A Delaware woman and a physician filed an appeal with the Third Circuit Court in a lawsuit challenging New Jersey’s residency requirement for assisted suicide — indicating a likely legal battle over whether a state can prevent its doctors from helping their out-of-state patients die.

The appeal was filed on behalf of a Delaware woman with stage-4 lymphoma, Judy Govatos, and a New Jersey-based physician, Dr. Paul Bryman, by a nonprofit group called Compassion & Choices. They argue that the residency rules violate the Constitution by preventing patients from accessing the procedure and by denying doctors the ability to provide it to their patients.  

If they are successful at dismantling the state’s residency requirement, it is expected to greatly expand access to assisted suicide to millions of residents living in states neighboring New Jersey — although they would still need to meet New Jersey’s other requirements, including that the patient be a terminally ill and mentally-capable adult.

Nine states and Washington, D.C. have made assisted suicide legal, and several additional states have been debating legalizing it this year. Assisted suicide — in which a physician provides a qualified patient with lethal drugs that the patient then self-administers — has been a growing topic of debate since a 1997 Supreme Court ruling in Washington v. Glucksberg opened up the decision to the states. Gallup polling, as the Sun has reported, indicates that there is broad public support for legalizing the measures for terminally ill patients. 

Yet the practice has also faced pushback, as opponents point to high death tolls coming out of Canada, where the practice has been expanded over the years, and they say that doctors should be encouraged to treat, rather than assist in the death of, their patients. 

In the New Jersey lawsuit, the plaintiffs are appealing a district court order that left the state’s residency requirement in place.

“The residence requirement makes sense: While medical aid in dying is permitted in New Jersey, it is indistinguishable from the criminal act of assisted suicide in neighboring states,” District Judge Renée Marie Bumb wrote in the ruling. “By limiting the pool of eligible patients to State residents, the requirement is rationally related to the legitimate objective of protecting from out-of-state liability providers and advocates who assist terminally ill patients in seeking medical aid in dying.”

The lawsuit, which follows two similar lawsuits in Oregon and Vermont that ultimately led to the states dropping their requirements, argues that New Jersey’s residency requirement violates the Privileges and Immunities Clause, the Dormant Commerce Clause, and the Equal Protection Clause of the U.S. Constitution.

“While the district court’s ruling was a profound disappointment, I remain hopeful that the appeals court will recognize the importance of respecting my right to self-determination, regardless of where I live,” the Delaware patient, Judy Govatos, said in a statement while appealing. “Medical aid in dying is not about giving up on life but about ensuring that my final days are defined by peace without needless suffering.”

The other plaintiff, Dr. Bryman, said that the residency requirement “reinforces a barrier that prevents me from providing patients with care consistent with their values at one of the most vulnerable times of their lives.” 

As debate about the practice of assisted suicide is picking up around the country, some disability rights groups, including an organization called Not Dead Yet, have warned that it leads to coercion of vulnerable patients.

“We oppose legalization of assisted suicide because of the dangers it poses to people who are older, ill, and disabled,” Not Dead Yet’s president, Diane Coleman, tells the Sun. She says these patients may face coercion from family or insurance companies wanting to save money. “Let’s face it, suicide is the cheapest and most profitable treatment from the standpoint of insurance companies,” she says. 

Ms. Coleman says that if New Jersey’s residency requirement is dropped, she would expect it to greatly open the door to assisted suicide along the East Coast, which she says is a “dangerous step.” 

“If the state has decided not to legalize existing suicide, that means they’re protecting their residents from a dangerous practice, and they should be permitted to do that,” she says of states such as Delaware, where the plaintiff in the lawsuit resides. 

The Sun reached out to the New Jersey attorney general’s office, which declined to comment, and the governor’s office, which did not respond. Both are named as defendants in the lawsuit.