'Death With Dignity' Laws by State

Whether through extreme old age or terminal illness, the final stages of a person’s life can be difficult for the patient and their families. Watching a loved one suffer through a fatal illness is excruciating for all involved. If there is nothing medically to be done, patients may wish to end their lives on their own terms.

Can individuals make a conscious choice to end their own lives? It depends on their state’s laws. Federal law does not recognize a right to physician-assisted suicide, protect the act of mercy killing or euthanasia, or prohibit the practice altogether. The right to physician-assisted dying, referred to as “death with dignity,” is considered a public health matter and left to state law.

This article provides an overview of dignity laws that allow terminally ill patients to choose when and how they die.

Aid-in-Dying Terminology

The terminology used with medical aid-in-dying laws may vary slightly from state to state, but the intent remains the same. In all states and federal law, “euthanasia” means a doctor or third party directly administering a lethal dose of medication. Euthanasia is illegal, and the doctor can be charged with murder or manslaughter, even if the patient consented.

All states allow patients to refuse life-preserving treatment. This is common in nursing homes and hospice care, where patients have entered end-of-life care and wish to refuse heroic treatment to prolong their lives. “Do not resuscitate” and “do not intubate” orders help ensure that patients pass away in a dignified manner.

Medical aid in dying, also known as “physician-assisted death” or “physician-assisted suicide,” is legal in 12 states and the District of Columbia as of May 2026. This is subject to change, as other states are considering expanding their existing laws. In states with aid-in-dying laws, doctors prescribe qualified patients a lethal dose of medication. Patients self-administer the dose.

“Mercy killing” is illegal in all 50 states. Taking another person’s life, no matter what your intention, is considered murder and is prosecuted as such.

State Death With Dignity Laws: An Overview

In 1990, the U.S. Supreme Court ruled that patients or their designated healthcare agents may refuse life-preserving medical treatment. The vast majority of states do not allow patients to end their lives, either on their own or through the aid of a doctor.

A healthcare agent is named by a patient to make healthcare decisions on their behalf, usually through a durable power of attorney. Healthcare agents are required to follow patients’ wishes as listed in a living will or “do not resuscitate” form.

While all states allow patients to refuse treatment, only a few allow doctors to assist in a patient’s passing. Physicians are the only healthcare professionals authorized to prescribe lethal drugs in most states.

General Requirements

All states with medically assisted dying laws have the same general requirements. The most important of these is residency. Patients must live in the state where they plan to end their lives. They cannot travel to a state solely to access medical aid in dying. Most states may not want terminally ill patients coming to their hospitals and healthcare facilities just to end their lives. Oregon and Vermont, which have removed their residency requirements, are exceptions.

Other requirements for end-of-life assistance include:

• Terminal diagnosis: Patients must have a terminal illness prognosis of six months or less to live. The condition should be such that no further treatment is expected to help or improve the patient’s quality of life.
• Second opinion: A single physician’s diagnosis is not sufficient for end-of-life assistance. The patient should have at least one other medical opinion confirming both the diagnosis and prognosis of the disease.
• Mental capacity: The patient must fully understand what they’re requesting. They must make and communicate their healthcare decisions.
• By their own choice: The request must be voluntary and free of undue influence, duress, or coercion. Doctors may ask to speak to the individual in private if there are concerns.
• Taking the dose: The patient must be able to self-administer the medication. In some cases, the medication is orally administered.
• Verification: Some states allow written requests. If so, signatures from independent witnesses are often required.

Most states require at least two requests, usually separated by a waiting period that ranges from 48 hours to several days. States have provisions for emergency cases where a patient is not expected to survive the entire waiting period.

Physician Protections: What if the Doctor Refuses?

Doctors, other healthcare providers, and medical facilities can refuse to participate in a patient’s medical end-of-life plans. The jurisdictions with medically-assisted suicide laws protect both a patient’s right to end their life and a physician’s Hippocratic Oath to do no harm. If your doctor will not give you the assistance you request, what should you do next?

• In most states, such as California, your doctor must record your request in your medical records, and transfer all records to your next attending physician when you find one
• Most states must refer you to a physician who will assist you, or to an agency such as Compassion & Choices that can help you find another doctor
• Your doctor should still be willing to give you palliative care while you seek assistance with your end-of-life plans

If either you or someone in your family is considering an end-of-life procedure, it’s a good idea to consider speaking with a healthcare attorney specializing in the field. Their expertise can help navigate the process, providing peace and release.

