymphocytic leukemia) asked the court to establish a constitutional right "to receive and provide aid in dying."

Judge Dorothy McCarter ruled that a terminally ill, competent patient has a legal right to die with dignity under Article II, Sections 4 and 10 of the Montana Constitution. That includes a right to "use the assistance of his physician to obtain a prescription for a lethal dose of medication that the patient may take on his own if and when he decides to terminate his life." It further held "[t]he patient's right to die with dignity includes protection of that patient's physician from liability under the State's homicide statutes."

State Supreme Court: Baxter v. Montana

Decided: Dec. 31, 2009 in favor of plaintiffs 5-4

The Attorney General of Montana appealed the ruling of Judge McCarter to the Montana Supreme Court. The Court found that "we find no indication in Montana law that physician aid in dying provided to terminally ill, mentally competent adult patients is against public policy" and therefore, the physician who assists is shielded from criminal liability by the patient’s consent.
*No legal protocol in place.

[Editor's Note: Calls to the Montana Department of Public Health and Human Services on July 9 and July 11, 2012 to clarify Montana's physician-assisted suicide protocol were not returned.]

On Feb. 17, 2011, the Montana legislature tabled two proposed physician-assisted suicide bills. According to the Billings Gazette, "one would have banned the practice altogether (LC0041 - Republican Senator Greg Hinkle), while the other (LC0177 - Democratic Senator Dick Barrett) would have required a doctor to diagnose a patient as being terminally ill and the patient to make voluntary oral and written requests for a lethal prescription of medication. The request would have had to be signed by two witnesses and the patient also would have had to get a second doctor's opinion."

Death With Dignity National Center, on its website at deathwithdignity.org, explains that "existing Montana state law provides immunity for physicians for withholding or withdrawing life-sustaining treatment for a terminally-ill patient," but "does not specifically address physician-assisted suicide."
5. Oregon

Ballot Measure 16: Allows Terminally Ill Adults to Obtain Prescription for Lethal Drugs (Death With Dignity Act)

Decided: Nov. 8, 1994 (51% for)

"An adult who is capable, is a resident of Oregon, and has been determined by the attending physician and consulting physician to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to die, may make a written request for medication for the purpose of ending his or her life in a humane and dignified manner.”

Ballot Measure 51: Repeals Law Allowing Terminally Ill Adults To Obtain Lethal Prescription

Decided: Nov. 4, 1997 (60% against)

Supreme Court of the United States: Gonzales v. State of Oregon

Decided: Jan. 17, 2006 (6-3 in favor of the State of Oregon)

According to the court's majority opinion, the Controlled Substances Act does not empower the Attorney General of the United States to prohibit doctors from prescribing regulated drugs for use in physician-assisted suicide under state law permitting the procedure. The court's ruling upheld the Death With Dignity Act.
Oregon Health Authority
Address: 800 Northeast Oregon Street, Portland, OR 97232
Phone #: 971-673-1222
Email: [email protected]
Website: Oregon Health Authority - Death With Dignity Act


Patient eligibility:
  • 18 years of age or older
  • Resident of Oregon
  • Capable of making and communicating health care decisions for him/herself
  • Diagnosed with a terminal illness that will lead to death within six months

Physician protocol:
  • The attending physician must be licensed in the same state as the patient.
  • The physician's diagnosis must include a terminal illness, with six months or less to live.
  • The diagnosis must be certified by a consulting physician, who must also certify that the patient is mentally competent to make and communicate health care decisions.
  • If either physician determines that the patient's judgment is impaired, the patient must be referred for a psychological examination.
  • The attending physician must inform the patient of alternatives, including palliative care, hospice and pain management options.
  • The attending physician must request that the patient notify their next of kin of the prescription request.

Patient request timeline:
  • First oral request to physician
  • 15-day waiting period
  • Second oral request to physician
  • Written request to physician
  • 48-hour waiting period before picking up prescribed medications.
  • Pick up prescribed medications from the pharmacy

Other:
  • Use of the law cannot affect the status of a patient's health or life insurance policies.
  • The Department of Human Services - Health Services enforces compliance with the law. Compliance requires physicians to report all prescriptions to the state. Physicians and patients who comply with the law are protected from criminal prosecution.
  • Physicians and health care systems are not obligated to participate.
6. Vermont

Act No. 39. An Act Relating to Patient Choice and Control at End of Life

Signed into law: May 20, 2013


"A physician shall not be subject to any civil or criminal liability or professional disciplinary action if the physician prescribes to a patient with a terminal condition medication to be self-administered for the purpose of hastening the patient's death and the physician affirms by documenting in the patient's medical record [the required information]."

