West Virginia Amendment 1, Prohibit "Medically-Assisted Suicide, Euthanasia, and Mercy Killing" Measure (2024)

West Virginia Amendment 1
Election date November 5, 2024
Topic Assisted death
Status a Approved
Type Constitutional amendment	Origin State legislature

West Virginia Amendment 1, the Prohibit "Medically-Assisted Suicide, Euthanasia, and Mercy Killing" Measure, was on the ballot in West Virginia as a legislatively referred constitutional amendment on November 5, 2024. The ballot measure was approved.

A "yes" vote supported amending the West Virginia Constitution to prohibit people from participating in "the practice of medically assisted suicide, euthanasia, or mercy killing of a person."

A "no" vote opposed amending the West Virginia Constitution to prohibit people from participating in "the practice of medically assisted suicide, euthanasia, or mercy killing of a person."

Election results

West Virginia Amendment 1
Result		Votes	Percentage
Yes		340,403	50.44%
No		334,521	49.56%

Results are officially certified.

Source

Overview

What did this amendment do regarding assisted death?

See also: Constitutional changes

This amendment prohibited people, including healthcare providers and physicians, from participating in "the practice of medically assisted suicide, euthanasia, or mercy killing of a person." This practice is sometimes referred to as assisted death, assisted suicide, or aid-in-dying. The amendment does not prevent the administration or prescription of medication to alleviate pain or discomfort while the patient's condition follows its natural course, nor does it prohibit withholding or withdrawing life-sustaining treatment at the request of the patient or patient's decision maker. The amendment also does not prevent the state from providing capital punishment.

Was assisted death legal in other states?

See also: Physician-assisted death in other states

As of 2024, physician-assisted death was legal in nine states—California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Oregon, Vermont, Washington—and the District of Columbia. Oregon became the first U.S. state to legalize physician-assisted death in 1997. It was decriminalized in Montana following a court ruling. Three states—Colorado, Oregon, and Washington—legalized assisted death by ballot initiative. Six states—California, Hawaii, Maine, New Jersey, New Mexico, and Vermont—legalized assisted death by legislation. The last state to legalize assisted death by ballot initiative was Colorado in 2016.

How did this measure get on the ballot?

See also: Path to the ballot

For the state legislature to place a constitutional amendment on the ballot, a two-thirds vote in each chamber is required during one legislative session. The amendment was introduced as House Joint Resolution 28 (HJR 28) on January 31, 2024. On February 15, 2024, the House of Delegates voted 88-9 to pass HJR 28. On March 9, 2024, the Senate voted 28-4 to approve an amended version of HJR 28. As HJR 28 was amended, concurrence was required in the House of Delegates. Later on March 9, 2024, the House voted 88-10 to refer the constitutional amendment to the ballot.

Text of measure

Ballot title

The ballot title was as follows:

“

Protection of persons against medically assisted suicide The purpose of this amendment is to protect West Virginians against medically assisted suicide.

”

Constitutional changes

See also: Article III, West Virginia Constitution

The ballot measure added a new section, Section 23, to Article III of the West Virginia Constitution. The following underlined text was added:

§3-23. Protection against medically assisted suicide.

No person, physician, or health care provider in the State of West Virginia shall participate in the practice of medically assisted suicide, euthanasia, or mercy killing of a person. Nothing in this section prohibits the administration or prescription of medication for the purpose of alleviating pain or discomfort while the patient's condition follows its natural course; nor does anything in this section prohibit the withholding or withdrawing of life-sustaining treatment, as requested by the patient or the patient's decision-maker, in accordance with State law. Further, nothing in this section prevents the State from providing capital punishment.

Readability score

See also: Ballot measure readability scores, 2024

Using the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) formulas, Ballotpedia scored the readability of the ballot title for this measure. Readability scores are designed to indicate the reading difficulty of text. The Flesch-Kincaid formulas account for the number of words, syllables, and sentences in a text; they do not account for the difficulty of the ideas in the text. The state legislature wrote the ballot language for this measure.

The FKGL for the ballot title is grade level 14, and the FRE is 15. The word count for the ballot title is 21.

