Compassion & Choices believes that medical aid in dying should be available to all qualified patients, regardless of their zip code. At present, in every state where medical aid in dying has been authorized via the legislative process, there is statutory language that limits the use of the practice to in-state residents. However, firsthand experiences from doctors and patients, and decades of data, make it clear that the residency restriction functions more as a barrier to access than as a safeguard. 

The process of establishing residency in a new state while terminally ill is an extremely burdensome and expensive process that no one should have to endure. The residency restriction is a barrier to accessing medical aid in dying for nearly all dying people who live in a jurisdiction where aid in dying is not yet authorized. A significant number of terminally ill people residing in states where medical aid in dying is authorized have also been adversely impacted by these restrictions as many receive their regular medical care across state lines. Further, the residency restriction is out-of-step with all other medical care provided in this country; Compassion & Choices has been unable to identify any other medical care that has been limited to in-state residents. 

Whether it be through the courts or the legislature, Compassion & Choices continues to advocate for greater access to all forms of end-of-life care.

Gideonse v. Brown

In 2021, Compassion & Choices filed a lawsuit in federal court on behalf of Dr. Nicholas Gideonse that challenged the constitutionality of the residency restriction contained in Oregon’s Death with Dignity Act. In this case, Gideonse v. Brown, et al., Dr. Gideonse explained that he regularly treats patients from neighboring Washington State and that medical aid in dying was the only type of care that he was unable to provide to these individuals. The residency restriction required these patients to either find a new doctor during the dying process or to not have the option of medical aid in dying. Dr. Gideonse argued that the residency restriction violated the United States Constitution because it unlawfully discriminated against his out-of-state patients. 

On March 28, 2022, Dr. Gideonse and the State of Oregon defendants reached a settlement in the case. As a result of this settlement, the Oregon Health Authority (OHA), Oregon Medical Board, and the Multnomah County District Attorney have all agreed not to enforce the residency restriction. Further, the OHA has also agreed to initiate a legislative request to permanently remove the residency restriction from the law. 

What now?

As a result of this settlement, the Oregon Health Authority (OHA) and Oregon Medical Board have all agreed not to enforce the residency restriction. Additionally, as a condition of settling the lawsuit, the District Attorney of Multnomah County officially stated that the residency restriction will not be enforced within the county. Further, the OHA has also agreed to initiate a legislative request to permanently remove the residency restriction from the law. 

Bluestein v. Scott

On August 25, 2022, Compassion & Choices filed a lawsuit on behalf of Lynda Bluestein, a terminally-ill Connecticut resident, and Diana Barnard, a Vermont physician specializing in hospice and palliative care and associate professor of family medicine at University of Vermont. Both Ms. Bluestein and Dr. Barnard’s non-Vermonter patients are unable to access medical aid in dying in Vermont, due solely to a provision of The Patient Choice and Control at End of Life Act (the Act) that restricts the option to Vermont residents. 

The lawsuit alleges that the residency requirement contained in the Act is unconstitutional. Filed on the heels of the State of Oregon agreeing to suspend enforcement of its residency requirement as a result of the settlement reached in the Gideonse v. Brown suit, this lawsuit is the most recent challenge to a residency restriction contained in a medical aid-in-dying law.