Last updated on: 7/7/2022 | Author: ProCon.org

Euthanasia & Medical Aid in Dying (MAID) around the World

Euthanasia (in which a doctor administers a lethal dose of medication to a patient) and medical aid in dying (MAID) are illegal in most countries. However, several countries have legalized one or both of the practices. Below, find a sampling of countries and the legal precedents concerning euthanasia and PAS.

These countries were chosen based on the availability of legal documents and information on medical practices, and an effort to include countries that represent a variety of cultures, religions, and ethnicities. Do not rely on this information without first checking with a current and official edition of the applicable law.

Australia

Euthanasia:

Illegal

(Legal in Victoria & Western Australia)

Medical Aid in Dying (MAID):

Illegal

(Legal in Victoria & Western Australia)

The Northern Territory of Australia passed the Rights of the Terminally Ill Act, which legalized voluntary euthanasia in 1995. The law went into effect on July 1, 1996 and was used by four Australians who were dying from cancer.  

Two 1996 court challenges, one in the Supreme Court of the Northern Territory and one in the High Court, resulted in the law being declared valid.

A bill to overturn the Act was introduced at the federal level on Sep. 9, 1996 and passed both Houses by Mar. 25, 1997, when the Northern Territory’s Act was officially overturned, making both euthanasia and PAS illegal in Australia again.

The Green Party introduced the Voluntary Assisted Dying Bill of 2013 in Tasmania in an effort to legalize medical aid in dying in that state. The bill was defeated in 2013.

On Nov. 29, 2017, Victoria (Australia’s second-most populous state) legalized medical aid in dying and limited euthanasia. The law went into effect on June 19, 2019 and allows terminally ill patients (with a life-expectancy of 6 months in most cases) to obtain a lethal drug for self-administration. The law allows the drug to be administered by a doctor if the patient is unable to do so themselves.

As of July 1, 2021, medical aid in dying and limited euthanasia is legal in Western Australia per the Voluntary Assisted Dying Act 2019. Terminally ill adult patients may request lethal drugs for self-administration or for administration by a medical practitioner.

Sources:

Adam Baidawi, “Australian State Passes Assisted Dying Law,” nytimes.com, Nov. 29, 2017

Government of Western Australia Department of Health, “Voluntary Assisted Dying,” health.wa.gov.au, May 31, 2022

Right to Life, “Media Release: Physician Assisted Suicide Defeated in Tasmania,” righttolife.com.au (accessed June 8, 2016)

Victoria Department of Health, “Voluntary Assisted Dying,” health.vic.gov.au, Oct. 23, 2021

The World Federation of Right to Die Societies, “Euthanasia and Assisted Suicide in Australia,” worldrtd.net (accessed June 8, 2016)

Austria

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Legal

In Dec. 2020, Austria’s constitutional court ruled that the legislature was violating fundamental rights by banning assisted suicide and ordered the government to lift the ban that was punishable with up to five years in prison.

On Oct. 23, 2021, Austria’s government announced plans to legalize medical aid in dying in 2022. Two doctors, one specializing in palliative care, have to review each case and a 12-week waiting period will apply unless the patient is in the terminal phase of their illness. Medical aid in dying became legal on Jan. 1, 2022.

Sources:

The Local, “Austria Court Rules Assisted Suicide Must Be Legalised,” thelocal.com, Dec. 12, 2020

Ben McPartland, “Austria to Make Assisted Suicide Legal from Next Year,” thelocal.com, Oct. 24, 2021

Belgium

Euthanasia:

Legal

Medical Aid in Dying (MAID):

Legal

The Belgian Act on Euthanasia of May 28, 2002 went into effect on Sep. 3, 2002, legalizing both euthanasia and PAS for “competent” adults and emancipated minors suffering from “constant and unbearable physical or mental suffering that cannot be alleviated.” The patients do not have be suffering from terminal illnesses. On Feb. 13, 2014, the law was extended to minors. Belgium was the second country to legalize euthanasia, after the Netherlands in 2001.  

Sources:

Rachel Aviv, “The Death Treatment,” newyorker.com, June 22, 2015

“The Belgian Act on Euthanasia of May, 28th 2002,” ethical-perspectives.be, 2002

Patients Rights Council, “Belgium,” patientsrightscouncil.org (accessed June 8, 2016)

Canada

Euthanasia:

Legal

Medical Aid in Dying (MAID):

Legal

Suicide has been decriminalized in Canada since 1972, but a provision criminalizing suicide assistance remained in the Criminal Code and was upheld by the Supreme Court of Canada in Rodriguez v. British Columbia (Attorney General) in 1993.  

In June 2014, Quebec passed Bill 52, legalizing euthanasia but not medical aid in dying.

In a unanimous decision on Feb. 6, 2015, the Supreme Court of Canada struck down the prohibition on assisting suicide, giving the Canadian Parliament a year to pass a law legalizing and regulating medical aid in dying and, possibly, euthanasia. The Court extended the deadline four months to allow then-incoming Prime Minister Justin Trudeau’s administration to draft a law. Bill C-14 passed the House of Commons but was in the Senate when the June 6, 2016 deadline passed, legalizing PAS (and possibly euthanasia) without legislative regulation.

