A 66-year-old US woman with advanced cancer has become the first person to die under a new assisted suicide law in Washington State.
The woman, Linda Fleming, died on Thursday night after taking drugs prescribed by her doctor.
The "Death with Dignity" law was approved by 60% of Washington State voters in a referendum last year.
It is based on a law in neighbouring Oregon, where 400 people have chosen to die over the last 12 years.
The advocacy group, Compassion and Choices of Washington, said Ms Fleming died with her family, her dog and her physician at her side.
In a statement, Ms Fleming, who lived in the town of Sequim, said: "I had only recently learned to live in the world as I had always wanted to, and now I will no longer be here.
"The pain became unbearable, and it was only going to get worse. I am a very spiritual person, and it was very important to me to be conscious, clear-minded and alert at the time of my death."
She was diagnosed with pancreatic cancer last month.
Under the "Death with Dignity" law, any patient seeking to die must be at least 18, terminally ill, and live in Washington State. In addition, the patient must be declared competent, make two spoken statements 15 days apart, and produce a written request witnessed by two people.