Country Comparison

The table below summarises the legal position of various countries on euthanasia and assisted suicide (AS)

Country

Is euthanasia allowed?

Is Assisted Suicide (AS) allowed?

Australia

•> Euthanasia is now illegal in Australia.
•> It was once legal in the Northern Territory, by the Rights of the Terminally Ill Act 1995. In 1997, the Australian Federal House of Representatives passed an anti-euthanasia bill which overturned the 1995 Act.

> AS is illegal in Australia.

Belgium

2002:
•> Belgium legalised euthanasia in 2002, the second EU country to do so after the Netherlands [1].
•> The Belgian Act on Euthanasia allows adults who are in a "futile medical condition of constant and unbearable physical or mental suffering that cannot be alleviated" to request voluntary euthanasia.

2012:
•> Belgium is considering a significant change to its decade-old euthanasia law that would allow minors and Alzheimer's sufferers to seek permission to die [2].

•> The law does not refer to assisted suicide.
•> Doctors who practise euthanasia commit no offence if they respect the prescribed conditions and procedures, and have verified that:
a. the patient is an adult or a mature minor who must be a least 15 years old person possessing legal capacity and aware of what he or she is doing when he or she formulates the request (which must be made in writing);
b. the request is made voluntarily, carefully and repeatedly, and is not the result of outside pressure;
c. the patient’s medical state is hopeless, and he or she is experiencing constant, unbearable physical or mental suffering, which cannot be relieved and is caused by a serious and incurable injury or pathological condition [3].

•> Advance directives: In a similar approach to the Netherlands, Belgium recognises the validity of advanced directives for euthanasia. This enables physicians to practice euthanasia on persons who are no longer capable of expressing their wishes, but who have done so in writing when they still had capacity.

Canada

•> Euthanasia and assisted suicide are illegal in Canada under the Criminal Code.

2013:
•> A draft euthanasia bill is due to be proposed in the Quebec parliament later this year, following the publication of the Menard report in January. It recommended specific amendments to Quebec's laws to make euthanasia legal and safe [4].

•> Euthanasia and assisted suicide are illegal in Canada under the Criminal Code.

•> A survey of Canadian Medical Association (CMA) members' views on major end-of-life issues has found that only 20% of respondents would be willing to participate if euthanasia is legalized in Canada, while twice as many (42%) would refuse to do so. Almost a quarter of respondents (23%) are not sure how they would respond, while 15% did not answer [5].

France

2012:
> In December the French government has announced that it will introduce legislation allowing assisted suicide and some forms of euthanasia.
•> A government-commissioned report has recommended that France allow doctors to “accelerate death” for terminally-ill patients who want to end their lives [6].
•> It is anticipated that legislation could be presented to the National Assembly as early as June 2013.
•> A poll conducted in late 2012 found that French people overwhelmingly support medically-assisted suicide [7].

2005:
•> The French senate approved a law granting terminally ill patients the right to end their life. This allows for doctors to stop giving medical assistance when it "has no effect other than maintaining life artificially” [8].

2012:
•> The French government has announced that it will introduce legislation allowing assisted suicide and some forms of euthanasia.
•> The report recommends that doctors should be given the authority to green-light an “acceleration of death” under three circumstances:
a. When the patients concerned are able to make a request explicitly, or that instructions had been given in advance before their situation had deteriorated leaving them unable to give instructions.
b. Doctors could withdraw life-supporting treatment or nourishment when requested by the patient’s family and when the patient is considered unconscious.
c. Doctors would be able to withdraw treatment when it is merely keeping a body alive in a vegetative state [9].

Germany

••> Active euthanasia is illegal. Such an act is punishable by up to five years in prison in Germany.

•> Assisted suicide is legal in Germany.

2010:
•> A ruling by Germany's Federal Court of Justice stated that it is not a criminal offence to cut off the life support of a dying person if that person has given consent.
•> This does not legalise active assisted suicide.
•> The German Medical Association has issued new guidelines for assisted suicide which allow doctors to make conscientious decisions about whether to assist ill patients in dying. The new text states: “The doctor's assistance with suicide is not a medical duty.”[10]
•> Many of the clients who travel to Switzerland to seek help in suicide are Germans and, at one point, Dignitas suggested it might set up a German office in Hanover.

