On Wednesday, The New England Journal of Medicine released a study which calls into question the primary talking point used by supporters of assisted suicide — that people who ask for assisted suicide are suffering so much pain that forcing them to continue living is cruel and unjust.

The study, based on information collected by Canada’s University Health Network from March 2016 to March 2017, found that most patients pursue assisted suicide simply because they are not satisfied with their lives. It is not primarily due to pain from their illnesses.

Madeline Li, an associate professor at the University of Toronto, described the assisted suicide patients’ feelings like this: “Their quality of life is not what they want. They are mostly educated and affluent — people who are used to being successful and in control of their lives, and it’s how they want their death to be.” “It’s what I call existential distress,” she added.

This finding was consistent with a 1999 study on the first year of legalized assisted suicide in Oregon.

Many physicians reported that their patients had been decisive and independent throughout their lives or that the decision to request a lethal prescription was consistent with a long-standing belief about the importance of controlling the manner in which they died. Thus, the decision to request and use a prescription for lethal medications during the first year of legalized physician-assisted suicide in Oregon was associated with views on autonomy and control, not with fear of intractable pain or concern about financial loss.

If such patients are allowed access to assisted suicide merely because they are not satisfied with their lives, what is to stop any person — even someone not in immediate danger of death — who is not satisfied with his or her life from demanding a right to euthanasia? Allowing assisted suicide for people with terminal illnesses is a slippery slope which could lead to permitting anyone unhappy with life the option of ending it.

Countries like Belgium and the Netherlands have already travelled far down this road. Belgium gained international attention in 2015 when doctors granted a 24-year-old depressed woman the right to assisted suicide. And in the Netherlands, less than 20 years after assisted suicide was originally legalized only for those with “unbearable suffering with no prospect of improvement,” depressed people who have no life-threatening illnesses are now receiving help to end their lives. Speakers at the Euthanasia 2016 conference in Amsterdam went even further by promoting assisted suicide for anyone who is “tired of life,” including children as young as 12 years old.

In the United States, however, proponents of assisted suicide have — fortunately — not been so successful. On Tuesday, in the latest setback for their movement, euthanasia legislation in Maine hit a major roadblock. By a bipartisan vote of 85-61, the Maine House of Representatives rejected a bill which had previously passed the Senate by just one vote. If passed and signed, LD 347 would have permitted doctors to prescribe lethal doses of medication to terminally ill patients who are not expected to live more than six months.

The Maine legislature’s attempt to legalize physician assisted suicide represents a common trend. While anti-life lawmakers across the country have been active this year in proposing “death with dignity” statutes, not a single one of them has been successful.

Death with Dignity brags that 27 of the 44 states which do not already permit assisted suicide are considering it during this year or session. However, none of these bills have gained much traction.

This October will mark 20 years since Oregon became the first state to legalize physician assisted suicide. It was not until over a decade later that neighboring Washington state joined Oregon in permitting the practice, and since then, only three other states (Vermont, California, and Colorado) have passed “death with dignity” statutes.

With the release of this new study, one hopes other states will consider long and hard the likely negative consequences of assisted suicide before opting to join them.