In December, a state court in Montana found that it was not illegal for physicians to prescribe lethal medication to terminally ill patients in certain situations. But the ruling did not provide the state-regulatory mechanisms put into place in Washington and Oregon, and Montana officials said it was unclear whether physicians there had been prescribing lethal medications.

The issue is also prominent in some other states. Physicians in Connecticut have filed a lawsuit seeking to have the courts clarify whether the law there allows them to prescribe lethal drugs to terminal patients. And lawmakers in Massachusetts are considering a measure supporting physician-assisted suicide, but its sensitivity has also made for strong opposition, particularly among religious groups.

Most patients who died under the law in Washington last year had cancer. Prescribing doctors, who must submit forms to the State Department of Health about patients who received the medication, said all who died cited “loss of autonomy” as a reason for seeking it. Most also said they could no longer enjoy life and feared losing “dignity.”

Ten patients said they were concerned about being a burden on their family and friends, 11 cited pain and one said finances were an issue. Critics of the law have said it could prompt disproportionate use by lower-income people. Almost all of those who died in Washington said they had private insurance, Medicare, Medicaid or some combination. None said they had no insurance at all, though coverage was listed as unknown for five people. Most died within 90 minutes of taking the medicine, though at least one person lived for 28 hours. Two woke up after taking the medicine, then died later.