In Washington v. Glucksberg (1997), the U.S. Supreme Court unanimously held that the Constitution does not protect a fundamental right to physician-assisted suicide, upholding a Washington state law that made it a felony to help another person end their life. The ruling did not ban the practice; it left each state free to decide for itself. As of early 2026, thirteen states and the District of Columbia have chosen to authorize medical aid in dying, while most others continue to prohibit it.1Justia. Washington v. Glucksberg
How the Case Got to the Supreme Court
Washington law made it a felony to knowingly assist a suicide attempt. Four physicians led by Dr. Harold Glucksberg, three terminally ill patients, and the nonprofit Compassion in Dying sued to block enforcement. The doctors said they were willing to prescribe lethal medication to mentally competent, terminally ill adults who wanted to hasten their deaths, and the statute stopped them.1Justia. Washington v. Glucksberg
The Ninth Circuit sided with the challengers, reading the Fourteenth Amendment’s Due Process Clause to protect a liberty interest in choosing the time and manner of one’s death. Washington appealed, and the Supreme Court took the case.
The Question Before the Court
The Fourteenth Amendment forbids any state from depriving a person of “life, liberty, or property, without due process of law.” The Court has read “liberty” to cover certain rights that are not spelled out in the Constitution, including the right to marry, to raise children, and to refuse unwanted medical treatment. The question was whether that protected liberty stretches far enough to include a terminally ill patient’s right to a doctor’s help in dying.
To decide, the Court applied a specific test: is the asserted right “deeply rooted in this Nation’s history and tradition”?1Justia. Washington v. Glucksberg
What the Court Held
All nine justices agreed Washington’s ban was constitutional. Five joined Chief Justice Rehnquist’s majority opinion; the other four wrote separate concurrences that reached the same result on different reasoning. The Ninth Circuit was reversed, Washington’s law stood, and states were left free to prohibit physician-assisted suicide.2Library of Congress. Washington v. Glucksberg
The Majority’s Reasoning
Rehnquist’s opinion rested on history and state interests. Surveying more than 700 years of Anglo-American common law, the Court found consistent disapproval of assisting suicide, and nearly every state still criminalized it. A right to assisted suicide could not be called deeply rooted in the way that rights like marriage or bodily autonomy could.1Justia. Washington v. Glucksberg
The majority also drew a sharp line between refusing life-sustaining treatment and asking a doctor for lethal medication. The Court had assumed in Cruzan v. Director, Missouri Department of Health that a competent person has a constitutionally protected liberty interest in refusing unwanted treatment.3Justia. Cruzan v. Director, Missouri Department of Health Refusing treatment, the Glucksberg Court said, lets an existing condition take its natural course. Prescribing a lethal drug does something different.
On the state’s side of the ledger, the Court identified several interests strong enough to sustain the ban: preserving human life, preventing suicide generally, protecting the integrity of the medical profession, and shielding vulnerable people from pressure or abuse.1Justia. Washington v. Glucksberg
The Concurrences and What They Left Open
The concurrences matter, because four justices explicitly refused to close the door on every possible future claim.
Justice O’Connor joined the majority but wrote separately to say she was not answering whether a person facing unbearable end-of-life suffering has a protected interest in controlling the circumstances of their death. She thought the Court did not need to reach that question, because Washington already permitted palliative care that could hasten death as a side effect.
Justice Stevens concurred in the result but argued the opinion should not be read to foreclose all future claims; if a state ever blocked dying patients from adequate pain relief, the constitutional analysis might shift. Justice Souter would have used a more flexible method for evaluating liberty interests instead of demanding strict historical roots, and he was willing to give legislatures time before ruling anything out. Justice Breyer, joined in part by Justice Ginsburg, suggested the interest at stake was better described as a right to die with dignity or to avoid severe physical suffering, and he stopped short of foreclosing recognition of that interest later.1Justia. Washington v. Glucksberg
The judgment was unanimous. The reasoning was not.
