It’s been a few years since Governor Phil Murphy signed the Medical Aid in Dying for the Terminally Ill Act, and honestly, the conversation around assisted suicide in New Jersey is still a mess of confusion. People hear the term "assisted suicide" and their minds go to dark places. They think of rogue doctors or desperate, impulsive decisions made in a vacuum. But the reality on the ground in Jersey is much more clinical, much more bureaucratic, and—depending on who you ask—either a mercy or a moral crisis.
New Jersey isn't Oregon. We have our own quirks.
Since the law went live in August 2019, the state has seen a steady, though not explosive, number of residents choosing this path. It’s not a "right-to-die" free-for-all. It’s a tightrope walk of paperwork and waiting periods. If you’re looking into this for a family member or yourself, you’ve got to understand that the system is designed to be slow. It’s designed to make sure nobody is being coerced.
The Reality of Assisted Suicide in New Jersey
Let’s get the terminology straight first. The law officially calls it "Medical Aid in Dying" (MAID). Proponents get prickly when you call it assisted suicide because, in their view, suicide implies a choice between life and death. For someone with stage IV pancreatic cancer, that choice is already gone. They’re choosing between two different ways of dying.
To even get a foot in the door, a patient has to be 18 or older. They have to be a New Jersey resident. Most importantly, they have to be terminally ill with a prognosis of six months or less to live. This isn't for chronic pain that isn't terminal. It’s not for disability. It’s for the end of the road.
The process is a grind. You can't just walk into a CVS and ask for a pill.
First, the patient has to make two oral requests to their attending physician, at least 15 days apart. Then there’s a written request that has to be witnessed by two people. One of those witnesses can’t be a relative or someone who stands to inherit your vintage Springsteen vinyl collection. Then a second "consulting" physician has to swoop in to confirm the diagnosis and the patient’s mental capacity to make the decision. If there's even a whiff of depression or a mental health issue clouding the judgment, the doctor is legally required to refer the patient for a psychological evaluation.
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Who is Actually Using the Law?
According to data from the New Jersey Department of Health, the numbers tell a specific story. In the first full year of the law, about 33 people used it. By 2022 and 2023, those numbers climbed, but we aren't talking about thousands of people.
Most of these folks have cancer. We’re talking about aggressive, metastatic stuff. Others are facing the late stages of ALS or respiratory failures. They are usually older, and many are already enrolled in hospice. It turns out that for many, just having the prescription in the drawer is enough. A significant percentage of people who go through the whole process to get the medication never actually take it.
There’s a psychological safety net in knowing you could leave if the pain gets unbearable. That "out" actually helps some people stick around longer.
The "Opt-Out" Problem and Access Hurdles
You’d think that since it’s legal, every hospital in the state would be on board. Wrong.
New Jersey has a massive network of religiously affiliated healthcare systems. Places like Saint Peter’s Healthcare System or those under the Catholic umbrella don't participate. They don't have to. The law specifically allows individual doctors and entire hospital systems to opt out based on "conscience."
This creates a weird geographic lottery. If you live in a part of Jersey where the only major hospital system is religiously affiliated, your doctor might not even be allowed to discuss MAID with you on the clock. You’d have to find a "participating" physician, which often means traveling or finding a doctor through advocacy groups like Compassion & Choices.
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And then there's the pharmacist. Not every pharmacy stocks the specific compounds needed for the end-of-life protocol. It’s a cocktail, usually involving high doses of sedatives like diazepam or morphine, often mixed into a slurry. If your local pharmacist has a moral objection, they can refuse to fill it, though they are supposed to refer you elsewhere.
Basically, the law exists, but the "access" part is still a work in progress.
The Self-Administration Rule
This is the part that trips people up the most. The doctor does not "give" the injection. This isn't like what you see in movies about Switzerland or even some Canadian protocols. Under New Jersey law, the patient must be able to self-administer the medication.
Usually, this means drinking a mixture. If a patient is so weak or paralyzed that they can’t physically swallow or push a plunger on a feeding tube themselves, they are technically ineligible. This creates a terrifying "use it or lose it" window. If you wait until you’re "ready" but your body fails you before that moment, the window slams shut.
It’s a brutal irony. To use the law, you have to be sick enough to die soon, but healthy enough to drink a cup of liquid on your own.
Legal Battles and Moral Friction
It hasn't been a smooth ride. Since 2019, there have been multiple attempts to shut the law down.
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Dr. Yosef Glassman, a physician from Bergen County, was one of the first to challenge the law in court, arguing that it violated his rights and the Hippocratic Oath. The courts eventually tossed the lawsuits, but the friction remains. Organizations like the New Jersey Right to Life continue to monitor the state’s annual reports closely, looking for any sign of "bracket creep"—where the rules might be loosened over time.
On the other side, you have the advocates who say the current law is too restrictive. They point to the 15-day waiting period as a form of torture for someone in agony. Imagine being told you have to suffer for two more weeks just to prove you’re serious about wanting the suffering to stop.
Practical Steps for New Jersey Residents
If you or a loved one are seriously considering assisted suicide in New Jersey, you need to move faster than you think you do. The bureaucracy is the enemy of a peaceful exit.
- Check your doctor's stance early. Ask your oncologist or primary care physician directly: "Do you participate in the Medical Aid in Dying for the Terminally Ill Act?" If they say no, ask if they will at least act as the "consulting" physician or if they will transfer your records to someone who will.
- Find a participating hospice. Not all hospices are created equal. Some will allow their nurses to be present when a patient ingests the medication (though the nurse cannot help administer it). Others forbid their staff from even being in the room. Knowing your hospice's policy is vital for a peaceful environment.
- Documentation is everything. Keep a dedicated folder for the requests. The state is extremely picky about the dates. If the written request is signed even a day too early or by the wrong witnesses, the whole process resets.
- Consider the cost. Medicare typically does not cover the drugs used for MAID because it’s a federal program and assisted suicide is still illegal at the federal level. Private insurance varies wildly. Some of these drug protocols can cost between $400 and $3,000 out of pocket.
- Talk to your family. This is the hardest part. The law doesn't require you to tell your family, but the legal fallout for them if you do this in secret can be a nightmare. If they are in the loop, they can provide the emotional support needed to navigate the 15-day waiting period.
The law in New Jersey is a compromise. It’s a middle ground between those who believe in total bodily autonomy and those who fear a "slippery slope." Because it's a compromise, it's clunky. It's frustrating. It's full of red tape. But for those who find themselves in the final few months of a terminal illness, that red tape is the only thing standing between a traumatic end and a planned, quiet departure.
For more specific guidance, the New Jersey Department of Health maintains a portal with the necessary forms for both patients and physicians. Searching for "NJ MAID portal" will get you the most current versions of the required affidavits. Consulting with a legal professional who specializes in elder law or end-of-life planning can also ensure that your advanced directives don't conflict with your desire to utilize the act.
Ultimately, the best way to handle this is to start the conversation while the patient still has the "capacity" to sign their own name. Waiting until the final weeks often means the law is no longer an option.