Oregon's Death with Dignity Act

Earlier ballot measures had failed. In 1991 Washington voters rejected an initiative allowing physicians to give lethal injections, 54 to 46 percent, and a similar California measure lost by the same margin in 1992. The Oregon measure on the November 1994 ballot was drawn more narrowly: a physician could write a prescription for lethal drugs, but the patient had to take them. Voters approved it 51 to 49 percent. It did not take effect for several years, survived a 1997 ballot measure seeking its repeal, and came into force on 27 October 1997.

The act covers adults who can make and communicate their own health care decisions and have a terminal illness expected to cause death within six months, as determined by an attending and a consulting physician. The patient must make oral requests and a written request signed before two witnesses, at least one of whom is not a relative, heir or employee of the patient's care facility. At least 15 days must pass between the first oral request and the prescription, and 48 hours after the written request. Nothing in the law authorizes lethal injection, mercy killing or active euthanasia. Acts in compliance with it are not legally suicide or homicide, and participants acting in good faith are protected from civil, criminal and professional liability.

On 9 November 2001 the US Attorney General issued an interpretive rule declaring that prescribing controlled substances to assist suicide was not a legitimate medical purpose under the federal Controlled Substances Act. Oregon, a physician, a pharmacist and terminally ill residents challenged the rule, and on 17 January 2006, in Gonzales v. Oregon, the Supreme Court held that the Controlled Substances Act did not allow the Attorney General to bar doctors from prescribing drugs for this purpose under a state law permitting it.

Since 2020 the waiting periods can be waived for patients expected to die within 15 days, and in 2023 the residency requirement was removed. By January 2026, 5,520 people had received prescriptions under the act and 3,691 had died after taking the medication. In 2025 such deaths were about 1 percent of all deaths in Oregon, and the most common concerns reported were loss of autonomy and of the ability to enjoy life's activities.