Article Figures & Data
Tables
Legal MAID Year Effective Mental Health Assessment Requirement Oregon Death With Dignity Act26 1997 “If in the opinion of the attending physician or consulting physician a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment.”27 Washington Death With Dignity Act28 2009 “If, in the opinion of either the attending qualified medical provider or the consulting qualified medical provider, a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment.”29 Baxter v. Montana30a 2009 No legislation Vermont Patient Choice and Control at the End-of-Life Act31 2013 “The physician either verified that the patient did not have impaired judgment or referred the patient for an evaluation by a psychiatrist, psychologist, or clinical social worker licensed in Vermont for confirmation that the patient was capable and did not have impaired judgment.”32 California End of Life Option Act33 2016 “If there are indications of a mental disorder, the physician shall refer the individual for a mental health specialist assessment.”34 Colorado Proposition 106 End of Life Options Act35 2017 “Refer the individual to a licensed mental health professional…if the attending physician believes that the individual may not be mentally capable of making an informed decision.”36 DC Death with Dignity Act37 2017 “If, in the opinion of the attending physician or consulting physician, a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment.”38 Hawai'i Our Care, Our Choice Act39 2019 “The attending provider shall refer the patient for counseling. No medication . . . shall be prescribed until the person performing the counseling determines that the patient is capable, and does not appear to be suffering from undertreatment or nontreatment of depression or other conditions which may interfere with the patient’s ability to make an informed decision.”40 An Act to Enact the Maine Death with Dignity Act9 2019 “If, in the opinion of the attending physician or the consulting physician, a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment.”41 New Jersey Bill A1504 Aid in Dying for the Terminally Ill Act8 2019 “If, in the medical opinion of the attending physician or the consulting physician, a patient…may not be capable, the physician shall refer the patient to a mental health care professional to determine whether the patient is capable.”42 New Mexico Elizabeth Whitefield End of Life Options Act10 2021 “If an individual has a current history of a mental health disorder or an intellectual disability that could cause impaired judgment…or if, in the opinion of the prescribing health care provider or consulting health care provider, an individual currently has a mental health disorder or an intellectual disability that may cause impaired judgment…”43 MAID, medical aid in dying. Data for this table were retrieved from the individual statutes.8,–,10,26,27,29–33
↵aIn its 2009 decision Baxter v. Montana, the Montana Supreme Court ruled that assisted suicide did not violate Montana legal precedent or state statutes, but there is no legal protocol in place.30
Eligibility Criteria Minimum age requirement of 18 years Residency requirementb Able to independently formulate and convey healthcare decisions Must be diagnosed with a terminal illness with an anticipated life expectancy of six months or less Clinician Requirements Licensed in the jurisdictionc Provide a diagnosis for the patient indicating a terminal illness anticipated to result in death within six months or fewer A clinician offering consultation is required to confirm both the terminal diagnosis and prognosis, in addition to ensuring that the patient has the capacity to make the decision As necessary, a recommendation for consultation with a mental health professional must be initiatedd Must provide the patient with counseling regarding available alternatives Additional Safeguards Two oral requests with a time interval in betweene A written request with a witness present The patient can withdraw the request at any given moment Healthcare professionals are not under any obligation to engage or partake The application of the law should not affect the standing of a patient’s health, life, or annuity insurance policies Data for this table were retrieved from the individual statutes.8,–,10,26,28,31,33,35,37,39
↵aMontana has legal MAID via court ruling, but there is no legal protocol in place, and therefore, the criteria in this table do not apply to Montana.30
↵bOregon and Vermont do not have a residency requirement. There is ongoing litigation surrounding New Jersey’s residency requirement.26,31,84
↵cIn New Mexico (10), Washington (28), and Hawaii (39), non-physician advanced practice professionals are authorized prescribers. Colorado’s statute, newly amended in 2024, will also permit this practice. once the amended law takes effect (35).
↵dRefer to Table 1.
↵eThis time frame ranges from 48 hours to 20 days.8,–,10,26,28,31,33,35,37,39 New Mexico does not have an oral request requirement.10 Oregon specifies that patients with less than 15 days left to live can skip the 15-day waiting period.26
Wrongful Death or Negligence Claims Allegations that a healthcare provider failed to comply with the legal requirements or safeguards or that the patient’s decision was influenced by coercion or mental incapacity. A forensic mental health professional may be asked to assess the deceased’s mental state, decision-making capacity, and the circumstances leading to their choice. Informed Consent Disputes Disagreements regarding whether the patient was able to provide informed consent for MAID may call for a forensic mental health professional to evaluate the patient’s capacity to make an informed choice. Coercion or Undue Influence Claims In situations where there are allegations of coercion or undue influence, a forensic mental health professional may be asked to assess the patient’s vulnerability and the extent of external pressures, helping to determine the validity of these claims. Compliance with Legal Safeguards A forensic mental health professional may be called upon to evaluate whether healthcare providers or institutions followed the legal safeguards for MAID, ensuring that the process adhered to the law and ethical standards. Wrongful Termination In cases where clinicians face wrongful termination for their engagement in or avoidance of MAID, a forensic mental health professional may be called upon to assess the mental and emotional state of the terminated clinician and to determine whether the clinician’s mental health was affected by the termination. MAID, medical aid in dying.
