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| Alex Schadenberg |
Executive Director,
Euthanasia Prevention Coalition
When a jurisdiction is debating an assisted suicide bill, many organizations and individuals will present information about the necessary safeguards that the jurisdiction must implement to “safely” legalize assisted suicide.
The Euthanasia Prevention Coalition knows that it is not possible to “safely” legalize assisted suicide and once legal the law will inevitably expand.
Great Britain is currently debating an assisted suicide bill that is sponsored by Kim Leadbeater. Many states have already introduced assisted suicide bills in 2025 and we anticipate many more legalization bills this year. We also know that some states that have legalized assisted suicide will debate bills to expand their law.
This article focuses on the experience with assisted suicide in jurisdictions where it is legal.
This article focuses on the experience with assisted suicide in jurisdictions where it is legal.
Nearly every jurisdiction that has legalized assisted suicide, later expanded their law.
The assisted suicide lobby groups know that it is more difficult to legalize assisted suicide than it is to expand the law once it is legal.
On June 5, 2024 Colorado Governor Gary Polis signed Senate Bill 24-068 which expanded their state assisted suicide law by: allowing advanced practice registered nurses to approve and prescribe assisted suicide, reducing the waiting period from 15 days to 7 days, and allowing the doctor or advanced practise registered nurse to waive the waiting period if the person is deemed to be near to death (same day death).
In previous years other states expanded their assisted suicide laws.
In 2019 Oregon passed Bill SB 0579 which expanded their assisted suicide law by giving doctors the right to waive the 15 day waiting period when a person was deemed to be near to death.
In 2021 California passed Bill SB 380 which expanded their assisted suicide law by reducing the waiting period from 15 days to 48 hours, it forced doctors who oppose assisted suicide to be complicit in the act and it forced all medical institutions to post their policy on assisted suicide.
In 2022 Vermont expanded their assisted suicide law by removing the 48 hour waiting period, (allowing a same day death), removing the requirement that an examination be done in person, (allowing approvals by telehealth), and it extended legal immunity to anyone who participates in the act.
The assisted suicide lobby groups know that it is more difficult to legalize assisted suicide than it is to expand the law once it is legal.
On June 5, 2024 Colorado Governor Gary Polis signed Senate Bill 24-068 which expanded their state assisted suicide law by: allowing advanced practice registered nurses to approve and prescribe assisted suicide, reducing the waiting period from 15 days to 7 days, and allowing the doctor or advanced practise registered nurse to waive the waiting period if the person is deemed to be near to death (same day death).
In previous years other states expanded their assisted suicide laws.
In 2019 Oregon passed Bill SB 0579 which expanded their assisted suicide law by giving doctors the right to waive the 15 day waiting period when a person was deemed to be near to death.
In 2021 California passed Bill SB 380 which expanded their assisted suicide law by reducing the waiting period from 15 days to 48 hours, it forced doctors who oppose assisted suicide to be complicit in the act and it forced all medical institutions to post their policy on assisted suicide.
In 2022 Vermont expanded their assisted suicide law by removing the 48 hour waiting period, (allowing a same day death), removing the requirement that an examination be done in person, (allowing approvals by telehealth), and it extended legal immunity to anyone who participates in the act.
In 2023 Hawaii expanded their assisted suicide law by reducing the waiting period from 20 days to 5 days, by allowing the waiting period to be waived if the person is deemed to be near to death and by allowing advanced practice registered nurses to approve and prescribe lethal poison.
In 2023 Oregon expanded their assisted suicide law by passing House Bill 2279 which removed their state assisted suicide residency requirement.
In 2023 Vermont also expanded their assisted suicide law by passing Senate Bill 26 which removed their state assisted suicide residency requirement.
Oregon and Vermont removed their state assisted suicide residency requirements in response to legal challenges by Compassion & Choices, an assisted suicide lobby group.
By removing the state residency requirement assisted suicide was expanded nationally because anyone in America can die by assisted suicide in Oregon and Vermont.
There is currently a lawsuit by Compassion & Choices challenging the New Jersey state assisted suicide residency requirement. On September 19, 2024, a US District Court Judge upheld New Jersey’s right to limit assisted suicide to state residents. This decision was appealed by Compassion & Choices on October 18, 2024.
