Is Assisted Suicide Legal In The United States? State Laws & Recent Court Rulings

Assisted suicide, legally termed “medical aid in dying” (MAID), is legal in twelve US jurisdictions as of 2025: California, Colorado, Delaware, the District of Columbia, Hawaii, Montana, Maine, New Jersey, New Mexico, Oregon, Vermont, and Washington. However, 40 states affirmatively prohibit assisted suicide and impose criminal penalties on anyone who helps another person end their life. Delaware’s landmark End of Life Options Law, signed in May 2025 and effective January 1, 2026, makes it the newest jurisdiction to legalize medical aid in dying and expands the role of advanced practice registered nurses in prescribing life-ending medication.

This isn’t a settled issue. Nearly 20 states considered MAID legislation in 2025, with many bills making significant progress through legislative chambers. Illinois could become the first Midwest state to legalize physician-assisted death if its End-of-Life Options Act passes the Senate this fall. The landscape is shifting rapidly, driven by ballot initiatives, court challenges, and changing public sentiment—71% of Americans now support medical aid in dying—creating urgent questions for terminally ill patients, healthcare providers, and families navigating end-of-life decisions.

Is Assisted Suicide Legal in the United States?

The US Supreme Court ruled in Washington v. Glucksberg (1997) that assisted suicide is not a constitutionally protected right under the Due Process Clause. However, the Court affirmed that individual states hold the authority to regulate the practice, creating a patchwork of state-level laws across the country.

Medical aid in dying differs from euthanasia because terminally ill patients self-administer prescribed medication, while euthanasia involves a healthcare provider directly administering the fatal dose. Active euthanasia remains illegal in all 50 states.

Montana is the only state where medical aid in dying is legal through court ruling rather than legislation. The Montana Supreme Court ruled in Baxter v. Montana (2009) that it found no state law or public policy reason prohibiting physician-assisted dying.

More than one-fifth of the US population now lives in jurisdictions where medical aid in dying is authorized.

Is Assisted Suicide Legal in the United States? 2025 State Laws & Recent Court Rulings

Which States Allow Assisted Suicide or Medical Aid in Dying?

States Where MAID is Currently Legal

As of 2025, medical aid in dying is legal in the following 12 US jurisdictions:

California (2016) – End of Life Option Act
Colorado (2016) – Colorado End of Life Options Act
Delaware (2025, effective Jan. 1, 2026) – Ron Silverio/Heather Block End of Life Options Law
District of Columbia (2017) – Death with Dignity Act
Hawaii (2019) – Our Care, Our Choice Act
Maine (2019) – Maine Death with Dignity Act
Montana (2009) – Legal through Baxter v. Montana court ruling
New Jersey (2019) – Medical Aid in Dying for the Terminally Ill Act
New Mexico (2021) – Elizabeth Whitefield End-of-Life Options Act
Oregon (1997) – Death with Dignity Act (first state to legalize)
Vermont (2013) – Patient Choice and Control at End of Life Act
Washington (2008) – Washington Death with Dignity Act

Oregon became the first state to legalize physician-assisted dying in 1997, following a 1994 ballot initiative that survived multiple legal challenges.

States Considering MAID Legislation in 2025

More than 15 states are actively considering medical aid in dying legislation in 2025, including Arizona, Connecticut, Florida, Illinois, Indiana, Kentucky, Maryland, Massachusetts, Minnesota, Missouri, Nevada, New Hampshire, North Carolina, Pennsylvania, Rhode Island, and Tennessee.

Illinois’s End-of-Life Options Act (SB 1950), passed by the House 63-42 in May 2025, awaits a Senate vote during the fall veto session. If passed, Illinois would become the first Midwest state to legalize assisted suicide.

Maryland legislators reintroduced The Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass End-of-Life Option Act in February 2025, reviving efforts after previous failures.

New Hampshire’s End of Life Freedom Act (HB254), introduced in January 2025, would allow adults with six months or less to live to access aid-in-dying drugs.

What Are the Legal Requirements for Medical Aid in Dying?

