Medical aid in dying becomes available to millions more Americans this fall. By September, nearly one-third of the U.S. population will live in states where terminally ill patients can legally obtain medication to end their lives. This expansion follows recent legislative victories in states like New York and others considering similar laws.
Public opinion strongly favors medical aid in dying. Polls consistently show 70 to 80 percent of Americans support the practice for terminally ill patients experiencing unbearable suffering. Yet actual usage remains surprisingly low wherever it's legal.
In Oregon, the first state to legalize physician-assisted death in 1997, approximately 250 people use the law annually out of a population exceeding 4 million. That's roughly 0.006 percent. In California, around 600 people used medical aid in dying in 2022, representing less than 0.002 percent of the state's 39 million residents.
Why the gap between support and utilization? Experts point to multiple factors. Many terminally ill patients never learn about the option. Others lack access to willing physicians who feel comfortable prescribing lethal medications. Some worry about burdening family members despite legal protections. Religious beliefs, hope for new treatments, and concerns about the dying process itself all play roles.
The actual process requires multiple steps. Patients must make two separate requests typically separated by two weeks. Physicians must confirm terminal diagnosis and mental competence. Many patients who obtain prescriptions never use them, finding comfort in simply having control over their death.
Dr. Barbara Coombs Lee, president of the Death With Dignity National Center, notes that the availability itself provides relief. Knowing the option exists helps patients feel less trapped, even when they ultimately choose to let natural disease progression occur.
As more states move toward legalization, this pattern will likely continue. Legal access appears to matter less about dramatic