Compassion & Choices advocates for end-of-life options, including medical aid in dying, for all — regardless of a person’s ZIP code. Today, 11 states (California, Colorado, Delaware, Hawai’i, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont, and Washington State) plus Washington, D.C., authorize medical aid in dying for a person 18 years old or older, who is mentally capable of making medical decisions, has a prognosis of six months or less to live, and is able to self-ingest the prescribed medication. Outside of these jurisdictions, how can people who want medical aid in dying access the option?

Apart from Vermont and Oregon, which do not have residency restrictions — a direct result of Compassion & Choices’ lawsuits — every other state where medical aid in dying has been authorized via the legislative process has statutory language that limits the use of the practice to in-state residents. Terminally ill residents of other states are prohibited from accessing the medication, healthcare, and related services unless they have legally established residency. 

Relocating to access medical aid in dying can be extremely burdensome for someone with a terminal illness, due to a limited timeframe, restricted mobility, the need to find a supportive healthcare team, lack of financial resources, and possibly reduced support from family and friends. According to the Oregon Health Authority 2023 Data Summary, only 23 people from out-of-state died using medical assistance in 2023 in Oregon, representing just over 6% of the total who used medical aid in dying that year.

Ashley Fry, DNP, director of clinical advocacy at Compassion & Choices, shares, “Individuals who meet the criteria for medical aid in dying and have a very limited life expectancy may be experiencing advanced symptoms such as weakness, fatigue, pain, or shortness of breath. They may require the use of oxygen for disease management and/or comfort. Care of these individuals requires diligent symptom management to ensure they can travel safely and comfortably to a jurisdiction where medical aid in dying is authorized.”

Fry says hospice care in one’s home state is beneficial for providing expert symptom management near the end of life. Hospice offers specialized care that focuses on compassion, quality of life, and comfort during a person’s final months. 

Terminally ill people who can relocate have more options, but they may also face hurdles. They will need to find a practicing doctor in-state who is willing to prescribe the medication and a local pharmacy to fill the prescription. Anyone interested should explicitly identify a local doctor who will support a request for medical aid in dying and confirm eligibility under that state's law before beginning the process of transferring care.

In 2023, Compassion & Choices filed a federal lawsuit on behalf of two New Jersey doctors and cancer patients in Delaware and Pennsylvania asserting the residency mandate in New Jersey’s medical aid-in-dying law violates the U.S. Constitution’s guarantee of equal treatment. Currently, New Jersey allows only residents to access aid in dying, prohibiting access for non-residents. 

Plaintiff Judy Govatos, who lives in neighboring Delaware, said, “I’d like not to die in terrible pain and terrible fear. Having the option to use aid-in-dying medication in my own state, when I decide to, would be an act of mercy and kindness. For now, it would be an incredible gift to be able to go to New Jersey.”

To determine if relocating is the right choice for you or your loved one, start by answering the following questions. These apply in all jurisdictions except Oregon and Vermont, which have removed the residency restrictions and now allow medical practitioners to help non-residents obtain medical aid-in-dying services.

If you are an attorney and want to get involved in advancing end-of-life justice: