A deeply personal and complex legal battle has concluded, with a federal appeals court affirming New Jersey’s right to limit its medical aid-in-dying law to its own residents. The ruling dashed the hopes of out-of-state patients seeking access to the option and the physicians who wished to provide it, highlighting the starkly different approaches states are taking on this sensitive issue.
The Third U.S. Circuit Court of Appeals decisively upheld the state’s residency requirement, stating New Jersey isn’t obligated to extend this deeply personal choice to those who don’t call the state home. Judge Stephanos Bibas, writing for the court, acknowledged the agonizing decisions faced by those nearing the end of life, but emphasized the law’s clear boundaries.
“Death brings good things to an end, but rarely neatly,” Judge Bibas wrote, capturing the somber reality of terminal illness. The court’s decision underscored that while New Jersey offers this pathway to a peaceful exit, it is reserved for those within its borders—a distinction that proved fatal for some who pursued legal recourse.
New Jersey stands among eleven states, plus Washington, D.C., that permit physician-assisted suicide for adults facing terminal diagnoses. However, most of these jurisdictions, unlike Oregon and Vermont, maintain residency restrictions, creating a patchwork of access across the nation.
The legal challenge originated with a Delaware woman battling stage four lymphoma, denied access to New Jersey’s law due to her non-resident status. Tragically, she passed away after the case had been argued, becoming a poignant symbol of the limitations imposed by state lines. A New Jersey physician, eager to extend care to patients in neighboring states, also joined the fight, as did others who have since passed or retired.
Dr. Paul Bryman, one of the plaintiffs, expressed his disappointment, arguing that terminally ill individuals should not be forced to undertake arduous journeys to exercise this option. His plea resonated with the core of the debate: the right to dignity and control in one’s final moments.
Governor Phil Murphy signed the law in 2019, acknowledging the profound moral weight of the decision. Despite his personal faith potentially preventing him from choosing this path, he championed the right of others to make that deeply personal determination.
The law itself is carefully constructed, demanding stringent safeguards. Patients must be New Jersey residents, adults, diagnosed with a terminal illness, and have a prognosis of six months or less to live. Two physicians must independently confirm both the diagnosis and the patient’s mental capacity.
Multiple requests, including one written with witnesses, are required, and patients retain the right to rescind their decision at any point. Witnesses cannot be family members, beneficiaries, or affiliated with the patient’s care team, ensuring impartiality. Crucially, patients must self-administer the medication, and doctors are obligated to discuss alternatives like palliative care.
A lower court had previously dismissed the challenge, asserting that physician-assisted suicide isn’t a fundamental right states are compelled to offer non-residents. The appeals court concurred, reinforcing the principle of state autonomy in navigating this complex issue.
“In our federal system, states are free to experiment with policies as grave as letting doctors assist suicide,” the ruling stated. “Other states are free to keep it a crime.” The court explicitly rejected the notion that access to this option constitutes a fundamental right extending beyond state borders.
Meanwhile, Delaware is moving forward with its own aid-in-dying law, set to take effect in January, offering a new option for its residents. The global landscape is also evolving, with countries like Canada, Germany, Belgium, Switzerland, the Netherlands, Australia, and Colombia also legalizing physician-assisted suicide.
This case serves as a stark reminder of the ongoing national conversation surrounding end-of-life choices, the delicate balance between individual autonomy and state regulation, and the profound human stories at the heart of this debate.
