country profile
Assisted Dying in the United States 
A look at the legal status of Medical Aid in Dying (MAID) across the United States.
MAID in the USA
The United States uses the term Medical Aid in Dying (MAID) or Death with Dignity to describe the laws that allow the provision of assistance to a terminally ill person for the self-administration of a medication that will cause their death.
State Jurisdiction
Medical Aid in Dying (MAiD) is legal in 14 U.S. states and Washington D.C., including Oregon, Washington, Montana, Vermont, California, Colorado, Hawaii, New Jersey, New York, Maine, New Mexico, Delaware, and Illinois. These jurisdictions allow terminally ill, mentally competent adults to request a prescription for medication to end their life, with Oregon pioneering the practice in 1997.
Useful Link
● Legal / Decriminalized ● Pending / Proposed ● Illegal
Summary
Medical assisted dying is illegal in every state. However, Medical Aid in Dying ( voluntary assisted dying) is authorized in 14 jurisdictions (13 states and Washington, D.C.) as of late 2025.
States and territories
Oregon was the first state to legalize the practice in 1997. Since then, Washington, Montana (via court ruling), Vermont, California, Colorado, Washington, D.C., Hawaii, New Jersey, Maine, New Mexico, Delaware, New York, and Illinois have followed.
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Oregon
The Oregon Death with Dignity Act was the first of its kind in the USA. The law has been in effect since October 27, 1997. It has served as the model for almost all subsequent legislation in the US.
Oregon Death with Dignity Act
Click to view the statute.
Process: Two oral requests separated by a waiting period (originally 15 days, now exempted if survival is less than 15 days), one written request, and two doctor assessments.
Eligibility: Adult residents with a terminal illness (less than 6 months to live) and mental capacity.
Amendments: In 2020, the law was updated to allow an exemption to the waiting period for patients near death.
The pioneer of Death with Dignity in the USA, Oregon’s 1997 law serves as the model for all other jurisdictions. It remains robust, with recent updates removing waiting periods for patients facing imminent death. Like other jurisdictions, Oregon produces regular reporting of Medical Aid in Dying, which can be accessed HERE.
Visit Death with Dignity National Centre (World Federation Member)
For more info.
Vermont
Vermont passed Act 39 in 2013, becoming the first state to legalize aid in dying through the legislative process rather than a ballot initiative.
Patient Choice and Control at End of Life Act (Act 39)
Click to view the full bill.
Recent Changes: In 2023, Vermont removed the residency requirement, becoming the first state to allow non-residents to access MAiD, provided they can travel to Vermont and find a participating physician.
Telehealth: Recent clarifications have facilitated the use of telehealth for some parts of the request process.
Vermont became the first state to legalize aid in dying through the Legislature in 2013. In a landmark 2023 move, it removed the residency requirement, allowing non-residents to access care if they can travel to the state.
Visit Vermont Department of Health
for more Reporting Info.
Washington
Since March 2009, Washington has had a Death with Dignity Act in effect. It functions very similarly to the Oregon model.
Washington Death with Dignity Act
Click to view the statute.
- Statistics: Since 2009, hundreds of patients have utilized the law safely. Official data from Washington State can be found HERE
- Access: In 2021, bills were introduced to further improve access, reflecting a trend across states to reduce unnecessary bureaucratic hurdles.
- Requirements: Two doctors must confirm the prognosis and capacity. The patient must self-administer the medication.
Legal since 2009, Washington uses a well-established system similar to Oregon’s. Recent legislative efforts have focused on modernising the law to improve patient access and reduce unnecessary bureaucratic delays.
Visit End Of Life Washington (World Federation Member)
for more info.
California
In 2016, the End of Life Option Act came into effect. It was significantly updated in 2021 by Senate Bill 380 to improve access.
End of Life Option Act
Click to view the legislative details.
Improvements (SB 380): The mandatory waiting period between oral requests was reduced from 15 days to 48 hours.
Transparency: Healthcare systems must now post their aid-in-dying policies on their websites.
Sunset Clause: The original law was set to expire in 2025; this has been removed.
Annual Reports: Like most jurisdictions, California regularly publishes reports on access to MAiD (available here)
Visit The Hemlock Society of San Diego ( World Federation Member)
for more info.
Colorado
Approved by voters as Proposition 106 in 2016, the Colorado End-of-Life Options Act allows eligible terminally ill adults to request aid in dying medication.
Colorado End-of-Life Options Act
Click to view the legislative details.
Model: The law is modelled after Oregon’s statute.
Process: Requires two physicians to agree on the terminal diagnosis (less than 6 months).
Access: While legal, finding providers can sometimes be a challenge in rural areas or within religiously affiliated hospital systems.
Approved by voters in 2016, this law allows terminally ill adults to request aid in dying. While legal statewide, patients often face challenges finding participating providers in rural areas or within religious hospital networks.
Visit Colorado Dept of Public Health & Environment
for more Reporting info.
Hawaii
The Our Care, Our Choice Act went into effect on January 1, 2019
Our Care, Our Choice Act
Click to view the legislative details.
Geography: The unique geography of Hawaii initially made finding two consulting doctors difficult for residents on smaller islands.
Amendments: Amendments have been proposed and passed to ease these barriers, including waiving waiting periods for those likely to die before the wait is over.
The Our Care, Our Choice Act requires patient consultation with three healthcare providers. As of June 1, 2023, Medical Doctors and qualified Advanced Practice Registered Nurses (APRNs) are authorized to serve as Attending or Consulting Providers.