The Court ruling stated that “‘physician-assisted death’ and ‘physician-assisted dying’ [are used] to describe the situation where a physician provides or administers medication that intentionally brings about the patient’s death at the request of the patient.” While physician-administered medication that results in death is generally referred to as “euthanasia,” the Court did not make that distinction, which made their ruling unclear about which practice is legal.

On June 18, 2016 C-14 was passed by the Senate, making assisted suicide and euthanasia legal effective immediately and regulating medical aid in dying and euthanasia. The law states, “medical assistance in dying means (a) the administering by a medical practitioner or nurse practitioner of a substance to a person, at their request, that causes death; or (b) the prescribing or providing by a medical practitioner or nurse practitioner of a substance to a person, at their request, so that they may self-administer the substance and in doing so cause their own death.”

Eligible persons must be citizens or permanent residents of Canada, at least 18-years-old, and have a “grievous and irremediable medical condition.”

Sources:

Rachel Aviv, “The Death Treatment,” newyorker.com, June 22, 2015

“Bill C-14,” openparliament.ca, June 7, 2016

Florence Kellner, “Suicide,” thecanadianencyclopedia.ca, Apr. 24, 2015

Vanessa Milne, Jill Konkin, and Terrence Sullivan, “Physician-Assisted Death and Euthanasia in Canada: Should It Be Legal or Banned?,” healthydebate.ca, Aug. 7, 2014

Paul Wells, “‘This Is a Big Step in Canadian Society and Justice,’ Trudeau Says of Assisted Dying Bill: Paul Wells,” thestar.com, June 7, 2016

China

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

Euthanasia and medical aid in dying are illegal in China under Articles 232 and 233 of the Criminal Law of the People’s Republic of China: “Article 232 Whoever intentionally commits homicide shall be sentenced to death, life imprisonment or fixed-term imprisonment of not less than 10 years; if the circumstances are relatively minor, he shall be sentenced to fixed-term imprisonment of not less than three years but not more than 10 years.” And, “Article 233 Whoever negligently causes death to another person shall be sentenced to fixed-term imprisonment of not less than three years but not more than seven years; if the circumstances are relatively minor, he shall be sentenced to fixed-term imprisonment of not more than three years, except as otherwise specifically provided in this Law.”  

In Mar. 1994 a group of China’s National People’s Congress (NPC) legislators proposed euthanasia laws but they were not passed. In Mar. 2007, a woman with muscular dystrophy had a television journalist broadcast her proposal for euthanasia legislation during the NPC annual session.

Sources:

China.org.cn, “Farmer Jailed for Assisting Suicide Triggers Controversy,” china.org.cn, Aug. 15, 2011

National People’s Congress of the People’s Republic of China, “Criminal Law of the People’s Republic of China,” npc.gov.cn (accessed June 29, 2016)

Wendy Zeldin, “China: Case of Assisted Suicide Stirs Euthanasia Debate,” loc.gov, Aug. 17, 2011

Colombia

Euthanasia:

Legal

Medical Aid in Dying (MAID):

Illegal

Euthanasia became legal in Colombia on May 20, 1997 when the Constitutional Court (the country’s highest court), ruled (6-3) that a person may choose suicide and that physicians could not be prosecuted for helping by passing Article 326 of the 1980 Penal Code. The Court ruled against the plaintiff, Jose Euripides Parra Parra, who brought the case to the Court hoping to have euthanasia declared unconstitutional and stated, “Tendencies of totalitarian fascist and Communist States are reflected in mercy killing, they respond to Hitler’s and Stalin’s ideas; where the weakest, the most seriously ill are lead and condemned to the gas chambers, to probably ‘help them die better.’” The Court instead asserted, “in the case of a terminally ill [person]… no responsibility should be attributed to the acting physician, as his conduct is justified.” The Court asked that Congress legislate the act, but Congress did not, thus putting the legalization on hold for eight years until the Health Ministry was instructed to release guidelines, which it did on Apr. 20, 2015, officially legalizing euthanasia in Colombia.  

Ovidio Gonzalez, a 79-year-old man with terminal throat cancer, was the first patient to use the law on July 3, 2015 in Pereira, Colombia. DescLAB, a legal rights advocacy group, stated 178 people with terminal illnesses had been legally euthanized between 1997 and Oct. 15, 2020 in Colombia.

In 2021, the Colombian court recognized that the procedure should not be only available to those with terminal illnesses and, on Jan. 7, 2022, Victor Escobar, who had a degenerative disorder (end-stage chronic obstructive pulmonary disease), was the first person with a non-terminal illness to die via legally regulated euthanasia in Colombia. The next day, Martha Sepulveda, who suffered with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s Disease, was the second person with a non-terminal illness to die via legally regulated euthanasia in Colombia.

Sources:

AP, “Euthanasia Regularly Practiced in Colombia,” nbcnews.com, July 31, 2005

Katlyn Babyak, “Colombia Opens Its Doors to Euthanasia,” worldwng.org, July, 7, 2015

BBC News, “Cancer Patient Becomes Colombia’s First Legal Euthanasia Case,” bbc.com, July 3, 2015

Sabrina Martín, “Colombia Physicians Get the Final Go-Ahead for Euthanasia,” panampost.com, Apr. 23, 2015

Sabrina Martín, “Colombia to Finalize Euthanasia Law in March,” panampost.com, Feb. 19, 2015

Republic of Colombia, “Republic of Colombia Constitutional Court Sentence #C-239/97 REF. Expedient #D-1490,” patientsrightscouncil.org, May 20, 1997

Reuters, “Man Becomes First Person in Colombia with Non-Terminal Illness to Die by Legal Euthanasia,” cnn.com, Jan. 9, 2022

Denmark

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

Both euthanasia and medical aid in dying are illegal in Denmark. The Parliament’s advisory panel on ethics, Etisk Råd, debated the topic in 1997, 2003, and 2012, moving from collectively against the practice in 1997 to divided on the issue in 2012.  

