The Oregon House of Representatives took a significant step forward for end-of-life care on February 20, 2026, passing House Bill 4142 with a vote of 39-3. Known as Ryan’s Law, this legislation would allow patients in hospice and palliative care facilities to access medical cannabis during their final days—a change advocates say is long overdue.
The bill passed the Senate Health Care Committee by a narrow 3-2 vote yesterday and will now move to the Senate floor for a full vote, if enacted Ryan’s Law would take effect on January 1, 2027, moving Oregon closer to joining the growing list of states recognizing cannabis as a compassionate option for terminally ill patients.
What Ryan’s Law Would Change in Oregon
Under current Oregon law, medical marijuana cardholders can designate organizations providing hospice, palliative, or home health care as additional caregivers. However, many facilities have been reluctant to allow cannabis use on their premises due to unclear policies and concerns about legal liability.
HB 4142 addresses these barriers directly. The legislation would require hospice, palliative care, and residential facilities that serve as designated caregivers to establish clear written policies covering the procurement, storage, administration, and disposal of medical cannabis. These facilities would also need to provide educational training for direct care staff on cannabis pharmacology, dosing strategies, delivery methods, and potential drug interactions.
Importantly, the bill protects these organizations and their employees from criminal liability related to marijuana possession, delivery, or manufacture when providing care to registered medical cannabis patients. It also prohibits the Oregon State Board of Nursing from disciplining nurses who discuss medical cannabis use with their patients.
The legislation does exempt hospitals and hospital-affiliated clinics from these requirements, focusing instead on facilities that specialize in end-of-life care. Home health agencies and home hospice programs providing services in private residences are also excluded.
Why This Matters for Patients
Representative Farrah Chaichi, who sponsored the bill, shared a deeply personal perspective during the House floor debate. Having lost her own mother while she was intubated, Chaichi understands the importance of patients remaining present and alert during their final days with loved ones.
“This bill is an important tool to facilitate cannabis use as an alternative or addition to opioid use in end-of-life care,” Chaichi explained. “While sometimes necessary, opioids are often overly sedative, preventing quality family time interactions in a person’s final days. This is a quality of life and quality of care issue.”
Research supports these concerns. Heavy opioid use can leave patients in a fog, unable to communicate meaningfully with family members or participate in important end-of-life conversations. For many patients, cannabis offers symptom relief without the extreme sedation that can rob them of precious final moments with loved ones.
A Legacy Named After Ryan
Ryan’s Law takes its name from Ryan Bartell, a U.S. Coast Guard veteran who battled stage 4 pancreatic cancer. During his final weeks in hospice care, Ryan chose to use medical cannabis instead of heavy opioids, allowing him to remain awake and alert enough to spend meaningful time with his family.
His father, Jim Bartell, witnessed firsthand how cannabis improved his son’s quality of life during those precious final days. After Ryan’s passing, Jim became a tireless advocate for changing laws to ensure other families wouldn’t face unnecessary barriers to compassionate care.
California passed the original Ryan’s Law in 2021, becoming the first state to grant terminally ill patients the legal right to use medical cannabis within healthcare settings. The law was implemented statewide in 2022, and since then, several other states have introduced similar legislation.
Oregon’s Previous Attempts
HB 4142 represents Oregon’s third attempt in recent years to expand medical cannabis access in hospice settings. House Bill 3214, introduced during the 2025 legislative session, aimed to mandate that hospice and palliative care organizations permit cannabis use for patients in end-of-life care. That bill passed the House Committee on Behavioral Health and Health Care with a 7-1 vote but ultimately died in the Joint Committee on Ways and Means when the session adjourned in June 2025.
According to Compassionate Oregon, a coalition that has championed this legislation, a similar bill was also introduced in 2023 but failed to advance.
During discussions of the 2025 bill, legislators raised concerns about potential loss of federal funding to facilities that allow cannabis use on their premises. While cannabis remains illegal under federal law, advocates argue that state-level protections and the specific focus on medical use for terminally ill patients should mitigate these risks.
“The Ryan’s Law Foundation will continue its mission to fight for compassionate care implementation in hospice care for terminally ill patients in all states where medical cannabis is legal,” Jim Bartell said in response to Oregon’s progress. “We are aware that it will not be easy, but we are up for the challenge.”
The persistence of advocates and legislators in reintroducing this legislation highlights a growing recognition that current policies create unnecessary suffering for patients who could benefit from medical cannabis during their final days.
Implementation Timeline and Requirements
If HB 4142 becomes law, organizations and residential facilities would have time to prepare for compliance. The bill allows the Oregon Health Authority to conditionally designate facilities as additional caregivers before the January 1, 2027 operative date.
Designated facilities would need to create their required written policies by June 30, 2027, and make educational training available to staff by December 31, 2027. This gradual implementation recognizes that facilities will need time to develop appropriate protocols and train staff on cannabis-related care.
The bill also expands Oregon’s definition of “debilitating medical condition” to include the need for hospice, palliative care, comfort care, or other symptom management, including comprehensive pain management. This broader definition acknowledges that cannabis can serve therapeutic purposes beyond specific disease categories.
To engage in medical marijuana use under the law, patients would need to be registered medical marijuana cardholders or have applied for a registry identification card within the preceding 35 days.
What Happens Next
The Senate Health Care Committee hearing on February 25, 2026, proved to be a critical juncture for HB 4142. The bill passed by a narrow margin, with several senators nearly voting against it, citing the need for more information before they could offer their full support. Despite the cautious approval, the bill will now move to the full Senate for consideration. While advocates are concerned about the close vote, they remain hopeful, pointing to the strong bipartisan support the measure received in the House, where only three members voted against it.
For families facing end-of-life care decisions, the passage of Ryan’s Law could mean the difference between a loved one spending their final days heavily sedated or remaining present and engaged. For healthcare providers, it would offer clear guidelines and legal protections for incorporating medical cannabis into palliative care plans.
Oregon has long been at the forefront of progressive end-of-life policies. The state was the first to legalize physician-assisted death in 1997, recognizing that terminally ill patients should have autonomy over their final days. Ryan’s Law in Oregon would represent a continuation of this commitment to compassionate, patient-centered end-of-life care.
As the Senate prepares to consider this legislation, the experiences of patients like Ryan Bartell remind us why these policy changes matter. Medical cannabis offers many terminally ill patients a path to symptom relief without sacrificing their ability to remain present with loved ones. For those facing life’s final chapter, that presence can be the most precious gift of all.
