Active euthanasia (in which a doctor administers a lethal dose of medication to a patient) and physician-assisted suicide (PAS) are illegal in most countries. However, at least eight western countries have legalized one or both of the practices. Below find information on 28 countries' laws, court cases, and debates about euthanasia and PAS.
These countries were chosen based on the availability of legal documents and information on medical practices, and in an effort to include countries that represent a variety of cultures, religions, and ethnicities. While reasonable effort has been made to assure the accuracy of this data, do not rely on this information without first checking with a current and official edition of the applicable law.
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 physician-assisted suicide in that state. The bill was defeated in 2013.
On Nov. 29, 2017, Victoria (Australia's second-most populous state) legalized physician-assisted suicide and limited euthanasia. The law will go into effect in mid-2019 and will allow 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 her/himself.
Right to Life, "Media Release: Physician Assisted Suicide Defeated in Tasmania," righttolife.com.au (accessed June 8, 2016)
The World Federation of Right to Die Societies, "Euthanasia and Assisted Suicide in Australia," worldrtd.net (accessed June 8, 2016)
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.
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 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 physician-assisted suicide 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 does 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 (as possibly euthanasia) legal effective immediately and regulating physician-assisted suicide and, possibly, 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."
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
Toronto Star, "'This Is a Big Step in Canadian Society and Justice,' Trudeau Says of Assisted Dying Bill: Paul Wells," thestar.com, June 7, 2016
Euthanasia and physician-assisted suicide 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.
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)
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, stating "Tendencies of totalitarian facist and Communist States are reflected in mercy killing, they respond to Hilter'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.
Republic of Colombia, "Republic of Colombia Constitutional Court Sentence #C-239/97 REF. Expedient #D-1490," patientsrightscouncil.org, May 20, 1997
Both euthanasia and physician-assisted suicide 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.
Copenhagen Post, "’Difference of Opinion’ over Assisted Suicide Emerging in Ethical Panel," cphpost.dk, June 8, 2012
Agnes van der Heide, et al., "End-of-Life Decision-Making in Six European Countries: Descriptive Study," thelancet.com, June 17, 2003
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.
Ministry of Social Affairs and Health, "Human Dignity, Hospice Care and Euthanasia," etene.fi, Jan. 1, 2012
France's Parliament passed a law on Jan. 27, 2016 that allows doctors to sedate terminally-ill patients until their death from their illness or starvation. President Francois Hollande called for the law as a compromise to euthanasia and physician-assisted suicide.
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
On Nov. 6, 2015, Germany legalized physician-assisted suicide that is performed on an "individual basis out of altruistic motives." "[C]ommercial euthanasia" or "suicide business" is illegal.
Prior to the 2015 law, doctors were allowed to provide high doses of pain medication to accelerate death.
Abigail Abrams, "Assisted Suicide Law in Germany Passes Despite Concerns over Nazi Association," ibtimes.com, Nov. 6, 2015
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 support 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.
Tabassum Barnagarwala, "Between Life and Death for 42 Long Years, Aruna Shanbaug Passes Away," indianexpress.com, May 19, 2015
Both euthanasia and physician-assisted suicide 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."
Nicky Ryan, and TheJournal.ie, "Ireland's Euthanasia Laws Are Some of the Most Strict in Europe," thejournal.ie, Jan. 3, 2015
Israeli law and Jewish law ban physician-assisted suicide 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.
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)
Piergiorgio Welby, who suffered from a rare, terminal type of muscular dystrophy, petitioned the court to be allowed physician-assisted suicide 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.
Japan has no specific laws banning euthanasia but physician-assisted suicide 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.
Tomohiro Osaki, "U.S. 'Death with Dignity' Case Stokes Japanese Supporters and Opponents Alike," japantimes.co.uk, Nov. 14, 2014
Luxembourg became the third country in Europe, after the Netherlands and Belgium, to legalize euthanasia and physician-assisted suicide. 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 physician-assisted suicide 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 simultaneous 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.
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 physician-assisted suicide 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.
E. Eduardo Castillo, "Mexico Court Upholds State Right-to-Life Amendment," cnsnews.com, Sep. 28, 2011
Matthew Cullinan Hoffman, "Two More Mexican States Pass Pro-Life Amendments by Overwhelming Majorities," catholicexchange.com, Apr. 15, 2009
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 physician-assisted suicide would not be punished.
Euthanasia and physician-assisted suicide 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.
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)
University Medical Center, "Paediatricians Call for Nationwide Protocol for the Ending of Life of Unbearably and Incureably Suffering Newborns," umcg.nl, Dec. 10, 2004
Section 179 of the New Zealand Crimes Act 1961 makes "aiding and abetting suicide" illegal, including physician-assisted suicide, 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 physician-assisted suicide. The debate on the bill was vetoed on May 4, 2016, killing the bill.
Jo Moir and Tracy Watkins, "Euthanasia Debate Back on the Political Agenda," stuff.co.nz, June 6, 2015
Euthanasia and physician-assisted suicide 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.
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.
Euthanasia is specifically prohibited by the "On Health Care of Russian Citizens" law passed in 1993.
In 1997 the South African Law Commission published a report that included a draft law to legalize both euthanasia and physician-assisted suicide. 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.
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
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
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 physician-assisted suicide, but legalized passive euthanasia (the withdrawal of treatment or life-sustaining machinery) when approved later in 2011.
Spanish News Today, "Parents Demand Passive Euthanasia for Their Daughter in Santiago de Compostela," spanishnewstoday.com, Jan. 10, 2015
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." Physician-assisted suicide and euthanasia remain illegal in Sweden.
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.
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
Both euthanasia and physician-assisted suicide 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).
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 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.
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.
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)
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.