Within North America (Canada, the United States, and Mexico), only the state of Oregon had a law passed by the Legislature that legalised Physician Assisted Suicide (PAS). That law became effective in 1997.
Subsequent developments, year 2000 to now:
2000-JAN-11: California:The California legislature was scheduled to
consider a "Death with Dignity Act." The
law in California currently allows adults of sound mind to "execute
a declaration governing the withholding or withdrawal of life
sustaining treatment." The proposed law would go further by allowing
a person under severely restricted circumstances to obtain "medication
for the purpose of ending his or her life in a humane and dignified
manner." Doctors would have immunity from civil or criminal
actions as long as they participated "in good faith compliance
with the act." The act was rejected by the Legislature on FEB-3.
2001-NOV-5: USA:Attorney General attempted to override Oregon's
law: The federal Attorney General John Ashcroft wrote a letter to Asa
Hutchinson, chief of the Drug Enforcement Administration. He
declared that assisting a terminally ill patient to commit suicide is
not a "legitimate medical purpose" for federally controlled
drugs. He said that any physicians who use drugs to help patients die
face suspension or revocation of their licenses to prescribe federally
controlled drugs. A court injunction was obtained to block Ashcroft's
initiative. More details.
2002-MAY: HawaiI: Physician assisted suicide bill rejected: The "Death with Dignity Act," HB 2487, was passed by a House
committee in late 2002-FEB.
It would have allowed "a terminally ill, competent adult to obtain a prescription
for medication to end his or her life in a humane and dignified manner through a
self-administered oral lethal dose. [The bill] Prohibits mercy killings, lethal
injections, and active euthanasia." Senator David Matsuura the chairperson of the Senate Health Committee, personally disagreed with the bill, and refused
to allow it to be voted upon by his committee. In a
surprise move, the Senate overruled Matsuura by voting to pull the bill out of
the Health Committee. HB 2487 was debated on 2002-MAY-2, but was defeated by a margin of one
vote on the next day. More details.
2002-JUN-30: USA: NRLC expands mandate: The National Right
to Life Committee was organized in 1972 to restrict or eliminate
abortion access. They decided at their Pittsburgh PA convention,
(held JUN-27 to 29), to expand their mandate to include seeking bans on
human embryo stem-cell research, physician-assisted suicide, and human
2002-SEP-22: Belgium: A PAS law, "Termination of Life on Request and Assisted Suicide Act" that legalized PAS became effective.
2004-MAY: Oregon: Federal Attorney General Ashcroft loses court case: U.S. Attorney
General John Ashcroft had challenged Oregon's assisted suicide law in
the Ninth Circuit Court of Appeals. He argued that physicians who
prescribed lethal medications were in contravention of the federal
Controlled Substances Act. By a vote of 2 to 1, a three judge panel
disagreed, ruling that the regulation of medical practice is a state
matter and is outside the jurisdiction of the federal government.
2004-JUL-20: Ashcroft asks for review: John Ashcroft asked
that the May decision of its three-judge panel be reviewed by at least
11 judges. His request was denied in August after most of the 25 judges
on the court voted against a review.
2004-AUG: Oregon: Results of pain study: Researchers at the Oregon Health & Science University (OHSU)
conducted a survey of the level of pain among 1,724 patients in Oregon,
as subjectively perceived by family members of the
patient, not the patients themselves. They found that since assisted suicide
became available, pain has apparently increased. Conservative Christian
and secular media disagree about the cause. More
2004-NOV-09: Oregon: Ashcroft requested appeal of Oregon's
assisted suicide law: U.S. Attorney General John Ashcroft asked the
U.S. Supreme Court to review the decision by the 9th U.S. Circuit Court
of Appeals which ruled that the federal government cannot regulate
medical practice by preventing physicians from prescribing lethal
medication to persons who want to commit suicide under Oregon's assisted
2005-MAR-30: Vermont: Physician assisted suicide bill proposed: A bill was introduced into the Vermont legislature during 2004 to
legalize physician assisted suicide. It was patterned after the Oregon
law which had been in place for six years. The bill was not acted upon.
It was reintroduced in 2005-FEB and has a possibility of being examined
by legislative committees during 2005-APR. A Xogby poll conducted in
2004-DEC showed that 78% of 500 randomly selected adults said that they
would support a bill to allow terminally ill patients to get medication
from their physicians to hasten death. The bill is opposed by an group
of physicians and religious organizations called the Vermont Alliance
for Ethical Healthcare. They have put forward the slippery slope
argument: they are concerned that the bill could lead to abuses, and
eventually to mandatory euthanasia. The Alliance's president, Dr. Robert
Orr, said: "The biggest concern is the expansion of the criteria and
the abuses that have been increasingly evident" in the Netherlands,
where euthanasia is legal. The bill is being promoted by Death With
Dignity Vermont. One of its founders is Dick Walters, 79, a retired
merchandise manager for retail department store chains, who was troubled
during the death of his father. He said: "He asked me to help him,
and there was nothing I could do. It frustrated me." He was jointed
by Dr. Richard Austin, 82 who said: "I've seen some of my friends
here die rotten deaths." He doesn't want to die a similar death.
