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More than 10 years after Oregon stoked fears when it became the first state in the nation to legalize physician-assisted suicide, Washington and Montana quietly followed suit in late 2008.

On Election Day, 58 percent of Washington voters approved a measure allowing terminally ill adults to obtain lethal prescriptions if they are deemed competent. Just two states away, a judge in Montana ruled in early December that physician-assisted suicides are legal in the state. That decision is likely to be appealed.

Oregon's move in 1997 stirred widespread concerns in the medical community of a domino effect in other states, said David Stevens, CEO of the Christian Medical Association. This time around, the decisions did not receive nearly as much publicity because of the presidential election and the debate over Proposition 8 in California.

"The proponents of this are delighted," Stevens said. "The crack in the dam has broadened, and the chance for the dam to burst open and go to the rest of the country is very good." In January, legislatures in Hawaii and New Hampshire introduced assisted-suicide bills.

Physician-assisted suicide is legal in some countries, including the Netherlands and Belgium. In late December, a Quebec man was found not guilty of helping his disabled uncle kill himself, opening the door to its legalization in the Canadian province.

The U.S. Supreme Court ruled in 1996 that terminally ill patients have no constitutional right to physician-assisted suicide, but did nothing to prevent states from making it legal. The court affirmed in 2006 the constitutionality of Oregon's Death with Dignity Act, under which over 340 patients have died.

Catholics and evangelicals worked together to oppose Oregon's assisted-suicide law, ...

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