The legal status of assisted dying around the world

The British parliament will debate whether to legalise assisted dying for the terminally ill, potentially paving the way for the law to change in England, Northern Ireland and Wales. Below is an interactive map and a list of countries that allow people to choose to end their lives or are considering doing so, including Australia.

Legislated

Switzerland

Switzerland legalised assisted dying in 1942 on the condition the motive of the person assisting is not selfish, making it the first country in the world to permit the practice. Doctors can prescribe drugs and administer them or hand them over for self-administration. A number of Swiss organisations, such as Dignitas, offer their services to foreign nationals.

Anjelika Elliott holds her husband Dr John Elliott’s hands in a Zurich hotel room a day before going to the Dignitas clinic where he ended his life in 2007. The Sydney couple travelled to Switzerland, where assisted dying is legal.Credit: Kate Geraghty

United States

Medical aid in dying, also known as physician-assisted dying is legal in 10 states: California, Colorado, Hawaii, Montana, Maine, New Jersey, New Mexico, Oregon, Vermont and Washington, plus the District of Columbia. Oregon was the first state to legalise it under a law that came into effect in 1997. It allows mentally competent patients who are terminally ill and with less than six months to live to ask for life-ending medication. People from outside Oregon may travel to the state to take advantage of the law.

The Netherlands

The Termination of Life on Request and Assisted Suicide (Review Procedures) Act came into effect in 2002. A doctor is immune from punishment for euthanasia and assisted suicide where patients are experiencing “unbearable suffering with no prospect of improvement”. Minors can request euthanasia from the age of 12 but require parental permission before the age of 16.

Belgium

Belgium legalised medically assisted dying in 2002 for the terminally ill and for people experiencing unbearable suffering, which includes patients with psychiatric conditions. Since 2014, those under the age of 18 who are terminally ill are covered by the law as long as they have parental permission.

Luxembourg

Euthanasia and assisted dying has been legal in Luxembourg since 2009, provided the patient has no way out of a medical situation and reports constant and unbearable physical or psychological suffering; is conscious and capable at the time of the request to a doctor, consults another physician, and the request is recorded in writing.

Canada

Canada introduced “medical assistance in dying” in 2016 for those whose death was deemed to be “reasonably foreseeable”. Five years later, the law was extended to permit people with a “grievous and irremediable” medical condition to request assisted dying. The country has delayed until 2027 a plan to extend medical assistance in dying to include those with a mental illness.

Courts in several countries have ruled self-determination includes a person’s right to die.Credit: Getty Images

Australia

Voluntary assisted dying for the terminally ill or those with a condition that is causing intolerable suffering is legal in all Australian states and the ACT, but illegal in the Northern Territory, where Australian Dr Philip Nitschke, founder of pro-euthanasia group Exit International, began his campaign for the right to die in 1996. Voluntary assisted dying was first introduced in Victoria in 2019. To qualify, adult patients must be state residents, of sound mind, and have six months or less to live in most cases. Similar criteria apply in NSW. Doctors can administer the medication or prescribe it for self-administration.

New Zealand

New Zealand’s End of Life Choice legislation was enacted in 2021, after passing parliament in 2019 and being approved by voters in a binding referendum conducted at the same time as the 2020 general election. Adult patients must be permanent residents, be suffering from a terminal illness that is likely to end their life within six months, be in an advanced state of irreversible decline in physical capability, and experiencing unbearable suffering. They also must be competent to make an informed decision about assisted dying, although a mental illness does not disqualify them.

Spain

Spain approved a law in 2021 that allows euthanasia and medically assisted suicide for people with incurable or debilitating diseases who want to end their life.

Austria

Assisted suicide in Austria was strictly prohibited, as was any help Austrians could give other citizens seeking the service abroad. But in 2022 a court ruled the prohibition denied people the right to self-determination and a new law was passed allowing the practice when those willing to die are ill, and capable of making the decision (to be confirmed by two doctors). They need to wait 12 months before seeking a “death order” at a notary or patient advocate. This prescription is then fulfilled by a pharmacy and noted in a register. Those with little time to live can seek the prescription after two weeks. A patient with an incurable or terminal illness can specify their wishes in a “death will” provided the decision is made while they were mentally capable.

Portugal

It took four approvals by parliament before Portugal’s Assistance in Dying bill became law in 2023. It gives access to assistance in dying for citizens and legal residents over the age of 18, who are terminally ill, and suffering intolerably.

Allowed but yet to be legislated

Italy

According to Politico, Italy’s Constitutional Court ruled in 2019 that assisted suicide was permissible when patients are able to make decisions and in overwhelming pain, legalising it in practice. The first patient to die by medically assisted suicide was a 44-year-old man in 2022. Lawmakers are yet to legislate the practice.

Germany

Assisted dying had been legal in Germany until 2015, when the country outlawed its provision on an organised or commercial basis, effectively banning it in many cases. In 2020, the country’s top court ruled that a person’s right to freedom includes the right to self-determine life and death, and ruled in favour of groups providing terminally ill adults with assisted suicide services, but lawmakers are yet to finalise new rules

Colombia

Colombia became the first Latin American country to decriminalise medically assisted suicide in May 2022, by allowing doctors to supply the drugs for patients to self-administer if they have a terminal or chronic illness that prevents them from living a dignified life. The 2022 ruling by the Supreme Court has yet to be followed up with legislation.

Under consideration or unclear

France

Doctors in France have since 2016 been allowed to put a person who is close to death and in great pain into deep sedation, but not to administer life-ending medication. President Emmanuel Macron earlier this year backed new legislation which would allow assisted dying for those with incurable conditions, and a bill was introduced in April, but elections in June and July interrupted the proposed law’s progress.

England and Wales

A bill to allow terminally ill adults with six months or less left to live the right to end their lives was introduced to parliament earlier in October and will be debated on November 29. It is modelled on a 23-year-old law in Oregon, US, adopted by 10 other American states, three Australian states and New Zealand. Two independent doctors and a High Court judge would have to assess each request. If granted, it would enable a terminally ill person to die in a manner, time and place of their choosing in England and Wales. Assistant dying is already legal on the Isle of Man and Jersey, and illegal in Northern Ireland.

Scotland

Scotland is allowed to determine its own healthcare laws, although it is part of the UK. A bill was introduced to its parliament in March, but it is yet to come to a vote.

Ireland

A cross-party Irish parliamentary committee recommended this year that the government should legalise assisted dying in certain restricted circumstances. A majority of MPs voted in favour of “noting” the committee’s findings in October. With a national election due on November 29, it will be up to the next government to decide whether to consider proposing a new law.

South Korea

In July 2024, a new proposal to legislate assisted dying was introduced in the South Korean parliament, according to the World Federation of Right to Die Societies.

Other countries where legal developments are under way include Iceland, Argentina and Uruguay.

A note on terminology

The British Parliamentary Office of Science and Technology briefing note on assisted dying defines the term and other variations as follows:

“Assisted dying refers here to the involvement of healthcare professionals in the provision of lethal drugs intended to end a patient’s life at their voluntary request, subject to eligibility criteria and safeguards. It includes healthcare professionals prescribing lethal drugs for the patient to self-administer (physician-assisted suicide) and healthcare professionals administering lethal drugs (euthanasia).”

Reuters, with Lia Timson