The state’s highest court ruled on Monday that the practice of allowing doctors to give mentally competent patients with terminal illnesses a lethal dose of medication is not protected by the state constitution.

The Supreme Judicial Court concluded that the Massachusetts Declaration of Rights does not go so far as to protect physician-assisted suicide in its ruling, despite the fact that it acknowledges the paramount importance and profound significance of all end-of-life decisions. We come to the conclusion that physician assisted suicide is something that the law of manslaughter can prohibit without violating constitutional rights.

The high court stated that the state has the final say on physician-assisted suicide, also known as medical aid in dying, despite noting the delicate nature of the case.

According to the court, “each of us is free to vote and to encourage our legislators to enact laws and to design appropriate procedural safeguards, with respect to one of the few human experiences that will affect us all.”

The court also made a distinction between a patient’s voluntary decision to forgo medical care or nutrition and physician-assisted suicide, stating that “whereas withdrawing or withholding medical care is not the primary cause of a patient’s death, physician-assisted suicide is.”

Dr. Roger Kligler, a retired physician with stage 4 prostate cancer, and another doctor who feared manslaughter charges if he prescribed end-of-life medications to terminally ill patients filed the original lawsuit in 2016.

The decision will cause people to suffer to the point of death, said Kligler, 70, in a telephone interview from his Cape Cod home.

Kligler promised to fight as long as he is able to despite saying he is “not doing well” and in “chronic pain.”

He urged lawmakers to pass the End of Life Options Act, adding, “I will keep pleading with them to respect the bodily autonomy of dying Massachusetts residents.”

Although the Legislature has received more than a dozen bills to legalize physician assisted suicide, none of them have ever gone to a vote. The court also noted that Massachusetts voters in 2012 rejected a ballot question allowing patients in the final stages of their illness to receive a lethal dose of medication.

The state’s attorney general’s office, which argued the case on the state’s behalf, also asserted that the Legislature is the best forum for dealing with the problem.

According to Jillian Fennimore, the attorney general’s spokesperson, “Our office understands the complexities of end-of-life care.” “We are pleased that the Court has upheld our contention that the Legislature is the most suitable forum for discussion of this significant matter of public policy. According to AG Healey, she is in favor of legislation that permits medical assistance in dying as long as it provides adequate protections for both patients and providers.

Next month, Democrat Healey will become governor.

Organizations opposed to physician-assisted suicide applauded the decision.

Chris Schandevel, senior counsel for the nonprofit Alliance Defending Freedom, which filed a friend-of-the-court brief in the case on behalf of the Euthanasia Prevention Coalition, stated that patients “should be able to trust their doctors to support and care for them.” “Offering patients who are terminally ill or disabled a ‘quick exit’ through drugs that cause death destroys that trust.”

According to the advocacy organization Compassion and Choices, 10 states and Washington, D.C. have legalized medical aid in dying.