In the USA, patients retain the rights to refuse medical treatment and to receive appropriate management of pain at their request (passive euthanasia), even if the patient’s choices hasten their death. Additionally, futile or disproportionately burdensome treatments, such as life-support machines, may be withdrawn under specified circumstances.

In Oregon, the Oregon Death with Dignity Act gives terminally ill, mentally competent people the option of an assisted death. In 2008 Washington state voted in favour of a assisted dying law modelled on the Oregon legislation, and in a Dec 2009 opinion/order, the Montana Supreme Court affirmed 4-3 that physician-assisted suicide is not “against public policy” in the state of Montana. That Court further ruled that state law protects doctors in Montana from prosecution for helping terminally ill patients die.