Last month, Vermont became the fourth state to legalize physician-assisted suicide for terminally ill patients. It’s also the first to do so via legislation, in a year that’s seeing a rebirth of state bills to legalize this practice. Given this trend, it’s worth knowing what, if anything, is happening in your state.

Legislation Proposed in 2013:  Bills have been introduced this year in 5 states: Connecticut, New Jersey, Kansas, Hawaii, and in Maine (defeated). A ballot initiative in Massachusetts was defeated last year.

Current Law. According to ProCon.org, physician-assisted suicide is:

• Legal in 4 states:  Oregon, Washington, Montana and Vermont. In Montana, legalization was by state court decision; in Washington and Oregon by statewide referenda.

• Illegal by common law in 3 states:  Alabama, Massachusetts, West Virginia, plus the District of Columbia.

• Unclear status in 4 states: Nevada, North Carolina, Utah, Wyoming (no specific law, state may not recognize common law, or otherwise unclear)

• Illegal by statute in the remaining 39 states.

For the specific governing law or legal authority in your state, look here.

What exactly is physician-assisted suicide? In the 4 states where the practice is legal, it applies only to individuals who are terminally ill – and who also want to end their own lives. These states have varying protocols and requirements for ensuring that these conditions are met. A doctor would write a prescription for a lethal dose of medication which the patient administers themselves, slipping into a coma and dying.

Clearly, this is a controversial subject. Advocates of doctor-assisted suicide principally invoke a patient’s right to self-determination, and also champion it on the basis of compassion, by sparing some people with terminal illnesses from years of pain and suffering. And while very few terminally ill people actually exercise this option, advocates also argue that simply knowing that this option is available brings comfort to many more terminally ill individuals.

Opponents, who include many ethicists and physicians, counter that the potential for abuse poses too great a risk, especially for the elderly, frail, poor and less educated persons. The abuse could come from adult children or other family members who want to “kill off” the patient for financial, emotional, or other personal reasons. Or, it could be from insurers or others who have a financial responsibility for the patient.

Many physicians also explain that they can control and counter the depression and pain that they claim account for much of the desire for death among terminally ill persons. A leading geriatrician I spoke with recently on this topic said that until we have good pain management services available to patients nationwide, we shouldn’t even consider assisted suicide as a legitimate option.

Stay tuned. There’s sure to be more on this topic. Have you ever had a client ask you about assisted suicide? Do you know more about any recent developments in your state? Please let me know.

Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), the largest advance directives registry in the U.S., which ensures that the emergency information and healthcare directives of its 200,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the Center for Advocacy for the Rights and Interests of the Elderly, the International Society of Advance Care Planning, and the Coalition to Transform Advanced Care, she is active in health education and public engagement related to advance care planning and advance directives and serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative. Randi is an ongoing contributor to the Academy blog.

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