Illinois legalizes physician-assisted suicide and reopens ethical, legal and health care debate

The Democratic governor of Illinois, J.B. Pritzker, this week signed the so-called "Deb's Law," legislation that legalizes physician-assisted suicide for terminally ill adults. The rule, passed by narrow margins in both houses of the state Congress, will go into effect on Sept. 12, 2026, following an implementation period by the Illinois Department of Public Health (IDPH).

With this decision, Illinois becomes the 12th state in the country, besides Washington DC,  to allow physicians to prescribe lethal drugs to patients with a life prognosis of six months or less, provided they self-administer them. The measure has generated strong political and social polarization, with advocates presenting it as an extension of personal autonomy at the end of life and critics viewing it as a dangerous slippery slope.

What does the law establish?

The legislation, formally called the End-of-Life Choices for Terminally Ill Patients Act, allows Illinois residents over the age of 18 to apply for end-of-life medications if they meet strict requirements. These include:

The bill is named after Deb Robertson, a supporter of the bill who was terminally ill. Robertson said in a statement released by the governor's office that the regulation seeks to ensure that patients have access to medical aid in dying without being forced to travel out of state.

The government's argument and the drivers

In signing the bill, Pritzker argued that the decision was motivated by testimonies from patients and families who went through terminal illnesses with intense suffering.

"I have been deeply impacted by the stories of Illinoisans or their loved ones that have suffered from a devastating terminal illness," said the governor in the published message, who defended the law as a way to respect "freedom and choice at the end of life."

In the same vein, Illinois House Majority Leader Robyn Gabel (D-Evanston) stated that the rule reinforces "compassionate care for every patient, bodily autonomy for every person, and basic human dignity at every stage of life."

Supporters stress that the law does not force anyone to resort to assisted suicide, but rather expands the range of decisions available to terminally ill patients, in consultation with medical professionals.

Criticism from the medical, legal and religious spheres

Reaction from opponents was immediate. State Rep. Bill Hauter, R-Morton and a practicing physician, sharply questioned both the content and the legislative process.

"The process was lousy. This was passed in the wee hours of the morning, without adequate notice to disability groups, medical ethics groups or religious communities," Hauter told The Center Square. According to the lawmaker, the law risks creating a two-tiered health care system, in which patients with fewer financial resources could be pressured, explicitly or implicitly, to opt for death rather than expensive treatments.

Hauter also warned of safety risks, as the regulations do not require the presence of medical personnel when the patient ingests the lethal drugs, which can cause vomiting, convulsions or may not be immediately effective. In addition, he questioned the reliability of medical prognoses: "We cannot accurately predict life expectancy; many patients are well beyond six months."

Conscientious objection and ongoing litigation

One of the most controversial points is the conscientious objection clause. Although the law allows physicians to refuse to participate directly, critics argue that it remains problematic because it requires referral of the patient to another professional willing to intervene.

Thomas Olp, executive vice president and attorney for the Thomas More Society, called the law "a tragic and dangerous turning point for the moral and constitutional landscape" for Illinois. In public statements, it asserted that the mandatory referral violates the Illinois Right of Conscience Act and poses a conflict with the First Amendment.

The organization is already litigating a related case before the Seventh Circuit Court of Appeals and contends that the new rule especially threatens religious hospitals and clinics by allowing individual physicians to engage in off-site assisted suicides without disciplinary sanctions, even if they contradict institutional policies.

"True compassion means helping people live, not helping them die," the Illinois Catholic Conference noted in a statement.

Fear for vulnerable groups

Criticism also came from Republican lawmakers, pro-life organizations and advocates for people with disabilities. In a joint statement, state House Republicans said the law sends the message that certain lives, those of the poor, disabled or sick, are a burden.

Some opponents cite the case of Canada, where access to euthanasia has expanded significantly in recent years, as an example of a possible drift beyond the initial supposed limits.