Individual State Death With Dignity Laws

The following is a breakdown of the states that allow assisted suicide or “death with dignity,” either through statutes or established case law:

California (End of Life Option Act)

Gov. Jerry Brown signed the End of Life Option Act, modeled after similar laws in Oregon, Washington, and Vermont, into law in 2015. Physicians can prescribe lethal drugs to certain terminally ill patients. Patients expected to die within six months who have a medically confirmed diagnosis, request assistance three times, and give their consent may obtain a prescription for lethal drugs.

• Legalized through: Legislature
• Number of months until expected death: Six (6)
• Minimum age: 18
• Number of doctor requests: Two (2) oral (at least 48 hours apart)

Colorado (End-of-Life Options Act)

Colorado voters passed Initiative 106, “Access to Medical Aid in Dying,” by a wide margin in 2016. Passage of the ballot initiative amended state law to include the Colorado End-of-Life Options Act. The law specifically states that termination of one’s life under the law technically is not suicide, since the patient is already facing certain death. Several safeguards are in place to ensure that the patient is mentally capable of making such an important decision, including the opportunity to withdraw the request at the last minute.

• Legalized through: Voter approval
• Number of months until expected death: Six (6)
• Minimum age: 18
• Number of doctor requests: Two (2) oral (at least 15 days apart); One (1) written

Delaware (Death with Dignity Act)

In May 2025, Delaware’s Death with Dignity Act (formerly the Ron Silverio/Heather Block End of Life Options Act) was signed into law. It took effect on January 1, 2026, allowing mentally competent, terminally ill adult residents to request, obtain, and administer lethal medications to end their lives. The resident must have a terminal diagnosis with six months or less to live.

• Legalized through: Legislature
• Number of months until expected death: Six (6)
• Minimum age: 18
• Number of doctor requests: Two (2) oral (at least 15 days apart); One (1) written request signed with two (2) witnesses

District of Columbia (D. C. Death with Dignity Act)

Lawmakers in the District of Columbia passed the D. C. Death with Dignity Act in 2016. It became law on February 18, 2017, and was applicable as of June 6, 2017. Under this law, terminally ill persons who want to end their lives voluntarily can request lethal doses of medication from a D.C. licensed physician. Only District of Columbia residents with less than six months to live can use this law.

The terminally ill person must make two separate oral requests and one in writing, separated by a 15-day waiting period, before an attending physician can prescribe lethal drugs. The patient submits the written request before their second oral request and at least 48 hours before a pharmacist can dispense it. Two witnesses must, in the patient’s presence, attest that the patient is “capable, acting voluntarily, and not unduly influenced to sign the request.”

The D.C. Department of Health maintains a portal where attending physicians, pharmacists, or patients can learn more.

• Legalized through: Legislature
• Number of months until expected death: Six (6)
• Minimum age: 18
• Number of doctor requests: Two (2) oral (at least 15 days apart); One (1) written

Hawaii (Our Care, Our Choice Act)

The Hawaii legislature passed the Our Care, Our Choice Act with overwhelming support. Governor David Ige signed it into law in 2018 (taking effect on January 1, 2019). As with similar laws in other states, the requesting patient must be mentally capable of making and communicating healthcare decisions. The prescribing physician must inform the patient of alternatives (e.g., pain management), notify the next of kin of the request, and offer the patient a final opportunity to change their mind. The waiting period can be reduced for patients not expected to survive that long.

• Legalized through: Legislature
• Number of months until expected death: Six (6)
• Minimum age: 18
• Number of doctor requests: Two (2) oral (at least 5 days apart); One (1) written

Maine (Maine Death With Dignity Act)

Maine lawmakers approved the Maine Death With Dignity Act in 2019. Approved on June 12, 2019, it became effective on September 19, 2019. Under the Maine Death with Dignity Act, terminally ill Maine residents can ask for a dose of life-ending medication to hasten their death. The patient must have an incurable and irreversible illness and less than six months to live with reasonable medical certainty.

Like many other states with similar laws, the terminally ill patient must make two separate oral requests and one in writing, separated by a waiting period, before doctors can prescribe lethal drugs. Forty-eight hours must pass after the written request before the physician can write a prescription. A consulting physician must confirm that the patient meets the requirements. The patient must provide informed consent and sign the written request, which must be attested by two witnesses.

