Assisted suicide and the right to die has sparked political and emotional discourse in this country for over a century. In 1906, the first euthanasia bill was drafted in Ohio. Although unsuccessful, this bill marks the inception of a debate that has raged on since in this country.

Euthanasia is defined in the Merriam-Webster Dictionary as, “the act or practice of killing someone who is very sick or injured in order to prevent any more suffering.”

Proponents sight euthanasia as a means to offer patients dignity and compassion by offering a quick death. It has even been argued that the right to die is protected by the same constitutional safeguards that guarantee such rights as marriage, procreation, child rearing and the refusal or termination of life-saving medical treatment (ACLU Amicus brief in Vacco v. Quill).

The opposing side says the Hippocratic Oath taken by doctors means they have a moral responsibility to keep patients alive. However, only 14 percent of modern oaths prohibit euthanasia explicitly. Some also argue that legalization of assisted suicide could unfairly target the poor, minorities,  and the disabled and create incentives for insurance companies to terminate lives in order to save money. Others go as far to claim it would be a “slippery slope,” potentially leading to murder.

One might assume an issue as pressing as the right to end one’s life would be at the forefront of discussion of the 2016 Presidential election. However, the topic has seemed to take a backseat to other issues thus far. This could be explained, in part, by the fact that as of now it is a state, rather than federal, decision.

Individual states, not the federal government, licenses physicians and determines what is and is not a legitimate medical practice. This means that the laws regarding end of life options vary drastically from state to state.

The official political platform of the Republican party is that federal funds should not be used for the drugs that cause the destruction of human life and there should be a restoration of the Drug Enforcement Administration’s ban on the use of controlled substances for physician assisted suicide (Rep. platform, p.40).

Paradoxically, none of the 2016 Republican Presidential frontrunners have taken an official position on the issue. While, the Democratic Platform is silent on euthanasia and assisted suicide, the front runners for the 2016 Democratic Presidential nomination are both pro-euthanasia or physician-assisted suicide.

Hillary Clinton stated in an interview with the Oregon newspaper the Register Guard, “…[W]ith appropriate safeguards and informed decision-making, I think it’s an appropriate right to have.”

At the Senior Decide 2016 forum at George Mason University, a volunteer with pro-assisted suicide group Compassion & Choice Action Network, asked Bernie Sanders what he thought can be done on the federal level to increase end-of-care options. The Vermont Senator also took a pro-stance, saying “I think if a human being is in a situation where they are going to see their life end in a short period of time, where they are suffering, where they choose no longer to be alive. I think they have the right to make that decision for themselves.”

In a groundbreaking case, Gonzales v. Oregon, the US Supreme Court voted 6 to 3 to uphold the Oregon physician-assisted suicide law in 2006. Attorney General John Ashcroft, under the Bush administration sought to punish doctors who prescribed drugs to help terminally ill patients end their lives under the Controlled Substances Act. The court decided that the Oregon Law supersedes federal authority to regulate physicians.

One might assume that this controversial topic would be reflected clearly in legislation based on a state’s political affiliation.  However, legislation is fairly mixed across blue and red states (graphic).

Copy of Copy of Map of the United States copy

Currently, physician assisted suicide is legal in California, Oregon, Washington, and Vermont. In Montana, it is legal after a court ruling.  In 2015, legislation was introduced or active in Maine, New York, Massachusetts, Connecticut, Pennsylvania, New Jersey, Maryland, North Carolina, Tennessee, Wisconsin, Missouri, Iowa, Minnesota, Kansas, Colorado, Utah, Wyoming, and Nevada.

Because legislation varies so drastically from state to state, there have been cases of individuals relocating in order to end their life peacefully.

Brittany Maynard, a 29- year-old woman suffering from brain cancer, made headlines last year when she posted a video on YouTube explaining why she chose to move from California to Oregon in order to access Oregon’s death-with-dignity law. The video has received over 11 million views and reignited the debate over right-to-die laws across the country.

For many terminally ill patients who live in states without right-to-die laws, the options are grim.

Jim Carberry, of Natick, Massachusetts, a state which has yet to pass any right-to-die laws, described watching his wife die a painful death to the Boston Globe. Suffering from cancer, Margie Carberry decided to remove her feeding tube in the summer of 2011 and slowly starved to death over the course of five weeks. She was given prescription narcotics, Ibuprofen, and other pain medications, but according to Jim Carberry, “Doctors told her there was nothing more they could do for her.”

Many patients also choose to take matters into their own hands while they are still physically able. There are books and organizations that guide people how to end their life as painlessly as possible. A popular option is to use an “insert gas hood kit.” This method requires the patient to put a plastic bag over their head and open a tank of helium. Since the body reflexively wants to breathe, the patient will breathe in pure helium, pass out after a minute or so and in a few more minutes die.

The topic of assisted suicide is one of the most divisive topics on a personal and political level. However, the topic has gained increased attention in recent years and legislation hangs in limbo as of this year. There will be many changes in laws and practice soon.