In 2023 Vermont also expanded their assisted suicide law by passing Senate Bill 26 which removed their state assisted suicide residency requirement.
Oregon and Vermont removed their state assisted suicide residency requirements in response to legal challenges by Compassion & Choices, an assisted suicide lobby group.
By removing the state residency requirement assisted suicide was expanded nationally because anyone in America can die by assisted suicide in Oregon and Vermont.
There is currently a lawsuit by Compassion & Choices challenging the New Jersey state assisted suicide residency requirement. On September 19, 2024, a US District Court Judge upheld New Jersey’s right to limit assisted suicide to state residents. This decision was appealed by Compassion & Choices on October 18, 2024.
It must be noted that Compassion & Choices support legislators attempts to legalize assisted suicide, but once it is legal they soon go on the offensive to expand that law.
This was also true in Canada, where euthanasia and assisted suicide were legalized in June 2016 (Bill C-14) and the law was expanded by Bill C-7 in March 2021 by (among other things) removing the terminal illness requirement, removing the 10-day reflection period, allowing euthanasia for incompetent people who were previously approved and allowing euthanasia for mental illness alone. The implantation of euthanasia for mental illness alone has now been delayed until March 2027.
The groups that support euthanasia will state that Bill C-7 was related to the Truchon court decision in Quebec, but Bill C-7 expanded the law further than the Truchon required.
Push back to assisted suicide legal expansions in America.
In March 2022 a group of California doctors launched a court case designed to protect the conscience rights of medical professionals who oppose assisted suicide. In September 2022 US District Judge Fernando Aenlle-Rocha ruled that the California End of Life Options Act that had been amended by Bill SB 380, violated First Amendment rights of doctors by requiring them to participate in assisted suicide.
In April 2023, The United Spinal Association, Not Dead Yet, the Institute for Patients’ Rights, Communities Actively Living Independent and Free, Lonnie Van Hook and Ingrid Tischer launched a lawsuit to strike down the California assisted suicide law. The case asserts that the California assisted suicide law is a discriminatory scheme that contravenes the Americans with Disabilities Act. This case continues.
As stated earlier in this article that it is harder to legalize assisted suicide than to expand the law after it is legal. No new state assisted suicide law has become law in the past three years yet in the same time 5 states, that had legalized assisted suicide, expanded their law.
Expansion occurs for many reasons
When we examine the expansions of the American assisted suicide laws we recognize several key themes. There is the removal of waiting or reflection periods, allowing non-physicians to do the act, and allowing non-residents to die by assisted suicide.
Other expansions to assisted suicide laws include the redefinition of the language of the law.
In December 2017, Fabian Stahle, a Swedish researcher asked the Oregon Health Authority how they define terminal illness. Stahle learned that the Oregon Health Authority defined the six month terminal illness prognosis as including someone who would have a six month prognosis if they reject effective medical treatment. This was clearly an expansion of the law by redefining the language of the law.
A similar redefinition of the meaning of the law has occurred in the Netherlands. The Netherlands has never actually amended their law but they have changed the interpretation of the meaning of the law.
For instance, originally the Netherlands did not consider euthanasia for people with psychological conditions. In 2009, an interpretation of the law suggested that euthanasia for people with psychological conditions was possible. Since that time the number of deaths for psychological conditions has continuously expanded.
In Canada, most of the expansions the MAiD law have been based on equality. The Truchon court case in Quebec was decided based on the concept that preventing MAiD for people who do not have an irremediable medical condition was discriminatory. Justice Baudouin decided that it was unconstitutional to deny some people MAiD based on the person not being terminally ill.
Once legal, expansion of the law is inevitable.
When a legislature debates an assisted suicide bill they will do so based on the language of the bill. They will argue that the bill before them is tightly worded with effective “safeguards” but even if this were true, most often a bill that is legalized is expanded a few years later.
Once assisted suicide is legal, restrictions on the law become discriminatory. For instance, it becomes unjust to force a person to wait to die, it becomes unjust to limit it to terminal illness, it becomes unjust to limit it to physical conditions, it becomes unjust to force people to have to self-administer.
