New Jersey’s medical aid in dying law just survived its biggest legal stress test yet, after a federal appeals court ruled that the state can legally bar terminally ill patients from crossing state lines to obtain life-ending medication. The decision keeps one of the nation’s more closely watched end-of-life statutes strictly in-house — and tees up a new round of political and ethical battles over who gets access.
The U.S. 3rd Circuit Court of Appeals upheld New Jersey’s residency requirement, making clear that assisted suicide is not a protected right states must extend beyond their borders. The judges warned that removing the restriction could entangle New Jersey doctors in criminal prosecutions in states that still outlaw the practice. As Judge Stephanos Bibas wrote, “A prescription lawful in Camden can be evidence of a felony in Philadelphia,” underscoring the legal minefield that would come with statewide open access.
The ruling is a blow to advocates who hoped New Jersey would become a regional option for terminally ill patients in Pennsylvania, Delaware, and other nearby states without aid-in-dying laws. The case itself was brought by two out-of-state patients — Delaware’s Judy Govatos and Philadelphia’s Andrea Sealy — along with two New Jersey physicians. Both patients died as the litigation dragged on, one doctor retired, and only Dr. Paul Bryman remained to hear the outcome.
Bryman, in a statement, said the decision leaves suffering patients stranded. He argued that “no one near the end of life should be forced to drive hours across state lines to access compassionate care,” calling the court’s ruling a setback for patient autonomy.
New Jersey’s five-year-old Medical Aid in Dying for the Terminally Ill Act allows adults with a prognosis of six months or less to request a self-administered life-ending prescription, subject to multiple safeguards, including one written and two oral requests to a physician. Since 2019, 409 New Jersey residents have used the law.
Supporters of the appeals court ruling say those safeguards are exactly why the state shouldn’t open the door to nonresidents. Oversight mechanisms and coercion protections vary widely across the country, and advocates for the residency rule argue that importing out-of-state patients could weaken the program’s guardrails and expose doctors to cross-border legal jeopardy.
Opponents counter that the ruling deepens a patchwork of state laws that already leaves thousands of terminally ill patients without meaningful options. With New Jersey now formally off-limits to nonresidents, fewer avenues remain for those seeking medically assisted death — even if they live just minutes across the bridge.