State-by-State Guide to Physician-Assisted Suicide - Euthanasia

Last updated on: 7/9/2018 7:37:12 AM PST

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.]

States and DC Have Legalized Physician-Assisted Suicide
(see section I below)

6	states (CA, CO, HI, OR, VT, and WA) and DC legalized physician-assisted suicide via legislation

1	state (MT) has legal physician-assisted suicide via court ruling

States Consider Assisted Suicide Illegal
(see section II below)

36	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. Seven States and DC 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. Hawaii	Apr. 5, 2018	HB 2739, Hawai'i Our Care, Our Choice Act	Yes	18	Six or less	Two oral (at least 20 days apart) and one written
5. Montana	Dec. 31, 2009	Montana Supreme Court in Baxter v. Montana (5-4)	Yes	*	*	*
6. Oregon	Nov. 8, 1994	Ballot Measure 16 (51%)	Yes	18	Six or less	Two oral (at least 15 days apart) and one written
7. 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
8. 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 themselves 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 took 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 themselves 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 themselves 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. Hawaii HB 2739, Hawai'i Our Care, Our Choice Act Signed into law: Apr. 5, 2018* "The legislature concludes that adult, terminally ill residents of the State can determine their own medical treatment as they near the end of life and should have a full complement of support services available, including palliative care, hospice care, aggressive medical care, and the right to choose to avoid an unnecessarily prolonged life of pain and suffering. The choice elected by an individual must be fully informed, including about options for care that are presented and discussed with health care providers in a values-neutral manner. The purpose of this Act is to allow qualified patients in this State with a medically confirmed terminal illness with less than six months to live and possessing decisional capacity to determine their own medical care at the end of their lives." *[Note: Hawaii's law will take effect on Jan. 1, 2019.]	Hawaii Department of Health Address: 1250 Punchbowl St, Honolulu, HI 96813 Phone #: 808-586-4400 Email: [email protected] Website: Hawaii Department of Health website Patient eligibility: 18 years of age or older Resident of the Hawaii Capable of making and communicating health care decisions for themselves 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. 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. A counselor must confirm that the patient is capable, is not suffering from undertreatment or non treatment of depression or other conditions that would impair the ability to make informed decisions. 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 20-day waiting period Second oral request to physician Written request witnessed by two people, of whom one may not be a relative, a healthcare professional, or anyone who could gain from the estate of the patient 48-hour waiting period between written request and the writing of the prescription Other: The patient retains the right to rescind her/his request at any time and is under no obligation to fill the prescription. 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.
5. 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."
6. 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 themselves 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.
7. 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 themselves 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.
8. 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 themselves 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. Idaho	18-4017	Felony
10. Illinois	12-34.5	Class 2 felony, class 4 felony, class 3 felony, or class A misdemeanor.
11. Indiana	35-42-1-2	Class B felony
12. Iowa	707A.2	Class C felony
13. Kansas	21-5407	Person felony
14. Kentucky	216.302	Class C felony or class D felony
15. Louisiana	32.12	Up to ten years imprisonment and/or a fine up to $10,000.
16. Maine	204	Class D crime
17. Maryland	3-102	Felony
18. Massachusetts	Common law	First or second degree murder
19. Michigan	750.329a	Felony
20. 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.
21. Mississippi	97-3-49	Felony
22. Missouri	565.023.1	Voluntary manslaughter, which is a class B felony
23. Nebraska	28-307	Class IV felony
24. Nevada	Unclear	There is no specific statute for assisted suicide and the act may not be covered by common law.
25.New Hampshire	630:4	Class B felony if suicide or attempted suicide results; misdemeanor if no suicide or attempt results
26. New Jersey	2C:11-6	Second degree crime if suicide or suicide attempt results; fourth degree crime if no suicide or suicide attempt results.
27. New Mexico	30-2-4	Fourth degree felony
28. New York	125.15	Second degree manslaughter
29. North Carolina	Unclear	There is no specific statute for assisted suicide and the act may not be covered by common law.
30. North Dakota	12.1-16-04	Class C felony or AA felony
31. Ohio	3795	Injunction and professional discipline
32. Oklahoma	21-818	Felony
33.Pennsylvania	2505	Second degree felony if suicide or attempted suicide results; second degree misdemeanor otherwise
34. Rhode Island	11-60	Felony
35. South Carolina	16-3-1090	Felony
36. South Dakota	22-16-37	Class 6 felony
37. Tennessee	39-13-216	Class D felony
38. 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
39. Utah	Unclear	Utah does not recognize common law and has no specific statute for assisted suicide.
40. Virginia	8.01-622.1	Liable for damages and possible cease and desist order.
41. West Virginia	Common law	The penalty is unclear because there is no specific statute making assisted suicide illegal.
42. Wisconsin	940.12	Class H felony
43. Wyoming	Unclear	Wyoming does not recognize common law and has no specific statute for assisted suicide.

Should Euthanasia or Physician-Assisted Suicide Be Legal?

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

[Editor's Note: On May 24, 2018, California's End of Life Options Act was invalidated by court decision, making PAS not legal in the state. A June 15 court decision stayed the May decision, making PAS legal again. However, the judge gave opponents until July 2 to file objections, keeping the PAS law in the courts. While the law is debated in the courts, we have left the details of California's law below.]

States and DC Have Legalized Physician-Assisted Suicide

6	states (CA, CO, HI, OR, VT, and WA) and DC legalized physician-assisted suicide via legislation

1	state (MT) has legal physician-assisted suicide via court ruling

States Consider Assisted Suicide Illegal

36	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.]

Should Euthanasia or Physician-Assisted Suicide Be Legal?

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Should Euthanasia or Physician-Assisted Suicide Be Legal?

Should Euthanasia or Physician-Assisted Suicide Be Legal?