End of life. Euthanasia, assisted suicide… what is authorized (or not) among our European neighbors

End of life.  Euthanasia, assisted suicide… what is authorized (or not) among our European neighbors

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“Assistance in dying” announced by Emmanuel Macron and which would be introduced in France as part of the future end-of-life bill would bring France closer to some of its European neighbors where assisted suicide and/or euthanasia are authorized.

The Netherlands and Belgium ahead

The Netherlands and Belgium were the first two European countries to authorize euthanasia – death caused by a caregiver at the request of a patient.

In the Netherlands, euthanasia has been strictly regulated since April 1, 2002. Dutch law provides that the doctor and an independent expert must determine that the patient is in unbearable suffering with no hope of improvement. It must also be established that the request for euthanasia is carefully considered, voluntary, and that there is no other “realistic option”. After years of debate, 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 on May 28, 2002. In 2014, Belgium became the first country in the world to authorize euthanasia for minors. without age limit.

Spain followed in 2021

More recently, Spain voted in March 2021 in favor of euthanasia and medically assisted suicide, namely when the patient himself takes a prescribed product to cause death. Spanish 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 the medical profession to die and thus avoid “intolerable suffering”.

Euthanasia decriminalized in Luxembourg and Portugal

Luxembourg decriminalized euthanasia and assisted suicide in 2009. “The fact by a doctor of responding to a request for euthanasia or assisted suicide is not criminally sanctioned and cannot give rise to a civil action for damages”, according to the Luxembourg law promulgated on March 17, 2009. .

Portugal recently decriminalized euthanasia after a laborious process: a law governing “medically assisted death” was promulgated in May 2023 despite the opposition of conservative President Marcelo Rebelo de Sousa. This law stipulates in particular that euthanasia is authorized in cases where “medically assisted suicide is impossible due to the physical incapacity of the patient”.

Assisted suicide authorized 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. The voluntary 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. A doctor must declare death.

The person must be an adult, capable of discernment, suffering from an incurable illness, intolerable suffering, or disabling polypathologies linked to age. However, a person can be prosecuted if they assist in the suicide of a third party when they are “driven by a selfish motive” such as the prospect of an inheritance.

Austria legalized, by a vote of Parliament in December 2021, assisted suicide for people suffering from a serious or incurable illness. This law came into force on January 1, 2022.

Blur in Italy and Germany

In Italy, assisted suicide is prohibited but the Constitutional Court allowed an exception in September 2019 for fully conscious patients “kept alive by treatments […] and suffering from an irreversible pathology, a source of physical and psychological suffering that they consider intolerable.”

In Germany, active euthanasia is not permitted. But according to the World Right to Die Federation, assisted suicide is tolerated as long as it is not carried out by an organization or person practicing it professionally. But in 2020, the Federal Constitutional Court declared the ban on professionally assisted suicide unconstitutional.

A murder across the Channel

In the United Kingdom, active euthanasia is considered homicide and is potentially punishable by life in prison. Assisted suicide is also not permitted. Same thing in Ireland, where despite recent debates on the subject, euthanasia and assisted suicide can also be assimilated to murder and punishable by a prison sentence of up to life.

Poland, Bulgaria, Romania… Many other European countries punish euthanasia with prison sentences.

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