A June 17, 2003 study published in The Lancet found that 1% of deaths in Denmark were caused by the “[a]dministration of drugs with the explicit intention of hastening death” and that these deaths were more often performed outside of the hospital.

In 2022, Svend Lings, a Danish doctor who helped at least 10 patients die, was found guilty of helping two people die and a third attempted suicide. His medical license was revoked and he was sentenced to 60 days in jail. Lings appealed his conviction to the European Court of Human Rights, stating he had only legally given information to patients. The ECHU upheld Lings’s conviction on the grounds that he procured the lethal medication for patients, going beyond legal information distribution.

Sources:

Michael Cook, “Denmark Quietly Debates Euthanasia,” bioedge.org, June 29, 2012

Copenhagen Post, “’Difference of Opinion’ over Assisted Suicide Emerging in Ethical Panel,” cphpost.dk, June 8, 2012

Derek Humphry, The Good Euthanasia Guide: Where, What, and Who in Choices in Dying, 2004

Molly Quell, “Physician Convicted of Assisted Suicide Loses Rights Appeal,” courthousenews.com, Apr. 12, 2022

Agnes van der Heide, et al., “End-of-Life Decision-Making in Six European Countries: Descriptive Study,” thelancet.com, June 17, 2003

Finland

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Legal

A debate about legalizing euthanasia emerged in 2012 after the National Advisory Board on Social Welfare and Health Care Ethics (ETENE) brought the topic to debate and established a working group on the issue in 2011.  

The Jan. 1, 2012 ETENE statement released by the Ministry of Social Affairs and Health that resulted from the working group stated, “Assisted suicide is not a crime in Finland. Assisted suicide is connected to end-of-life care when the patient takes the deadly dose of medicine himself/herself. Placing the dose of medicine within the patient’s reach at the patient’s request when he/she has decided to end his/her life, is considered assisted suicide.” The group stated that the discussion on euthanasia should continue but declined to make a recommendation about the legalization of the practice.

Sources:

Ministry of Social Affairs and Health, “Human Dignity, Hospice Care and Euthanasia,” etene.fi, Jan. 1, 2012

Klaus Törnudd, Finland and the International Norms of Human Rights, 1986

YLE, “‘Right to Die’ Gains Ground in Finland,” yle.fi, Sep. 6, 2012

France

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

France’s Parliament passed a law on Jan. 27, 2016 that allows doctors to sedate terminally-ill patients until their deaths from their illness or starvation. President Francois Hollande called for the law as a compromise to euthanasia and medical aid in dying.  

Sources:

Associated Press, “France Adopts Sedated Dying Law as Compromise on Euthanasia,” theguardian.com, Jan. 27, 2016

David Chazan, “France Passes New End-of-Life Legislation to Alleviate Suffering,” telegraph.co.uk, Mar. 17, 2015

Susan Scutti, “Is France Moving Toward Physician Assisted Suicide? Hollande Calls for Terminal Sedation,” medicaldaily.com, Dec. 15, 2014

Germany

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Legal

On Nov. 6, 2015, Germany legalized medical aid in dying that is performed on an “individual basis out of altruistic motives.” “Commercial euthanasia” or “suicide business” is illegal. Prior to the 2015 law, doctors were allowed to provide high doses of pain medication to accelerate death.

On Feb. 26, 2020, a high court overturned the ban on professionally provided assisted suicide, which will allow patients to seek the procedure from doctors.

In 2021, the German Doctors’ Federation removed the edict, “A doctor may not provide any assistance for suicide,” from its code of conduct.

Sources:

Abigail Abrams, “Assisted Suicide Law in Germany Passes Despite Concerns over Nazi Association,” ibtimes.com, Nov. 6, 2015

Heiner Kiesel, “Germany Seeks to Clarify Euthanasia Laws,” dw.com, Aug. 8, 2012

Derek Scally, “Vote by Germany’s Doctors Paves Way for Assisted Suicide,” irishtimes.com, May 6, 2021

Christopher F. Schuetze, “German Court Overturns Ban on Assisted Suicide,” nytimes.com, Feb. 26, 2020

RT.com, “German Parliament Votes to Ban ‘Commercial’ Assisted Suicides,” rt.com, Nov. 6, 2015

India

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

The Supreme Court of India legalized passive euthanasia (the withdrawal of treatment or life-sustaining machinery) on Mar. 7, 2011. The same ruling reaffirmed the illegality of active euthanasia. The Court held that their decision was the “law of the land” until Parliament passes a law on the issue.  