• Legalized through: Legislature
• Number of months until expected death: Six (6)
• Minimum age: 18
• Number of doctor requests: Two (2) oral (separated by a waiting period); One (1) written

Montana (Montana Rights of the Terminally Ill Act)

The Montana Supreme Court issued a ruling in late 2009 that broadened the state’s Rights of the Terminally Ill Act to include physician-assisted suicide. Like other states, Montana allows terminally ill patients to end their lives with assistance from their doctor.

Patients must be:

• 18 years of age or older
• Have a terminal diagnosis with less than six (6) months to live
• Be mentally capable of making an informed decision about their choice
• Capable of self-ingesting the prescribed medication

The patient must make two separate requests at least 15 days apart. Family or friends cannot make the requests. Medication must be swallowed, although it can be administered through a feeding tube.

Doctors are not required to assist patients with their end-of-life plans. If a patient requests such assistance, the request must be included in the patient’s medical records.

New Jersey (New Jersey Medical Aid in Dying for the Terminally Ill Act)

New Jersey lawmakers approved the Medical Aid in Dying for the Terminally Ill Act on April 12, 2019. It became effective on August 1, 2019. This law allows an attending physician to prescribe lethal medications for terminally ill patients who want to end their lives.

Under this law, the patient must be at the terminal stage of an irreversibly fatal illness, disease, or prognosis with less than six months to live. The prognosis is based on reasonable medical certainty.

The terminally ill person must make two separate oral requests and one in writing, separated by a 15-day waiting period, before doctors can prescribe lethal drugs. The patient must submit the written request before their second oral request and at least 48 hours before the medication is dispensed.

When the patient makes the second verbal request, the physician must offer the patient an opportunity to change their mind. A consulting physician must confirm the prognosis and the patient’s statement.

The patient must sign the written request. Two witnesses must sign the request and attest that the patient acted voluntarily.

• Legalized through: Legislature
• Number of months until expected death: Six (6)
• Minimum age: 18
• Number of doctor requests: Two (2) oral (at least 15 days apart); One (1) written

New Mexico (Elizabeth Whitefield End-of-Life Options Act)

New Mexico lawmakers approved the Elizabeth Whitefield End-of-Life Options Act on April 8, 2021. It became effective on June 18, 2021. Terminally ill New Mexico residents over 18 years of age, with the mental capacity to make health care decisions and six months or less to live, are eligible for aid-in-dying.

A consulting physician must confirm the prognosis, and a mental health provider must ensure the patient’s mental capacity to make this decision. Special rules apply to patients receiving end-of-life palliative care. Terminally ill patients in hospice do not need a second opinion.

Unlike other states with death with dignity laws, terminally ill New Mexico patients can get assistance with one request. There is a 48-hour waiting period before dispensing medication. Nurse practitioners and physician assistants can prescribe these medications, or the terminally ill patient can self-administer the dose.

• Legalized through: Legislature
• Number of months until expected death: Six (6)
• Minimum age: 18
• Number of doctor requests: One (1), with a 48-hour waiting period

Oregon (Death with Dignity Act)

Oregon voters passed the Death with Dignity Act in 1994 with 51% of the vote, which allows terminally ill patients to obtain a prescription for lethal drugs. A ballot measure to repeal the law failed, with 60% of voters opposing it. The U.S. Supreme Court upheld this law in 2006.

Under the Oregon Death with Dignity Act, eligible patients must wait 15 days after making an oral request to a doctor before submitting another oral and written request, followed by a 48-hour waiting period before medications are made available. The 15-day waiting period does not apply to patients who are imminently dying.

• Legalized through: Ballot initiative
• Number of months until expected death: Six (6)
• Minimum age: 18
• Number of doctor requests: Two (2) oral (at least 15 days apart); One (1) written

Vermont (Patient Choice and Control at End-of-Life Act)

Vermont lawmakers passed the Patient Choice and Control at End-of-Life Act in 2013. The law protects doctors who follow the steps outlined in the Act from liability. Doctors are then able to prescribe lethal drugs to terminally ill patients.

The state also requires patients of sound mind to make two separate oral requests and one in writing, separated by a 15-day waiting period, before doctors can prescribe lethal drugs. The initial diagnosis must be certified by a consulting physician.

