Death With Dignity in Michigan: SB681 and Current Options

Death with dignity is not legal in Michigan. Helping another person end their life is a felony under MCL 750.329a, punishable by up to five years in prison, a fine of up to $10,000, or both.¹ The most recent effort to change that, Senate Bill 681 (the Michigan Death with Dignity Act), was introduced in November 2023 but stalled in the Senate Health Policy Committee and never became law.² Michigan residents currently have no in-state legal path to obtain a prescription for life-ending medication.

What Michigan Law Prohibits Right Now

MCL 750.329a makes it a felony to knowingly assist in another person’s suicide. The statute reaches three types of conduct: providing the means used in a suicide attempt or completed suicide, participating in the act itself, or helping the person plan it. Each carries up to five years in prison and a fine of up to $10,000.¹

The statute carves out one important exception. Withholding or withdrawing medical treatment is not covered, so a patient’s decision to stop life-sustaining care through an advance directive remains legal.¹ Refusing treatment is legal in every state. Prescribing medication a patient takes to hasten death is different, and it requires a specific aid-in-dying statute that Michigan does not have.

How Michigan Got Here

Michigan’s assisted-death debate is older and more charged than in most states, largely because of Dr. Jack Kevorkian, who publicly assisted in dozens of deaths during the 1990s and was convicted of second-degree murder in 1999. Voters were asked directly in 1998 whether physician-assisted death should be legalized. Proposal B failed decisively, with roughly 71 percent voting against it.³

The permanent criminal statute followed. Bills to reverse course have come and gone. House Bills 4461 and 4462 in 2017 proposed a Death with Dignity Act; neither advanced. Senate Bill 681 in 2023, introduced by Senator Mary Cavanagh, was the most detailed attempt. It was referred to committee in November 2023 and never received a hearing or vote before the 2023–2024 session ended.²

What Senate Bill 681 Would Have Done

SB 681 was modeled on Oregon’s Death with Dignity Act. Had it passed, it would have let terminally ill adult Michigan residents request a prescription for life-ending medication, subject to a defined process and safeguards. None of what follows is currently in effect. It matters mainly because any future Michigan bill is likely to look similar.

Who Would Have Qualified

A patient would have needed to meet every one of these conditions:

Be at least 18 years old.
Be a Michigan resident, shown through documents like a driver’s license or voter registration.
Have an incurable, irreversible disease expected to cause death within six months, confirmed by both an attending and a consulting physician.⁴
Be capable of making and communicating informed healthcare decisions. If either physician suspected depression or another condition affecting judgment, the bill required a counseling referral before the process could continue.⁴
Be acting voluntarily, free from coercion or undue influence.

The Request Process

The patient would first make an oral request to the attending physician, then a written request signed and dated in front of at least two adult witnesses. At least one witness had to be unrelated to the patient, not entitled to any part of the estate, and not connected to the treating facility or attending physician.⁴

At least 15 days after the first oral request, the patient had to make a second oral request and be offered a chance to rescind. The physician also could not write the prescription until at least 48 hours after receiving the written request.⁴ Both clocks had to run before a prescription could be issued. During the waiting period, the physician was expected to discuss alternatives, including palliative care, hospice, and pain management.

Safeguards

The bill layered in the protections common to states that have passed similar laws:

A consulting physician had to independently confirm the diagnosis, capacity, and voluntary nature of the request.
A counseling evaluation was required if either physician suspected impaired judgment.
The attending physician had to document every step in the medical record, including the medication prescribed.⁴
The patient had to ingest the medication themselves; a physician or family member could not administer it.⁵
An action taken under the act would not have been classified as suicide, assisted suicide, mercy killing, or homicide for any legal purpose.⁴

Penalties for Abuse

Forging or altering a request, concealing a rescission, or coercing a patient into requesting life-ending medication would each have been a felony punishable by up to 20 years in prison and a fine of up to $375,000. Those penalties were far harsher than the five-year maximum under the current assisted-suicide statute. The bill also preserved the ability to prosecute offenders under any other applicable criminal law.⁵

Provider, Facility, and Insurance Rules

No healthcare provider would have been required to prescribe life-ending medication, and a provider who declined could not be censured, disciplined, or have a license revoked. A provider who participated in good faith received the same protection. Hospitals, hospices, and nursing homes could have prohibited participation on their premises after giving providers advance notice.⁴

On the insurance side, the sale, issuance, or pricing of a life, health, or accident policy or annuity could not have been conditioned on whether the patient made or rescinded a request, and ingesting the medication could not have affected any existing policy.⁵ A life insurer could not have denied a death benefit by treating the death as suicide.

Options for Michigan Residents Now

Roughly 14 jurisdictions currently allow medical aid in dying, including Oregon, Washington, California, Colorado, Vermont, New Jersey, Maine, Hawaii, New Mexico, Delaware, New York, Illinois, and the District of Columbia. Montana permits it through a court ruling rather than a statute. Eligibility rules, waiting periods, and residency requirements vary by state, though most track the general framework SB 681 proposed.

Some states that once required residency have dropped that condition in recent years. Traveling to another state to pursue aid in dying raises complex legal and logistical questions, and a healthcare attorney familiar with both Michigan law and the destination state’s law is the right person to evaluate a specific situation. Within Michigan, the legal options that remain are advance directives, refusing or withdrawing treatment, and palliative and hospice care.

1
Michigan Legislature. MCL 750.329a – Criminal Assistance to Suicide
2
Michigan Legislature. Senate Bill 681 of 2023
3
Ballotpedia. Michigan Proposal B, Physician Assisted Death Initiative (1998)
4
Michigan Legislature. Senate Bill No. 681 – Death with Dignity Act
5
Michigan Legislature. Senate Bill No. 681 (PDF)