The Supreme Court ruling was in response to a case concerning Aruna Shanbaug, a nurse who was strangled and sexually assaulted in 1973. The attack left Shanbaug in a vegetative state. Pinki Virani, a friend of Shanbaug’s, filed suit to have Shanbaug taken off life-support, stating that the “continued existence of Aruna is in violation of her right to live with dignity.” The hospital treating Shanbaug did not agree with the removal of life-support. The Supreme Court sided with the hospital staff and, thus, laid out regulations for passive euthanasia. The Court stated that only parents, a spouse, close relatives, or a “next friend” (if no relatives were available) could make the decision to remove life-sustaining treatment. The Court contended that the hospital staff, not Virani, was the “next friend” to make the decision. Aruna Shanbaug died on May 18, 2015 from pneumonia after being in a coma for 42 years.

Sources:

Tabassum Barnagarwala, “Between Life and Death for 42 Long Years, Aruna Shanbaug Passes Away,” indianexpress.com, May 19, 2015

BBC News, “India Court Rejects Aruna Shanbaug Euthanasia Plea,” bbc.com, Mar. 7, 2011

The Hindu, “India Joins Select Nations in Legalising ‘Passive Euthanasia,’” thehindu.com, Mar. 7, 2011

Mark Magnier, “India’s Supreme Court Lays out Euthanasia Guidelines,” latimes.com, Mar. 8, 2011

TNN & Agencies, “Aruna Shanbaug Case: SC Allows Passive Euthanasia in Path-Breaking Judgment,” timesofindia.indiatimes.com, Mar. 7, 2011

J. Venkatesan, “Supreme Court Disallows Friend’’ Plea for Mercy Killing of Vegetative Aruna,” thehindu.com, Mar. 8, 2011

Ireland

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

Both euthanasia and medical aid in dying are illegal in Ireland under the Criminal Law (Suicide) Act, 1993, which states, “A person who aids, abets, counsels or procures the suicide of another, or an attempt by another to commit suicide, shall be guilty of an offense and shall be liable on conviction on indictment to imprisonment for a term not exceeding fourteen years.”  

Sources:

Dan Buckley, “Special Report – Euthanasia,” irishexaminer.com, June 9, 2014

Irish Statute Book, “Criminal Law (Suicide) Act, 1993,” irishstatutebook.ie (accessed June 24) 2016

Nicky Ryan, and TheJournal.ie, “Ireland’s Euthanasia Laws Are Some of the Most Strict in Europe,” thejournal.ie, Jan. 3, 2015

Israel

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

Israeli law and Jewish law ban medical aid in dying and active euthanasia. Passive euthanasia (the withdrawal of treatment or life-sustaining machinery) is banned by Jewish law but was allowed by the Tel Aviv District Court on Dec. 9, 2014. Other bills called “physician-assisted suicide” or “Sabbath clock” bills have been discussed in Parliament but have not become law and would only legalize passive euthanasia.  

Sources:

Moran Azulay, “‘Physician-Assisted Suicide’ Bill Passes First Hurdle,” ynetnews.com, Aug. 6, 2014

Tim Butcher, “Israelis to Be Allowed Euthanasia by Machine,” telegraph.co.uk, Dec. 8, 2005

i24news, “For First Time in Israel, Court Permits Euthanasia for Terminal Patient,” i24news.tv, Dec. 9, 2014

Yaakov Neeman and Eliot Sacks, “Jewish Medical Ethics: Euthanasia: The Approach of the Courts in Israel and the Application of Jewish Law,” jewishvirtuallibrary.org (accessed June 20, 2016)

Italy

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Legal

Piergiorgio Welby, who suffered from a rare, terminal type of muscular dystrophy, petitioned the court to be allowed medical aid in dying in 2006. After Weby’s death, which happened when his anesthetist, Mario Riccio, turned off Welby’s life-support, Riccio was investigated for “consensual homicide.” Riccio was cleared of the charges and the court called on lawmakers to legalize passive euthanasia (the withdrawal of treatment or life-sustaining machinery).  

In July 2008, a court allowed Beppino Englaro to disconnect his daughter Eluana’s feeding tubes. Eluana was in a car accident in 1992 and was left in a vegetative state. Prime Minister Silvio Berlusconi issued an emergency decree that would have forced the clinic to feed Eluana but President Giorgio Napalotono refused to sign the decree. Eluana died before the Senate could enact a law that prevents doctors from withholding nutrition.

In 2019, Italy’s Constitutional Court ruled that medical aid in dying was not illegal if a patient met the following circumstances summarized in the New York Times: “they had to have full mental capacity and suffer from an incurable disease that caused severe and intolerable physical or psychological distress. They also had to be kept alive by life-sustaining treatments.”

On June 16, 2022, Federico Carboni, who was paralyzed in a traffic accident in 2010, became the first patient to legally use medical aid in dying in Italy via a special machine that allowed him to self-administer a fatal drug. Italian Parliament is now tasked with creating legislation and regulation for the practice.

Sources:

BBC, “Euthanasia: A Continent Divided,” bbc.co.uk, Feb. 11, 2009

Scott Gleeson, “Man Paralyzed 12 Years Ago Becomes Italy’s First Medically Assisted Suicide,” usatoday.com, June 17, 2022

Corallina Lopez Curzi, “Free Until the End: Is It Time for a Euthanasia Law in Italy?,” liberties.eu, Feb. 4, 2016

Elisabetta Povoledo, “Man Paralyzed 12 Years Ago Becomes Italy’s First Assisted Suicide,” nytimes.com, June 20, 2022

Japan

Euthanasia:

Unclear

Medical Aid in Dying (MAID):

Illegal

Japan has no specific laws banning euthanasia but medical aid in dying is a criminal offense. “Death with dignity,” or “songenshi,” means passive euthanasia in Japan.  

