Legal Advocacy Updates: Defending the Future of End-of-Life Care

The momentum of our legal advocacy continues to grow. With this year’s launch of Compassion Legal — the nation’s first nonprofit law firm for end-of-life rights — we’re breaking new ground in courts across the country. Here are the latest updates.

Death Doulas Win in Indiana

On August 28, 2025, the U.S. Court of Appeals for the Seventh Circuit ruled in Richwine v. Matuszak that death doulas in Indiana can continue their work regardless of state funeral home regulations. The Court affirmed that doulas provide essential guidance and support for families, which is not the same service as funeral directors.

This victory came after the state attempted to shut down death doula provider Death Done Differently, LLC, run by Lauren Richwine, by claiming it needed a funeral home license. Compassion & Choices filed an amicus brief supporting Richwine and underscoring the unique role doulas play in patient-directed end-of-life care.

The Court acknowledged that “the fortunate among us will have little experience burying loved ones” and “the many details associated with a loved one’s death can be overwhelming … ‘Death doulas,’ like Lauren Richwine, seek to make those arrangements easier.” In finding that Indiana had violated Richwine’s First Amendment rights, the Court reiterated the importance of death doula services: “Not everyone who experiences the death of a loved one will have a trusted companion to call for assistance and guidance on how to proceed.”

Indiana has not yet announced whether it will appeal to the U.S. Supreme Court.

Fighting for End-of-Life Autonomy in Kansas

In May, Compassion Legal and our partners at If/When/How: Lawyering for Reproductive Justice and Irigonegaray & Revenaugh filed Vernon v. Kobach. The case challenges Kansas’s “Pregnancy Exclusion” law, which automatically invalidates a person’s advance directive if they are pregnant, denying them the same end-of-life autonomy as other Kansans.

In a recent request to dismiss the case, state officials described the potential harms of the law as “trivial,” arguing that any forced treatment would last only as long as a pregnancy. The reality is anything but trivial. Just this year in Georgia, Adriana Smith’s family endured the trauma of watching her body kept on life support for months against her wishes — all because she was pregnant at the time she was declared brain dead. In our response to the Sept. 5 motion to dismiss, we emphasized the very real harm caused by the Pregnancy Exclusion to patients and their loved ones, and asked the court to deny the state’s motion. 

This case is about more than one law in Kansas — it’s about protecting the right of every person to have their healthcare decisions honored without government interference.

Alongside Loss, A Continuing Legacy of Advocacy

While we press on in the courts, we are also mourning the loss of Minnesota resident and medical aid-in-dying advocate Jeff McComas, who died on September 8, 2025. He was 55 years old.

A lifelong Minnesotan who had been living with a terminal intestinal cancer diagnosis since 2023, McComas remains a plaintiff in the federal lawsuit brought in May by Compassion Legal on his behalf (McComas v. Polis) challenging the Colorado’s End-of-Life Options Act’s residency requirement.

The fourth of its kind brought by Compassion Legal, the suit argues that the residency provision is unconstitutional on the grounds that it prevents otherwise qualified terminally ill individuals from receiving an aid-in-dying prescription if they are not a Colorado resident and further prevents providers from offering the same end-of-life options to non-residents as they can offer to those who live in CO. 

Oregon and Vermont both reached a settlement with Compassion Legal clients agreeing to not enforce residency requirements in their respective state laws and lawmakers in both states ultimately removed those requirements, allowing qualified out-of-state residents access to medical aid in dying. Oral arguments were heard earlier this month in ongoing New Jersey litigation (Govatos v. Murphy) challenging the residency requirement in its aid-in-dying law.

In an obituary he wrote before his passing, McComas said that his biggest regret was that he, “… didn’t have enough time with you.” “I left much too soon,” he said, “but was surrounded by love at the end.”

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