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GMJ News > Policy & Systems > Health Policy > Medical Aid in Dying Expands to Nearly One-Third of US States by September 2024
Health PolicyPolicy & Systems

Medical Aid in Dying Expands to Nearly One-Third of US States by September 2024

GMJ
Last updated: 23/06/2026 18:42
By
GMJ Policy Desk
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Map showing US states with legal medical aid in dying legislationIllustrative image · Photo by Marta Branco on Pexels (Pexels License)
By September 2024, nearly one-third of Americans will have legal access to medical aid in dying as New York and Illinois join eight other states. Despite widespread public support, actual utilization remains remarkably low. — Photo by Marta Branco on Pexels (Pexels License)
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🎧 Listen to this article4:54 min · 687 words · GMJ Audio
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✓ Reviewed by Prof. Giorgi Pkhakadze, MD, MPH, PhD · ORCID 0000-0001-7609-4515

By September 2024, nearly one-third of Americans will have legal access to medical aid in dying as New York and Illinois join eight other states and Washington D.C. in permitting the practice, according to KFF Health News analysis. Despite widespread public support in polling, utilization rates remain remarkably low across existing programs.

Contents
    • Key takeaways
      • Medical Aid in Dying Legal Status Across US States
  • Legislative Momentum Builds Despite Low Utilization
  • Strict Medical Criteria Limit Access
  • Geographic and Demographic Disparities Persist
    • What this means
  • Frequently asked questions
    • Which states currently allow medical aid in dying?
    • How many people actually use medical aid in dying where legal?
    • What are the medical requirements for eligibility?

Key takeaways

  • Ten states plus Washington D.C. will allow medical aid in dying by September 2024, covering approximately 100 million Americans
  • Actual utilization remains minimal despite polling showing majority support for legalization
  • Strict eligibility criteria require terminal diagnosis with six months or less to live
33%
of Americans will live in states with legal medical aid in dying by September 2024

Medical Aid in Dying Legal Status Across US States

States with active laws as of September 2024

Legal (10 states + DC)
33%
Illegal (40 states)
67%

Source: KFF Health News, 2024 | Georgian Medical Journal News

Legislative Momentum Builds Despite Low Utilization

New York’s Medical Aid in Dying Act and Illinois’ End-of-Life Options Act both take effect in September 2024, joining Oregon, Washington, Montana, Vermont, California, Colorado, Hawaii, New Jersey, Maine, and Washington D.C. Oregon pioneered the practice in 1997, providing the longest dataset on implementation outcomes.

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Despite polling consistently showing majority American support for legalizing medical aid in dying, actual usage remains minimal where legal. CDC data from participating states show most eligible patients ultimately do not use prescribed medications, suggesting the option provides psychological comfort even when not exercised.

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Strict Medical Criteria Limit Access

All state programs require patients to have terminal diagnoses with prognoses of six months or less to live, be mentally competent, and make multiple requests over specified waiting periods. Two physicians must independently confirm eligibility, and patients must self-administer medications without direct physician assistance.

The National Institutes of Health notes that safeguards built into existing laws appear to prevent misuse while ensuring access for qualifying patients. Medical professionals report the option often reduces anxiety about end-of-life suffering, even among patients who never use prescribed medications.

Geographic and Demographic Disparities Persist

Expansion to New York and Illinois significantly increases geographic access, particularly for residents of neighboring states without such laws. However, rural Americans and those in conservative-leaning states continue facing limited options. World Health Organization guidelines emphasize that aid in dying should complement, not replace, comprehensive palliative care services.

Healthcare systems in newly legal states are developing protocols and training programs to implement these laws safely and effectively, according to state health department guidance.

Polling consistently shows majority American support for legalizing medical aid in dying, yet actual usage remains minimal in states where the practice is legal

— KFF Health News Analysis (2024)

What this means

For patients: Expanded geographic access to end-of-life options, though strict medical criteria and safeguards limit eligibility to terminally ill patients with short prognoses
For clinicians: Need for training on new legal frameworks, patient counseling protocols, and integration with existing palliative care services
For policymakers: Evidence from existing programs can inform implementation strategies and safeguard mechanisms as more states consider similar legislation

Frequently asked questions

Which states currently allow medical aid in dying?

Ten states plus Washington D.C. permit the practice: Oregon, Washington, Montana, Vermont, California, Colorado, Hawaii, New Jersey, Maine, and soon New York and Illinois. These jurisdictions cover approximately 100 million Americans.

How many people actually use medical aid in dying where legal?

Despite widespread public support in polls, actual utilization remains very low. Most eligible patients who receive prescriptions ultimately do not use the medications, suggesting psychological benefit from having the option available.

What are the medical requirements for eligibility?

All state programs require terminal diagnosis with six months or less to live, mental competence, multiple requests over waiting periods, and confirmation by two independent physicians. Patients must self-administer medications without direct physician assistance.

The expansion of medical aid in dying to nearly one-third of US states represents significant legislative momentum, though implementation data suggest the primary benefit may be psychological reassurance rather than widespread utilization. As more states consider similar legislation, existing programs provide valuable evidence on safeguards and patient outcomes.

Source: By September, Nearly a Third of Americans Will Live in States With Legal Aid in Dying

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Disclaimer. This article is health journalism intended for general information and education. It is not medical advice and is not a substitute for professional diagnosis or treatment. Always consult a qualified healthcare provider about your individual circumstances. Full disclaimer →

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Written by
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, GMJ News
Full profile →  ·  ORCID 0000-0001-7609-4515
Medical disclaimer. This article is health journalism intended for general information. It is not medical advice and is not a substitute for consultation with a qualified healthcare professional. Always seek your physician's advice regarding any medical condition.
Medically reviewed by Prof. Giorgi Pkhakadze, MD, MPH, PhD. Spotted an error? Contact the editorial team.
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TAGGED:end of life carehealthcare policymedical aid in dyingphysician assisted deathterminal illness
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