What are the guidelines for physician-assisted death under new Illinois law?

A new Illinois law will allow for physician-assisted death in Illinois following Illinois Gov. JB Pritzker’s signature this week, making Illinois the first Midwest state to legalize “medial aid in dying.”

The law won’t take effect until later in 2026 to allow time for health officials to put processes and protocols in place, but some guidelines have already been named.

“I have been deeply impacted by the stories of Illinoisans or their loved ones that have suffered from a devastating terminal illness, and I have been moved by their dedication to standing up for freedom and choice at the end of life in the midst of personal heartbreak,” Pritzker said in a statement Friday.

Here’s what to know:

What is the “medical aid in dying” bill?

The legislation allows certain terminally ill patients to end their lives with a doctor’s help.

Also called Deb’s Bill, the legislation was inspired by Deb Robertson, a retired Lombard social worker with a rare terminal illness.

“Today, I know the end for me could be near. But I’m pleased to have been able to play some role in ensuring that terminally ill Illinoisans have access to medical aid in dying,” Robertson said in a statement.

When will the new law take effect?

The law will take effect on Sept. 12, 2026, to allow the Illinois Department of Public Health time to implement processes and protocols outlined in the legislation.

What’s required to be eligible?

There are strict requirements for patients and physicians.

Patients who are at least 18 years old who wish to request medication to end their lives must have a terminal illness. Here are the requirements, according to Pritzker’s office:

• Two physicians must provide an in-person examination and conclude the patient’s illness will result in death within six months.
• Doctors must inform the patient about all of their end-of-life care options, including comfort care, hospice, palliative care and pain control.
• The patient must have the mental capacity, confirmed by their physician, to make medical decisions. If the physician has questions about mental fitness, the patient will be referred to a licensed mental health professional. If the mental health professional determines that the patient does not have mental capacity, the patient will not qualify.
• The patient must make written and oral requests in order to receive the aid-in-dying medication, among other requirements. Only the patient can make the request.
• The patient’s written request must be signed by the patient and witnessed by at least two people who attest that the patient has the mental capacity to make the decision.
• The patient must make the request voluntarily and not be coerced or under duress.
• The patient must be able to self-administer the medication.
• The patient has the right to withdraw their request at any time or choose not to ingest it.

The death certificates of those who take end-of-life medication under the bill will attribute their cause of death to the underlying terminal disease. If a patient chooses this option, doctors must submit information within 60 days after death to the Illinois Department of Public Health regarding the patient, their diagnosis, notice that requirements under the Act were completed, and notice that medication has been prescribed. The information is confidential, privileged, and not discoverable in any civil, criminal, administrative, or other proceeding.

Doctors, health care providers and pharmacists are not required to participate in the option. The law makes it a felony to coerce anyone to request the medication or to forge a request. Health care entities can also ban staff from practicing aid-in-dying care while working for the organization.

Where else is physician-assisted death legal?

Eleven other states and Washington D.C. already authorized medical aid in dying, according to the nonprofit Compassion & Choices, which advocates for the expansion of end-of-life care options. The nonprofit said Illinois is the first state in the Midwest to enact the law.

Delaware’s law takes effect on Jan. 1, 2026. New York state lawmakers passed legislation earlier this year, and New York Gov. Kathy Hochul must make a decision by the end of 2025.

What else to know

Not everyone was in full support of the bill.

Disability rights organizations, religious leaders and other opponents held a candlelight vigil outside Pritzker’s Chicago office Thursday evening, ahead of the bill signing, urging the governor to veto the legislation. Groups that do not support the bill believe physician-assisted death is “life-threatening” to people who are vulnerable or disabled at a time when federal legislation threatens to strip Medicaid coverage from hundreds of thousands of people in Illinois. They also believe people with disabilities will feel pressured into choosing the option to die simply because living independently has become unaffordable or inaccessible.

“This is an emotional and deeply personal issue for many families, including mine. When my mother passed at home, I know she would have chosen this path to ease our pain, not her own. That’s exactly why strong safeguards matter,” House Minority Leader Tony McCombie said in a statement. “This bill goes too far without the protections Illinois families deserve. Coroners, who will be responsible for determining causes of death, were never brought into the conversation. Stakeholders raised red flags that were brushed aside. Those gaps pose real and dangerous consequences. I opposed this legislation because compassion must be paired with caution. Illinois should have taken a more responsible, inclusive approach before moving forward.”