Medical Aid-in-Dying Laws Expand Across US as Illinois, New York Join 13 States

Medical aid in dying, which allows doctors to help terminally ill patients end their lives with medication, has been legalized in several countries in recent years. In the United States, New York and Illinois recently became the latest of 13 states to adopt such laws, marking an accelerating pace of legislation.

Oregon was the first US state to legalize the practice, with its law taking effect in 1997. Since then, the core requirements have remained largely consistent: a person must have an incurable illness and less than six months to live, according to Thaddeus Pope, a bioethicist and professor at Mitchell Hamline School of Law in St. Paul, Minnesota. Montana is the only exception, where the practice became legal through a court ruling rather than the legislature. To qualify, individuals must also be able to understand and make a voluntary decision and be able to take the medications without assistance.

The newest states to legalize it are among the nation's most populous. New York's law came into effect in August, and Illinois followed earlier this month. At least 15 other states considered medical aid-in-dying legislation this year, though most proposals stalled or missed legislative deadlines. Today, about one-third of Americans live in a state where the practice is legal.

Illinois became the first state in the Midwest and the 13th state overall, plus the District of Columbia, to authorize medical aid in dying. The measure is widely known as "Deb's law," honoring Deb Robertson, who has a rare terminal illness. She pushed for the measure's approval and testified about the suffering of people seeking the chance to decide for themselves how and when their lives should end.

"I believe that God gave me this extra time so that I could see this law through," Robertson said. "I believe that people have the right to leave this Earth with dignity and on their own terms."

Pope Leo XIV urged Gov. JB Pritzker not to sign the bill and said he was "very disappointed" that his home state of Illinois approved the law. After signing "Deb's law," Pritzker said he had been moved by stories of patients suffering from terminal illness and their dedication to standing up for freedom and choice at the end of life amid personal heartbreak.

Nilsa Centeno, who advocated for the cause dear to her son, Miguel Carrasquillo, a Chicago chef who died in 2016 at age 35 from an aggressive form of brain cancer, burst into tears when she learned the law had passed.

"My joy was so immense. I cried because my son was an advocate for that law and as a good Puerto Rican, he would have shouted out: 'Wepa! At last!'" Centeno said. For years, she witnessed her son suffer from painful treatments while the cancer spread.

Robert Drake, an interfaith hospice and palliative care chaplain, believes that when terminal suffering reaches an intolerable level, people must have a choice.

"At the end of the day, it gets down to respect for the sanctity and sovereignty of any individual and respect for their suffering and for their right to die in some way in congruence with the way they have lived," he said. "We're not playing God by allowing a person to have their own choice. We're trusting God to end that person and their relationship with whatever they think is sacred."

Opponents, including many religious groups, lawmakers and disability advocates, have moral objections to someone ending their life. Some argue that even with safeguards in place, the decision could be made for the wrong reasons. Catholic teaching holds that life must be defended from conception until natural death.

Chicago's archbishop, Cardinal Blase Cupich, and Springfield Bishop Thomas Paprocki challenged "Deb's law" in separate lawsuits and won limited protections without blocking the law from being enacted. In the days before the law took effect, a judge temporarily blocked the state of Illinois from enforcing the law on some Catholic groups that challenged it. They had argued the law could compel Catholic healthcare providers to refer or provide help against their faith in what they believe is assisted suicide.

Anita Hannig, a cultural anthropologist and author of "The Day I Die: The Untold Story of Assisted Dying in America," wrote in a piece published by The Conversation that equating assisted dying with suicide is not only antiquated or misleading but harmful. She said the stigma can lead severely ill patients to be left without critical support because they hide their wish from loved ones for fear of being judged for "suiciding." It also creates shame for those who want relief from suffering but worry their religion deems suicide a sin. Her research shows the conflation can also cause families to feel isolated as they process their grief.