Recently, there has been a dramatic increase in the number of states considering death with dignity laws. Sometimes called “assisted suicide” or “right to die” initiatives, these laws make it possible for terminally ill patients to use prescribed medication to end their lives peacefully rather than suffering a painful and protracted 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 death with dignity law, and Oregon was one of the few states that allowed terminally ill patients to receive aid in dying.
Spurred by Maynard’s decision and the resulting publicity, the North Carolina General Assembly is now considering a death with dignity bill, HB789, called the North Carolina End of Life Option Act, 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 North Carolina’s proposed law.
“Death with dignity” is one 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, North Carolina’s proposed law states that terminating one’s life under the law is not suicide. (See HB789, Section 90-326.20.)
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 a North Carolina advance health care directive. (See the end of this article for more information.)
North Carolina’s proposed law is modeled closely on Oregon’s Death With Dignity Act, which took effect in 1997. If North Carolina’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, attorney-in-fact, or conservator -- may make a request for aid-in-dying medication on behalf of the patient.
You can read the full text of North Carolina's End of Life Option Act on North Carolina’s General Assembly 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.