By September, nearly a third of Americans will live in states with legal aid in dying

Jules Nederland has traveled several times over the past few years from his home in the Bronx to the New York State Capitol in Albany, hoping to persuade the Legislature to pass a medical aid in dying bill, allowing terminally ill patients to end their lives with a lethal prescription.

Addressed the gathering. Along with other members of the advocacy organization Compassion & Choices, she visited legislators’ offices. In 2024, while the state legislature was debating the aid-in-dying bill, he helped unveil a banner in the chamber gallery that read, “Stop Suffering.”

His activism was becoming difficult. Nederland, who is 59 and works for a nonprofit organization, was diagnosed with breast cancer in 2019. “I had aggressive treatment for a whole year,” he said “Chemotherapy. A mastectomy. Radiation treatment every weekday for five weeks. Two oral medications for six months.”

He recovered and felt healthy until the cancer returned a few years later. Although metastatic breast cancer is curable, drugs are currently palliating her disease. Nederland feels lucky but tired, and struggles with brain fog, gastrointestinal symptoms, and joint pain.

“My energy is really limited,” he said.

As she emailed and called lawmakers, Nederland feared she might die before the aid-in-dying bill — first introduced in New York in 2016 — could become law.

‘A breakthrough moment’

On June 9, 2025, after the Assembly approved the bill, the Netherlands was in the state Senate chamber, watching the I votes mount and see it pass. Govt. Kathy Hochul signed A revised version in February; It is scheduled to come into effect from August 5.

A similar law scheduled for execution Illinois in September, which will be 13th state (plus the District of Columbia) where medical assistance in dying is illegal.

“A landmark moment,” said Kevin Diaz, president of Compassion and Choice, which has led the long campaign for such legislation. Nearly 30 years later — Oregon’s law, the first in the nation, was enacted in 1997 — adding two populous states means that nearly a third of Americans will live in a state where medical aid in dying is legally available. “It shows that there is broad support for this model,” Diaz said.

Polls consistently support that claim. A Pew Research Center survey Last spring found that nearly two-thirds of respondents did not consider the practice “morally wrong,” because they thought it was acceptable or not a moral issue. Support crosses many political and religious lines: both a narrow majority of Republicans and 76% of Democrats think “physician-assisted death” (sometimes called “physician-assisted suicide”) is permissible; So did most Catholics, Jews, and non-evangelical white Protestants.

in new york, A Sienna pole has been found 54% of respondents assisted in dying, including mostly men and women, of all ages, and residents of cities, suburbs, and upstate. A plurality of Latinos supported it; Black respondents narrowly opposed it.

Passing these laws has been somewhat easier, said Thaddeus Pope, a bioethicist and professor at Mitchell Hamline School of Law in St. Paul, Minnesota, who tracks such policies. “You can say, ‘We’ve had 10 years in California, 18 years in Washington and 29 years in Oregon, and nothing bad has happened.’ It’s more accepted.”

‘You need A, B and C’

Yet legalizing medical assistance in dying, or MAID, was and remains a long, controversial process. Catholic leadership and many disability organizations strongly oppose this. (Pope Leo XIV personally asked Illinois Governor JB Pritzker (Don’t sign the bill.)

The American Medical Association says that “physician-assisted suicide is fundamentally incompatible with the physician’s role as a healer” and that it poses “serious social risks,” although several state medical bodies have chosen to remain neutral or, as in New York, support transition.

The Patients’ Rights Action Fund, through a subsidiary, has lawsuits pending or on appeal in California, Delaware and Colorado, arguing that aid-in-dying laws discriminate against people with disabilities by leading to physician-assisted suicide rather than treatment.

“It’s a litigation strategy that we’ve developed to ultimately go to the Supreme Court,” said Matt Vallier, the group’s executive director, who declined to say whether he would sue to block the Illinois and New York laws.

Even when aid in dying laws are successful, using them can prove challenging. In every state (except Montana, where it became legal through a court decision, so there is no law enforcement), aid in dying is available only to people with terminal illnesses who are expected to die within six months.

It usually consists of oral and written requests to two doctors, with mandatory waiting periods between requests. Patients must have the mental capacity to make decisions, which incapacitates people with dementia, and must take medication without assistance. (One amendment Hochul insisted on was to add a psychologist or psychiatrist to the process.)

All patients must be residents of all but two states. Oregon and Vermont have eliminated their residency requirements to settle the case Brought by compassion and choice. (The court ruled against A Similar suits in New Jersey.)

Furthermore, any doctor, hospital or health care system can legally refuse to provide assistance in dying, and religiously affiliated institutions often opt out. Participants can add their own requirements.

“The state can say, ‘You need A, B, and C,’ and Columbia-Presbyterian can say, ‘We want D, E, and F, too,'” said Pope, a Minnesota bioethicist.

Hotly debated, rarely used

Perhaps these restrictions, or a lack of public awareness, help explain why, despite the headlines and heated debate, the number of people who actually use the law is tiny in each state—typically less than 1% of the deaths recorded annually. Support for giving patients such autonomy at the end of life remains widespread, but the willingness to exercise it in private appears not.

Still, studies show that many patients who seek MAID die Before they complete the processThe trend has been to relax restrictions. California reduced its 15-day waiting period to 48 hours; New Mexico allows physician assistants and advanced-practice nurses to write prescriptions with doctors.

“Most states have now revised their laws two or three times,” Pope said. “We have liberalized.” Telehealth may also facilitate access to participating doctors.

Compassion and Choices is planning a legal challenge to end the additional state residency requirement, Diaz said. “How to enter a jurisdiction with a different cultural and political environment” is also being considered, he added, referring to Florida and other southern states.

Medical assistance in dying represents a shift in power, Diaz said. “Whoever has to bear the burden of suffering should have the power to decide when enough is enough,” he added.

Anne Gurnett Bander, 72, a retired research scientist from Carmel, New York, cared for her husband for four years as ALS — the relentlessly disabling neurological disorder also known as Lou Gehrig’s disease — left him bedridden and dependent on feeding and breathing tubes. “When he died, all he could do was bow his head,” she recalled.

So being diagnosed with ALS herself last year was “my worst possible nightmare,” says Gurnette Bander. He had planned to fly to Switzerland, where the non-profit organization Dignitas provides medical aid in dying, when he learned of the New York bill and began to speak publicly in support of it, but his voice weakened as his illness progressed.

Gurnett Bander and Nederland said they weren’t sure if they would use lethal drugs to end their lives because their symptoms were getting worse. Not infrequently, patients complete the necessary steps, secure the prescribed medication, decide they no longer need it, and die of their disease. But both women insist the choice should be theirs.

“It can give a lot of peace of mind,” Nederland said. “I thought, ‘People should have this option.’ Now, they will.”

New Old Age was created through a partnership with The New York Times.

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