7 - Aid in Dying in the United States

Summary

Until Oregon voters approved an aid-in-dying referendum in 1994, no jurisdiction in the United States had given legal approval to aid in dying. Moreover, fourteen years passed before a second state, Washington, legalised aid in dying. Since then, recognition has accelerated. Now, aid in dying is permitted in nine states and the District of Columbia, with nearly one in four Americans living in a jurisdiction that permits the practice. While a right to aid in dying has taken different paths—voter approval, legislative action, or judicial decision—all legalising US jurisdictions recognise the right in the same basic way: patients must be adults with decision-making capacity, must be terminally ill, and must self-administer the lethal dose of medication. This chapter discusses why the different jurisdictions have converged on the same legal framework for a right to aid in dying. In particular, there are key reasons for limiting a right to aid in dying to patients who are terminally ill (i.e., life-expectancy of six months or less). The chapter also discusses the implications of the common legal framework for future evolution of the right to aid in dying in the United States.