In the Tokai University Hospital University case, on March 28, 1995 the Yokohama District Court found a doctor guilty of homicide for injecting a patient suffering from myeloma with several drugs, at the request of the patient’s son, that ultimately killed the patient. The court ruled that in order for active euthanasia to be legal: 1. The patient must be in “unbearable physical pain;” 2. The death of the patient is “unavoidable and… imminent;” 3. The doctor has tried everything else to remove the patient’s pain and nothing has worked; and 4. The patient explicitly consents to shorten his or her life. The court ruling also set forth standards for passive euthanasia (the withdrawal of treatment or life-sustaining machinery).

Ten years later, the same court decided the Kawasaki Kyodo Hospital case on Mar. 25, 2005, in which another doctor was found guilty of homicide for removing a breathing tube and then injecting a patient with muscle relaxant, which resulted in the patient’s death. The doctor was found guilty because she did not seek or get the patient’s permission. The Tokyo High Court took up the case and reversed the lower court’s decision but upheld the homicide conviction on Feb. 28, 2007, stating that the lower court’s rules for euthanasia were problematic. The Tokyo High Court did not establish any new rules for euthanasia. The ruling was appealed to the Supreme Court but the Court declined to hear the case.

The debate over euthanasia and medical aid in dying was reignited in 2020 when two doctors, Yoshikazu Okubo and Naoki Yamamoto were arrested for aiding in the suicide via the euthanization of Yuri Hayashi, who had ALS (amyotrophic lateral sclerosis). The doctors were reportedly paid 1.3 million yen (about $9,500) to administer barbiturates via gastrostomy (a small hole in the stomach).

Sources:

Jun Hongo, “Euthanasia: The Dilemma of Choice,” japantimes.co.jp, Feb. 15, 2014

Katsunori Kai, “Euthanasia and Death with Dignity in Japanese Law,” waseda.jp, Mar. 2009

The Japan Times, “Top Court Dismisses Euthanasia Appeal,” japantimes.co.jp, Dec. 10, 2009

Nippon.com, “2 Doctors Indicted for Murder of ALS Woman at Her Request,” nippon.com, Aug. 13, 2020

Tomohiro Osaki, “U.S. ‘Death with Dignity’ Case Stokes Japanese Supporters and Opponents Alike,” japantimes.co.uk, Nov. 14, 2014

Luxembourg

Euthanasia:

Legal

Medical Aid in Dying (MAID):

Legal

Luxembourg became the third country in Europe, after the Netherlands and Belgium, to legalize euthanasia and medical aid in dying. The law was adopted by Parliament on Feb. 19, 2008 and went into effect in Apr. 2009. Under the law, doctors have legal immunity from sanctions and lawsuits for performing euthanasia or medical aid in dying if a patient with a “grave and incurable condition” has asked repeatedly for the procedure.  

Grand Duke of Luxembourg Henri refused to sign the bill into law so, on Dec. 10, 2008, Parliament passed a constitutional amendment (56-0) eliminating the requirement of the monarch’s signature and reducing the position’s power overall. The law was passed simultaneously to a law providing palliative care and paid leave for relatives with family members who are terminally ill and in the final stages of life.

Sources:

AP, “Luxembourg Strips Monarch of Legislative Role,” theguardian.com, Dec. 11, 2008

Le Gouvernement du Grand-Duchy de Luxembourg, “Euthanasia and Palliative Care,” Luxembourg.public.lu, Apr. 28, 2015

Patients Rights Council, “Luxembourg,” patientsrightscouncil.org (accessed June 22, 2016)

Tehran Times, “Luxembourg Becomes Third EU Country to Legalize Euthanasia,” webarchive.org, Apr. 4, 2009

Mexico

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

Passive euthanasia (the withdrawal of treatment or life-sustaining machinery) was legalized in Mexico City (Jan. 7, 2008) and the states of Aguascalientes (Apr. 6, 2009) and Michoacán (Sep. 1, 2009) but remains illegal in the remainder of the country. A majority of Mexican states adopted constitutional amendments in line with Catholic Church doctrine to protect the right to life “from conception until natural death,” making the legalization of passive euthanasia, active euthanasia, or medical aid in dying difficult.  

Bills to decriminalize active euthanasia were introduced by the Party of the Democratic Revolution (PRD) and the Institutional Revolutionary Party (PRI) in 2007 and 2009 but failed to pass.

