A bill that would allow medical aid in dying for certain terminally ill Virginians is moving forward in the state Senate.
A Senate subcommittee voted Tuesday, three to two with one abstention, to advance the measure to the full Senate Education and Health Committee. The vote was largely split along party lines.
Bill patron Sen. Jennifer Boysko (D-Herndon) said the proposal is designed to give dying patients more autonomy.
“We know that when someone knows that they're going to be dying, they want to have some control over how it's done. You know, people face extraordinarily painful situations,” Boysko said.
The bill would allow adults diagnosed with an incurable terminal illness and given six months or less to live to request a prescription to end their life.
Patients would be required to make two oral requests at least 15 days apart, submit a written request signed by a witness, and undergo evaluations by two independent health care providers. A mental health assessment would be required if either provider raises concerns about the patient’s decision-making capacity.
The adult must be competent, meaning able to make informed health care decisions, and may withdraw the request at any time.
Dozens of supporters wearing yellow shirts filled the hearing room in Richmond Tuesday, alongside a large crowd of opponents.
Constance Muscenti, a cancer patient who lives in Nelson County, told the committee she wants the legal right to avoid what she described as a slow, unbearable decline and to spare her family from witnessing prolonged suffering.
“I've been offered experimental drugs requiring long hospital stays and side effects that I'm unwilling to expect,” Muscenti said. “I do accept, respect and honor the fact that I am mortal, and it's extremely important for me to maintain control over my final days before my quality of life has totally deteriorated.”
Melissa Stacy, regional advocacy manager at Compassion & Choices, a national end-of-life advocacy group, called medical aid in dying a “trusted and time-tested” end-of-life option that has been implemented in multiple other states, including Oregon, Maine and New Jersey.
The American Medical Association opposes physician-assisted suicide, but James Sabin, a retired psychiatrist and former chair of the AMA’s ethics council, said in a letter read by Boysko in front of the committee some doctors disagree after spending three years reviewing its historical opposition.
“We concluded that the 25-year-old opinion that has declared it to be unethical represents the views of physicians who oppose it,” Sabin wrote. “But equally wise, caring, ethically-oriented and thoughtful physicians believe that it should be legal and available as an option to consider at the end of life.”
In 2019, the AMA said for the first time that physicians may provide medical aid in dying “according to the dictates of their conscience” without violating their professional obligations.
Medical groups and disability advocates raise concerns
Representatives from the Medical Society of Virginia voiced strong opposition. The group was previously neutral on such legislation.
“This past October, our membership met… and changed our position,” said Clark Barrineau, speaking on behalf of the society.
Thomas Eppes, a family physician from Lynchburg and former president of the Medical Society of Virginia, said the bill could undermine the patient-physician relationship and skew incentives in health care.
“Our profession needs to stand with patients from cradle to grave,” Eppes said. “It’s only appropriate when hospice and palliative care is done, because that's aid in dying.”
Disability rights advocates also warned that the measure could create pressure on vulnerable patients in a system already strained by limited resources, caregiver shortages and unequal access to long-term support.
“This bill is often framed as expanding choice, but choice is not real when the systems that make living possible are broken,” said Nichole Davis of the Virginia Association for Centers for Independent Living.
Opponents cited data from Oregon, where medical aid in dying has been legal for decades, noting that only 34% of patients cited concerns about pain while nearly 89% feared losing autonomy, and arguing that pain is not the primary reason patients seek the option.
The bill advanced after a close series of procedural votes and lingering concerns among lawmakers.
Sen. Barbara Favola (D-Arlington) said the measure includes “enough guardrails,” noting it could be a helpful tool if used properly.
Sen. Tara Durant (R-Fredricksburg) raised worries about whether the safeguards are sufficient, pointing to questions raised about Canada’s medical aid in dying program.
Sen. David Suetterlein (R-Roanoke) said the bill could create harmful financial incentives in health care, pointing to the growing influence of insurance companies and targeted marketing.
He warned it could “incentivize the end of life through the worst form of capitalism.”
Sen. Lashrecse Aird (D-Petersburg) abstained from the vote.
A long-running debate in Virginia
The proposal has been debated in Virginia for years.
Angie Herring, a retired family physician and volunteer with Compassion & Choices, said the legislation has been introduced repeatedly. Ghazala Hashmi, now the lieutenant governor, carried the bill for several sessions when she served in the Senate.
In 2024, Herring said, the Senate passed the bill and a House version cleared committees, but lawmakers ultimately pulled it before a floor vote because supporters were unsure they had enough votes to pass it.
The bill did not move forward last year after Gov. Glenn Youngkin signaled he would not sign it.
With a new Democratic administration in the Governor’s mansion and the bill returning this session under Boysko’s sponsorship, Herring said they see a renewed path forward, though opposition remains strong.
The bill now heads to the full Senate Education and Health Committee.