"A patient with a terminal condition who self-administers a lethal dose of medication shall not be considered to be a person exposed to grave physical harm... and no person shall be subject to civil or criminal liability solely for being present when a patient with a terminal condition self-administers a lethal dose of medication or for not acting to prevent the patient from self-administering a lethal dose of medication."
Vermont Department of Health
Address: 108 Cherry Street, Burlington, VT, 05402
Phone #: 800-464-4343
Website: Vermont Department of Health


Patient eligibility:
  • 18 years of age or older
  • Resident of Vermont
  • Capable of making and communicating health care decisions for him/herself
  • Diagnosed with a terminal illness that will lead to death within six months

Physician protocol:
  • The attending physician must be licensed in the same state as the patient.
  • The physician's diagnosis must include a terminal illness, with six months or less to live.
  • The diagnosis must be certified by a consulting physician, who must also certify that the patient is mentally competent to make and communicate health care decisions.
  • If either physician determines that the patient's judgment is impaired, the patient must be referred for a psychological examination.
  • The attending physician must inform the patient of alternatives, including palliative care, hospice and pain management options.

Patient request timeline:
  • First oral request to physician
  • 15-day waiting period
  • Second oral request to physician
  • Written request to physician
  • 48-hour waiting period before picking up prescribed medications.
  • Pick up prescribed medications from the pharmacy

Other:
  • Use of the law cannot affect the status of a patient's health or life insurance policies.
  • Physicians and health care systems are not obligated to participate.
7. Washington

Ballot Initiative 1000: Death With Dignity Act

Decided: Nov. 4, 2008 (58% for)

"An adult who is competent, is a resident of Washington state, and has been determined by the attending physician and consulting physician to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to die, may make a written request for medication that the patient may self-administer to end his or her life in a humane and dignified manner."

Washington State Department of Health
Address: P.O. Box 47856, Olympia, WA 98504-7856
Phone #: 360-236-4030
Email: [email protected]
Website: Washington State Department of Health - Death With Dignity Act


Patient eligibility:
  • 18 years of age or older
  • Resident of Washington
  • Capable of making and communicating health care decisions for him/herself
  • Diagnosed with a terminal illness that will lead to death within six months

Physician protocol:
  • The attending physician must be licensed in the same state as the patient.
  • The physician's diagnosis must include a terminal illness, with six months or less to live.
  • The diagnosis must be certified by a consulting physician, who must also certify that the patient is mentally competent to make and communicate health care decisions.
  • If either physician determines that the patient's judgment is impaired, the patient must be referred for a psychological examination.
  • The attending physician must inform the patient of alternatives, including palliative care, hospice and pain management options.
  • The attending physician must request that the patient notify their next of kin of the prescription request.

Patient request timeline:
  • First oral request to physician
  • 15-day waiting period
  • Second oral request to physician
  • Written request to physician
  • 48-hour waiting period before picking up prescribed medications.
  • Pick up prescribed medications from the pharmacy

Other:
  • Use of the law cannot affect the status of a patient's health or life insurance policies.
  • The Department of Health enforces compliance with the law. Compliance requires physicians to report all prescriptions to the state. Physicians and patients who comply with the law are protected from criminal prosecution.
  • Physicians and health care systems are not obligated to participate.
II. 44 States and DC Where Assisted Suicide Is Illegal
 