Sources:

Cecilia Barria, “Growing Debate over Euthanasia in Mexico City,” bbc.com, Nov. 26, 2009

Catherine Bremer, “Euthanasia Stance Affirmed in Mexico,” washingtonpost.com, July 9, 2009

E. Eduardo Castillo, “Mexico Court Upholds State Right-to-Life Amendment,” cnsnews.com, Sep. 28, 2011

El Economista, “Michoacán Aprueba Ley de Voluntad Anticipada” [“Michoacán Approves Advance Directive Law”], eleconomista.com, Sep. 1, 2009

Matthew Cullinan Hoffman, “Two More Mexican States Pass Pro-Life Amendments by Overwhelming Majorities,” catholicexchange.com, Apr. 15, 2009

ReporterosLJA, “Sólo Falta Reglamentar la Voluntad Anticipada para Aplicarla: Ruvalcaba” [“Just Need to Regulate the Advance Directive to Apply: Ruvalcaba”], lja.mx, Apr. 8, 2009

Reuters, “Mexico Moves to Legalise Euthanasia,” uk.reuters.com, Apr. 13, 2007

El Universal, “Publica GDF Ley de Voluntad Anticipada” [“Post GDF Advance Directive Act”], archive.eluniversal.com.mx, Jan. 7, 2008

The Netherlands

Euthanasia:

Legal

Medical Aid in Dying (MAID):

Legal

Euthanasia, though reported to be regularly practiced, was a criminal act in the Netherlands until 1973 when, in the Postma Case, Geertruida Postma, a doctor, was convicted for giving her terminally ill mother a lethal injection. The court decided to sentence Dr. Postma to a one-week suspended sentence and one-week probation instead of the 12 years maximum sentence. Because of the Postma Case and others, the courts established a set of conditions under which euthanasia and medical aid in dying would not be punished.  

Euthanasia and medical aid in dying were legalized on Apr. 1, 2002 by the Termination of Life on Request and Assisted Suicide (Review Procedures) Act for Dutch citizens over 12 years old. The Act states that physicians who perform the procedures will be exempt from criminal liability and set forth criteria for physicians to follow to legally euthanize or assist in the suicide of a patient.

Under the law, newborns may be euthanized if they are born with unbearable suffering, there is no alternate solution, and the parents, physician, and an independent physician agree to the procedure. Called the Groningen Protocol, the criteria under which infants may be euthanized was written by Eduard Verhagen, MD, JD, in Sep. 2004.

On Oct. 16, 2020, then Dutch Health Minister Hugo de Jonge announced plans to extend legal medical aid in dying to terminally ill children between the ages of one and 12 years old, but the law was not immediately changed. In June 2022, Dutch Health Minister Ernst Kuipers outlined protocol for expanding the law to children aged one to 12. The final proposal was expected in Oct. 2022

Sources:

Maria Cramer and Claire Moses, “Netherlands to Allow Doctors to Help End Lives of Terminally Ill Children,” nytimes.com, Oct. 16, 2020

DutchNews.nl, “Health Minister Proposes Euthanasia Protocol for Children under 12,” dutchnews.nl, June 28, 2022

Government of the Netherlands, “Euthanasia, Assisted Suicide and Non-Resuscitation on Request,” government.nl (accessed June 22, 2016)

Guardian Staff, “Euthanasia and Assisted Suicide Laws around the World,” theguardian.com, July 17, 2014

Patients Rights Council, “Assisted Suicide & Death with Dignity: Past, Present & Future – Part III,” patientsrightscouncil.org (accessed June 22, 2016)

Brian Pollard, “Current Euthanasia Law in the Netherlands,” catholiceducation.org, 2003

University Medical Center, “Paediatricians Call for Nationwide Protocol for the Ending of Life of Unbearably and Incureably Suffering Newborns,” umcg.nl, Dec. 10, 2004

New Zealand

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Legal

Section 179 of the New Zealand Crimes Act 1961 made “aiding and abetting suicide” illegal, including medical aid in dying, and is subject to a maximum sentence of 3 years in prison.  

On Aug. 2, 1995, MPs (Members of Parliament) Michael Laws and Cam Campion, the latter of whom was dying of bowel cancer, introduced a “Death with Dignity” bill following the legalization of euthanasia in Australia’s Northern Territory. The bill was defeated with a 61-29 vote. Campion died of cancer on Oct. 16, 1995.

In May 2003, MP Peter Brown introduced a “Death with Dignity” similar to the Laws/Campion bill. A Ministry of Justice report argued that the bill could be in conflict with the Bill of Rights, which states that a person has the right to not be deprived of life. The bill was defeated 60-58.

MP Maryan Street planned to introduce an “End of Life Choices” bill in Oct. 2012 that would legalize euthanasia, but the proposed legislation was dropped due to rumored Labour party pressure in July 2013. MP David Seymour introduced a bill on Oct. 14, 2015 that would legalize medical aid in dying. The debate on the bill was vetoed on May 4, 2016, killing the bill.

An Oct. 2020 nationwide vote in favor of the practice legalized medical aid in dying in New Zealand on Nov. 7, 2021.

Sources:

Isaac Davison, “Euthanasia Bill under Party Pressure,” nzherald.co.nz, July 17, 2013

Life Choice, “MPs Dodge Assisted Dying Debate,” eolc.nationbuilder.com, May 4, 2016

Life.org, “2003 Death with Dignity Bill,” life.org.nz (accessed June 23, 2016)

Life.org, “The First Death with Dignity Bill,” life.org.nz (accessed June 23, 2016)

Preeti Jha, “New Zealand Euthanasia: Assisted Dying to Be Legal for Terminally Ill People,” bbc.com, Oct. 30, 2020

Jo Moir and Tracy Watkins, “Euthanasia Debate Back on the Political Agenda,” stuff.co.nz, June 6, 2015

New Zealand Ministry of Health, “Assisted Dying Service,” health.govt.nz, Nov. 8, 2021

Parliamentary Counsel Office, “Crimes Act of 1961,” legislation.govt.nz, July 3, 2015

David Seymour, “Seymour Lodges Assisted Dying Bill,” act.org.nz, Oct. 14, 2015

Sarah Young, “Street in Fresh Bid for Right-to-Die Law,” stuff.co.nz, Oct. 3, 2012

Norway

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

Euthanasia and medical aid in dying are illegal in Norway, though, according to Penal Code § 278 (June 19, 2009), “[i]f any of compassion kills a person who is terminally ill, or who for other reasons are close to death, the penalty may be set below the minimum punishment or a milder punishment than is required by § 275.” § 275 requires that the punishment for murder be imprisonment of 8-12 years. 