Support

Vote for Amendment 1 (Caring Not Killing) was leading the campaign in support of the measure.

Supporters

Officials

• State Del. Pat McGeehan (R)
• State Del. Chris Pritt (R)
• State Del. Brandon Steele (R)

Organizations

• West Virginians for Life

Arguments

• State Del. Pat McGeehan (R-1): "There’s this phenomenon of nihilism that’s sort of spreading across the country, and I think it’s an important issue we need to address. To the best of my knowledge, we’ll be the first to place this and take a stand in the state constitution."
• State Del. Pat McGeehan (R): "That’s why it is vital to vote for Amendment One this November. It secures our state from medically-assisted suicide and the culture of indifference and carelessness it promotes. It affirms the goodness of suicide prevention. And it sends a clear and confident message that West Virginia is not a place of fear and despair, but a state of courage and hope."
• Mary Tillman, legislative coordinator for the West Virginia alliance for Ethical Health Care: "If there is a fear of pain at the end of life, good palliative care and hospice care are ways to provide comfort and care until a person’s life ends naturally. A vote FOR Amendment One will protect all West Virginians from physician-assisted suicide. This November, please vote to keep West Virginia a state where all lives are valued and protected."

Opposition

Opponents

Officials

• State Del. Joey Garcia (D)
• State Del. Anitra Hamilton (D)

Organizations

• ACLU of West Virginia
• Death with Dignity

Arguments

• Death with Dignity: "While Death with Dignity is already illegal under current West Virginia law, this constitutional amendment would mark the first time any state amended its constitution to explicitly prohibit aid in dying. Never before has a legislature in this country mobilized an attack like this on terminally ill patients. And to make matters worse, proponents of the ban are on a press tour spreading malicious lies about how Death with Dignity works in states where it’s legal."
• Eli Baumwell, interim executive director for ACLU West Virginia: "'Mountaineers are always free' is a promise that the ACLU of West Virginia works every day to ensure is kept. Amendment One runs counter to that promise by enshrining a prohibition into the state constitution designed to take away the last free choice Mountaineers can make. West Virginians, like most Americans, do not believe that the government should interfere in personal medical decisions. As shown by the Legislature going zero for four last year in seeking permission from the people to modify our Constitution, they do not represent the will of the people. Instead, they represent a dangerous and out of touch minority: lawmakers who want to take the last medical decision you can ever make about yourself."

Campaign finance

See also: Campaign finance requirements for West Virginia ballot measures

Ballotpedia did not identify ballot measure committees registered to support or oppose the ballot measure.

	Cash Contributions	In-Kind Contributions	Total Contributions	Cash Expenditures	Total Expenditures
Support	$0.00	$0.00	$0.00	$0.00	$0.00
Oppose	$0.00	$0.00	$0.00	$0.00	$0.00
Total	$0.00	$0.00	$0.00	$0.00	$0.00

Background

Physician-assisted death

Physician-assisted death, sometimes referred to as assisted death, assisted suicide, or aid-in-dying, is the practice of a physician providing a potentially lethal medication to a terminally ill patient at their request.

There were two U.S. Supreme Court cases concerning assisted death, both decided in 1997. In the Vacco v. Quill case, the ruling concerned the constitutionality of New York's ban on assisted death. Dr. Timothy E. Quill, along with other physicians and three seriously ill patients, challenged the ban and said it violated the Equal Protection Clause and the Due Process Clause of the Fourteenth Amendment. The Supreme Court ruled unanimously in favor of the state and upheld New York’s ban, and affirmed that it is up to the states to regulate assisted suicide. In the Washington v. Glucksberg case, Dr. Harold Glucksberg, along with other physicians and terminally ill patients, challenged Washington’s ban on physician-assisted death. The Supreme Court ruled unanimously that there was no fundamental right to physician-assisted suicide protected by the Constitution, and that it is up to the states to regulate physician-assisted death.

Oregon became the first U.S. state to legalize physician-assisted death. Physician-assisted death is legalized in nine states—California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Oregon, Vermont, and Washington—as well as the District of Columbia. It is decriminalized in Montana following a court ruling.

