Medical aid in dying is not legal in Massachusetts as of 2026. State law does not allow a physician to prescribe life-ending medication to a terminally ill patient, and a 2024 Massachusetts court ruling confirmed that changing this is the legislature’s job, not the courts’. A bill that would authorize the practice, the End of Life Options Act, is currently working its way through committees on Beacon Hill but has not been signed into law.
Where the Bill Stands Now
Two companion bills are moving through the 194th legislative session: S.1486 in the Senate and H.2505 in the House.1General Court of Massachusetts. Bill S.1486 – An Act Relative to End of Life Options S.1486 has been reported favorably by the Joint Committee on Health Care Financing and referred to Senate Ways and Means. H.2505 was reported favorably by the Joint Committee on Public Health and referred to the Joint Committee on Health Care Financing.2General Court of Massachusetts. Bill H.2505 – An Act Relative to End of Life Options
Neither bill has passed. The 194th session runs through early January 2027, and if the legislation does not clear both chambers and receive the governor’s signature by then, it will need to be refiled in the next session.3General Court of Massachusetts. Office of the Clerk of the House – Deadlines Similar versions have been introduced in earlier sessions without reaching the governor’s desk.
For context, thirteen states and Washington, D.C. currently authorize medical aid in dying. Oregon’s law, the oldest, dates to 1994. Delaware and Illinois enacted laws in 2025, and New York did so in 2026. Massachusetts is not among them.
Who Would Qualify If the Law Passed
The End of Life Options Act sets five requirements a patient would need to meet at the same time:1General Court of Massachusetts. Bill S.1486 – An Act Relative to End of Life Options
- Be at least 18 years old.
- Be a Massachusetts resident.
- Have a terminal diagnosis with a prognosis of six months or fewer, confirmed by a second physician.
- Be mentally capable of making an informed decision.
- Be physically able to take the medication without help.
That last requirement matters. The patient, not a doctor or family member, would have to take the medication themselves. This is the line the bill draws between medical aid in dying and euthanasia, where a physician administers the dose directly. Under the proposal, a patient who becomes unable to self-administer would no longer qualify.
How the Request Process Would Work
The bill lays out a deliberately slow, multi-step process built around the idea that a patient’s decision should be sustained rather than momentary. A patient would need to make two separate requests to the attending physician: one oral and one written, at least 15 days apart. A patient can rescind the request at any point in the process.
The written request has to be witnessed by two people. At least one witness cannot be a relative, cannot stand to inherit from the patient, and cannot be an employee of the healthcare facility treating the patient. The attending physician cannot serve as a witness either. The point of these restrictions is to screen out anyone with a financial or professional stake in the outcome.
Two physicians would need to independently confirm the diagnosis, the prognosis, and the patient’s capacity. The attending physician handles the primary evaluation, and a separate consulting physician provides a second opinion.1General Court of Massachusetts. Bill S.1486 – An Act Relative to End of Life Options
A mental health evaluation would be required for every patient, not only those whose physicians suspect impaired judgment. The bill requires that each patient be consulted with and evaluated by a licensed mental health provider before any medication can be prescribed.1General Court of Massachusetts. Bill S.1486 – An Act Relative to End of Life Options This is stricter than some other state laws, where a mental health referral only kicks in when a doctor has a specific concern about capacity.
The overall process described in the bill runs to about ten steps once physician evaluations, the mental health consultation, and the two requests are counted together.1General Court of Massachusetts. Bill S.1486 – An Act Relative to End of Life Options None of it is available to Massachusetts patients today.
What Terminally Ill Patients Can Do in Massachusetts Now
The unavailability of medical aid in dying does not mean a terminally ill patient has no legal options for shaping the end of their life. Several are already well established in Massachusetts.
Any patient has the right to refuse medical treatment, including life-sustaining interventions such as ventilators and feeding tubes. Advance directives and healthcare proxies let a patient put those choices in writing before losing the ability to communicate.
Hospice care is available for patients with a prognosis of six months or fewer and focuses on comfort rather than cure, providing pain management, emotional support, and practical assistance. Palliative care serves a similar purpose but can begin at any stage of a serious illness and can run alongside curative treatment. Massachusetts law requires attending healthcare providers to offer patients information and counseling about palliative care options.
For patients experiencing severe symptoms that cannot be controlled by other means at the very end of life, palliative sedation, which reduces consciousness to relieve refractory suffering, is an accepted medical practice. It is legally and medically distinct from aid in dying.
Watching the Legislation
If a Massachusetts resident wants to follow the End of Life Options Act, the two bill pages on the legislature’s website show current committee assignments and any activity in the session. S.1486 is with Senate Ways and Means; H.2505 is with the Joint Committee on Health Care Financing. Whether either advances to a floor vote before the session ends in January 2027 will determine whether Massachusetts joins the states that have authorized the practice, or whether the question returns to the legislature in another session.