Survey results of Americans have remained consistent over many years. In August of 2024, the Gallup Organization reported that just over 7 out of every 10 Americans believe that doctors “should be allowed by law to end the patient’s life by some painless means if the patient and his or her family request it.” This support for legal euthanasia by the American public has not translated into a reality in this country. Euthanasia is, in fact, illegal in every state in the United States despite public support. What is legal in certain states is Medical Aid in Dying (MAID) (sometimes called physician-assisted suicide) which allows a physician, under very defined and limited circumstances, to prescribe a lethal medication to a patient who meets specific criteria and ingests the medication on her own. According to Gallup, approximately 66% of Americans support the legality of MAID. A smaller percentage (53%) view MAID as morally acceptable. It is thought that the gap in legal versus moral acceptability has to do with the negative connotations of the sometimes-used label “assisted suicide” along with strong religious objections from certain segments of our society. For a good overview of the current state of this type of legislation and the challenges patients and families face in attempting to take advantage of it, click here.

Ten states plus the District of Columbia currently have laws permitting MAID under certain well-defined circumstances. In the 2023-2024 legislative session of states around the country, 19 states considered new bills to permit MAID. Delaware was the only state that actually passed legislation, which was subsequently vetoed by the governor of Delaware. Thus, the number of states permitting MAID has remained relatively static over the years. NPR recently profiled the legislative process for considering MAID in the state of Maryland, where survey results showed that 70% of the Maryland population supported the legality of MAID. The bill to legalize MAID failed by one vote in the Maryland legislature, and divisions about this did not fall neatly along partisan lines. Often Catholic and Black groups align together to fight this type of legislation.

What is new and becoming more frequent is the use of medical aid in dying laws by people who do not reside in the state where it is legal. In May of 2023, Vermont became the first state to allow non-residents to gain access to the use of their MAID legislation, provided the out-of-state patient met all the criteria and ingested the medication in the state. Shortly thereafter, Oregon followed suit. While this may seem to be a good workaround for people in desperate need who reside in states without this legislation, the fact remains that many obstacles continue to make it difficult. Doctors in Vermont and Oregon report being overwhelmed with requests and insufficiently staffed, and patients must often travel far distances under difficult circumstances for several visits to meet the many requirements, all while experiencing the ravages of a terminal illness (usually cancer) that’s led them to seek out MAID in the first place. Patients and their loved ones often need help with housing, finding doctors, and paying for the lethal medication (which is not covered by insurance and can run many hundreds of dollars if not more). In Vermont, a support and advocacy group has sprung up to help out-of-state residents, but it relies on volunteers and donations to navigate what is often rocky terrain.

Often the true heartbreak of these situations is best illustrated by personal situations. For example, 60 Minutes recently did a story about MAID, including a young woman in California who availed herself of the Oregon MAID law (before California passed its own law) with the support and help of her husband as well as a profile of an older woman in Pennsylvania with stage 4 ovarian cancer who has made several treks to Vermont in preparation of taking advantage of the Vermont MAID Law. There’s also a recent documentary, now streaming on Amazon, called Take Me Out Feet First which relays the stories of the parents of filmmaker Serene Meshel-Dillman, both of whom had cancer and ended their lives utilizing the California MAID law. Finally, there is the story told by author Steven Petrow, a highly regarded writer and columnist on various aspects of aging, whose sister utilized the MAID law of New Jersey (which some legislators are now trying to repeal) after struggling with an ovarian cancer diagnosis for 6 years. Petrow reveals his ambivalence about the process but his ultimate support and understanding of what his sister was experiencing. “She didn’t want to die, but she didn’t want to suffer.” He gradually came to terms with his sister’s choice and eloquently and compassionately explained his sister’s eventual passing. To find out more, grab your Kleenex and read here. While none of these stories are happy, they usually conclude with a peaceful death in harmony with the wishes of the patient, in accord with what the laws of the state permit.