Sources:

Lovdata, “Lov om Straff (Straffeloven)” [“Law on Penalty (Penal Code)”], lovdata.no (accessed June 23, 2016)

Philippines

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

In June 1997, the Philippine Senate considered a bill to legalize passive euthanasia (the withdrawal of treatment or life-sustaining machinery). The bill did not advance. On Oct. 14, 2013, Senator Miriam Defensor-Santiago filed Senate Bill 1887, which would have made passive euthanasia legal. The bill died in the Senate.   

Sources:

Amado S. Tolentino, Jr., “Mercy Killing: Yes, No, Why?” manilatimes.net, Apr. 16, 2014

Claire Wallerstein, “Philippines Considers Euthanasia Bill,” BMJ, June 7, 1997

Portugal

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

In 2021 and 2022, Portugal’s Parliament voted three times to legalize medical aid in dying and euthanasia. The most recent set of bills passed with a 128-88 vote on June 9, 2022. The other bills had similar vote tallies. However, President Marcelo Rebelo de Sousa blocked the earlier bills for unclear wording. The June 2022 bills are expected to to be combined into one bill before being voted on by Parliament again and then sent to the president.

Sources:

Barry Hatton, “Portugal’s Lawmakers Approve 3rd Attempt to Allow Euthanasia,” abcnews.go.com, June 9, 2022

Russia

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

Euthanasia is specifically prohibited by the “On Health Care of Russian Citizens” law passed in 1993.  

Sources:

Derek Humphry, “Assisted Suicide Laws around the World,” dignitysa.org, Nov. 26, 2015

South Africa

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Unclear

In 1997 the South African Law Commission published a report that included a draft law to legalize both euthanasia and medical aid in dying. The report was largely ignored and a law never passed.  

In 2015, Robert James Stransham-Ford, a lawyer in his 60s with terminal stage 4 cancer, asked the Pretoria High Court to allow his physician to assist his suicide. The court ruled on Apr. 30, 2015 that the physician would face no criminal charges for assisting the suicide. Stransham-Ford died that morning, before the ruling was read. The scope of the ruling as it might apply to other cases remains unclear.

Sources:

Andrew Konstant, “Euthanasia Case in South Africa: Does the Right to Life Include the Right to Die with Dignity?,” ohrh.law.ox.ac.uk, June 3, 2015

RDM Newswire, “Robin Stransham-Ford Died before Hearing Court Ruling,” sowetanlive.co.za, Apr. 30, 2015

South African Law Commission, “Euthanasia and the Artificial Preservation of Life,” justice.gov.za, June 30, 1997

South African Legal Information Institute, “Stransham-Ford v Minister of Justice and Correctional Services and Others (27401/15) [2015] ZAGPPHC 230; 2015 (4) SA 50 (GP); [2015] 3 All SA 109 (GP) (4 May 2015),” saflii.org, May 4, 2015

Spain

Euthanasia:

Legal

Medical Aid in Dying (MAID):

Legal

The Ministry of Health, at the request of the Government of Spain, wrote a “death with dignity” bill in Feb. 2011. The law would not have authorized euthanasia or medical aid in dying, but legalized passive euthanasia (the withdrawal of treatment or life-sustaining machinery) when approved later in 2011.  

On Mar. 18, 2021, Spain’s parliament legalized both euthanasia and medical aid in dying for adult Spanish nationals and legal residents who are suffering a “serious or incurable illness” or a “chronic or incapacitating” condition that causes “intolerable suffering.” The person must be “fully aware and conscious” when they make two requests, 15 days apart, in writing. The law took effect on June 24, 2021.

Sources:

BBC, “Spain Passes Law Allowing Euthanasia,” bbc.com, Mar. 18, 2021

Fox News Latino, “Kin of Comatose Spanish Woman Invoke Death with Dignity Law,” latino.foxnews.com, Aug. 24, 2011

Kirstie Mckenzie, “Explainer: Euthanasia Law in Spain Comes into Force,” theolivepress.es, June 27, 2021

Graciela Rodriguez-Ferrand, “Spain: Bill on Dignified Death,” loc.gov, Feb. 2, 2011

Spanish News Today, “Parents Demand Passive Euthanasia for Their Daughter in Santiago de Compostela,” spanishnewstoday.com, Jan. 10, 2015

Sweden

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

On Apr. 26, 2010, Sweden legalized passive euthanasia (the withdrawal of treatment or life-sustaining machinery). The National Board of Health and Welfare issued the legalization ruling after the Swedish Society of Medicine asked for clarification between one law that allowed passive euthanasia and another law that prohibited “assisted-suicide” by means such as turning off a respirator (commonly known as passive euthanasia). The National Board ruled that a “patient who wished to discontinue treatment has a right to do so. The condition is that he or she understands the information provide by the doctor and the consequences of his or her decision.” Medical aid in dying and euthanasia remain illegal in Sweden. 

