As of 2025, medical aid in dying is legal in 11 U.S. states and the District of Columbia. These jurisdictions are Oregon, Washington, Montana, Vermont, California, Colorado, Hawaii, New Jersey, Maine, New Mexico, Delaware, and Washington, D.C. Together, they cover more than one-fifth of the U.S. population. New York signed its own medical aid in dying law in early 2026.
The Full List of Jurisdictions
Oregon was the first state to authorize medical aid in dying when voters passed the Death with Dignity Act in 1997. Washington followed in 2008, and Montana’s authorization came through a 2009 state supreme court ruling rather than legislation. Vermont passed its law in 2013, California and Colorado in 2015 and 2016, the District of Columbia in 2016, Hawaii in 2018, New Jersey and Maine in 2019, New Mexico in 2021, and Delaware in 2024.
Most of these laws were passed through state legislatures. Montana is the notable exception: its supreme court ruled that nothing in state law prohibited a physician from honoring a terminally ill patient’s request, but the state has never passed a detailed statute with the same procedural safeguards other states require.
Who Qualifies
The eligibility criteria are remarkably consistent across all jurisdictions. To qualify, you must be:
- An adult (18 or older)
- A resident of the state where you are requesting the medication, though Oregon has stopped enforcing its residency requirement following a 2022 legal settlement
- Diagnosed with a terminal illness expected to result in death within six months, as confirmed by two physicians independently
- Mentally capable of making an informed medical decision
- Able to self-administer the medication through your own voluntary, conscious action
If a physician has any concern that a mental health condition might be affecting your judgment or decision-making capacity, the law requires a referral to a licensed psychiatrist or psychologist for evaluation before the process can continue.
How the Process Works
Medical aid in dying is not a single appointment. Every state with a detailed statute builds in multiple steps designed to confirm that the request is voluntary, informed, and consistent over time. The general framework requires two separate oral requests to your physician, spaced apart by a waiting period, plus a formal written request. The written request typically needs to be witnessed by at least two people.
Two physicians must independently confirm both the terminal diagnosis and your mental capacity. After all requirements are met and any waiting period has passed, the prescribing physician writes a prescription for a lethal dose of medication. You fill it at a pharmacy and decide if, when, and where to take it. Many people who receive prescriptions never use them. In Oregon, about 66% of people who received prescriptions between 1998 and 2024 ultimately ingested the medication.
One critical legal requirement: you must self-administer the medication. A doctor, nurse, or family member cannot give it to you. Self-administration means taking a deliberate, conscious action, whether swallowing a drink or opening a valve, without which you would not receive the medication. This distinguishes medical aid in dying from euthanasia, which is not legal anywhere in the United States.
The “Five to Midnight” Problem
The self-administration requirement creates a difficult timing issue that clinicians call the “five to midnight problem.” Some patients lose the physical or cognitive ability to take the medication before they are ready to use it. This can happen when a disease progresses faster than expected, or when a neurodegenerative condition gradually takes away the ability to swallow, communicate, or understand the decision. In these cases, the window to use the prescription closes even though the patient originally qualified and made a clear, informed request. No current U.S. law offers an exception for this situation.
Oregon’s Long-Term Data
Oregon offers the most complete picture of how medical aid in dying works in practice, with 27 years of annual reports from the state health authority. In 2024, 607 people received prescriptions under the Death with Dignity Act and 376 died after ingesting the medication. Those numbers have grown steadily from the early years of the law but remain a small fraction of all deaths in the state. Since 1997, a total of 4,881 people have received prescriptions and 3,243 have died from the medications.
The gap between prescriptions written and medications taken is a consistent pattern. For some patients, simply having the prescription provides a sense of control and peace of mind, even if they ultimately die of their illness without using it. In 2024, 135 physicians served as attending (prescribing) doctors across the state.
Which Providers Can Prescribe
In most states, only licensed physicians (MDs or DOs) can serve as the prescribing and consulting providers. A few of the newer laws have expanded eligibility to include nurse practitioners or physician assistants in certain roles, reflecting broader trends in healthcare access. Regardless of who prescribes, the two-provider confirmation requirement remains standard: one clinician manages the overall process and a second independently verifies the diagnosis, prognosis, and the patient’s capacity.
States Where Legislation Is Pending
Medical aid in dying bills have been introduced in numerous state legislatures beyond the current 11 states and D.C. New York’s bill, signed into law in February 2026, is the most recent addition. Several other states have had bills introduced in recent sessions, though the pace of passage has been slow. Most bills that advance follow the same basic framework established by Oregon’s original law: terminal prognosis of six months or less, two oral requests, a written request, two physician confirmations, and mandatory self-administration.