Medical aid in dying is currently legal in 13 states and Washington, D.C. The most recent additions are Delaware and Illinois (both in 2025) and New York (2026). In every jurisdiction where it’s authorized, the law requires a terminal illness diagnosis with a life expectancy of six months or less.
Full List of States Where Aid in Dying Is Legal
Oregon was the first state to legalize medical aid in dying in 1994, and the list has grown steadily since. Here’s every state and territory where it’s currently authorized, along with the year the law took effect:
- Oregon (1994)
- Washington (2008)
- Montana (2009)
- Vermont (2013)
- California (2015)
- Colorado (2016)
- Washington, D.C. (2016)
- Hawai’i (2018)
- Maine (2019)
- New Jersey (2019)
- New Mexico (2021)
- Delaware (2025)
- Illinois (2025)
- New York (2026)
Most of these laws were passed through state legislatures. Montana is an outlier: its authorization came through a 2009 state Supreme Court ruling rather than legislation, which gives it a somewhat different legal framework than the others.
Who Qualifies
The eligibility requirements are similar across all states. To request aid-in-dying medication, a person must be an adult (18 or older) with a terminal disease that cannot be cured or reversed and is expected to result in death within six months. Two physicians must independently confirm both the diagnosis and the prognosis.
Mental competency is a core requirement. The person must be able to make and communicate their own healthcare decisions. If either physician suspects the patient’s judgment is impaired by depression or another condition, a referral for a mental health evaluation is typically required before the process can continue.
One critical distinction separates these laws from euthanasia practices in some other countries: the patient must self-administer the medication. A doctor prescribes it, but the person must be physically capable of taking it themselves. No physician, nurse, or family member can administer it on the patient’s behalf. This self-administration requirement is consistent across all U.S. jurisdictions where the practice is legal.
Safeguards Built Into the Process
These laws include multiple layers of procedural safeguards designed to prevent misuse. The process is not quick. In most states, a patient must make two oral requests separated by a waiting period, plus a written request signed in front of witnesses. The attending physician and a separate consulting physician must each independently evaluate the patient. The entire process, from first request to receiving the prescription, typically takes a minimum of 15 to 20 days, though some states have shortened the waiting period for patients very close to death.
Physicians can decline to participate for any reason, including personal or moral objections. No doctor is required to write a prescription under these laws. Healthcare systems and hospitals can also establish their own policies about whether their providers participate.
Every jurisdiction requires reporting. Physicians must document each step of the process, and state health departments collect data on how many prescriptions are written, how many are filled, and how many people ultimately take the medication. A significant number of patients who receive a prescription never use it. For many, simply having the option provides a sense of control over their end-of-life experience.
Residency Requirements Are Changing
Most states originally required patients to be residents in order to use their aid-in-dying law. That’s been shifting. Oregon dropped its residency requirement after a legal challenge argued it was unconstitutional. The Oregon Health Authority and the Oregon Medical Board agreed to stop enforcing the requirement and to ask the legislature to formally remove it from the statute.
Several other states have followed suit or are in the process of loosening residency restrictions. This matters most for people living in states where aid in dying is not legal, since traveling to another state is the only option. However, even in states without a formal residency requirement, the process still requires establishing a relationship with local physicians who can evaluate your condition, which can take weeks and involves logistical challenges for someone with a terminal illness.
States Considering Legislation
Several states have active bills working through their legislatures. In Michigan, a bill introduced by House Democrats would allow qualified patients to request medically assisted death, though it faces long odds in the Republican-controlled House and is currently pending in committee. Similar bills have been introduced in states like Massachusetts, Connecticut, and others in recent legislative sessions, with varying levels of momentum.
The trend over the past decade has been toward expansion. Between 2015 and 2026, the number of states with legal aid in dying roughly tripled. But passage is far from guaranteed in any given state. Bills often take multiple legislative sessions to build enough support, and opposition from religious organizations, disability rights groups, and medical associations remains significant in many states.
How These Laws Differ From Euthanasia
U.S. aid-in-dying laws are narrower than what’s legal in countries like Canada, Belgium, or the Netherlands. In those countries, euthanasia (where a physician directly administers a lethal medication) is permitted, and in some cases the eligibility criteria extend beyond terminal illness to include chronic suffering or mental health conditions. No U.S. state allows euthanasia. No U.S. state extends eligibility beyond a six-month terminal prognosis. The American model is specifically limited to self-administered medication for people who are already dying.
This distinction is important because the terms “assisted death,” “assisted suicide,” and “euthanasia” are often used interchangeably in public conversation, but they describe very different practices with different legal frameworks. Advocacy organizations generally use “medical aid in dying” to describe the U.S. model and consider the term “assisted suicide” inaccurate, since the person is not choosing death over life but choosing the manner of a death that is already imminent.