End-of-Life Choice, Death with Dignity, Palliative Care and Counseling


Follow our decades of milestones in the modern end-of-life choice movement.


A right-to-die bill is introduced in the Florida legislature. It arouses extensive debate but is unsuccessful.


The Hemlock Society, an end-of-life care organization for those suffering with incurable illnesses, forms. It later evolves into End-of-Life Choices, which in 2005 merges with Compassion in Dying to form Compassion & Choices.


Oregon Senator Frank Roberts sponsors legislation championing choice at the end of life.


The U.S. Supreme Court decides the Cruzan v. Director, Missouri Department of Health ruling that Missouri was permitted to require clear and convincing evidence of the wishes of a patient regarding provision of artificial nutrition and hydration. This affirmed the right of Americans to refuse unwanted medical treatment and their right to appoint a healthcare proxy to speak for them when they could not.


Ballot measure I-119 to allow mentally competent, terminally ill patients physician aid in dying is voted on in Washington state. It fails by narrow margin.


Proposition 161, the California Death With Dignity Act, is widely supported but does not pass.


Compassion in Dying is founded to provide support and advocacy programs for terminally ill individuals in Washington state.


Kathryn L. Tucker
Kathryn L. Tucker

Compassion in Dying develops and files two federal lawsuits asserting that a mentally competent, terminally ill patient has a right protected by the U.S. Constitution’s guarantees of liberty, privacy and equal protection to choose aid in dying. The first case, Glucksberg v. Washington, is filed in Washington state. The second case, Quill v. NY, is filed in New York. The Federal District Court for the Western District of Washington holds for the plaintiffs. The state of Washington appeals to the Ninth Circuit Court of Appeals. The plaintiffs in both suits are represented by attorney Kathryn Tucker, who later becomes legal director for Compassion in Dying and subsequently Compassion & Choices.

Oregon voters approve Measure 16, the Oregon Death With Dignity Act, a ballot initiative that permits terminally ill patients, under specified safeguards, to obtain a physician’s prescription to end life in a humane and dignified manner. The measure passes with 51 percent of the vote. Co-author and chief petitioner is Barbara Coombs Lee, president of Compassion in Dying and subsequently Compassion & Choices.


The Ninth Circuit Court of Appeals (in Glucksberg v. Washington) and the Second Circuit Court of Appeals (in Quill v. NY) both find that the U.S. Constitution protects the choice of a competent terminally ill patient to choose aid in dying. The states of New York and Washington file for review in the U.S. Supreme Court.


The Compassion in Dying Federation is formed by Compassion in Dying of Washington, expanding to launch national advocacy and support programs.

The National Right-to-Life Committee challenges Oregon’s Death With Dignity Act. The challenge stalled implementation until it was dismissed by the Ninth Circuit Court in 1997. That year, the Oregon legislature put a measure on the ballot to rescind the law, but it was defeated by 60 percent of the voters.

In Glucksberg v. Washington and Vacco v. Quill, the U.S. Supreme Court declines to find federal constitutional protection for aid in dying, leaving the possibility open that it will do so in the future, and refers the issue to the states. The court recognizes a federal constitutional right for dying patients to receive as much pain medication as necessary to obtain relief, even if this advances time of death.

Rep. Henry Hyde and Sen. Don Nickles introduce The Lethal Drug Abuse Prevention Act to prohibit legal aid in dying.

States consider enacting death with dignity laws, including Hawaii, Vermont and California. Strong, well-funded opposition from the Catholic Church, right-to-life advocacy groups and disability advocacy groups is successful in defeating measures despite strong public support.

Oregon Death With Dignity Act begins implementation.

Compassion in Dying’s client “Helen” becomes the first person to take lethal medication under Oregon’s law.


The U.S. House of Representatives passes the Pain Relief Promotion Act (PRPA). The bill would have criminalized aid in dying and nullified the Oregon law.


Oregon Sen. Ron Wyden’s threatened filibuster keeps the PRPA from reaching the Senate floor.


Attorney General John Ashcroft issues a directive that would effectively nullify the Oregon Death With Dignity Act. The state of Oregon sues to enjoin the directive, joined by a group of terminally ill Oregonians and represented by Compassion & Choices. Federal District Court Judge Robert E. Jones enjoins the Ashcroft directive.

Compassion & Choices represents the Bergman family of California in bringing the nation’s first case to claim that failure to treat pain adequately constitutes elder abuse, winning a $1.5M verdict for patient’s pain and suffering; the case establishes that failure to treat pain adequately can result in significant financial risk to healthcare providers.

Compassion in Dying drafts and sponsors legislation passed in California (AB 487) requiring that physicians receive continuing education in pain management.


October 6 marks the fifth anniversary of Oregon’s Death With Dignity Act; 129 terminally ill Oregonians have used it to die peacefully.