Italy

•> Euthanasia is illegal.
•> Italian law does uphold the patient's right to refuse care. This potential contradiction has resulted in several cases which have divided Italians.
•> In a country where the influence of the Roman Catholic Church remains strong, the debate is especially passionate and opposition to euthanasia remains strong.

•> Assisted suicide is illegal.

Luxembourg

2009:
•> Luxembourg became the third European country to legalise euthanasia, after the Netherlands and Belgium.
•> Following a vigorous public debate, Luxembourg's parliament has voted to legalise euthanasia. A predominantly Catholic country, the medical profession was broadly against the legislation.
•> Head of state, Grand Duke Henri, refused to sign off on the bill, triggering a constitutional crisis. As a result, Luxembourg’s parliament voted for legislation to give the monarch a purely ceremonial role [11].
•> Euthanasia and assisted suicide is permitted for those with incurable conditions to die if they asked repeatedly to do so and had the consent of two doctors and a panel of experts.

2009:
•> Euthanasia and assisted suicide were legalized in the country in April.
•> Doctors who carry out euthanasia and assisted suicides would not face "penal sanctions" or civil suits for damages and interest [12].

The Netherlands

2002:
> The Netherlands was the first country in the world to legalise euthanasia in 2002. Since the early 1970s it had been widely tolerated.
•> The rules are strict and cover only patients with an incurable condition who face unbearable suffering. Key criteria included:
a. The patient has to be in full possession of mental faculties.
b. Each case has to have a second medical opinion before euthanasia is carried out in a medically appropriate way.
c. After the event, it is referred to a regional review committee including a doctor, a legal expert and a medical ethicist.

2002:
•> Assisted suicide has been lawful since April.

Switzerland

•> All forms of active euthanasia like administering lethal injection remain prohibited in Switzerland.
•> According to Swiss law, a person can be prosecuted only if helping someone commit suicide out of self-interested motivation.

1930s
•> Since the 1930s assisted suicide has been legal in Switzerland, where the activities of the Dignitas clinic have made international news. Non-physicians can be involved.

USA

> Active euthanasia remains illegal in most of the United States.
•> There have been several attempts in the last 20 years to legalise euthanasia and assisted suicide.

1997:
•> State of Oregon: Since 1997, the Oregon Death with Dignity Act has been in place for 10 years. It gives terminally ill, mentally competent people the option of an assisted death.

2008:
•> Assisted suicide in the state of Washington was made legal based on a similar legal model as legislation in the state of Oregon legislation (the vote took place alongside the presidential election November 2008).
•> 58% of Washingtonians voted in favour of a change in the law in a voter initiative - the law will not come into effect instantaneously, and may face challenges (as the Oregon law did when it was endorsed in a similar voter initiative).
•> On December 5, state of Montana - state District Court judge Dorothy McCarter ruled competent, terminally ill patients have the right to self-administer lethal doses of medication as prescribed by a physician. Physicians who prescribe such medications will not face legal punishment [13].

References:

  1. http://news.bbc.co.uk/1/hi/world/europe/7322520.stm
  2. http://www.france24.com/en/20121218-belgium-looks-euthanasia-minors-alzheimers-sufferers 
  3. See: Parliamentary Assembly, Euthanasia, Doc. 9898, 10 September 2003, Report, Social, Health and Family Affairs Committee
  4. See link: http://news.nationalpost.com/2013/01/15/quebec-to-legalize-assisted-suicide-death-a-medical-issue-health-minister-says/
  5.  http://www.cma.ca/index.php?ci_id=205556&la_id=1
  6. http://www.france24.com/en/20121219-france-medically-assisted-suicide-euthanasia-healthcare-reform-hollande 
  7. Ibid.
  8. http://news.bbc.co.uk/1/hi/world/europe/4440027.stm
  9. http://www.france24.com/en/20121219-france-medically-assisted-suicide-euthanasia-healthcare-reform-hollande
  10. http://www.dw.de/german-medical-association-eases-rules-on-assisted-suicide/a-14851309 
  11. http://www.google.com/hostednews/afp/article/ALeqM5i0yQDSE_oKIBOFwmvPlw1o347tww
  12. Ibid.
  13.  http://www.nbcnews.com/id/28085809/