States remove protections from assisted suicide

When Conrad Reynoldson was diagnosed with Duchenne muscular dystrophy at age 3, a doctor said he likely wouldn’t live to see his 18th birthday. Now 36, Reynoldson runs a disability rights nonprofit organization in Washington state.

Even though he has surpassed that doctor’s prediction, Reynoldson said he might qualify for assisted suicide under a state law that allows adult residents to request life-ending drugs if they have a terminal disease. His condition is terminal if not treated.

Assisted suicide for the terminally ill is legal in 10 states and the District of Columbia. Reynoldson described these laws as inherently discriminatory. “You’ll have suicide prevention for someone who’s considered ‘healthy,’” he said. “But then if someone has a terminal condition, which much of the time overlaps with disability, they’re offered assisted suicide instead.”

In states where assisted suicide is legal, laws currently limit it to terminally ill adults who have the capacity to make and communicate their decision. Nearly all states explicitly require that individuals self-administer the lethal drug.

Reynoldson said limiting assisted suicide to terminally ill patients only serves to make the initial laws more palatable. “Once … a particular state has assisted suicide, then it’s much more likely that they’re going to then gradually pass expansions of it,” he said.

This year, several states have cut protections from assisted suicide laws by removing residency requirements, shortening waiting periods, and allowing new categories of medical workers to prescribe lethal drugs.

Lawmakers have introduced bills allowing or expanding assisted suicide in at least 19 states since the beginning of the year, although most have stalled in committee. Nevada lawmakers passed a bill allowing for assisted suicide this spring, but Gov. Joe Lombardo vetoed it.

In May, Vermont became the first state to remove the residency requirement from its assisted suicide law. Under the new law, people may come to Vermont for lethal drugs they can’t get in their home states, though laws in other states could still prevent individuals from bringing the drugs home to self-administer them.

In July, Oregon also repealed its residency requirement, which the state had already agreed not to enforce as part of a legal settlement in 2022.

Hawaii law previously required an individual to make two verbal requests for a lethal drug at least 20 days apart, which was the longest waiting period in any state where assisted suicide is legal. New legislation in April shortened the mandatory waiting period to five days and waived it for patients not expected to survive that long. Lawmakers also cut a requirement that only physicians prescribe drugs for assisted suicide.

Also in April, Washington state reduced the waiting period between oral requests from 15 days to seven and eliminated the 48-hour waiting period after the written request.

Reynoldson worked with a coalition of organizations and individuals that tried to preserve protections against assisted suicide in Washington. He said they fought off the legislation in previous sessions but couldn't forestall the enactment this year.

“I think we’ve found in states where there has been successful opposition, the disability community has been a key part of that, and I think it helps people realize some of the inherent issues with assisted suicide,” he said. “In states where groups that traditionally oppose it—religious groups, pro-life groups, that sort of thing—when they really include the disability community and work together, then they’re able to successfully keep the door from being opened in the first place or prevent expansion.”

Reynoldson said assisted suicide laws are rooted in prejudices about disability, adding that some people view disability as “a fate worse than death.”

According to Washington’s 2020 Death with Dignity Act Report, people who chose physician-assisted suicide most commonly listed as a concern their decreasing ability to engage in activities that made life enjoyable. Fewer than half listed pain control.

According to Reynoldson, states that allow assisted suicide already faced compliance issues before these expansions. In 2020, the most recent year with complete data, the Washington State Department of Health was missing at least 175 mandatory records related to assisted suicide, including written request forms from patients and compliance forms from physicians.

“We don’t actually have enough data to know whether people are potentially being coerced or abused with it,” Reynoldson said. “There really hasn’t been any effective enforcement.”