Attorneys present oral arguments for Oregon v. Ashcroft arguing states’ rights. Months later, Judge Robert E. Jones rules against Ashcroft and rebukes the federal government for its attempt to “stifle an ongoing, earnest and profound debate in the various states concerning physician-assisted suicide.”


The Hemlock Society evolves to become End-of-Life Choices.


The Department of Justice appeals Oregon v. Ashcroft to the United States Ninth Circuit Court of Appeals. The Ninth Circuit Court affirms the lower court, leaving the Oregon Death With Dignity Act intact.

As Attorney General John Ashcroft resigns, he files an appeal to the U.S. Supreme Court to review the Ninth Circuit’s affirmation of lower court injunction of the Ashcroft directive. Now known as Gonzales v. Oregon, the case asks the high court to consider whether the federal Controlled Substances Act authorizes the Department of Justice to displace state regulators and determine legitimate use of medications. Traditionally, this prerogative has been reserved for the states.


Compassion and ChoicesCompassion in Dying and End-of-Life Choices unify to become Compassion & Choices. The new organization maintains headquarters in both Denver and Portland, and it is the largest organization in the United States advocating for patients’ rights at the end of life.


The American Medical Women’s Association (AMWA) adopts policy in support of aid in dying.

Compassion & Choices’ spokespeople testify at an emotional hearing before the California State Assembly in support of AB 374, the California Compassionate Choices Act. AB 374, which would have allowed death with dignity in the state, was supported by a wide coalition of organizations and individuals but failed by a narrow margin.


The American Public Health Association (APHA) adopts a policy, “Supporting Appropriate Language Used to Discuss End-of-Life Choices.”

In October, Compassion & Choices and Missoula litigator Mark S. Connell file Baxter v. Montana, a suit on behalf of Bob Baxter, Montana physicians and Compassion & Choices, asserting that the Montana Constitution protects a peaceful death with dignity.

The Washington State Psychological Association (WSPA) approves policy regarding value-neutral terminology regarding end-of-life choices.


WaThe American Medical Students’ Association adopts a policy reiterating and broadening support of aid in dying.

Washington Initiative 1000, modeled after Oregon’s Death With Dignity Act, qualifies for November 2008 ballot.

A bill developed by Compassion & Choices designed to ensure that terminally ill patients have access to information about a full range of end-of-life choices accepted in law and medicine passes in California, On September 30, 2008, Gov. Schwarzenegger signs AB 2747, the Terminal Patients’ Right to Know End-of-Life Options Act.

The American Public Health Association (APHA) adopts a position supporting death with dignity for terminally ill patients.

On November 4, 2008, Washington voters overwhelmingly approve I-1000, 59% to 41%. Washington becomes the second state to legalize aid in dying.

Montana District Court Judge Dorothy McCarter held in December 2008 that the Montana Constitution protects a peaceful death with dignity, making Montana the third state to permit legal aid in dying.


montanaOn January 1, the Terminal Patients’ Right to Know End-of-Life Options Act, AB 2747, goes into effect in California.

Compassion & Choices calls on the Obama Administration to repeal last-minute regulations allowing denial of medical services based on healthcare workers’ religious beliefs.

On March 5, Washington’s Death With Dignity Act begins implementation.

Compassion & Choices files suit in Connecticut on behalf of two Connecticut physicians, Gary Blick and Ron Levine, asserting that the Connecticut statute that makes a crime of assisting someone to “commit suicide” does not reach the conduct of a physician providing aid in dying.

On October 29, Congressman Earl Blumenauer of Oregon stood with leaders of the House of Representatives as they unveiled The Life-Sustaining Treatment Preferences Act of 2009 that would provide coverage under the Medicare program for consultations regarding physician orders for life-sustaining treatment (POLST).

Senator Jay Rockefeller champions end-of-life care in his report to the Senate Finance Committee’s healthcare reform legislation. Compassion & Choices continues work to assure end-of-life choice remains a key component of the final health insurance reform package.

Compassion & Choices hosts “Dignity & Choices, A Symposium on End-of-Life Advocacy” in Washington, D.C. Physicians, social workers, nurses, attorneys and advocates for end-of-life choice filled the National Press Club to hear aspects of end-of-life care rarely discussed.

On December 31, the Montana Supreme Court rules in favor of the landmark case brought by Compassion & Choices (Baxter v. Montana) affirming that it is not against Montana public policy for a physician to provide aid in dying to a mentally competent, terminally ill individual.


The Older Women’s League (OWL) devotes its 30th anniversary Mother’s Day Report to end-of-life choices and hosts a Capitol Hill policy briefing on the issue.

On June 2, Blick et al v. Connecticut is dismissed without reaching the merits, on sovereign immunity grounds, denying plaintiffs the opportunity to make their case to distinguish committing “suicide” from a mentally competent terminally ill patient ingesting medications to bring about a peaceful death.

