Illinois’ End-of-Life Options for Terminally Ill Patients Act has been in effect since Sept. 12, while three federal lawsuits are already shaping which providers must follow its requirements.
The law, also known as Deb’s Law, was signed by Gov. JB Pritzker in December 2025 and is modeled on Oregon’s 1997 Death with Dignity Act, according to an Oct. 27 healthcare alert from Chicago-based law firm Hinshaw & Culbertson. It allows adult Illinois residents with a terminal illness expected to cause death within six months to request medication they can self-administer, as long as an attending physician and a consulting physician confirm the diagnosis, prognosis and the patient’s decision-making capacity.
Mr. Pritzker has said the law offers “freedom and choice at the end of life.”
Patients must make an oral request, submit a written request on an Illinois Department of Public Health form and repeat the oral request at least five days after the first, according to Hinshaw. Attending physicians must confirm the request is not coerced, inform patients of all feasible end-of-life options and refer them to a licensed mental health professional if capacity is in doubt. Physicians must file a checklist with the state health department within 30 days of prescribing, and death certificates must list the underlying terminal illness as the cause of death.
Participation is voluntary, and institutions may prohibit clinicians from providing aid-in-dying care on their behalf. Physicians who decline must still transfer medical records without delay, and objecting providers keep informational and referral obligations under the law. Those obligations are at the center of the religious-liberty litigation, according to Hinshaw.
The broadest of the cases, Kirchoff v. Treto, was filed Aug. 11 by the Thomas More Society on behalf of four Catholic physicians, Bishop Thomas Paprocki of Springfield and Lutheran Care Center, a nursing home in south-central Illinois. The plaintiffs argue the act and 2016 amendments to the state’s Health Care Right of Conscience Act violate their free speech and free exercise rights.
A judge entered a stipulated temporary restraining order in the case Aug. 21, then replaced it Oct. 5 with an amended order that extends protection to Catholic health entities in the Diocese of Springfield and to members of the Illinois Catholic Health Association, the Christian Medical and Dental Associations, the National Association of Catholic Nurses and the Catholic Psychotherapy Association who provide written confirmation of membership. The order remains in effect until the 7th U.S. Circuit Court of Appeals issues its mandate in two related appeals and the district court rules on an anticipated preliminary injunction motion.
A second case, Carmelite Sisters for the Aged and Infirm v. Prince, was filed Sept. 3 by Becket on behalf of Cardinal Blase Cupich of Chicago, the Carmelite Sisters, the Chicago Province of the Little Sisters of the Poor and an Illinois pharmacist. The court entered a stipulated restraining order Sept. 11, the day before the law took effect, but it exempts only the named plaintiffs. Counsel has indicated that the case may be consolidated with Kirchoff, according to Hinshaw.
Cardinal Cupich has said the law’s provisions “violate core constitutional protections of freedom of speech and religion,” and called for them to be struck down permanently.
The third challenge has so far gained less traction in court. In Payne v. Pritzker, filed June 11, two people with disabilities, six disability-rights groups and a physician allege the law discriminates against disabled patients, steers them toward aid in dying and lacks adequate oversight. On Sept. 10, U.S. District Judge John J. Tharp Jr. denied a preliminary injunction for lack of standing, dismissed Mr. Pritzker as a defendant and dismissed the state health department except on statutory claims. He ordered the plaintiffs to show cause why the case should not be dismissed, and they responded Oct. 13. A similar challenge to New York’s law was dismissed in July.
Because the restraining orders cover only named parties and association members, Hinshaw advises institutions that will not participate to adopt and communicate a written policy. Organizations that will offer aid-in-dying care should build protocols covering request documentation, the five-day waiting period, referrals, prescribing and dispensing, death certificates and state reporting. The firm also recommends that health systems pursuing deals review targets’ policies and address conscience issues in affiliation and joint venture agreements.
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