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The question of whether people should have the right to choose how and when they die has been at the center of a long and complex debate in the United States. The concept of “Death with Dignity” (DWD), also known as the right-to-die (RTD), has evolved dramatically over more than a century—from early legal efforts in the early 1900s to powerful public cases that shaped national opinion.
The First Steps: A Movement Begins in the Early 1900s
The first known attempt to pass a law allowing assisted death in the U.S. came in 1906, when Ohio lawmakers introduced a euthanasia bill inspired by the suffering of a woman’s terminally ill mother. That same year, a similar bill was introduced in Iowa. Though neither law passed, they marked the beginning of what would become a major social and medical issue.
These early efforts were often mocked or dismissed. One British medical journal referred to the Iowa bill’s sponsor as either a “crank” or an attention-seeker. Despite public skepticism, these initial moves planted the seeds of a broader conversation about personal choice at the end of life.
Medical Advances Complicate the Conversation
By the late 1800s, morphine and chloroform had become standard tools for pain management. Some doctors began using them to ease the dying process. But in 1885, the American Medical Association (AMA) firmly opposed the use of these substances for intentionally ending a person’s life, drawing a moral line that would influence policy for decades.
The Euthanasia Society and the Invention of Living Wills
In 1938, the Euthanasia Society of America was formed with the aim of legalizing assisted death. After decades of limited progress, the group shifted its strategy in the 1960s, promoting the idea that patients should have the right to refuse medical treatment.
This led to the creation of the first living will in 1967, developed with the help of lawyer Luis Kutner. The document allowed individuals to spell out the care they wanted—or didn’t want—if they became too sick to communicate. It was a revolutionary idea that helped shift the conversation toward patient autonomy.
Legal Gray Areas and Criminal Charges
Throughout much of the 20th century, helping someone die remained legally dangerous. In 1911, two members of a Shaker colony were arrested for murder after helping a woman with one lung end her life. Though the case was eventually dismissed, it showed how uncertain and risky assisted death was under the law.
Landmark Cases That Changed Public Opinion
In 1976, the case of Karen Ann Quinlan, who fell into a coma and was kept alive on a respirator, captured national attention. Her family’s legal battle to remove life support led to a New Jersey Supreme Court ruling that said patients (or their guardians) had the right to make end-of-life decisions. The court also ruled that removing life support in such cases was not a criminal act.
Another major turning point occurred in 2014, when 29-year-old Brittany Maynard, diagnosed with terminal brain cancer, relocated to Oregon to legally end her life under the state’s Death with Dignity law. Her decision, and the attention it drew, reignited the national conversation. In the following year alone, over half of U.S. states introduced legislation related to assisted dying.
The Controversial Legacy of “Dr. Death”
One of the most polarizing figures in the Death with Dignity debate was Dr. Jack Kevorkian. Dr. Jack Kevorkian, also known as “Dr. Death.” In the 1990s, he assisted multiple patients with life-ending procedures, often using a device he designed himself. Kevorkian appeared on national TV and challenged legal boundaries, ultimately serving 8 years in prison for second-degree murder after showing footage of an assisted death on “60 Minutes.”
Religious, Ethical, and Political Pushback
Not everyone supported the right-to-die movement. In 1954, theologian Joseph Fletcher argued for a new ethical framework, rooted in religious thought, to navigate these complex issues. Others compared assisted dying laws to the horrific euthanasia programs of Nazi Germany, sparking fears of abuse and coercion.
Even modern healthcare debates, like those around the Affordable Care Act, have sometimes been framed as threatening, with false claims about “death panels” deciding who should live or die.
A Slow but Steady Shift in the Law
Though early attempts to legalize assisted dying failed, public support steadily grew—from just 37% of Americans in 1947 to 73% by 1993. Oregon became the first state to pass a Death with Dignity Act in 1997, allowing terminally ill, mentally competent adults with less than six months to live to request life-ending medication from a doctor.
Since then, other states—including Washington, California, Vermont, and Colorado—have passed similar laws. In 2016, even Washington, D.C. joined the list, despite attempts by Congress to block it.
A Debate That Continues
Today, Death with Dignity remains a deeply personal, political, and philosophical issue. As medicine advances and life expectancy increases, Americans continue to wrestle with how much control we should have over our own deaths—and what it truly means to die with dignity.
