Assisted dying can take two forms. Assisted suicide, or physician-assisted death, is when a "physician provid[es] a patient who requests aid-in-dying a prescription that the patient can self-administer to end his or her life," said the National Institute of Health. Physician-assisted suicide is different from physician-administered suicide, also called euthanasia, when the doctor can administer the prescription themselves. Assisted dying usually applies to patients suffering terminal illnesses who choose to die more peacefully. The practice is hotly contested and is still illegal in most of the world. However, a handful of countries have opted to allow the practice ,and others are discussing its legalization.
Where it's legal
In Austria, a law legalizing assisted suicide passed in 2021 and took effect in 2022. Per the law, "adults who want to end their lives must produce a diagnosis and have confirmation that they are able to make their own decisions," said BBC. Minors and those with mental health conditions are excluded.
Belgium legalized assisted death in 2002 and has more open laws than other nations. The country allows foreigners to submit end-of-life requests. making it a haven for neighboring countries. In addition, "people can make advance directives so that assisted dying can be administered in accordance with their wishes — even if they are not conscious to confirm those wishes," said Forbes. The doctor can also carry out the procedure unless the patient opts to do so themselves. Since 2014, age restrictions have been lifted, but parental consent is required for those under 18.
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In Canada, assisted dying was legalized in 2016 for mentally competent adults with an irredeemable medical condition. The condition does not have to be terminal as long as it is irreversible and causes severe mental or physical suffering. Canada also legalized physician-administered suicide in 2021.
In Colombia, the court legalized euthanasia for terminally ill adult patients in 2014. By 2018, the country approved the practice for children over 6, not requiring parental consent past the age of 14. In 2022, the country decriminalized assisted suicide for "people who suffer from severe health conditions that patients consider a threat to their dignity," even if they are not terminal, said Colombia Reports.
Ecuador decriminalized euthanasia and assisted suicide in 2024, allowing for the "option of ending the intense suffering caused by a serious and irreversible bodily injury or a serious and incurable illness," the country's court said. Ecuador is only the second South American country to legalize assisted dying.
Luxembourg legalized assisted suicide and euthanasia in 2009 for a person suffering "from an incurable condition … constantly in unbearable physical or mental pain," the Library of Congress said. Parental consent is required for those between the ages of 16 and 18, and assisted dying is not permitted for anyone younger than those ages.
The Netherlands legalized assisted dying in 2002, allowing assisted suicide and euthanasia. Minors can also request the practice starting at the age of 12 but need parental consent until they are 16.
New Zealand legalized euthanasia and assisted suicide in 2021 for terminally ill patients aged 18 and older. To be approved for an assisted death, two doctors must assess whether the patient's condition is eligible. "It is expected that the process for confirming a person's eligibility may take between four and six weeks after a request is made," said the country's Ministry of Health.
Spain legalized both physician-administered and physician-assisted suicide in 2021. To be approved, the patient must suffer a "severe, chronic and debilitating condition or a severe and incurable disease," said the law. Only adults are eligible.
In Switzerland, assisted suicide has been legal since 1942, given it is not being requested for selfish reasons. However, all forms of euthanasia are illegal, and doctors are not permitted to administer any life-ending drugs. Switzerland also serves as a haven for people in surrounding countries to seek assisted suicide through Dignitas, a nonprofit that runs assisted dying clinics in the country. Only adults are eligible for assisted suicide.
Where it's under review
Australia legalized assisted dying in all of its states by 2022. However, it is not yet legal in the country's Northern and Australian Capital Territories. That could be changing soon. In December 2022, "commonwealth laws that stopped the territories from making new laws on voluntary assisted dying were repealed, which opens a pathway to potential future legalization," said The Guardian.
In France, President Emmanuel Macron has backed a bill legalizing assisted dying in the country, which will be examined by the National Assembly in May. The bill will apply to those with incurable illnesses who are capable of making decisions for themselves. "France currently authorizes deep sedation before death, but active euthanasia and medically assisted suicide remain illegal," said France24.
In Germany, assisted suicide is not technically legal, but it has been a "legal gray area," The Associated Press said. In 2020 the country's Federal Constitutional Court lifted the ban on assisted suicide citing the right to personal freedom. Despite this, there has not been any legislation to regulate assisted dying, and some are still firmly against the practice. "The judgment is not extensively discussed among doctors or the public," Norbert Schürmann, the vice president of the German Society for Pain Medicine and head of the pain and palliative medicine department at St. Josef Hospital, said to Medscape. "The patient's autonomy, as emphasized by the … decision is not yet fully recognized."
In the United States, ssisted dying is legal in California, Colorado, Hawaii, Maine, Montana, New Mexico, New Jersey, Oregon, Vermont, Washington and Washington D.C. Close to 20 other states are considering bills legalizing it as well. "These bills typically allow people with six months or less to live to request prescriptions from a doctor that they can take at home if and when they decide to end their lives," said Axios. Overall, access to assisted dying is not available nationwide.