Visit Hawaii Department of Health
for more Reporting info.
New Mexico
The Elizabeth Whitefield End-of-Life Options Act went into effect in June 2021. It is considered one of the most accessible laws in the country.
Elizabeth Whitefield End-of-Life Options Act
Click to view the legislative details.
Innovation: It was the first state to authorize Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs) to participate as providers.
Speed: The waiting period is only 48 hours, and can be waived entirely if the patient is likely to die sooner.
Hospice: Patients already enrolled in hospice do not need a second consulting opinion on their prognosis.
The Elizabeth Whitefield End-of-Life Options Act (2021) is widely considered the most accessible law in the nation. It allows advanced practice nurses to prescribe medication and features a short 48-hour waiting period.
Visit End of Life Options New Mexico ( Not a World Federation Member)
for more info.
New Jersey
The Medical Aid in Dying for the Terminally Ill Act was signed in April 2019 and took effect on August 1, 2019.
Medical Aid in Dying for the Terminally Ill Act
Click to view the legislative details.
Requirements: Similar to other states, requiring a 6-month prognosis and residency in New Jersey.
Status: It withstood early legal challenges and is now fully operational.
Effective since 2019, the Medical Aid in Dying for the Terminally Ill Act provides end of life options to eligible residents. It successfully withstood early legal challenges and is now a settled part of the state’s healthcare landscape.
Visit New Jersey Department of Health
for More Reporting Info.
Maine
The Maine Death with Dignity Act was signed into law in June 2019 and took effect in September 2019.
Maine Death with Dignity Act
Click to view the legislative details.
Process: Requires two oral requests and one written request. The waiting period was originally 15 days.
Residency: Limits access to Maine residents.
Maine’s Death with Dignity Act was enacted in 2019, offering a strictly resident-only option for the terminally ill. The law follows standard safeguards, requiring multiple oral and written requests and two physician assessments. More information on reporting can be found on Maine Dept of Health and Human Services Click HERE and search ‘Death with Dignity’
Visit Maine Death with Dignity (World Federation Member)
for more info.
District of Columbia
The D.C. Death with Dignity Act passed in 2016 and went into effect in 2017 after a congressional review period.
D.C. Death with Dignity Act
Click to view the legislative details.
Usage: Utilization has been lower compared to states, partly due to the limited number of participating physicians in the District.
Legalized in 2017, the D.C. Death with Dignity Act faces unique hurdles due to the limited number of participating physicians in the District. Strict federal oversight and a small geographic footprint have kept utilization low.
Visit DC Health
for more Reporting info.
Montana
Montana does not have a specific “Death with Dignity” statute. Instead, it is legal via a Supreme Court ruling.
Baxter v. Montana (2009): The Montana Supreme Court ruled that a physician’s assistance in hastening death is not against public policy and that state law protects doctors from prosecution if they prescribe medication to a mentally competent, terminally ill patient.
Status: Attempts to ban the practice or codify it have both failed in the legislature, leaving the court ruling as the law of the land.
Unlike other states, Montana permits aid in dying via a 2009 Supreme Court ruling rather than a specific statute. This means the practice is legal and protected, but it lacks the formalized regulatory framework found elsewhere.
Visit Death With Dignity National Center (World Federation Member)
for more Reporting info.
Delaware
On May 20, 2025, Governor Matt Meyer signed the Ron Silverio/Heather Block End of Life Options Act (HB 140).
Status: Signed into law. It is scheduled to take effect on January 1, 2026.
Context: The bill passed after years of advocacy and a previous veto. It aligns Delaware with neighbouring New Jersey in offering end-of-life options.
Visit Delaware General Assembly
for more info.
Illinois
On December 12, 2025, Illinois legalised MAID when Governor J.B. Pritzker signed Senate Bill 1950, also known as “Deb’s Law”.
Details: The law authorises qualified terminally ill adults to request life ending medication.
Status: Signed into law. Effective date is set for September 12, 2026.
Signed in late 2025, “Deb’s Law” makes Illinois one of the newest states to authorise medical aid in dying. The law became active on September 12, 2026.
Visit Illinois General Assembly
for more info.
New York
Effective August 5, 2026, Medical Aid in Dying is available to terminally ill New Yorkers with less than six months to live under Public Health Law Article 28-F. The law expands end-of-life options for terminally ill New York residents and affirms their right to make informed decisions to reduce suffering at the end of life.
Status: Following a legislative agreement announced on December 17, 2025, Governor Kathy Hochul has committed to signing the Medical Aid in Dying Act in January 2026.
Details: The negotiated bill includes additional safeguards, such as a video recording requirement for oral requests, a mandatory mental health evaluation, and a residency requirement.
Implementation: The law came into effect on the 5th August
Following a breakthrough agreement in late 2025, New York is set to sign its Medical Aid in Dying Act in January 2026. The incoming law includes strict residency rules and enhanced safeguards, with access expected to start mid-year.
More information can be found on the New York State official Website –HERE
Visit Completed Life Initiative (World Federation Member)
for more info.
Members
Our Member Organisations in the USA
We currently have 63 are members of the World Federation, with 10 based around the USA.
latest news
The latest news from our members and from around the world
Our members produce helpful factsheets and newsletters. The Federation is always happy to share other sources of information in favour of our joint mission to advance assisted dying around the world.
