A federal appeals court has determined that a New Jersey law, which allows terminally ill individuals to obtain life-ending medication, is applicable exclusively to residents of the state, excluding non-residents. This ruling was issued by the 3rd U.S. Circuit Court of Appeals, based in Philadelphia, which dismissed challenges to New Jersey’s residency clause while recognizing the complexity of decisions regarding end-of-life care. The court emphasized that states vary in their policies on this sensitive issue.

Judge Stephanos Bibas, of the U.S. Circuit Court, reflected on the difficulties faced by terminally ill patients in his opinion delivered on Friday. He highlighted the harsh reality of an impending, painful death that many face and acknowledged that some patients might wish to avoid such suffering by choosing to end their lives with medical assistance. New Jersey permits this choice, but strictly for its residents.

Along with New Jersey, assisted suicide is legally sanctioned in the District of Columbia and ten other states for terminally ill patients. Most of these states, however, impose a residency requirement. In contrast, Oregon and Vermont extend this option to all individuals, regardless of residency.

The legal challenge originated from a Delaware woman suffering from stage 4 lymphoma, who sought the right to assisted suicide and contested New Jersey’s residency limitation. Unfortunately, she passed away following oral arguments in the case. Notably, Delaware has planned to legalize doctor-assisted suicide starting January 1.

The case was brought by a Delaware woman with stage 4 lymphoma who wanted the option of doctor-assisted suicide and challenged the New Jersey residency requirement but died after oral arguments in the case. Delaware will begin to allow doctor-assisted suicide on Jan. 1.

A New Jersey doctor who sought to help patients like the Delaware woman also challenged the law. Initially, there were other plaintiffs, including a Pennsylvania woman who had metastatic breast cancer but who died before the appeal of a lower court’s dismissal of the challenge, as well as another New Jersey doctor who has retired.

Messages seeking comment Wednesday were left with attorneys for the people challenging the law.

New Jersey Democratic Gov. Phil Murphy signed the legislation in 2019, saying that while his Catholic faith might lead him not to end his own life if he were terminally ill, he wouldn’t deny the choice to others.

The law requires two doctors to sign off on a request and that the terminally ill patient be deemed an adult resident of New Jersey who can make such a decision, who voluntarily expresses a wish to die and who has a prognosis of six months or fewer to live.

It requires patients to request the medication twice and says they must be given a chance to rescind their decision. At least one of the requests must be in writing and signed by two witnesses.

At least one witness cannot be a relative, entitled to any portion of the person’s estate, the owner of the health care facility where the patient is getting treatment or a worker there, or be the patient’s doctor.

Under the law, patients must administer the drug themselves, and their attending physician would be required to offer other treatment options, including palliative care.

A lower court dismissed the challengers’ complaint, reasoning that doctor-assisted suicide is not a fundamental privilege states must afford to non-residents.

The appeals court agreed.

“In our federal system, states are free to experiment with policies as grave as letting doctors assist suicide. Other states are free to keep it a crime,” the opinion said. “This novel option does not appear to be a fundamental privilege, let alone a fundamental right, that states must accord visitors.”