Most Americans support allowing some terminally ill patients to end their own lives. But a Maryland bill’s narrow defeat shows the issue is still religiously fraught and politically delicate.

Under a settlement reached in a federal lawsuit this week, terminally ill patients seeking physician-assisted death in Oregon are no longer required to be residents of the state.

Katie Engelhart explores the complexity of physician-assisted death in the book The Inevitable. She says patients seeking to end their own lives sometimes resort to veterinary drugs from overseas.