Since April 1, 2002, Dutch law has provided that a doctor and independent expert must determine the patient’s suffering is unbearable and without hope of improvement. End-of-life assistance was extended in April 2023 to children under 12 years old.
In Belgium, the request must be “voluntary, thoughtful, repeated”, “without external pressure”, according to a text promulgated in May 2002. In 2014, Belgium became the first country to authorize euthanasia for minors without limit of ‘age.
Luxembourg in turn decriminalized euthanasia in 2009 as well as assisted suicide, namely when the patient himself takes a prescribed product to kill himself.
Recent laws in Spain, Portugal
Spain adopted a law in March 2021 that allows euthanasia and medically assisted suicide. The law provides that any person with “a serious and incurable illness” or “chronic” pain placing them in a situation of incapacity” can request help from doctors to die and thus avoid “intolerable suffering”.
But the conditions are strict: around one in two requests is refused, according to the authorities.
In Portugal, the decriminalization of euthanasia, made official in May 2023, has not yet come into force.
Assisted suicide in Switzerland
Switzerland prohibits direct active euthanasia but authorizes assisted suicide. The practice of assisted suicide is regulated by codes of medical ethics and is supported by organizations such as the Exit association.
The volunteer attendants of these associations provide the patient with the lethal substance – obtained through a medical prescription – which he will ingest himself, without external intervention, to end his life.
The person must be an adult, capable of discernment, suffering from an incurable illness, intolerable suffering or disabling pathologies linked to age.
Austria also legalized, by a vote of Parliament in December 2021, assisted suicide for people suffering from a serious or incurable illness.
United States, Canada, Colombia, Ecuador, New Zealand, Australia
In the United States, around ten states or jurisdictions have adopted legislation allowing assisted suicide over the last 30 years: Oregon, Washington, Vermont, California, Colorado, Washington DC, Hawaii, New Jersey, Maine and New Mexico.
In Canada, “medical assistance in dying” has been legal since 2016 for consenting and responsible adults suffering from a serious, incurable and irreversible illness.
Colombia was, in May 2022, the first country in Latin America to legalize assisted suicide: the Constitutional Court ruled that “the doctor who helps a person experiencing intense suffering or serious illness (…) acts within the constitutional framework”. Ecuador followed in February 2024 with a similar decision.
New Zealand legalized “assisted dying” by referendum in October 2020 for certain terminally ill patients over the age of 18. This assistance is similar, depending on the case, to assisted suicide or euthanasia.
In Australia, five out of six states authorize “voluntary assistance in dying” for terminally ill patients.
French project postponed
In France, the examination of a bill establishing assistance in dying for adults suffering from a serious and incurable condition was interrupted by the dissolution of the National Assembly on June 9.
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