Only N.J. residents can end their lives through the state’s aid-in-dying law, appeals court rules

New Jersey is among the 10 states that allow physicians to assist terminally ill patients in ending their own lives, under certain conditions. But those patients must be New Jersey residents, a federal appeals court ruled.

The U.S. Court of Appeals for the Third Circuit said last week that New Jersey’s limit of the aid-in-dying law to state residents is constitutional, keeping on the books a significant hurdle for people from neighboring states — including Pennsylvania and Delaware — where the practice is not permitted.

“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,” U.S. Circuit Judge Stephanos Bibas wrote in the opinion. “This novel option does not appear to be a fundamental privilege, let alone a fundamental right, that states must accord visitors.”

» READ MORE: Philly woman with terminal cancer is suing N.J. to change its medical aid-in-dying law’s residency requirement

Jess Pezley, a staff attorney at the legal arm of Compassion and Choices, a nonprofit advocacy organization that brought the lawsuit challenging the residency requirement, said aid in dying “remains a critically important option for all terminally ill people who wish to receive healthcare in the state of New Jersey.”

The “ruling means that terminally ill patients who do not live in an authorized jurisdiction will continue to have to travel” to states like Oregon and Vermont that permit the practice for nonresidents, Pezley said in a statement.

Aid in dying is a controversial concept. While some argue the law creates a pathway for empowerment over end of life, others worry that it can lead to coercion and expansion beyond the terminally ill in a country that has a dark history in how it treats people with disabilities.

The residency requirement is meant to protect physicians from liability in states where assisting in suicide is a criminal offense, proponents of the restriction argue, and to prevent medical tourism in states with the option.

The law does not specify how long a person must live in New Jersey but sets other qualifying requirements: A patient must have a New Jersey driver’s license, be registered to vote in the state, have filed income taxes as a New Jersey resident in the last year, or have another official government record that confirms residency.

New Jersey enacted a medical aid-in-dying law in 2019. Last year, 122 people ended their lives through the program in the Garden State, according to New Jersey’s chief medical examiner. Nearly 70% of the patients had cancer and their average age was 72.

The law allows adults who are residents of New Jersey and are expected to die within six months to obtain a prescription for a lethal drug cocktail. They must be able to make their own decisions and administer the medication by themselves.

The ruling is the latest development in a lawsuit filed in August 2023 by a Camden County physician, Paul Bryman, who assists terminally ill patients in ending their lives on their own terms. He challenged the residency requirement, saying the law prohibits him from treating all patients equally because of where they live.

Bryman’s suit originally included another New Jersey physician, Deborah Pasik, and two cancer patients, Judith Govatos of Delaware and Andy Sealy of South Philadelphia. Pasik has since retired, and Govatos, 81, and Sealy, 44, died before the court made its ruling.

» READ MORE: Andy Sealy, metastatic breast cancer awareness advocate and medical aid-in-dying activist, has died at 44

The lawsuit argued the prohibition “discriminates” against patients like Govatos and Sealy by not allowing them to receive “specific medical care after crossing State lines into New Jersey, even though they would otherwise qualify for this care.”

New Jersey officials asked a federal district judge to dismiss the case, arguing that no court has recognized aid in dying as a constitutional right. The state further said that the residency requirement was among the “safeguards” in a policy that has “extraordinarily high stakes.”

The judge tossed out the lawsuit in 2024.

“And the residence requirement makes sense: While medical aid in dying is permitted in New Jersey, it is indistinguishable from the criminal act of assisted suicide in neighboring states,” District Judge Renee Marie Bumb wrote in her opinion. “By limiting the pool of eligible patients to State residents, the requirement is rationally related to the legitimate objective of protecting from out-of-state liability providers and advocates who assist terminally ill patients in seeking medical aid in dying.”

Compassion and Choices appealed the ruling to the Third Circuit, where the plea met a similar fate.

“The Constitution leaves moral questions like these to the states,” Bibas wrote. “New Jersey has answered them carefully.”