Federal appeals court upholds New Jersey’s assisted suicide residency rule

A federal appeals court ruled that New Jersey’s medical aid-in-dying law applies only to state residents, rejecting efforts by out-of-state patients and physicians to challenge the restriction.

The Third U.S. Circuit Court of Appeals upheld the state’s residency requirement, finding that New Jersey is not required to make assisted suicide available to non-residents. In an opinion written by Judge Stephanos Bibas, the court acknowledged the difficult decisions facing terminally ill patients but said the option remains limited under state law.

“Death brings good things to an end, but rarely neatly,” U.S. Circuit Court Judge Stephanos Bibas wrote in the opinion issued last week. “Many terminally ill patients face a grim reality: imminent, painful death. Some may want to avert that suffering by enlisting a doctor’s help to end their own lives. New Jersey lets its residents make that choice—but only its residents.”

New Jersey is one of 11 states, along with Washington, D.C., that allow physician-assisted suicide for terminally ill adults. Most states restrict the practice to residents, though Oregon and Vermont allow access regardless of residency.

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The case began when a Delaware woman with stage four lymphoma sought to use New Jersey’s law but was blocked by the residency rule. She died after arguments in the case. A New Jersey doctor who wanted to treat patients from nearby states also joined the challenge, as did other plaintiffs who have since passed away or retired.

One of the plaintiffs, Dr. Paul Bryman, said he was disappointed by the ruling. “Terminal patients outside New Jersey should have the option of medical aid in dying without having to travel long distances,” he said.

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New Jersey Gov. Phil Murphy, a Democrat, signed the measure into law in 2019, saying at the time that while his Catholic faith might prevent him from choosing assisted suicide for himself, he supported the right of others to make that decision.

Under the law, a patient must be an adult New Jersey resident with a terminal diagnosis and a prognosis of six months or fewer to live. Two physicians must confirm the diagnosis and the patient’s capacity to decide. Patients must make two requests — at least one of them in writing with two witnesses — and must be given the opportunity to rescind.

At least one witness cannot be a family member, heir, attending physician or an employee of the facility where the patient receives care. Patients must self-administer the medication, and doctors are required to offer alternatives such as palliative care.

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A lower court previously dismissed the challenge, finding that physician-assisted suicide is not a fundamental right states must extend to non-residents. The appeals court agreed.

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“In our federal system, states are free to experiment with policies as grave as letting doctors assist suicide. Other states are free to keep it a crime,” the appeals court ruling said. “This novel option does not appear to be a fundamental privilege, let alone a fundamental right, that states must accord visitors.”

Delaware’s own aid-in-dying law goes into effect on Jan. 1.

Several other countries, including Canada, Germany, Belgium, Switzerland, the Netherlands, Australia and Colombia, have also legalized physician-assisted suicide.

The Associated Press contributed to this report.