In the United States, euthanasia is distinguished from assisted death, and is illegal in the U.S. Voluntary euthanasia is legal in Belgium, Columbia, Luxembourg, and Canada.

Physician-assisted death in other states

Physician-assisted death is legal in nine states—California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Oregon, Vermont, and Washington—and the District of Columbia. It was decriminalized in Montana following a court ruling. Three states—Colorado, Oregon, and Washington—legalized assisted death by ballot initiative. Six states—California, Hawaii, Maine, New Jersey, New Mexico, and Vermont—legalized assisted death by legislation.

Physician-assisted death on the ballot

State	Year	Measure	Yes	No	Outcome
Washington	1991	Initiative 119	46.40%	53.60%	d
California	1992	Proposition 161	45.87%	54.13%	d
Oregon	1994	Measure 16	51.31%	48.69%	a
Michigan	1998	Proposal B	28.88%	71.12%	d
Maine	2000	Question 1	48.67%	51.33%	d
Washington	2008	Initiative 1000	57.82%	42.18%	a
Massachusetts	2012	Question 2	48.87%	51.13%	d
Colorado	2016	Proposition 106	64.87%	35.13%	a

Path to the ballot

Amending the West Virginia Constitution

See also: Amending the West Virginia Constitution

A two-thirds vote is required during one legislative session for the West Virginia State Legislature to place a constitutional amendment on the ballot. That amounts to a minimum of 67 votes in the West Virginia House of Representatives and 23 votes in the West Virginia State Senate, assuming no vacancies. Amendments do not require the governor's signature to be referred to the ballot.

House Joint Resolution 28

The constitutional amendment was introduced into the West Virginia State Legislature on January 31, 2024, as House Joint Resolution 28 (HJR 28). On February 15, 2024, the House of Delegates voted 88-9 to pass HJR 28. On March 9, 2024, the Senate voted 28-4 to approve an amended version of HJR 28. As HJR 28 was amended, concurrence was required in the House of Delegates. Later on March 9, 2024, the House voted 88-10 to refer the constitutional amendment to the ballot.

Vote in the West Virginia House of Delegates February 15, 2024
Requirement: Two-thirds (66.67 percent) vote of all members in each chamber
Number of yes votes required: 67  a
	Yes	No	Not voting
Total	88	9	3
Total percent	88%	9%	3%
Democrat	2	9	1
Republican	86	0	2

Vote in the West Virginia State Senate March 9, 2024
Requirement: Two-thirds (66.67 percent) vote of all members in each chamber
Number of yes votes required: 23  a
	Yes	No	Not voting
Total	28	4	2
Total percent	82.3%	11.7%	5.8%
Democrat	3	2	0
Republican	25	2	2

How to cast a vote

See also: Voting in West Virginia

See below to learn more about current voter registration rules, identification requirements, and poll times in West Virginia.

How to vote in West Virginia

Poll times

In West Virginia, all polling places are open from 6:30 a.m. to 7:30 p.m. Eastern Time. A voter who is in line at the time polls close must still be permitted to vote.

Registration

Check your voter registration status here.

To vote in West Virginia, an individual must be a citizen of the United States, a resident of West Virginia, and at least 18 years of age by the date of the next general election.

The registration deadline is 21 days prior to an election. An individual may register to vote by submitting a form by mail to his or her county clerk's office or the Secretary of State's Office. Registration can be completed online, in person at the county clerk's office, the Secretary of State's office, the Department of Motor Vehicles, any public assistance office, any agency that serves people with disabilities, any marriage license office, or any military recruiting agency.

Automatic registration

See also: Automatic voter registration

West Virginia automatically registers eligible individuals to vote through the Department of Motor Vehicles.

Online registration

See also: Online voter registration

West Virginia has implemented an online voter registration system. Residents can register to vote by visiting this website.

Same-day registration

See also: Same-day voter registration

West Virginia does not allow same-day voter registration.

Residency requirements

An individual must have resided in the state for at least 30 days of residency before they may vote.