Before legalization, everyone is equal under the law. Everyone is equally protected from being killed or equally protected from suicide. Once legal, people who “qualify” under the law are medically abandoned as they are told that they can have treatment or death. In other words, death becomes an alternative to treatment and care.
Legislatures need to know that we oppose killing people.
This was also true in Canada, where euthanasia and assisted suicide were legalized in June 2016 (Bill C-14) and the law was expanded by Bill C-7 in March 2021 by (among other things) removing the terminal illness requirement, removing the 10-day reflection period, allowing euthanasia for incompetent people who were previously approved and allowing euthanasia for mental illness alone. The implantation of euthanasia for mental illness alone has now been delayed until March 2027.
The groups that support euthanasia will state that Bill C-7 was related to the Truchon court decision in Quebec, but Bill C-7 expanded the law further than the Truchon required.
Push back to assisted suicide legal expansions in America.
In March 2022 a group of California doctors launched a court case designed to protect the conscience rights of medical professionals who oppose assisted suicide. In September 2022 US District Judge Fernando Aenlle-Rocha ruled that the California End of Life Options Act that had been amended by Bill SB 380, violated First Amendment rights of doctors by requiring them to participate in assisted suicide.
In April 2023, The United Spinal Association, Not Dead Yet, the Institute for Patients’ Rights, Communities Actively Living Independent and Free, Lonnie Van Hook and Ingrid Tischer launched a lawsuit to strike down the California assisted suicide law. The case asserts that the California assisted suicide law is a discriminatory scheme that contravenes the Americans with Disabilities Act. This case continues.
As stated earlier in this article that it is harder to legalize assisted suicide than to expand the law after it is legal. No new state assisted suicide law has become law in the past three years yet in the same time 5 states, that had legalized assisted suicide, expanded their law.
Expansion occurs for many reasons
When we examine the expansions of the American assisted suicide laws we recognize several key themes. There is the removal of waiting or reflection periods, allowing non-physicians to do the act, and allowing non-residents to die by assisted suicide.
Other expansions to assisted suicide laws include the redefinition of the language of the law.
In December 2017, Fabian Stahle, a Swedish researcher asked the Oregon Health Authority how they define terminal illness. Stahle learned that the Oregon Health Authority defined the six month terminal illness prognosis as including someone who would have a six month prognosis if they reject effective medical treatment. This was clearly an expansion of the law by redefining the language of the law.
A similar redefinition of the meaning of the law has occurred in the Netherlands. The Netherlands has never actually amended their law but they have changed the interpretation of the meaning of the law.
For instance, originally the Netherlands did not consider euthanasia for people with psychological conditions. In 2009, an interpretation of the law suggested that euthanasia for people with psychological conditions was possible. Since that time the number of deaths for psychological conditions has continuously expanded.
In Canada, most of the expansions the MAiD law have been based on equality. The Truchon court case in Quebec was decided based on the concept that preventing MAiD for people who do not have an irremediable medical condition was discriminatory. Justice Baudouin decided that it was unconstitutional to deny some people MAiD based on the person not being terminally ill.
Once legal, expansion of the law is inevitable.
When a legislature debates an assisted suicide bill they will do so based on the language of the bill. They will argue that the bill before them is tightly worded with effective “safeguards” but even if this were true, most often a bill that is legalized is expanded a few years later.
Once assisted suicide is legal, restrictions on the law become discriminatory. For instance, it becomes unjust to force a person to wait to die, it becomes unjust to limit it to terminal illness, it becomes unjust to limit it to physical conditions, it becomes unjust to force people to have to self-administer.
Before legalization, everyone is equal under the law. Everyone is equally protected from being killed or equally protected from suicide. Once legal, people who “qualify” under the law are medically abandoned as they are told that they can have treatment or death. In other words, death becomes an alternative to treatment and care.
Legislatures need to know that we oppose killing people.
We don’t just oppose killing people who are terminally or chronically ill, but we oppose killing all people.
Legislatures need to know that we support caring for people and not abandoning them to death
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