Why can’t I simply relocate to access Medical Aid in Dying?

By Judith Schwarz, PhD

End of Life Options: Conversations with Judy
This article is part of the End of Life Options: Conversations with Judy series — to learn more about the series, click here.

Why can’t I simply move/relocate to New Jersey in order to access Medical Aid in Dying?

Many residents of New York and other states without legal access to medical aid in dying (MAID) who live near New Jersey wonder if they could just move to New Jersey in order to gain access to MAID. Often these individuals are suffering from a terminal illness that causes them continuous physical and emotional distress. They often tell me they are “done”. They are tired of living, have few friends or family members available for support, and while they do not want to be a burden, they fear more future suffering.

Some may have a long-standing relationship with a primary care clinician, but have not discussed their end of life fears, hopes, and/or wishes with their provider. Others do not have a clinical relationship with any providers. Most people find it extremely difficult to discuss the “topic” of death or dying — particularly when it is their own death. Many fear that if they divulge their desire for MAID they will be negatively judged, be deemed “suicidal” and/or at risk for hospitalization due to acute depression.

Some may have heard about MAID and see this as the solution to their problems — a peaceful death that quickly follows self-administration of lethal medication. However, most are unfamiliar with the regulations and safeguards that all states with MAID legislation have established to prevent inappropriate use of this end of life option.

Currently, these are the states where MAID is legal and the year it was enacted: California (2015), Colorado (2016), DC (2016), Hawaii (2018), Montana (2009), Maine (2019), New Jersey (2019), New Mexico (2021), Oregon (1994), Vermont (2013) and Washington (2008).

Earlier this year, Oregon dropped its residency requirement in response to a federal lawsuit alleging that the residency requirement of the law violated the U.S. Constitution’s right to equal treatment. However, currently all other states where MAID is legal have some sort of residency requirement. New Jersey requires a New Jersey driver’s license or voter registration card to establish residency, and this can take several months. For many terminally ill patients in New York, a move to New Jersey would prove difficult — both because of the logistics, money, and energy it would take to move and also the potential emotional impact of leaving the place they have considered home at the end of their lives.

In addition, these states require that the patient be medically determined to be currently in the terminal stage of disease (usually understood as a prognosis of 6 months or fewer to live). Two physicians must agree to examine the patient to determine that the patient is: currently terminally ill, capable of making their own decisions, and making an informed and thoughtful request for assistance in dying. (It should be noted that locating two New Jersey physicians who will examine a patient moving to the state because they are seeking MAID is an extremely challenging endeavor.) The physician must also describe other options to relieve suffering such as access to hospice care and/or effective pain management. The patient must make two verbal requests for assistance in dying with an intervening 15 day waiting period, plus a written request, and be able to self-administer and ingest the lethal medication.

Therefore, while MAID is legal in New Jersey, relocating to the state is not a realistic option for many New Yorkers who are seeking access to medical aid in dying.

Judith Schwarz is a PhD prepared nurse, and has provided End of Life Counseling for 20 years for adults with living incurable/progressive or terminal illnesses. As the Clinical Director of End of Life Choices New York (EOLCNY), she answers New Yorkers’ questions about a range of end of life issues.

To learn more about EOLCNY’s counseling program, click here. To connect with Judy, please email judith@eolcny.org.

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EOLCNY provides advocacy, education, counseling, and support to expand end of life options and improve care for New Yorkers.

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End of Life Choices New York

EOLCNY provides advocacy, education, counseling, and support to expand end of life options and improve care for New Yorkers.