MAID Without Borders? Oregon Drops the Residency Requirement

Nancy Berlinger

The Hastings Center: Bioethics

Originally posted 1 APR 22

Oregon, which legalized medical aid-in-dying (MAID) in 1997, has dropped the requirement that had limited MAID access to residents of the state. Under a settlement of a lawsuit filed in federal court by the advocacy group Compassion & Choices, Oregon public health officials will no longer apply or enforce this requirement as part of eligibility criteria for MAID.  The lawsuit was filed on behalf of an Oregon physician who challenged the state’s residency requirement and its consequences for his patients in neighboring Washington State.

In Oregon and in nine other jurisdictions – California, Colorado, the District of Columbia, Hawaii, Maine, New Jersey, New Mexico, Vermont, and Washington – with Oregon-type provisions (Montana has related but distinct case law), MAID eligibility criteria include being an adult with a life expectancy of six months or less; the capacity to make a voluntary medical decision; and the ability to self-administer lethal medication prescribed by a physician for the purpose of ending life. Because hospice eligibility criteria also include a six-month prognosis, all people who are eligible for MAID are already hospice-eligible, and most people who seek to use a provision are enrolled in hospice.

The legal and practical implications of this policy change are not yet known and are potentially complex. Advocates have called attention to potential legal risks associated with traveling to Oregon to gain access to MAID. For example, a family member or friend who accompanies a terminally ill person to Oregon could be liable under the laws of their state of residence for “assisting a suicide.”

What are the ethical and social implications of this policy change? Here are some preliminary thoughts:

First, it is unlikely that many people will travel to Oregon from states without MAID provisions. MAID is used by extremely small numbers of terminally ill people, and Oregon’s removal of its residency requirement did not change the multistep evaluation process to determine eligibility. To relocate to another state for the weeks that this process takes would not be practicable or financially feasible for many terminally ill, usually older, adults who are already receiving hospice care.

The info is here.

Welcker v. Georgia Board of Examiners of Psychologists

Legal Decision

Synopsis: Georgia State Board of Psychology is permitted to deny a license to an applicant, when the applicant's doctoral program does not meet the residency requirement, and, without substantial hardship.

Here are two excerpts:

Neither the Board's decision to deny Welcker a license nor their denial of her petition for waiver can be considered a contested case. Georgia law allows the denial of a license without a hearing where an applicant fails to show that she has met all the qualifications for that license. OCGA § 43-1-19 (a). Therefore, because no hearing was required by law before the denial of Welcker's license, the Board's denial of Welcker's license application does not present a contested case subject to judicial review.

The Board's decision to deny a petition for waiver also cannot be considered a contested case. OCGA § 43-1-19 (j) explicitly states that the "refusal to issue a previously denied license" shall not be considered a contested case under the Administrative Procedure Act and "notice and hearing with the meaning of the [Act] shall not be required"; however, the applicant "shall be allowed to appear before the board if he or she so requests." Nevertheless, such rulings are expressly made subject to judicial review under OCGA § 50-13-9.1 (f), which provides that "[t]he agency's decision to deny a petition for variance or waiver shall be subject to judicial review in accordance with Code Section 50-13-19."

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The Board denied Welcker's petition for waiver on two grounds: (1) her failure to meet the appropriate residency requirements "as per the Board rules in effect in 2007" and (2) her failure to prove a substantial hardship resulting from strict application of the rule.

The ruling is here.