Eligibility Criteria in Permitting States

To qualify for medical aid in dying, patients typically must be terminally ill and expected to die within six months, be over 18, and be capable of making and communicating healthcare decisions.

In all states with death with dignity laws, patients must be at least 18 years of age, a resident of the state, and have six months or fewer until their expected death.

Procedural Safeguards Required by Law

Delaware’s new law requires two verbal requests at least 15 days apart, one written request witnessed by two qualified adults, confirmation from both an attending physician or advanced practice registered nurse and a consulting provider, and a 48-hour waiting period after the written request.

Maine’s law requires two oral requests with a 20-day waiting period between them, plus a signed written request witnessed by two people, one of whom cannot be a relative.

Two physicians must confirm the patient’s residency, diagnosis, prognosis, mental competence, and voluntariness of the request in all permitting states.

Expanded Provider Authorization

Delaware’s 2025 law marked a significant milestone by expanding advanced practice registered nurse (APRN) roles, allowing them to prescribe life-ending medication alongside physicians. Colorado and Delaware now legally authorize nurse practitioners to prescribe medical aid in dying medication.

Under Delaware’s law, both attending and consulting roles can be filled by either licensed physicians or APRNs.

Recent Court Rulings and Legal Developments

The Glucksberg Precedent Still Governs

In Washington v. Glucksberg (1997), the Supreme Court unanimously held that a right to assisted suicide was not protected by the Due Process Clause of the Fourteenth Amendment.

Chief Justice William Rehnquist wrote that assisted suicide had been “frowned upon for centuries” and that the Court found English common law penalties associated with assisted suicide particularly significant in determining what rights were “deeply rooted in the nation’s history.”

The Court held that Washington’s assisted-suicide ban was rationally related to legitimate government interests, including prohibiting intentional killing, preserving human life, preventing suicide, protecting the medical profession’s integrity, and protecting vulnerable groups from pressure to end their lives.

The Court also ruled in Vacco v. Quill that assisted suicide differs from withdrawing life-sustaining treatment, noting that patients have well-established traditional rights to bodily integrity and freedom from unwanted physical contact.

State-Level Judicial Actions

Montana’s Supreme Court ruled in Baxter v. Montana (2009) that it found no state law or public policy reason prohibiting physician-assisted dying, making Montana the only state where MAID is legal through court decision rather than legislation.

In March 2022, a settlement in an Oregon lawsuit stipulated that the state would not enforce Oregon’s physician-assisted suicide residency requirement.

Delaware’s 2025 Legislative Victory

Governor Matt Meyer signed Delaware’s Ron Silverio/Heather Block End of Life Options Act into law on May 20, 2025, making Delaware the 12th US jurisdiction to legalize Death with Dignity.

The 2025 bill passed after similar legislation was vetoed by former Governor John Carney in 2024, who cited moral opposition. The Senate vote was 11-8 with two absences, matching the narrow margins from the previous year.

What Are the Criminal Penalties for Assisted Suicide?

Federal Law

President Clinton signed the Federal Assisted Suicide Funding Restriction Act of 1997, which prohibits the use of federal funds in support of physician-assisted suicide.

The Patient Access to End of Life Care Act, introduced in Congress, seeks to provide an exception to the restrictions in the Assisted Suicide Funding Restriction Act for certain states where MAID is legal.

State Criminal Laws

Currently, 40 states affirmatively prohibit assisted suicide and impose criminal penalties on anyone who helps another person end their life.

Washington state’s law makes “promoting a suicide attempt” a felony, providing that “a person is guilty of that crime when he knowingly causes or aids another person to attempt suicide.”

In England and Wales, assisting suicide carries a penalty of up to 14 years in prison under the Suicide Act 1961.

Protections in Legal States

In states where medical aid in dying is legal, actions taken in accordance with the law do not constitute suicide, assisted suicide, mercy killing, or homicide.

Criminal penalties apply to anyone attempting to coerce people into obtaining life-ending medication or tampering with a patient’s request.

People acting in good faith and in accordance with generally accepted healthcare standards have immunity from criminal and civil liability, but those acting with negligence, recklessness, or intentional misconduct do not.

