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Eight U.S. jurisdictions (seven states plus the District of Columbia) now allow physicians to prescribe a lethal dose of medication to a mentally competent, terminally ill patient, provided that certain conditions are met. Hawaii passed a medical aid-in-dying law in April and similar proposed laws are currently under consideration in North Carolina, New York and other states. However, in the states where medical aid-in-dying, also known as physician aid-in-dying (PAD), laws are already in effect, patients who wish to use them still face substantial barriers to access, according to a new study. The study argues that although PAD laws are on the rise in the U.S., legalization does not guarantee access. Patients can and do encounter substantial barriers to access in jurisdictions where medical aid-in-dying is legal, and access is hindered by the same socioeconomic inequalities that are common in U.S. health care. For example, patients with higher incomes have easier access to physicians who are willing to prescribe the lethal medication. They are also more likely to have insurance that will cover it, or to be able to afford to pay for these services themselves.