In recent years there has been a dramatic increase in the number of states considering death with dignity laws. Sometimes called "assisted suicide," "right to die," or "medical aid-in-dying" initiatives, these laws make it possible for terminally ill patients to use prescribed medication to end their lives peacefully rather than suffering a difficult death.
The catalyst for greater national attention to this issue was 29-year-old Brittany Maynard, a woman diagnosed with terminal brain cancer who moved from California to Oregon to end her life in 2014. Maynard chose Oregon because California had not yet passed its aid-in-dying law, and Oregon was one of just a few states that allow terminally ill patients to legally end their lives.
Spurred by Maynard's decision and the resulting publicity, the Iowa legislature began introducing death with dignity bills in 2015. None of them passed. Now, in the 2023 legislative session, Iowa lawmakers are considering a bill called the Our Care, Our Options Act (numbered HF533 and HF612), that would allow terminally ill patients who meet certain requirements to request life-ending medication.
This article first clarifies some confusing language related to death with dignity laws and then sets out the basics of Iowa's proposed law.
"Death with dignity" and "medical aid in dying" are two of the most commonly accepted phrases describing the process by which a terminally ill person ingests prescribed medication to hasten death. Many people still think of this process as "assisted suicide" or "physician assisted suicide." However, proponents of death with dignity argue that the term "suicide" doesn't apply to terminally ill people who would prefer to live but, facing certain death within months, choose a more gentle way of dying. In fact, Iowa's proposed law states that terminating one's life under the law is not suicide. (See HF533, Section 11 and HF612, Section 11.)
Increasingly, health organizations are turning away from the term "suicide" to describe a terminally ill patient's choice to reduce the suffering of an inevitable death. The phrase "aid in dying" is becoming a more accepted way to refer to this process.
You may also see the phrase "right to die" used in place of "death with dignity." However, "right to die" is more accurately used in the context of directing one's own medical care—that is, refusing life-sustaining treatment such as a respirator or feeding tubes when permanently unconscious or close to death. You can provide your own health care directions by completing an Iowa health care proxy and a living will. (See the end of this article for more information.)
Iowa's Our Care, Our Options Act is modeled closely on Oregon's Death With Dignity Act, which took effect in 1997. If Iowa's law passes, a patient requesting aid-in-dying medication will have to be:
A patient who meets the requirements above will be prescribed aid-in-dying medication only if:
To use the medication, the patient must be able to ingest it on their own. A doctor or other person who administers the lethal medication may face criminal charges.
In addition, no other person—such as a health care agent or attorney-in-fact—may make a request for aid-in-dying medication on behalf of the patient. And the patient may not use a health care declaration to request aid-in-dying medication.
You can read the full text of Iowa's Our Care, Our Options Act on the Iowa legislature's website.
To find out more about the history and current status of death with dignity laws in the United States, visit the website of the Death With Dignity National Center.
For information about appointing a health care agent and making known your own wishes for medical care at the end of life, see the Living Wills & Medical Powers of Attorney section of Nolo.com.
Updated March 17, 2023