The “right to die” movement is gaining momentum in the states.
Most Americans consider the issue of assisted suicide, if they think about it at all, a foreign curiosity, the subject of a live debate in England or Canada, but a hypothetical in the United States. That’s probably true at the national level: Neither major candidate addressed it on the 2024 campaign trail, and it is hard to imagine President Donald Trump wading into its murky waters during his second term. But right now there are laws permitting assisted suicide—or medical aid in dying, as its proponents call it—on the books in ten states, as well as in Washington, D.C. And there is a growing movement to incorporate the “right to die” in state law across the country. That movement stands to make gains in the coming years.
Last year, 20 state legislatures considered assisted suicide bills, according to a tally kept by Death with Dignity, one of the leading assisted suicide advocacy groups in the United States. All the proposals pursued legalization more or less along the same lines of Oregon when in 1997 it became the first state to legalize the practice: allowances for mentally competent people with less than six months to live to seek prescriptions from their doctors for life-ending drugs. And all failed.
Some bills were dead on arrival. In Indiana, for instance, the measure was dismissed almost as soon as it was introduced. “Physician-assisted suicide is contrary to a physician’s duty as a healer and undermines the physician–patient relationship,” said the state senator Tyler Johnson, when introducing an additional resolution condemning the practice more generally. “It is not difficult to stand here today and draw a line in the sand.” The resolution was overwhelmingly backed by the Republican-dominated body. Similar bills died without a fight in states such as Florida, Iowa, and Kentucky.
But for other states, such as Delaware, Maryland, and Virginia, legislative opposition was not nearly so decisive. In Delaware, both the state house and senate passed an assisted suicide bill, only for Gov. John Carney to veto it—on the grounds that he is “fundamentally and morally opposed to state law enabling someone, even under tragic and painful circumstances, to take their own life.” Around the same time, Maryland Gov. Wes Moore indicated the exact opposite—he would be happy to sign such a bill—only for Maryland’s latest version of it to fail by one vote in a senate committee, meaning the state cannot take up the issue again until the next legislative session begins in 2027. Something comparable occurred in Virginia, where because the proposal fell slightly short, it will not be considered until 2025. (Even if it passes next year, it is likely to die on Gov. Glenn Youngkin’s desk.)
Assisted suicide advocates have held out their highest hopes for New York, where the movement has been building consensus since the introduction in 2016 of its current proposal. “We have momentum like we haven’t seen since the bill was first introduced close to a decade ago,” the state senator Brad Hoylman-Sigal told Axios early last year. But although a significant number of state Democrats—as well as influential groups such as the New York Bar Association and New York Civil Liberties Union—lent their support, the bill failed to make headway in party leadership or with the governor’s office. Its advocates remain confident that 2025 will be more successful. Assisted suicide groups are organizing January demonstrations in Albany to gin up the support needed for a majority.
There is a straightforward reason why a year of failure is not viewed as a serious impediment by the Right to Die movement: Public opinion is on its side. The majority of Americans have supported medically assisted suicide for the terminally ill since 1996, when Gallup first began collecting data on the question. Over the last decade, the number has risen from a bare majority to an overwhelming one. (One caveat here is that as with all polling, the level of support depends on how the question is phrased.) The most recent polling shows that 66 percent of those asked said that doctors should “be allowed by law to assist the patient to commit suicide.” Additionally, a majority of Americans also believe that if you are terminally ill the freedom to end your life without legal impediment is a moral right, and, to borrow the phrase of its proponents, a civil right.
Support is not necessarily divided along party or ideological lines. Majorities of both Republicans and Democrats say that assisted suicide should be legal (though Republicans are much less likely to call it moral). Neither a majority of Catholic or Protestants oppose its legality (though those who go to church weekly are more likely to call it wrong). Indeed, one of the most eloquent advocates for medical aid in dying is the conservative columnist George F. Will, who compares it to the great medical advances of the last century.
“Medical marvels extend, and enhance the quality of, life—up to a point,” he wrote recently in one of two columns in the Washington Post. “MAID, enveloped in proper protocols, can and should be a dignity-enhancing response to especially harrowing rendezvous with the inevitable.”
Terminally ill people seeking assisted suicide also often make such arguments about dignity. But almost always they add to that the language of rights. In one case that received much attention last year in New York, a man diagnosed with amyotrophic lateral sclerosis (ALS) declared that if the state legislature passed the Medical Aid in Dying Act, he would be the first to take advantage of it. And when it allowed the bill to die in committee, he accused the body of violating his rights by forcing him to seek an illegal end to his suffering.
“I was a law-abiding citizen all my life. I’ve done the right thing all my life,” he told the Staten Island Advance. “This is not living. This is suffering. Nobody has the right to allow me to suffer.”
Claims such as these tend to exercise a powerful hold on the public imagination, especially since in this country a reverence for rights is often prized above other goods. Advocates for medical aid in dying have good reason to be confident in their cause. Theirs may not be the dominant position today, but it is quickly gaining ground. In the one state where assisted suicide made the ballot in 2024, West Virginia, voters decided to enshrine opposition to the practice in its constitution. On its face, the vote was a loss for the MAID movement, but the numbers tell a different story. The ballot measure passed by less than half a percentage point, a statistical tie and the promise of a longer fight.
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