Verification of citizenship

See also: Laws permitting noncitizens to vote in the United States

West Virginia does not require proof of citizenship for voter registration. An individual applying to register to vote must attest that they are a U.S. citizen under penalty of perjury.

All 49 states with voter registration systems require applicants to declare that they are U.S. citizens in order to register to vote in state and federal elections, under penalty of perjury or other punishment. Seven states — Alabama, Arizona, Georgia, Kansas, Louisiana, New Hampshire, and Wyoming — have laws requiring verification of citizenship at the time of voter registration, whether in effect or not. In three states — California, Maryland, and Vermont — at least one local jurisdiction allows noncitizens to vote in some local elections. Noncitizens registering to vote in those elections must complete a voter registration application provided by the local jurisdiction and are not eligible to register as state or federal voters.

Verifying your registration

The West Virginia Secretary of State's office allows residents to check their voter registration status online by visiting this website.

Voter ID requirements

West Virginia requires voters to present identification while voting. The identification provided must be issued either by the State of West Virginia, or one of its subsidiaries, or by the United States government.

Signed into law in 2025, HB 3016 established that a document was valid if it:

“

(A) Has been issued either by the State of West Virginia, one of its political subdivisions or instrumentalities, or by the United States Government; (B) Contains the name of the person desiring to vote; and (C) Contains a photograph of the person desiring to vote: Provided, That a driver’s license or identification card issued in accordance with §17B-2-1(f)(4) of this code that does not contain a photograph of the person desiring to vote is a valid identifying document.

”

State law enumerates the following identifications that an individual may use to vote:

“

(A) A valid West Virginia driver’s license or valid West Virginia identification card issued by the West Virginia Division of Motor Vehicles, including a driver’s license or identification card issued in accordance with §17B-2-1(f)(4) of this code. (B) A valid driver’s license issued by a state other than the State of West Virginia; (C) A valid United States passport or passport card; (D) A valid employee identification card with a photograph of the eligible voter issued by any branch, department, agency, or entity of the United States Government or of the State of West Virginia, or by any county, municipality, board, authority, or other political subdivision of West Virginia; (E) A valid student identification card with a photograph of the eligible voter issued by an institution of higher education in West Virginia, or a valid high school identification card issued by a West Virginia high school; (F) A valid military identification card issued by the United States with a photograph of the person desiring to vote; or (G) A valid voter registration card that includes the voter’s photograph issued by a county clerk in the State of West Virginia or the Secretary of State. The county clerk or the Secretary of State may not charge or collect a fee for the application or issuance of a voter registration card that includes the voter’s photograph.

”

Lastly, state law provided for the following exceptions and alternative methods of verifying a voter's identity:

“

(3) Any expired document identified in §3-1-34(a)(2) of this code is a valid identifying document if presented by a registered voter 65 years of age or older: Provided, That the identifying document was not expired on the registered voter’s 65th birthday. (4) In lieu of providing a valid identifying document, as required by this section, a registered voter may be accompanied at the polling place by an adult known to the registered voter for at least six months. That adult may sign an affidavit on a form provided to clerks and poll workers by the Secretary of State, which states under oath or affirmation that the adult has known the registered voter for at least six months, and that in fact the registered voter is the same person who is present for the purpose of voting. For the affidavit to be considered valid, the adult shall present a valid identifying document with his or her name, address, and photograph. (5) A poll worker may allow a voter, whom the poll worker has known for at least six months, to vote without presenting a valid identifying document. (6) If the person desiring to vote is unable to furnish a valid identifying document, or if the poll clerk determines that the proof of identification presented by the voter does not qualify as a valid identifying document, the person desiring to vote shall be permitted to cast a provisional ballot after executing an affidavit affirming his or her identity pursuant to §3-1-34(a)(6)(B) of this code.

”

Voters can obtain a free voter ID card at their county clerk’s office.

See also

2024 measures

• 2024 ballot measures
• Assisted death on the ballot

West Virginia

• West Virginia ballot measures
• West Virginia ballot measure laws

News and analysis

• Ballot measure lawsuits
• Ballot measure readability
• Ballot measure polls

External links

• West Virginia House Joint Resolution 28 (2024)