A federal appeals court has blocked a major effort by “assisted suicide” activists to open New Jersey’s euthanasia system to out-of-state residents, preserving the state’s residency requirement and stopping what critics warned would become organized “death tourism.”
Experts have been sounding the alarm over the effort, warning that the Garden State would become a global hub for “suicide on demand.”
The Third Circuit Court of Appeals upheld New Jersey’s rule limiting physician-assisted suicide to state residents.
The court concluded that the state has legitimate and weighty reasons to restrict access to the controversial practice of euthanizing people.
“New Jersey has sound reasons to limit this grave choice to its own residents,” Judge Stephanos Bibas, a Trump appointee, wrote in the ruling.
“Protecting vulnerable patients and their doctors (not to mention avoiding friction with other states) justifies the residency requirement under any applicable test.”
Activists Sought to Strike Down Residency Limits
The challenge, brought by national advocacy group Compassion & Choices and New Jersey physician Paul Bryman, aimed to force the state to allow doctors to euthanize nonresidents under New Jersey’s Medical Aid in Dying law (MAiD).
A district court had previously dismissed the case.
The Third Circuit affirmed that decision.
“In our federal system, states are free to experiment with policies as grave as letting doctors assist suicide,” Bibas wrote,
“Other states are free to keep it a crime.”
Judge Bibas emphasized that assisted suicide “does not appear to be a fundamental privilege, let alone a fundamental right, that states must accord visitors.”
Even if it were considered such a right, Bibas added:
“New Jersey has good reasons to limit it to New Jerseyans: protecting doctors from prosecution, preventing friction with other states, guarding patients from coercion, and ensuring that their decisions are rational and considered.”
National Debate Intensifies
New Jersey is one of nine states that permit assisted suicide for qualifying residents. Delaware is set to join the list in 2026.
California, Colorado, Hawaii, Maine, New Mexico, Oregon, Vermont, Washington, and Washington, D.C., have all passed laws allowing doctors to euthanize residents.
Activists have increasingly pursued lawsuits to remove residency rules nationwide.
Compassion & Choices successfully pressured Oregon and Vermont into dropping their residency requirements.
However, critics warn that these moves created a pathway for “death tourism,” allowing people to be killed by lethal injections.
Regional Concerns
Opponents argue that eliminating New Jersey’s residency restriction would have uniquely sweeping consequences due to its proximity to several states, including Pennsylvania, New York, Connecticut, Maryland, and New Hampshire.
Those states currently do not allow “assisted suicide.”
They warn that this could turn New Jersey into a magnet for individuals from around the world to be euthanized with lethal drugs that their home states or nations prohibit.
International Cautionary Example
Skeptics of MAiD laws often point to Canada, where eligibility for assisted suicide has rapidly expanded.
In 2023, 4.7% of all deaths in Canada were physician-assisted, according to national statistics, fueling concerns about normalization and inadequate safeguards.
The Third Circuit ruling keeps New Jersey’s restrictions in place while national debates over MAID, state sovereignty, and patient protections continue to grow.
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