A New Mexico judge has ruled competent terminally ill adults have a right to physician-assisted suicide under the state’s constitution, despite it being against state law since the 1960s. New Mexico may become the fifth state to legalize the practice if the decision stands.

“This Court cannot envision a right more fundamental, more private or more integral to the liberty, safety and happiness of a New Mexican than the right of a competent, terminally ill patient to choose aid in dying,” wrote Judge Nan Nash of New Mexico’s second judicial district.

University of New Mexico Hospital oncologists Drs. Katherine Morris and Aroop Mangalik, who were featured in the award-winning documentary, How to Die in Oregon, brought the suit due to their fears of prosecution if they helped a person with a terminal illness die. Lawyers from the ACLU and Compassion and Choices provided legal assistance.

Barbara Coombs Lee, president of Compassion and Choices, is pleased the judge sees the importance of those with terminal illnesses to control their own deaths. She says aid in dying is the last resort and isn’t offered to a suicidal person. “I think it’s appropriate to have laws against assisting the suicide of a suicidal person but it’s different when you’re talking about a person who is imminently dying,” she says.

To advocates like Coombs Lee, aid in dying is fundamental to human dignity and she wants everyone, including people with disabilities, to be able to control their own lives. “It’s so important because of the principle that lies at the base of the disability rights movement and that’s autonomy,” she says.

However, the Disability Rights Education and Defense Fund and other disability advocacy organizations are concerned about the ruling. “This ruling tears away at the fabric of what those of us in the disability rights movement have been working to improve,” wrote DREDF senior policy analyst Marilyn Golden. “A health care system free to deal with each individual uniquely rather than as a line-item on an accounting ledger, the elimination of abuse and coercion by those seeking to profit or take advantage of someone during a difficult time, and the illusion that individuals with a severe illness or disability should be measured by a flawed societal definition of quality of life.”

The New Mexico Attorney General’s Office is reviewing Nash’s decision but hasn’t decided if it plans to file an appeal.

This article was edited on Feb. 3 for clarity.