Federal Judge Rules Residency Mandate in NJ Medical Aid-in-Dying Law is Constitutional

September 18, 2024

A federal judge Wednesday ruled the residency mandate in New Jersey’s medical aid-in-dying law does not violate the U.S. Constitution’s guarantee of equal treatment. New Jersey’s Medical Aid in Dying Act for the Terminally Ill Act allows mentally capable, terminally ill, hospice-eligible adults to obtain prescription medication to peacefully end their suffering.

The ruling was in response to a lawsuit filed in August 2023 by Compassion & Choices on behalf of terminally-ill cancer patients in Delaware and Pennsylvania and two New Jersey doctors asserting the residency requirement in New Jersey’s medical aid-in-dying law violates the U.S. Constitution’s guarantee of equal treatment.

The lawsuit asked the U.S. District Court in Camden, NJ to prohibit state officials and the Camden County prosecutor from enforcing this provision of the law because it violates the Privileges and Immunities Clause, Dormant Commerce Clause and Equal Protection Clause of the U.S. Constitution. The ruling rejected this request to stop enforcing the law’s residency mandate.

“We are disappointed that the court failed to recognize that barring medical care based solely on where patients live not only violates the Constitution but upends the standard of care for healthcare delivery. We are confident that this decision is merely a temporary roadblock to ensuring access to medical aid in dying for all Americans,” said attorney David B. Bassett, a partner at the law firm of Wilmer Cutler Pickering Hale & Dorr LLP in New York City and co-counsel in the case.

New Jersey’s Medical Aid in Dying for the Terminally Ill Act requires a patient’s physician to determine whether or not a terminally ill person who requests medical aid in dying is a New Jersey resident before writing a prescription for the medication. In opting for medical aid in dying, they may obtain a prescription for medication from a doctor, which they may then self-ingest at a time of their choosing.

“This ruling is a denial of compassion.  I want to leave my loved ones with the legacy of a life and death lived lovingly,” said patient plaintiff Judy Govatos, 79, a resident of Wilmington, DE, with stage 4 lymphoma who lives within driving distance of New Jersey. “I don’t want to die fearfully. I want to die affirming that I’ve had this opportunity to be alive in this amazing world and to say goodbye and I love you to my family and friends.”

“New Jersey’s medical aid-in-dying law has eased the suffering of numerous terminally ill New Jerseyans over the last five years,” said physician plaintiff Dr. Paul Bryman, a geriatrician who has provided terminally ill New Jersey patients with medical aid in dying and is the medical director at a hospice in Camden County, NJ. His office is within driving distance of the Delaware and Pennsylvania borders. “This ruling means I cannot provide non-resident patients who request this gentle dying option with care consistent with their values and wishes at one of the most important moments in their lives.”

“To be effective clinicians, New Jersey providers must establish trusting relationships with patients, families, and providers at a medically complex and highly emotional time,” said Kevin Díaz, the chief legal advocacy officer for Compassion & Choices. “As a result of this ruling, medical aid in dying remains the lone medical care option in their day-to-day practice for which a patient’s lack of New Jersey residency categorically denies to those clinicians the otherwise appropriate care that they can provide to their patients.”

This lawsuit is the third in the nation to challenge a medical aid-in-dying law’s residency requirement. Ten jurisdictions nationwide have passed medical aid-in-dying laws with a residency mandate (California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Oregon, Vermont, Washington, and Washington, D.C.). However, two states have removed the residency requirement after legal challenges by Compassion & Choices. In 2022, the end-of-life care advocacy group successfully settled a similar federal lawsuit in Oregon, resulting in the suspension of that state’s residency requirement. In March, Compassion & Choices settled a similar federal lawsuit in Vermont, resulting in the suspension of that state’s residency mandate for the Connecticut patient plaintiff only. Subsequently, Vermont and Oregon updated their medical aid-in-dying laws to remove the residency requirement in May and July, respectively.

Compassion & Choices
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