By Kim Callinan

Compassion & Choices President and CEO Kim Callinan

“Vision without action is merely a dream. Action without vision is merely passing time. But vision with action can change the world.” – Nelson Mandela

Compassion & Choices is in action, changing the world to realize our vision of “a society that affirms life and accepts the inevitability of death, embraces expanded options for compassionate dying, and empowers everyone to choose end-of-life care that reflects their values, priorities and beliefs.”

All eyes are on Delaware right now, hoping it will soon become the 12th jurisdiction to authorize medical aid in dying. The story of Delaware’s advancement of medical aid in dying is similar to that of other authorized states. Years — in the case of Delaware, a full decade — of defeats have been met with resilience and resolve demonstrated by Compassion & Choices and the Compassion & Choices Action Network, our bill sponsor Representative Paul Baumbach, terminally ill advocates and their families, and our amazing supporters, all of whom refused to accept defeat. This year, our perseverance resulted in considerable progress!

In April, the House passed the End of Life Option Act (HB140) in a bipartisan 21-16 vote. The Senate proved much more challenging: Last Thursday, it failed to pass when the bill came up for a vote. Many assumed the bill was dead for the session; however, our bill sponsor, terminally ill advocates, supporters, partners and Compassion & Choices Action Network staff refused to give up!

It was a long four days, but after strategizing with the bill sponsors, extensive organizing and campaigning, and a whole lot of blood, sweat and tears, on Tuesday, June 25, we secured the needed votes and passed the Ron Silverio/Heather Block Delaware End of Life Options Act (HB140) in the Senate. HB140 is now headed to Gov. Carney’s desk for him to decide whether to sign the bill, let it become law or veto it. While it’s unclear where the governor stands on medical aid in dying, what is clear is that our efforts will continue, as vision plus action eventually equals change: We are changing the world.

This year, 19 states had medical aid-in-dying bills in their state legislatures. In addition to Delaware, we are still proactively advancing bills in Illinois and Massachusetts with a chance for passage in 2024. Despite hard work and considerable progress in other states, the bills failed to become law. While disappointing, this is merely a temporary setback that supporters in nearly every state have repeatedly experienced. If there is one thing we know about medical aid-in-dying supporters, we don’t give up. Click here for our medical aid-in-dying legislative tracker. Below are some of the trends that were evident during the 2024 legislative session: 

• More Organizational Support: In 2024, we saw more organizational backing for medical aid in dying. For example, several New York organizations, including the New York State Bar Association and the New York State Council of Churches, have endorsed medical aid-in-dying legislation, adding significant credibility to the movement. These endorsements reflect a broader acceptance within professional communities, reinforcing the growing organizational support for compassionate end-of-life options​​.

• More Bipartisan Support: In New Hampshire, a medical-aid-in-dying bill passed through the all-Republican House, demonstrating that lawmakers from both parties are increasingly advocating for end-of-life choices​​​​​​. We also see bipartisan support in many (but not all) state legislatures. 

• One or Two Lawmakers Blocking Progress: Despite broad support and interest among lawmakers and the public, the passage of medical aid-in-dying legislation often faces opposition from a few influential lawmakers, as in states like New York, Maryland, Minnesota and Nevada. While frustrating, this is also a sign of our incredible progress in that we are votes away from passage. It also requires a different type of organizing. 

• Increased Opposition From the Catholic Church: Anti-choice groups are upping their investment in campaigning against medical aid in dying. In Minnesota, the Church has formed a coalition focused on “assisted killing,” highlighting its efforts to influence public opinion and legislative outcomes against such laws. In Delaware, the archdiocese of Wilmington organized against medical aid in dying, including media releases, testimony, and a rally, while the Delaware Right-to-Life group launched a radio campaign lobbying against three pro-choice issues (aid in dying, abortion, and campus health centers).
  
• Improved Strategy and Messaging by Opponents: The opposition has sharpened in sophistication, execution and attacks. They advance false claims, equate abortion with aid in dying and weave in examples of the “slippery slope” conflating international laws with U.S. laws.  Most troubling is that they have effectively gotten oppositional legislators nationwide to parrot their messaging in hearings despite the mounting evidence against their disinformation.

• Growing Support Within Medicine: The medical community increasingly supports medical aid in dying. For example, in New York, the Medical Society of the State of New York has dropped its opposition to aid in dying, reflecting a significant shift within the field toward supporting end-of-life options that align with patient wishes​​.  

• Strong Bipartisan Recognition of Need for the Law and for Improvements in Authorized States: In states where medical aid-in-dying is explicitly legal, bipartisan efforts are underway to improve these laws. Colorado became the fifth authorized state to have legislation improving the Oregon model.  ​​

These examples from 2024 illustrate the ongoing trends and growing momentum in the medical aid-in-dying movement, supported by a wide range of organizations, bipartisan legislative efforts and increasing acceptance within the medical community. What other trends are you seeing? Share your observations with me at [email protected].  

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