Medical Aid in Dying: Which States Allow It and How It Works

Medical aid in dying, also called death with dignity or physician-assisted dying, lets a terminally ill, mentally capable adult request a prescription for medication they can take themselves to bring about a peaceful death. It is one of the most personal and most heavily regulated decisions in American law, and it is legal only in a minority of states, under strict conditions.

What it is, and what it is not

Aid in dying is narrow and specific. The patient must self-administer the medication; a doctor may prescribe it, but no physician, nurse, or family member may give it to the patient. That self-administration requirement is what separates aid in dying from euthanasia (someone else administering a lethal dose), which is illegal everywhere in the United States. It is also different from simply refusing life-sustaining treatment, which every competent adult can do in every state.

Where it is legal

As of 2026, medical aid in dying is authorized in roughly a dozen-plus U.S. jurisdictions. Oregon was first, through a 1994 ballot measure, and others have followed by legislation, ballot initiative, or court ruling: Washington, Vermont, California, Colorado, the District of Columbia, Hawaii, New Jersey, Maine, New Mexico, and more recently Delaware, Illinois, and New York. Montana is a special case: there is no statute, but a 2009 state supreme court decision (Baxter) held that a patient’s consent can be a defense for a physician, so there is no formal regulatory framework there.

Because states continue to add and amend these laws, this list changes. Always confirm the current law in your own state before relying on it.

Who qualifies

The eligibility rules are strict and broadly similar across the states that allow it:

• An adult (18+) who is mentally capable of making and communicating health-care decisions.
• A terminal illness with a prognosis of six months or less, confirmed by two physicians.
• Physically able to self-administer the medication.
• Historically a resident of the state, though Oregon and Vermont have dropped their residency requirements after legal challenges, and others may follow.

How the process works

The safeguards typically require the patient to make two oral requests, separated by a waiting period, plus a written request signed before witnesses. A second physician confirms the diagnosis, prognosis, and the patient’s capacity, and refers for a mental-health evaluation if there is any question of impaired judgment. The patient must be told about all alternatives, including hospice and palliative care, and can change their mind and rescind the request at any time. Waiting periods and paperwork vary by state, and some states shorten the wait for patients who are very close to death.

Practical realities

Participation is voluntary for everyone: individual doctors, pharmacists, and health systems (including many religiously affiliated ones) can decline, so finding a willing provider can take time. Insurance coverage of the medication varies. Because the rules, timelines, and available providers differ so much by state and change over time, anyone considering this should speak early with their physician and, where helpful, an attorney.

This is general information, not legal or medical advice. Aid-in-dying laws vary significantly by state and change frequently. Confirm the current rules where you live and talk to a licensed physician and attorney.