Appeals Court Rules New Jersey’s Assisted Suicide Law Applies Only to State Residents

A federal appeals court has ruled that New Jersey’s medical aid-in-dying law will remain exclusively available to state residents, rejecting challenges from out-of-state patients and physicians who sought access to the state’s assisted suicide provisions.

The Third U.S. Circuit Court of Appeals upheld New Jersey’s residency requirement in a decision released last week. In the opinion, Judge Stephanos Bibas acknowledged the difficult circumstances facing terminally ill individuals but affirmed that the state can legally restrict the option to its own residents.

“Death brings good things to an end, but rarely neatly,” Bibas wrote. “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.”

The case originated when a Delaware woman with stage four lymphoma attempted to utilize New Jersey’s law but was prevented by the residency requirement. She subsequently died after arguments in the case were presented. Other plaintiffs included a New Jersey physician who wanted to extend treatment to patients from neighboring states, though several other plaintiffs have since passed away or retired.

Dr. Paul Bryman, one of the plaintiffs, expressed disappointment with the ruling. “Terminal patients outside New Jersey should have the option of medical aid in dying without having to travel long distances,” he stated.

New Jersey is among 11 states and Washington, D.C. that permit physician-assisted suicide for terminally ill adults. Most of these jurisdictions limit the practice to residents, though Oregon and Vermont recently removed their residency requirements, allowing access regardless of where patients live.

Democratic Governor Phil Murphy signed New Jersey’s aid-in-dying legislation in 2019. At the time, he acknowledged that his Catholic faith might prevent him from personally choosing assisted suicide, but he supported the right of others to make that decision for themselves.

New Jersey’s law includes several safeguards and requirements. Eligible patients must be adult New Jersey residents with a terminal diagnosis and prognosis of six months or less to live. Two physicians must confirm both the diagnosis and the patient’s mental capacity to make the decision. Patients must submit two requests – at least one in writing with two witnesses present – and must be given opportunities to rescind their request.

The law stipulates that at least one witness cannot be a relative, heir, attending physician, or an employee of the healthcare facility where the patient receives treatment. Patients must self-administer the life-ending medication, and physicians are required to offer alternatives such as palliative care.

The appeals court affirmed a lower court’s earlier dismissal of the challenge, concluding that physician-assisted suicide is not a fundamental right that states must extend to non-residents. The ruling emphasized the principles of federalism, stating: “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. This novel option does not appear to be a fundamental privilege, let alone a fundamental right, that states must accord visitors.”

The issue of medically assisted death continues to evolve across the United States and globally. Delaware’s own aid-in-dying law is set to take effect on January 1, potentially alleviating some pressure on neighboring states from Delaware residents seeking end-of-life options.

Several other countries have legalized physician-assisted suicide, including Canada, Germany, Belgium, Switzerland, the Netherlands, Australia, and Colombia, reflecting a global trend toward expanded end-of-life choices despite ongoing ethical and legal debates.

As more states consider similar legislation, questions about residency requirements and interstate access to assisted suicide are likely to remain contentious points in both legal and ethical discussions surrounding end-of-life care.