New York passes the Palliative Care Information Act (PCIA) in August. The law, drafted by Compassion & Choices and modeled after a similar measure in California, requires healthcare workers to provide information and counseling on end-of-life options.

Compassion & Choices files the groundbreaking lawsuit Hargett v. Vitas seeking accountability for the unnecessarily painful death of 43-year-old mother of three, Michelle Hargett-Beebee, who was never informed of the availability of palliative sedation. This is the first case in the nation to allege that failure to tell a patient about palliative sedation falls outside the standard of care.


Legislative opponents introduce SB 116 in Montana to nullify the Montana Supreme Court’s landmark ruling in Baxter v. Montana, a case litigated by Compassion & Choices. The Montana Medical Association testifies in official opposition to the measure. On February 16 the Montana Senate Judiciary Committee declines to adopt this measure, preserving the option of aid in dying for Montanans.

A bill amending Washington’s Death With Dignity Act, SB 5378, fails to clear committee in response to Compassion & Choices’ proactive efforts and voter support. SB 5378 would have amended the section of the Death With Dignity Act specifying deaths under the Act do not constitute “suicide.”

Compassion & Choices launches successful public campaign throughout Oregon to defeat HB 2016, a bill requiring all terminally ill patients who request aid in dying to undergo psychiatric evaluation. The Oregon House Healthcare Committee holds no hearing or work session on HB 2016.

The U.S. Conference of Catholic Bishops issues its first official statement condemning aid in dying, and Compassion & Choices answers back by holding a press conference on the same day – in the same building – and refuting the USCCB’s false claims throughout national media.

Compassion & Choices establishes a national office in Washington, D.C.

A careful review of Hawaii law indicates the state has no legal prohibition against aid in dying, and physicians may provide it to their terminally ill patients without fear of criminal prosecution. Compassion & Choices organizes local supporters and physicians to raise awareness and implement the practice.

Award-winning documentary about Oregon’s Death With Dignity Act, How to Die in Oregon, is released, featuring Compassion & Choices staff, volunteers and clients.


Dr. Peter Goodwin
Dr. Peter Goodwin

Dr. Peter Goodwin, longtime Compassion & Choices advocate who played a leading role in crafting and promoting Oregon’s Death With Dignity Act, uses the law to end his life at age 83 after suffering with a rare brain disease, corticobasal degeneration.

With plaintiffs Dr. Katherine Morris and Dr. Aroop Mangalik, Compassion & Choices files a lawsuit, Morris v. New Mexico, asserting that aid in dying is not prohibited by existing New Mexico law.

Compassion & Choices gains membership in the Leadership Conference on Civil and Human Rights in Washington, D.C., the nation’s premier civil and human rights coalition.

The Montana Board of Medical Examiners issues a statement confirming it will consider aid in dying as it would any other medical procedure when evaluating physician conduct in the state, rebuffing an effort to chip away at the recognition of the legality of aid in dying in Montana.


Opponents of choice in Montana introduce House Bill 505, dubbed the “Doctor Imprisonment Act,” which would send doctors to prison for ten years for providing aid in dying. Compassion & Choices kicks off an aggressive campaign that results in defeat of the bill.

Compassion & Choices launches a campaign to end unwanted medical treatment, and Chief Operating Officer Mickey MacIntyre brings the issue to the influential Institute of Medicine’s Committee on Transforming End-of-Life Care during its first meeting February 20.

Compassion & Choices expands its campaigning for death-with-dignity laws, with progress in several states:

The New Jersey Assembly Health and Senior Services Committee approved a death-with-dignity bill February 7, 7-2.

More than 100 people testified in support of the HB 6645, a death-with-dignity bill in Connecticut, with the last witness testifying at 1:30 am. Knowing that the bill would clear committee, opponents threatened a filibuster, halting the bill for the 2013 session.

On May 20, Vermont becomes the fourth state to legalize aid in dying and the first in the nation to do so through the legislature. Compassion & Choices President Barbara Coombs Lee calls the law “a political breakthrough that will boost support for death-with-dignity bills nationwide.” Compassion & Choices supported Patient Choices Vermont in getting the law passed and immediately began working to implement the law, providing education and assstance to members of the public and medical professionals.

Joe Yourshaw & daughter Barbara Mancini

Compassion & Choices files a civil suit, Hallada v. Lakeland, against Lakeland Regional Medical Center and Oakbridge Healthcare Center for failure to honor 91-year-old Marjorie Mangiaruca’s advance directive in their aggressive efforts to resuscitate her.

The Pennsylvania Attorney General charges Barbara Mancini for assisting the suicide of her 93-year-old, terminally ill father Joe Yourshaw, whom Barbara was caring for while Joe was dying in at-home hospice care. Compassion & Choices ignites a nationwide discussion on end-of-life autonomy through its campaign to have the charge dropped.

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