Ms. Taylor is a 56-year-old woman diagnosed with stage IV bladder cancer, which has metastasized to her bones. Her prognosis is poor, with an estimated life expectancy of only a few months. She is fully aware of the severity of her condition and has come to terms with it. While understandably saddened by the limited time she has left, her emotional response remains within normal limits. She has chosen to receive home hospice care to manage her symptoms and maintain comfort during her remaining time.

During a recent visit with her physician, Dr. Zeebs, Ms. Taylor disclosed her intention to pursue physician-assisted death (PAD), also known as medical aid in dying (MAID). Although she currently resides in a state where MAID is illegal, she retains legal residency in Portland, Oregon – where the practice is permitted – and has already obtained the necessary medication. Ms. Taylor shared that she plans to take the medication on the anniversary of her wedding, the happiest day of her life, to peacefully pass away while reflecting on cherished memories of her late husband.

However, a new law recently enacted in Ms. Taylor’s current state mandates that healthcare providers must report any patient expressing intent to engage in self-harm or assisted death. This law explicitly includes cases like Ms. Taylor’s. As a result, Dr. Zeebs is legally obligated to report her plan to state authorities, who would likely intervene by confiscating the medication and hospitalizing Ms. Taylor for the remainder of her life, thereby preventing her from accessing MAID.

Given the ethical and emotional complexity of the situation, Dr. Zeebs has sought guidance from an ethicist.