Vacco v. Quill: The Same-Day Companion Ruling
The Court decided Vacco v. Quill on the same day. The Vacco challengers attacked New York’s ban under the Equal Protection Clause, arguing the state treated similarly situated patients differently: those who refused life-sustaining treatment could die, but those who sought a lethal prescription could not.
The Court rejected the equal protection theory. The distinction between letting a patient refuse treatment and helping a patient die was, in the Court’s words, “important, logical, rational, and well established,” resting on longstanding principles of causation and intent. A patient who declines a ventilator dies from the underlying disease; a patient who takes a prescribed lethal drug dies from the drug. New York’s reasons for treating those situations differently easily survived constitutional review.4Justia. Vacco v. Quill
Between them, Glucksberg and Vacco closed the two most obvious constitutional routes to a federal right to die. The fight moved to state legislatures.
Gonzales v. Oregon: Can the Federal Government Override a State That Legalizes?
A follow-up question remained. If a state chose to allow assisted suicide, could federal drug law be used to shut it down? The Court answered in Gonzales v. Oregon (2006).
Oregon voters had approved the Death with Dignity Act in 1994 and reaffirmed it in 1997, making Oregon the first state to authorize physician-assisted suicide.5Oregon.gov. Death with Dignity Act History In 2001, Attorney General John Ashcroft issued a rule declaring that prescribing drugs to assist a suicide was not a “legitimate medical purpose” under the federal Controlled Substances Act, which would have put Oregon physicians at risk of losing their prescribing licenses for following state law.
The Supreme Court struck down the rule 6-3. The Controlled Substances Act, the Court held, did not give the Attorney General authority to override state medical standards or to declare an entire category of state-authorized medical practice illegitimate. Congress had aimed the statute at drug trafficking, not at regulating the practice of medicine, which remains primarily a state responsibility.6Justia. Gonzales v. Oregon
Glucksberg said states don’t have to permit assisted suicide. Gonzales said the federal government can’t easily stop them if they do. Together, the two decisions locked in the state-by-state approach.
Why Glucksberg Matters More After Dobbs
For years, Glucksberg was mostly a right-to-die case. That changed in 2022, when the Court decided Dobbs v. Jackson Women’s Health Organization and overturned Roe v. Wade. The Dobbs majority leaned heavily on the same “deeply rooted in this Nation’s history and tradition” test that Glucksberg had used, applied it to abortion, found no deep roots, and returned the issue to state legislatures.
Dobbs effectively promoted Glucksberg into the leading framework for evaluating any claim to an unenumerated fundamental right. For anyone hoping the Supreme Court will eventually recognize a constitutional right to assisted suicide, the path is steeper than it was in 1997, because the Court has already found no historical foundation for the claim and has since doubled down on the historical test. The realistic route to broader access runs through state legislatures.
Where the States Stand Today
Oregon acted first, with a statute that took effect in 1997.5Oregon.gov. Death with Dignity Act History Washington voters approved their own Death with Dignity law in 2008, eleven years after the state’s ban was upheld in this very case.
As of early 2026, thirteen states and Washington, D.C., authorize medical aid in dying. New York became the thirteenth in 2026.7PBS News. More States Legalize Medically Assisted Suicide for Terminal Patients The others are Oregon, Washington, Vermont, Colorado, the District of Columbia, California, Hawaii, New Jersey, Maine, New Mexico, Delaware, and Illinois. Montana sits in an unusual position: a 2009 state supreme court decision found nothing in Montana law prohibiting the practice, but no statute expressly authorizes it either.
The state laws share a common structure. The patient must be a mentally competent adult diagnosed with a terminal illness, usually defined as a condition expected to cause death within six months. The patient self-administers the medication; the physician prescribes but does not deliver the final dose. That distinction keeps the practice legally separate from euthanasia, which remains illegal everywhere in the United States. Most states also impose a residency requirement, though Oregon and Vermont have dropped theirs.
If you are trying to understand your own options, the controlling law is your state’s, not the federal Constitution. Washington v. Glucksberg is the reason it works that way.