SPRINGFIELD, Ill. — Gov. JB Pritzker on Friday signed into law a measure that would allow doctors to help terminally ill people end their lives after the controversial bill barely cleared the Senate during the fall legislative session, where one skeptic said it could bring “a culture of death” to Illinois.

Illinois now joins at least 10 other states, among them California, Hawaii, Colorado, Oregon, as well as Washington, D.C., in allowing medical aid in dying.

In a statement Friday morning, the governor said he was moved by supporters’ “dedication to standing up for freedom and choice at the end of life in the midst of personal heartbreak.”

“Today, Illinois honors their strength and courage by enacting legislation that enables patients faced with debilitating terminal illnesses to make a decision, in consultation with a doctor, that helps them avoid unnecessary pain and suffering at the end of their lives,” he said.

Pritzker’s signature ends the impassioned debate over a measure that took more than a year and multiple legislative sessions to pass through both chambers of the General Assembly amid high emotions for people on both sides of the issue — those who believe individuals on the verge of death should have the autonomy to choose whether they live or die and those who feel it’s immoral to give someone the option to take their own life.

Pritzker, who is starting to campaign for his third term and is mulling a 2028 presidential bid, even disclosed to reporters recently that he raised the issue during his November meeting with Pope Leo XIV, acknowledging there may be things the governor and Chicago-born pope “disagree about.”

The legislation passed the Senate on the last day of the spring session by a 30-27 margin — one vote shy of failing on the Senate floor — and five months after narrowly passing the House by a 63-42 vote.

While it was opposed by groups like the Catholic Conference of Illinois and disability rights activists who have argued that allowing terminally ill people to end their lives could lead to coercion, discrimination and abuse, the measure had the backing of groups like the American Civil Liberties Union of Illinois and Compassion and Choices Action Network.

“This is a choice. If you are opposed to it, whether the reason is moral, religious, you just don’t like the idea, fine. I would never tell you you should choose this option,” state Sen. Linda Holmes, a Democrat from Aurora and the main Senate sponsor of the legislation, said during the floor debate. “What I’m saying is ‘why? Why?’ If I am facing an illness where I am going to die in pain, do you think you should tell me I don’t have the option to alleviate that pain?”

On the last day of fall session, state Sen. Chris Balkema, a Republican from Channahon who opposed the measure, detailed how both his parents died in hospice care. He said he felt the medical aid-in-dying legislation was meant to curtail suffering, though he was not confident there were strong enough guardrails regarding the use of the end-of-life medication.

“It’s not right to introduce a culture of death into Illinois,” said Balkema.

On Thursday, a couple of dozen people held a vigil outside the new state of Illinois building at Monroe and Clinton streets — the site of Pritzker’s Chicago office — and protested the bill, imploring the governor not to sign it into law. The group held up signs that read “VETO ASSISTED SUICIDE,” “IT’S STILL SUICIDE,” and one sign said “STATE SANCTIONED SUICIDE” with the words crossed out with an “x.”

Among the attendees was Balkema, who said the issue was more personal than political.

“Republicans, Democrats, independents, everybody wants to have compassion for people, and we don’t like to see people suffer,” he told the Chicago Tribune. “The approach of allowing drugs to be administered, given to a person, taken home unsupervised and then those drugs could get anywhere in the community is a real concern for me.”

One speaker expressed the harmful effects a medical aid-in-dying law could have on people who are sick. Opponents said they believe people in such situations would be better suited with encouragement and hope while being treated for a terminal illness. Others spoke about the adverse effects it could have on disabled people.

“It does not support investment in equity of people with disabilities, especially those people of color,” said Candace Coleman, a community strategy specialist for the group Access Living. “We are at a time right now where every aspect of our lives is getting attacked, from the cuts to Medicaid, (the) higher costs, for us to live.”

According to the new law, an eligible patient “may orally request a prescription for medication” from their attending physician and it must be documented. The patient must also request the medication in writing to their physician after making the oral request. But the patient must also make a second oral request five days after the initial one.

The written request for the medication must also be witnessed by two people, “who attest that to the best of their knowledge” the patient is acting voluntarily and is mentally sound, according to the bill, which also lists various limitations as to who can act as witnesses.

“At the time the patient makes the second oral request, the attending physician shall offer the patient an opportunity to rescind the request,” the legislation states. “Oral and written requests for aid in dying may be made only by the patient and shall not be made by the patient’s surrogate decision-maker, health care proxy, health care agent, attorney-in-fact for health care, guardian, nor via advance health care directive.”

An attending physician must also “provide sufficient information to a patient regarding all appropriate end-of-life care options,” including comfort care, hospice care, palliative care and pain control, as well as the foreseeable risks and benefits of each.

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