They were joined by another doctor, Carmer Van Buren, 77 who was
initially troubled by the concept of helping a patient die. But he
concluded that hastening death for the terminally ill "is not suicide."
Nancy Dubler, a professor of bioethics at the Montefiore Medical Center
in New York said that without a law: "people of a certain education and
class and profession will have access to it when others will not.
[Oregon] "has demonstrated that it's socially and morally
responsible, socially and morally possible to have a physician-assisted
suicide program." However, she has reservations. She added: "I
fear if you take a program like Oregon's to a place like California or
New York you may get less admirable results." 2
2005-MAR-31: Florida: Terri Schiavo died: During 1990, when she ws 26 years-of-age, the supply of oxygen to her brain was stopped temporarily. She was left in a vegetative state. Her husband advocated removal of her feeding tube in 1998. After seven years of battles in the Florida Legislature and Courts, the tube was removed. She died 13 days later. An autopsy later revealed that, contrary to her parents' beliefs, she "was in a persistent vegetative state. ... she had massive and irreversible brain damage and was blind." 7
2005-OCT-05: Oregon: U.S. Supreme Court
hears arguments on Oregon's law: Oral arguments will be heard by the
U.S. Supreme Court in its first assisted suicide case since 1997 --
Gonzales v. Oregon. In
2001, U.S. Attorney General John Ashcroft issued a directive stating
that: "Assisting suicide is not a 'legitimate medical
purpose'....and that prescribing, dispensing, or administering federally
controlled substances to assist suicide violates the federal Controlled
Substances Act." So far, courts have decided that the federal act
does not restrict the behavior of physicians. 3
The Family Research Council, a fundamentalist Christian
advocacy group, filed an Amicus Curia brief in favor of preventing
Oregon doctors from engaging in physician assisted suicide. 4
2006-JAN-17: U.S.: Supreme Court upholds Oregon's law: In the case Gonzales v. Oregon, the
U.S. Supreme Court ruled by a 6 to 3 vote that in 2001 John Ashcroft had
incorrectly interpreted the Controlled Substances Act of 1970 -- a law
originally intended to fight illegal drugs. Justice Anthony Kennedy
issued the ruling for the majority. He wrote, in part:
difficult to defend the attorney general's declaration that the statue
impliedly criminalizes physicians-assisted suicide."
the strict constructionist judges on the Court -- Justice Antonin
Scalia, Justice Clarence Thomas, and Chief Justice John Roberts --
Reuters News Agency stated:
"White House spokesman Scott McClellan said the Justice
Department was reviewing the ruling. Both sides predicted the
decision likely will lead to more states adopting assisted suicide
2008: Oregon: The Oregon Department of Human Services collected data associated with the state's PAS law between 1998 and 2007. The New England Journal of Medicine reported that Oregon:
"... physicians wrote a total of 541 prescriptions for lethal doses of medication (almost always secobarbital or pentobarbital), and 341 people died as a result of taking the medications. Thirteen patients who had received prescriptions were alive at the end of 2007, and the rest of those who received prescriptions ultimately died of their underlying disease. The group of patients who died after ingesting a lethal dose of medication had a median age of 69 years, almost all were white and relatively well-educated, and the group consisted of slightly more men than women, according to data collected by the About 86% were enrolled in hospice programs, and 81.5% had terminal cancers." 9
2008-FEB-19: Luxembourg: The Parliament of Luxembourg passed a law that covered living wills and legalized physician-assisted suicide and euthanasia. It became effective on 2009-MAR-16. The law became effective on 2009-MAR-04. This made PAS avaialble in four locations around the world:
Belgium, the Netherlands, and Switzerland in Europe, and
The state of Oregon in the U.S. 9
The practice is technically illegal elsewhere in the world, but is frequently performed as an underground practice in secret, both by medical professionals, and relatives of the person seeking an end to their life.
2008-NOV: Washington State: Voters passed a plebiscite that legalized PAS. The vote was 58% to 42%. The Washington Death with Dignity Act was patterned after Oregon's law that was made effective in 1997-OCT. The law in Washington became effective in 2009-MAR-04. PAS is illegal elsewhere in North America (the rest of the U.S., Canada, and Mexico).
2013 Vermont: VT Statutes 5281 to 5293 in Chapter 113 "Patient Choice at End of Life" cover the PAS law in Vermont, which was passed by the state Legislature and became effective on 2013-MAY-20. Minor amendments were made in 2015-MAY.
2015-DEC: Status of PAS in the United States:
Physician Assisted Suicide (PAS) is available -- or will be avaailable in the future when laws become effective -- in five states:
Governors in four states -- California, Oregon, Vermont, and Washington state -- have signed physician assisted suicide bills into law.
It was legalized by a court decision in Montana.
Information sources on Physician Assisted Suicide:
The U.S. public, faith groups, and advocacy groups are severely divided on matters related to physician assisted suicide. Some of the web sites dealing with this topic are: