San Diego Law Review


Taimie Bryant

Library of Congress Authority File


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In the United States, where “assisting suicide” is illegal under the great majority of state laws, nonprofit aid-in-dying organizations play important roles in legal reform and client service to those who choose to hasten death when experiencing irremediable existential and physical suffering at the end of life. Legal pathways to aid in dying rest on respect for individual autonomy in end-of-life decision-making, but they are freighted with concerns about risks to individuals who may be vulnerable to transient depression, the influence of others, and internalized beliefs that they have become a burden.

This Article explores how nonprofits use different laws to ground their end-of-life assistance to clients while navigating laws that prohibit assisting suicide and the legal rules of their status as nonprofit public charities. Within those limitations, they seek legal change to support autonomous end-of-life decisions, cognizant of genuine concerns about the vulnerability of people making decisions to irreversibly end their lives and the autonomy of physicians who may not want to participate in bringing about a patient’s death. This Article concludes that these nonmedical advocacy and client service nonprofit organizations have participated in the creation of laws that actually limit fulfillment of their missions but that they will remain extremely important as long as such severe legal tension exists between autonomy and protection of vulnerable individuals, suicide is heavily stigmatized, and ending one’s own life to relieve end-of-life suffering is exclusively a “do-it-yourself” option in which an individual inexperienced at dying must self-administer a life-ending substance.

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