Tuesday, August 25, 2020

Medical Aid in Dying: Key Variations Among U.S. State Laws

Look for my forthcoming article in the October 2020 issue of the Journal of Health & Life Sciences Law from the American Health Law Association: "Medical Aid in Dying: Key Variations Among U.S. State Laws."

Medical aid in dying (MAID) is legal in eleven U.S. jurisdictions representing one-fourth of the U.S. population. But, despite its legality, MAID is practically available to only a subset of qualified patients in these states. Substantial evidence shows that restrictive eligibility requirements and onerous procedural safeguards impede access. In response, state legislatures have begun to craft more flexible rules as they recalibrate the balance between safety and access.

There is already significant variability among U.S. MAID statutes in terms of eligibility requirements, procedural conditions, and other mandates. While the Oregon Death with Dignity Act has served as the template for all subsequent MAID statutes, the states have not copied the Oregon law exactly. Furthermore, this nonconformity grows as states continue to engage in an earnest and profound debate about the practicality of MAID.

TABLE OF CONTENTS

Introduction

I. Medical Aid in Dying

    A. Why Hasten One’s Death

    B. What Is MAID?

    C. Who Uses MAID?

II. Non-Statutory Approaches

    A. Montana

    B. North Carolina

    C. Other Non-Statutory Approaches

III. Variations in Eligibility Requirements

    A. State Residency: How to Prove It?

    B. Capacity Assessments: Two or Three?

IV. Variations in Procedural Requirements

    A. Oral Request Waiting Period: 0, 15, or 20 Days?

    B. Written Request Waiting Period: 0 or 48 Hours?

    C. Route of Drug Administration: GI or IV?

V. Other Variations among U.S. MAID Statutes

    A. Conscience Based Objections by Clinicians

    B. Conscience Based Objections by Facilities

    C. Telehealth Assessment and Counseling

    D. Data Collection and Reporting

    E. Sunset Clauses

VI. Forthcoming Variations

    A. Scope of Practice: MD or APRN?

    B. Terminal Illness: 6 Months or Longer?

    C. Other Future Variations

Conclusion 




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