Sources:

AFP/The Swedish Wire, “Sweden Allows Passive Euthanasia,” swedishwire.com, Apr. 26, 2010

Switzerland

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Legal

Euthanasia is illegal in Switzerland by article 114 of the Penal Code of Switzerland: “Any person who for commendable motives, and in particular out of compassion for the victim, causes the death of a person at that person’s own genuine and insistent request is liable to a custodial sentence not exceeding three years or to a monetary penalty.” Further, Swiss law prohibits assisted suicide for “selfish motives” (article 115) and anyone breaking this law is subject to up to five years in prison or a fine.  

Assisted suicide is allowable if the person aiding the suicide has good intentions and does not actually commit the act that leads to death (such as injecting medication). “Accompanied suicides” are frequently performed at the Dignitas Clinic in Forch, Switzerland with barbituates. The suicide of Peter Smedley, who suffered from motor neuron disease, at the Dignitas Clinic was broadcast on the BBC in June 2011 as part of the “Choosing to Die” documentary series.

Sources:

Christian Schwarzenegger, “Criminal Law and Assisted Suicide in Switzerland,” rwi.uzh.ch, Feb. 3, 2005

Dignitas, dignitas.ch (accessed June 23, 2016)

Gordon Rayner, “Millionaire Hotelier Peter Smedley Named as Man Whose Dignitas Assisted Suicide Was Filmed by BBC,” telegraph.co.uk, June 7, 2011

Schweizerische Eidgenossenschaft [Swiss Federal Council], “311.0 Swiss Criminal Code of 21 December 1937,” admin.ch, June 18, 2016

Turkey

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

Both euthanasia and medical aid in dying are illegal under article 84 of the Turkish Penal Code: “(1) Any person who solicits, encourages a person to commit suicide, or supports the decision of a person for suicide or helps the suicide action in any manner whatsoever, is punished with imprisonment from two years to five years.” The article includes heavier penalties for commission of a suicide (four to ten years); encouraging others to commit suicide (three to eight years), and encouraging someone who does not understand the situation to commit suicide (felonious homicide, which carries a life sentence).  

Sources:

United Nations Office on Drugs and Crime, “Turkey Criminal Code,” unodc.org, Sep. 26, 2004

United Kingdom
(England, Northern Ireland, Scotland, & Wales)

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

Euthanasia is classified as either manslaughter or murder, depending upon the circumstances of the death, and carries a penalty of up to life in prison. Assisted suicide is illegal in England and Wales according to the Suicide Act 1961, which makes it illegal to “[a]id, abet, counsel or procure the suicide of another or an attempt of another to commit suicide,” and carries a penalty of up to 14 years in prison. The Suicide Act 1961 decriminalized suicide. The Coroners and Justice Act 2009 further clarified the illegality of assisted suicide and amended the Suicide Act 1961. In Northern Ireland, assisted suicide is illegal under the Criminal Justice Act (1966) and in Scotland the practice is not specifically illegal but those assisting suicide may be charged with homicide.

Diane Pretty, who was dying of motor neuron disease petitioned the Director of Public Prosecutions to allow her husband to aid her suicide. Pretty was paralyzed from the neck down and could not perform the act without assistance. She argued that the Human Rights Act 1998 should compel the Director to not prosecute anyone who assisted terminally ill people to die. The Director of Public Prosecutions refused her request. Pretty appealed the decision to the House of Lords, the United Kingdom’s Highest Court, which denied her case. Pretty died two weeks after the court ruling, on May 11, 2002 at age 43.

Sources:

Clare Dyer, “Diane Pretty Makes Final ‘Death with Dignity’ Plea,” theguardian.com, Mar. 20, 2002

Crown Prosecution Service, “Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide,” cps.gov.uk, Oct. 2014

In Brief, “What Is the Legal Position in the UK in Relation to Euthanasia,” inbrief.co.uk (accessed June 27, 2016)

Leah Kuntz, “Scotland Introduces Bill in Favor of Assisted Dying,” psychiatrictimes.com, June 25, 2021

Sandra Laville, “Diane Pretty Dies in the Way She Always Feared,” telegraph.co.uk, May 13, 2002

NHS Choices, “Euthanasia and Assisted Suicide,” nhs.uk, Nov. 8, 2014

UK Legislation, “Coroners and Justice Act 2009,” legislation.gov.uk, 2009

United States

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

(Legal in Some US States)

For more information on US medical aid in dying laws, please see: States with Legal Medical Aid in Dying (MAID).

Uruguay

Euthanasia:

Illegal

Medical Aid in Dying (MAID):

Illegal

While assisted suicide is illegal in Uruguay, article 37 of the Penal Code (1933) states, “(Of mercy killing) Judges have the power to exempt from punishment the subject of honorable history, author of a homicide, carried out with godly motives, induced by repeated requests by the victim.” Further, article 127 states that judges can make use of “judicial pardon” in cases involving article 37.  

Sources:

División Estudios Legislativos Cámara de Senadores República Oriental de Uruguay, “Codigo Penal,” parlamento.gub.uy, Feb. 2014

Derek Humphry, The Good Euthanasia Guide: Where, What, and Who in Choices in Dying, 2004