State
(click state for laws)
Criminal Statute Type of Crime or Degree of Punishment
1. Alabama Common law Class A felony
2. Alaska 11.41.120 Manslaughter
3. Arizona 13-1103 Manslaughter
4. Arkansas 5-10-104 Manslaughter
5. Connecticut 952.53a-56 Second degree manslaughter
6. Delaware 632 Manslaughter
7. Florida 782.08 Second degree felony
8. Georgia 16-5-5 One to ten years imprisonment
9. Hawaii 707-702 Manslaughter
10. Idaho 18-4017 Felony
11. Illinois 12-34.5 Class 2 felony, class 4 felony, class 3 felony, or class A misdemeanor.
12. Indiana 35-42-1-2 Class B felony
13. Iowa 707A.2 Class C felony
14. Kansas 21-5407 Person felony
15. Kentucky 216.302 Class C felony or class D felony
16. Louisiana 32.12 Up to ten years imprisonment and/or a fine up to $10,000.
17. Maine 204 Class D crime
18. Maryland 3-102 Felony
19. Massachusetts Common law First or second degree murder
20. Michigan 750.329a Felony
21. Minnesota 609.215 Up to 15 years in prison and/or a fine up to $30,000 if suicide results; up to seven years in prison and/or a fine up to $14,000 if attempted suicide results.
22. Mississippi 97-3-49 Felony
23. Missouri 565.023.1 Voluntary manslaughter, which is a class B felony
24. Nebraska 28-307 Class IV felony
25. Nevada Unclear There is no specific statute for assisted suicide and the act may not be covered by common law.
26. New Hampshire 630:4 Class B felony if suicide or attempted suicide results; misdemeanor if no suicide or attempt results
27. New Jersey 2C:11-6 Second degree crime if suicide or suicide attempt results; fourth degree crime if no suicide or suicide attempt results.
28. New Mexico 30-2-4 Fourth degree felony
29. New York 125.15 Second degree manslaughter
30. North Carolina Unclear There is no specific statute for assisted suicide and the act may not be covered by common law.
31. North Dakota 12.1-16-04 Class C felony or AA felony
32. Ohio 3795 Injunction and professional discipline
33. Oklahoma 21-818 Felony
34. Pennsylvania 2505 Second degree felony if suicide or attempted suicide results; second degree misdemeanor otherwise
35. Rhode Island 11-60 Felony
36. South Carolina 16-3-1090 Felony
37. South Dakota 22-16-37 Class 6 felony
38. Tennessee 39-13-216 Class D felony
39. Texas 22.08 Class C misdemeanor if no suicide or bodily injury results; state jail felony if suicide or attempted suicide with serious bodily injury
40. Utah Unclear Utah does not recognize common law and has no specific statute for assisted suicide.
41. Virginia 8.01-622.1 Liable for damages and possible cease and desist order.
42. West Virginia Common law The penalty is unclear because there is no specific statute making assisted suicide illegal.
43. Wisconsin 940.12 Class H felony
44. Wyoming Unclear Wyoming does not recognize common law and has no specific statute for assisted suicide.




 

[Editor's Note: We do not recommend or refer specific physicians, counselors, organizations, or other experts on end-of-life issues.]


6 States and DC Have Legalized Physician-Assisted Suicide
assisted suicide check mark legal
5 states (CA, CO, OR, VT, and WA) and DC legalized physician-assisted suicide via legislation

1 state (MT) has legal physician-assisted suicide via court ruling
44 States Consider Assisted Suicide Illegal
assisted suicide x mark illegal
37 states have laws prohibiting assisted suicide
3 states (AL, MA, and WV) prohibit assisted suicide by common law
4 states (NV, NC, UT, and WY) have no specific laws regarding assisted suicide, may not recognize common law, or are otherwise unclear on the legality of assisted suicide.
0 Federal Laws on Euthanasia and Assisted Suicide
The federal government and all 50 states prohibit euthanasia under general homicide laws. The federal government does not have assisted suicide laws. Those laws are generally handled at the state level.


[Editor’s Note:On Jan. 13, 2014, Second Judicial Judge Nan G. Nash ruled that physicians who help competent terminally ill patients end their lives could not be prosecuted. The ruling applied only to Bernalillo County in New Mexico and was appealed by New Mexico Attorney General Gary King on Mar. 13, 2014. King also requested a stay of Judge Nash’s ruling. New Mexico statute 30-2-4 outlawing assisted suicide remains in effect. A Nov. 5, 2014 phone call to Death with Dignity confirmed the above information. Phone calls to the New Mexico’s Attorney General’s office for clarification have not been returned.]