• Legalized through: Legislature
• Number of months until expected death: Six (6)
• Minimum age: 18
• Number of doctor requests: Two (2) oral (at least 15 days apart); One (1) written

Washington (Death with Dignity Act)

58% of voters approved the Washington Death with Dignity Act in 2008. The law permits eligible patients with a terminal illness to request lethal drugs to end their lives. Individual hospitals may prohibit participation in euthanasia, but must clearly state their policy.

Washington law is very similar to assisted suicide laws in Oregon and Vermont. The statute requires a series of requests and waiting periods, and requires the patient to be of sound mind and capable of clear communication.

• Legalized through: Ballot initiative
• Number of months until expected death: Six (6)
• Minimum age: 18
• Number of doctor requests: two (2) oral (at least 15 days apart); One (1) written

States Considering Death With Dignity Laws

A few more states have been considering amending their healthcare laws to include physician-assisted suicide laws. These laws move slowly through the legislature, so patients and families should stay in touch with their state lawmakers if they want to advocate for end-of-life legislation.

• Arizona: HB2569 failed to pass the state senate and stalled, but may be revived next year
• Georgia: SB610 did not pass out of committee before the spring session ended
• Indiana: End of Life Options Act (1011) did not pass out of the House Committee on Public Health before the session ended
• Iowa: HF2262 was scheduled for a hearing in February, but was canceled 24 hours before the legislators were to meet
• Kentucky: Rena’s Law (HB408), a pro-DWD bill, and HB646, a bill that makes it more difficult for doctors to prescribe painkilling medication, are both waiting for public hearings
• Massachusetts: H2505 and S1486 have both been referred to the state senate and are being considered by the state legislative committees on finance
• Minnesota: The End of Life Option Act (HF2998/SF3215) is under consideration by the Senate Health and Human Services Committee
• Missouri: The Marilyn Teitelbaum Death with Dignity Act (HB2188) and the Death with Dignity Act (H3497) have received two readings in the state house and are awaiting committee assignments
• North Carolina: H410 directs the North Carolina Institute of Medicine to begin a study on medical aid in dying and has been referred to the appropriate committee
• Pennsylvania: The Compassionate Aid in Dying Act (HB1109/SB570) bill is in the House and Senate Judiciary Committees
• Rhode Island: The Lila Manfield Sapinsley Compassionate Care Act (S2051/H7760) is waiting for a public hearing
• Tennessee: SB640 is before the state Senate Judiciary Committee
• Virginia: HB886, a medical aid-in-dying bill, has been tabled until 2027
• Wisconsin: The Our Care, Our Options Act (AB1164/SB1114) stalled in committee

Legislative law moves slowly. Until a bill is declared dead, it can continue moving forward. Interested advocates should continue to watch for updates.

When Do You Need an Attorney?

Contemplating the end of your life, or the end of a family member’s life, is never easy for anyone. When the discussion involves intentionally ending the patient’s life, the discussion may become emotional.

Only a patient can know for sure when or if it is time for them to consider assisted suicide. There are other end-of-life matters that patients and families need to discuss among themselves and with their attorneys before that. Some things that you should consider if you or a family member is old or has a serious chronic illness include your end-of-life care, your power of attorney, and other paperwork.

Healthcare Attorneys

Contact an attorney specializing in healthcare and long-term care for:

• Discussions about end-of-life wishes, and what it means for you and your family
• Concerns over whether a loved one has the ability to make the decision, and what to do if they do not
• Transferring care, residency requirements, and concerns over the facility
• Help when a doctor refuses to provide assistance

Estate Planning Attorneys

An estate planning attorney can assist you with the documentation needed to prepare for any legal concerns after you or your loved one passes. Estate planning attorneys can give you advice and help prepare:

• Advance healthcare directives or living wills
• Durable powers of attorney for healthcare and finance
• Do Not Resuscitate (DNR) and other refusal of care orders
• Physician Orders for Life-Sustaining Treatment (POLST) forms

You may also want an estate planning attorney to help you prepare your will and appoint an executor. These things can give you peace of mind, no matter what your final decision is regarding your end-of-life plans.

Learn More About Right To Die Laws: Contact a Local Attorney

Death with dignity is an emerging area of the law, and only a handful of states permit physician-assisted suicide. Those who live in one of these states and choose this option must follow specific procedures. If you have additional legal questions about this issue, including euthanasia and advanced directives, contact a healthcare attorney in your state.