“For 13 years, Vermont’s medical aid in dying law, Act 39, has provided hundreds of people profound peace of mind. We’re grateful for the visionary leaders who worked so hard to make autonomy at the end of life a reality, for Vermonters and non-residents alike.”
– Amy Bruce, MPP, Executive Director of Patient Choices Vermont

On May 19, 2013, Vermont made history when Governor Peter Shumlin signed the Patient Choice and Control at End of Life Act (Act 39) into law. More than a decade later, Vermont’s journey continues to reflect the power of compassion, persistence, and the belief that people facing terminal illness deserve choice at the end of life.

From the groundbreaking passage of the bill to later amendments and the removal of the residency requirement, Vermont’s story has helped shape the national movement for Death with Dignity.

Here are some key moments from Vermont’s history:

Passing Vermont’s Death with Dignity Law

Before Act 39 was passed, the only two medical aid in dying laws in the United States — in Oregon and Washington — had been approved through ballot measures. By passing Act 39 through the legislature, Vermont became the first state to enact a Death with Dignity law through legislative action, paving the way for future laws in California, Washington, D.C., Hawaiʻi, New Jersey, Maine, New Mexico, Illinois, Delaware, and New York to follow the same path.

At the bill signing ceremony, Governor Peter Shumlin reflected on the significance of the moment, telling the crowd: “Vermonters who face terminal illness and are in excruciating pain at the end of their lives now have control over their destinies. This is the right thing to do.”

The Vermont law aligns with the established “U.S. model”: Patients must have a terminal diagnosis with a prognosis of six months or less to live, make a voluntary request on their own behalf, possess the capacity to make their own healthcare decisions, and be able to self-administer the medication. 

Over the next decade, Vermont would work to make the law more accessible to terminally ill patients.

How Vermont Expanded Access to Medical Aid in Dying

After Act 39 became law in 2013, Vermont continued working to strengthen and expand access through a series of important amendments.

In 2015, Governor Peter Shumlin signed S.108 into law exactly two years after signing Act 39. The legislation removed the law’s sunset clause, ensuring that Vermont’s Death with Dignity law would remain permanent rather than expire on the original July 1, 2016, deadline. It was a powerful affirmation that compassionate end-of-life options were here to stay.

Years later, Vermont lawmakers took additional steps to make the law more accessible for terminally ill patients. In 2021, the Vermont State Senate introduced S.74, a bill designed to modernize the law by removing the requirement that medication requests and physician evaluations take place in person. The amendment also eliminated the mandatory 48-hour waiting period between certain required steps before a prescription could be written. Governor Phil Scott signed S.74 into law on April 27, 2022, helping reduce barriers for dying Vermonters seeking compassionate end-of-life care.

Leading the Nation by Eliminating the Residency Requirement

One of the most meaningful changes Vermont made to its law came in 2023, when it became the first state in the nation to legislatively remove its residency requirement for medical aid in dying.

The change followed a major shift in Oregon, where a lawsuit successfully challenged the residency requirement as unconstitutional in 2022. Oregon later passed legislation to formally codify that decision, just months after Vermont acted.

By removing the residency requirement, Vermont expanded access beyond its own borders, affirming the belief that compassionate end-of-life options should not depend on a ZIP code. The change allows terminally ill adults who qualify under the law to travel to Vermont and access Death with Dignity without needing to prove residency — offering comfort, autonomy, and choice to more qualified terminally ill adults at the end of life.

“Act 39 was the result of a small group of motivated people who worked diligently across the state to educate the citizens of Vermont and their legislators about the need for a law that allows dying people a measure of choice and control at a deeply personal time.
It was a grassroots, non-partisan effort that has helped to improve end-of-life care in Vermont.”
– Diana Barnard, MD, PCV Founding Board Member of Patient Choices Vermont

Shaping End-of-Life Experiences

Vermont continues to show what it looks like to build a compassionate, evolving law that responds to the real needs of terminally ill adults and their loved ones. Its history is a reminder that progress does not end when a bill is signed into law — it grows through continued advocacy, listening, and care.

If Vermont’s law shaped the end-of-life experience for you or someone you love, please consider donating today to help advance our work.