Euthanasia facts and figures

Physician-assisted death (PAD) is legal in nine US states as well as in Washington DC. For many, the choice to “opt-out” before severe pain or confusion makes end-of-life unbearable is a humane and dignified way to go. Here are the ins and outs of how and where this is possible.

“I lived my whole life following others’ wishes. Let me follow my own wish in my death.” – Shon Mehta, The Timingila

Laws pertaining to physician-assisted death, commonly called “Death with Dignity” laws, come primarily from the idea that people who are terminally ill, not the government or anyone else, should decide how much suffering they are prepared to endure at the end of life.  

The laws generally allow mentally competent adults with a confirmed terminal prognosis and less than six months to live to voluntarily request a prescribed medication that hastens the inevitable.

PAD is not euthanasia. The very distinct difference is that PAD involves making lethal doses of medication available to a patient that can be used if and when they choose. Euthanasia entails another person, usually a doctor, taking an active role. The latter is not legal in the United States full stop. 

This isn’t for everyone, of course, and is completely up to the individual facing the end to decide. In fact, it must be specifically requested, and carried out, by the terminally ill person so as to ensure that the choice is entirely free-will.  

Jack Kevorkian aka Dr Death 

The term euthanasia came into our vernacular with the advent in the 1990s of Dr Jack Kevorkian, an American pathologist and proponent of the practice. There is only one documented case of Kevorkian having euthanized a patient, which he did very publicly on camera as the patient gave his ascent. He was sentenced to prison for this act and served 8 years of a 10 to 25 year sentence. The remainder of the roughly 130 people were PAD cases, and though he was tried four times for these, he was never convicted. 

The problem with Dr Kevorkian, and why he became popularly known as “Dr Death”, was not that he believed that terminally ill patients should be able to choose their exit plan, it was that some of his patients reportedly were not terminal or even actually sick. Some were suffering with depression and some were garden variety hypochondriacs. Additionally, it was claimed that they were not given an adequate amount of time or psychiatric follow-up before receiving fatal doses of meds.  

Kevorkian drew fire from public statements in response to criticism such as, “What difference does it make if someone is terminal? We are all terminal.” It put his moral standing into question and turned some away from what was initially intended to be a humane practice, though since the practices he championed have become more acceptable to many.

How to Add this Choice and What it Entails

By adding a voluntary option to a will or to your end-of-life care instructions while you are still compos mentis, you will have the possibility to choose this route, though the process when the time comes is rigorous, with several stop-gaps that make certain no one can misuse or abuse the system. 

In practice, two doctors must confirm the person in question’s residency in the state. They must also separately confirm the patient’s diagnosis, prognosis, mental competence and that the terminally ill person has asked for this option of their own accord. Additionally, two waiting periods are required. The first between the oral requests and the second between receiving and filling the prescription. 

Where is it Legal

Eight states and the District of Columbia have state statutes on the books allowing PAD. The states that have mandates according to state law are: Colorado, Washington DC, Hawaii, Maine, New Jersey, Washington, Oregon and Vermont. California allows it if mandated by a court ruling. 

One wild card state in this is Montana. Their Supreme Court ruled there is nothing in state law prohibiting PAD, but since, several bills have been introduced to codify or ban the practice. None have passed, but it leaves the citizens and doctors there in a bit of a grey area.  

In the end, his is a very personal decision, one that can only be made by you. There is no right or wrong way to go. We all get to the same place ultimately. It’s just how we get there, nature’s way or our own, that differs.   


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