What Does Federal Law Say About Assisted Suicide?

Supreme Court’s State Authority Ruling

The 1997 Supreme Court decisions in Washington v. Glucksberg and Vacco v. Quill affirmed that individual states hold the authority to regulate the practice of medical aid in dying, paving the way for today’s varied state-level approaches.

These decisions suggest that while the right of privacy guaranteed by the US Constitution does not include a right to assisted suicide, states under their own constitutions may legalize the practice.

Federal Funding Restrictions

The Federal Assisted Suicide Funding Restriction Act of 1997 prohibits the use of federal funds in support of physician-assisted suicide. This means Medicare and Medicaid do not cover life-ending medications.

With roughly 40% of Delaware residents relying on Medicaid or Medicare, the cost of the medication could pose a financial barrier for some patients.

State vs. Federal Jurisdiction

In the United States, federal law allows states to make their own choices regarding assisted suicide. The Supreme Court has consistently held that this is a matter of state regulation rather than federal constitutional protection.

The Court summed up the consensus, saying: “In almost every State—indeed, in almost every western democracy—it is a crime to assist a suicide. The States’ assisted suicide bans are not innovations. Rather they are longstanding expressions of the States’ commitment to the protection and preservation of all human life.”

Healthcare Provider Liability and Legal Protections

Physician and Nurse Practitioner Participation

Doctors and hospitals can opt out of medical aid in dying programs, and those who agree to participate would not be subject to civil or criminal liability for assisting in the death.

Healthcare institutions may prohibit physicians or APRNs from prescribing medication under medical aid in dying laws on their premises, and individual providers may refuse to prescribe the medication.

The current law does not require additional training or certification for medical providers, though the Delaware Department of Health and Social Services may work with the Division of Professional Regulation to develop forms and protocols.

Professional Medical Organization Positions

The American Medical Association’s code of ethics opposes the practice, stating that “permitting physicians to engage in assisted suicide would ultimately cause more harm than good.”

However, the AMA code was recently updated to affirm physicians’ rights to exercise their own conscience “without violating their professional obligations.”

The American Academy of Family Physicians maintains a neutral position on medical aid in dying.

Insurance and Employment Implications

Insurers and healthcare providers may not deny or alter healthcare benefits based on the availability of medication to end life or coerce or require a request for medical aid in dying as a condition of receiving care.

The sale, procurement, or issuance of life, health, or accident insurance policies cannot be conditioned upon or affected by an individual’s act of making or rescinding a request for medication to end life.

State-by-State Statistics and Usage Data

Oregon’s Long-Term Data

About 5,330 people in the US died with medical assistance as of 2020, and 8,451 received a prescription for the drugs.

The vast majority of patients who ended their lives were non-Hispanic white people (95.6%), and about three-quarters had a cancer diagnosis.

California’s Recent Numbers

In 2023, 1,281 individuals received prescriptions under California’s End of Life Option Act. Of those, 884 (69%) died following their ingestion of the prescribed aid-in-dying drugs.

Since California’s law came into effect in June 2016 through December 31, 2023, 6,516 individuals have been written prescriptions and 4,287 individuals, or 66%, have died from ingesting the medications.

In 2023, 92.7% of individuals who died following ingestion of aid-in-dying drugs were over 60 years of age.

Colorado’s Utilization Rates

Since Colorado’s law came into effect June 9, 2016, through December 31, 2023, 6,516 individuals have been written prescriptions and 4,287 individuals, or 66%, have died from ingesting the medications.

Maine’s Patient Profile

In 2023, 80 patients began the process in Maine to receive aid-in-dying drugs, though four died before completing the process and nine were still alive at the time of reporting.

From 2019 to 2022, 117 people have been prescribed and taken life-ending drugs in Maine. Cancer was the most common diagnosis, representing 42 of the 2023 patients, or 53%.

Public Opinion and Legal Trends

Growing Public Support

A Gallup poll found that 71% of Americans believe medical doctors should be “allowed by law to end a patient’s life by some painless means if the patient and his or her family request it.”

