The decision comes after New Jersey physician Dr. Paul Bryman carried on a fight to offer the practice to out-of-state patients.
In a news release Friday, Bryman lamented the court’s decision.
“I am deeply disappointed by today’s ruling,” Bryman said. “Terminal patients outside New Jersey should have the option of medical aid in dying without having to travel long distances.”
In 2019, New Jersey enacted the Medical Aid in Dying for the Terminally Ill Act, legalizing physician-assisted suicide via pills for terminally ill patients.
The law contains several stipulations. The patient must have a prognosis of six months or fewer to live, and they must live in New Jersey.
Amid a battle with stage IV lymphoma in 2023, Judith Govatos, a Delaware resident and activist in support of physician-assisted suicide, sought access to the practice for herself. However, it was still illegal in Delaware at the time.
In an attempt to go out on her own terms, Govatos in August 2023 sued several New Jersey officials in federal court over the state’s residency requirement, arguing she had a constitutional right to cross state lines to obtain a final prescription. Only 11 U.S. jurisdictions allow for physician-assisted suicide, and only two — Vermont and Oregon — permit out-of-state patients.
Also included as plaintiffs in the suit were Bryman; Deborah Pasik, a second, now-retired New Jersey physician; and Andrea Sealy, a Philadelphia resident with metastatic breast cancer who also wanted access.
A federal judge dismissed the case in September 2024.
The case continued even as the patient-plaintiffs died. Sealy died of cancer in August 2024, shortly before the case’s dismissal. Govatos passed away this November. Meanwhile, Pasik retired as a physician, leaving Bryman as the lone plaintiff.
Bryman’s primary argument relied on the federal Privileges and Immunities Clause, which prevents U.S. states from treating citizens of other states in a discriminatory manner. He argued physician-assisted suicide was a form of general medical care and thus a fundamental privilege.
The appeals panel — U.S. Circuit Judges Stephanos Bibas, a Donald Trump appointee; Tamika Montgomery-Reeves, a Joe Biden appointee; and Thomas L. Ambro, a Bill Clinton appointee — were not swayed, ultimately affirming the lower court’s dismissal.
Writing for the panel, Bibas expressed skepticism of Bryman’s argument that physician-assisted suicide was a fundamental privilege. But he accepted the premise nonetheless, to show why New Jersey had legitimate reasons to treat outsiders differently.
For one, Bibas noted, the residency requirement protects doctors from out-of-state legal challenges.
“The Act shields doctors from criminal and civil liability in New Jersey,” Bibas wrote, “but it cannot protect doctors from prosecution in states where assisted suicide remains a crime.” Thus, he said “the law aims to keep both patients and pills in-state.”
On the patient side, Bibas said New Jersey “cannot safeguard nonresidents from coercion as effectively.” For example, while New Jersey laws ban insurance companies from pressuring patients to follow through, patients from outside the Garden State would not have those same protections.
Finally, Bibas wrote that limiting the practice to in-state residents “prevents friction among states.”
“Some states hold to the traditional bans on assisting suicide; New Jersey does not,” Bibas wrote. “Cabining its policy preference in this morally fraught area preserves interstate harmony. That is one of the Constitution’s central goals.”
“In sum, New Jersey’s justifications are weighty, rooted in real dangers of extending doctor-assisted suicide to nonresidents,” Bibas wrote for the court.
The governor’s office could not be reached for comment on the decision.
Compassion Legal, a legal organization that represented the plaintiffs, expressed disappointment.
“Access to medical aid in dying remains a critically important option for all terminally ill people,” said Jess Pezley, senior staff attorney for Compassion Legal. “Today’s ruling means that terminally ill patients who do not live in an authorized jurisdiction will continue to have to travel all the way to Oregon or Vermont to have the option of medical aid in dying in this country.”