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1 Step Forward, 2 Steps Back for Physician-Assisted Suicide

New Jersey is the eighth state to approve "aid in dying" for terminally ill patients. But similar legislation was defeated in two other states.

(AP/Russell Contreras)
Last Updated April 15 at 9:06 a.m. ET

On Friday, New Jersey Gov. Phil Murphy signed a bill to legalize physician-assisted suicide.

“Allowing terminally ill and dying residents the dignity to make end-of-life decisions according to their own consciences is the right thing to do. I look forward to signing this legislation into law," he said in a statement after the legislature passed the bill last month.

Seven other states and the District of Columbia allow patients to request a prescription for life-ending medication when they’re expected to live less than a year and are in pain. 

New Jersey's legislation will apply to people with a prognosis of six months or less. A patient must ask their doctor three times -- once orally and twice in writing. The written request has to be witnessed by two people, and one of them can't be a family member or a will beneficiary.

Oregon was the first to legalize what's also known as "aid in dying" or "death with dignity," in 1997. In the two decades since, the policy has slowly gained support. But last month, a bill died in the Maryland state Senate, one vote shy of passage. Days before that, an aid-in-dying effort failed in Connecticut.

In addition to New Jersey, New York could legalize death with dignity this year. A bill to do so is currently in committee.

Connecticut state Rep. Jonathan Steinberg, a Democrat, became interested in the policy when a constituent of his was indicted for helping his father die because he was in so much pain at the end of his life.

“It was an eye-opener. I had no idea of the magnitude of the problem. The world of palliative and hospice care has improved in the past couple of years, but there remains a percentage of people where this is simply insufficient,” says Steinberg.

If Steinberg's bill had reached Democratic Gov. Ned Lamont's desk, there is reason to believe he would have signed it.

In Maryland, which has a significant Catholic population, the church lobbied against assisted suicide. In Connecticut, the biggest opposition came from disability advocates.

“Many of us with severe and obvious disabilities tend to be thought of, prematurely, by medical practitioners as having reached a final stage where death might be expected in the near future,” said Cathy Ludlum, co-founder of Second Thoughts Connecticut, in a public hearing on the legislation.

Connecticut’s bill was modeled after the Oregon law, which Steinberg refers to as the “gold standard.” The legislation would have required a prognosis of less than six months, consent from two doctors and opportunities to rescind the request at any time. (Maryland’s also required a patient to be alone with their physician at the time of one of the requests.)

In an interview with Governing, Maryland state Del. Shane Pendergrass quoted a woman -- who has since passed away -- who once testified in support of aid in dying. She said '"we’re all one bad death away from supporting this.'"

“One of our delegates co-sponsored this legislation because when his mother passed away, he had to experience a bad death,” said Pendergrass.

While the Maryland legislation is dead, the governor's stance on assisted suicide appears to be evolving. Republican Larry Hogan spoke against aid in dying as a candidate in 2014, but more recently, he said he would consider it more closely and that the policy is “one that I really wrestle with from a personal basis.”

Still, the movement faces court battles and legislative hurdles.

Last May, a court overturned California’s End of Life Option Act, which was signed into law in 2016. The law was reinstated when an appeals court stayed the ruling, but the long-term future of the law is uncertain. And in 2018, 21 states introduced aid-in-dying bills, but only Hawaii signed one into law.

Mattie covers all things health for Governing.

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