A 2025 national survey found that while 44% of respondents would consider MAID if terminally ill, more than half were unsure whether it was legal in their state.

Legislative Momentum

Nearly 20 states considered MAID legislation in 2025, and many of these bills made significant progress passing one or both legislative chambers.

While fewer than 1 percent use MAID, nearly 75 percent of the public want to have this option.

When polled, 71% of Illinois voters supported passing the End-of-Life Options Act.

Political Patterns

Generally blue states pass MAID legislation and red ones do not. Few expect to see MAID authorized in the South or even the Midwest except for Illinois and Minnesota.

The COVID-19 pandemic put a spotlight on the importance of the circumstances around a person’s death, with people watching loved ones spend their final days in hospitals without getting to say goodbye.

Frequently Asked Questions

What’s the difference between assisted suicide and euthanasia?

In assisted suicide or medical aid in dying, terminally ill patients self-administer prescribed medication to hasten death. In euthanasia, another party acts to bring about the person’s death in order to end ongoing suffering. Active euthanasia is illegal in all 50 US states.

Can I travel to another state for medical aid in dying?

As of March 2022, Oregon no longer enforces its residency requirement for physician-assisted suicide. Vermont removed its residency requirement in May 2023. However, most states with MAID laws still require patients to be legal residents.

Will Medicare or Medicaid cover the cost of life-ending medication?

The Federal Assisted Suicide Funding Restriction Act of 1997 prohibits the use of federal funds in support of physician-assisted suicide. This means patients must pay out-of-pocket for life-ending medications, which could pose a financial barrier for the roughly 40% of Americans relying on Medicaid or Medicare.

Can advanced practice nurses prescribe aid-in-dying medication?

Yes, in Colorado and Delaware. Delaware’s 2025 law marked a significant milestone by expanding advanced practice registered nurse (APRN) roles to prescribe life-ending medication. Both attending and consulting providers can be either licensed physicians or APRNs in Delaware.

What happens if someone coerces a patient into requesting MAID?

Criminal penalties apply to anyone attempting to coerce people into obtaining life-ending medication or tampering with a patient’s request. Those acting with negligence, recklessness, or intentional misconduct do not have criminal or civil immunity.

Is assisted suicide legal in any other countries?

Medical aid in dying is legal under certain circumstances in Austria, Belgium, Canada, Germany, Luxembourg, Australia, the Netherlands, Portugal, Spain, and Switzerland. The constitutional courts of Colombia, Ecuador, Estonia, and Italy have legalized assisted suicide, but their legislatures have not yet enacted regulating laws.

What safeguards exist to protect vulnerable populations?

No one may request medication to end life on behalf of another individual, and patients cannot qualify solely because of age or disability. Two physicians must confirm mental competence and voluntariness, and there are mandatory waiting periods between requests. Patients must be capable of self-administering the medication and making their own healthcare decisions.

Related Resources

For more information on end-of-life legal issues and healthcare law:

Legal Disclaimer: This information is for educational purposes only and does not constitute legal advice. Consult an attorney specializing in healthcare law, end-of-life law, or your state’s regulations for specific legal guidance on your situation. State laws regarding medical aid in dying are subject to change through legislation, court rulings, and ballot initiatives.

Sources:

Wikipedia: Assisted suicide in the United States (October 2025)
Death With Dignity National Center (October 2025)
Newsweek: Map Shows Assisted Dying Laws Across US (June 2025)
Clinical Advisor: Medical Aid in Dying Guidelines (September 2025)
Delaware General Assembly: Bill Detail HB140 (2025)
US Supreme Court: Washington v. Glucksberg, 521 U.S. 702 (1997)
Americans United for Life: State-by-State Physician Assisted Suicide Laws (July 2025)

About the Author

Sarah Klein, JD, is a licensed attorney and legal content strategist with over 12 years of experience across civil, criminal, family, and regulatory law. At All About Lawyer, she covers a wide range of legal topics — from high-profile lawsuits and courtroom stories to state traffic laws and everyday legal questions — all with a focus on accuracy, clarity, and public understanding.
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