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EUTHANASIA

How does Spain’s new euthanasia law compare to others in Europe?

As Spain becomes one of a handful of countries that have decriminalised euthanasia, we look at how its new law compares to other countries' legislation on euthanasia and assisted suicide.

How does Spain's new euthanasia law compare to others in Europe?
Photo: Stocksnap

Where is it fully legal in Europe?

The Netherlands legalised active and direct euthanasia in 2002.

Lethal doses of drugs are authorised if patients make the request while lucid.

They must also be experiencing unbearable suffering from a condition diagnosed as incurable by at least two doctors.

Last year the country’s highest court ruled that doctors will be able to conduct assisted suicides on patients with severe dementia without fear of prosecution, even if the patient no longer expressed an explicit death wish.

The Netherlands also moved towards making euthanasia legal for terminally-ill children aged between one and 12.

Belgium lifted restrictions on euthanasia in 2002 for patients facing constant, unbearable and untreatable physical or psychological suffering.

They must be aged 18 or over and request termination of life in a voluntary, reasoned and repeated manner, free from coercion.

In 2014 Belgium became the first country to authorise children to request euthanasia if they suffer a terminal disease and understand the consequences of the act.

In Luxembourg a text legalising euthanasia in certain terminal cases was approved in 2009. It excludes minors.

Swiss exception

Switzerland is one of the rare countries that allows assisted suicide with patients administering a lethal dose of medication themselves.

It does not allow active, direct euthanasia by a third party but tolerates the provision of substances to relieve suffering, even if death is a possible consequence.

Australian scientist David Goodall (C) leaves in a wheelchair after a press conference on May 9 2018, on the eve of his assisted suicide in Basel. Goodall, resentful that he was forced overseas to die, did not have a terminal illness but said his quality of life had deteriorated and that he wants to die. He was barred from seeking help to end his life in Australia, so he was forced to travel to Switzerland. Photo: SEBASTIEN BOZON/AFP

 Spain and Portugal are the latest to decriminalise euthanasia

On Thursday March 8th, Spain’s parliament voted through a law allowing euthanasia under strict conditions so terminally-ill or gravely-injured patients could end their own suffering.

In March Portugal’s top court rejected a law decriminalising euthanasia that had been approved by parliament in January.

The bill, which would have legalised access to assisted suicide for adult patients in a situation of “extreme suffering and irreversible damage”, now goes back to parliament for a possible amendment.

Italian compromise

Italy’s Constitutional Court ruled in 2019 it was not always a crime to help someone in “intolerable suffering” commit suicide. Parliament is set to debate a change in the law banning the practice.

The halting of medical procedures that maintain life, called passive euthanasia, is also tolerated.

Centenarian Helene Wuillemin, seen here at her flat in Laxou, eastern France, went on hunger strike after her applications for euthanasia in Switzerland and Belgium were rejected. Photo :JEAN-CHRISTOPHE VERHAEGEN/AFP

‘Right to die’

In France a 2005 law legalised passive euthanasia as a “right to die”. A 2016 law allows doctors to couple this with “deep and continuous sedation” for terminally ill patients, while keeping euthanasia and assisted suicide illegal.

Sweden authorised passive euthanasia in 2010 and Ireland also recognises the “right to die”.

Britain has allowed medical personnel to halt life-preserving treatment in certain cases since 2002. Prosecution of those who have helped a close relative die, after clearly expressing the desire to end their lives, has receded since 2010.

In Austria and Germany passive euthanasia is permitted if requested by the patient.

Austria’s constitutional court ruled in October the country was violating fundamental rights in ruling assisted suicide illegal and ordered the government to lift the ban in 2021.

Refusing treatment

Denmark has allowed people to file written refusal of excessive treatment in dire situations since 1992, with the document held in a centralised register.

In Norway passive euthanasia is permitted if requested by the patient or by a relative, if the patient is unconscious.

In Hungary people with incurable diseases can refuse treatment.

It is also legal to end treatment of terminally ill people in Lithuania and Latvia.

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EUTHANASIA

Switzerland: What is the difference between assisted suicide and euthanasia?

While the terms often are used interchangeably, assisted suicide and euthanasia - and the laws that govern them - are quite different. Here’s what you need to know.

A person in a medical coat holds hands with another
Euthanasia and assisted suicide might be spoken of in the same breath, but they are quite different. Here's what you need to know. Photo by Matheus Ferrero on Unsplash

The terms assisted suicide, assisted dying and euthanasia are often used interchangeably – even by media and politicians covering the matter. 

There are however some key differences, both in terms of the legal situation and the practice itself. 

Assisted suicide is where a medical professional, usually a doctor but sometimes a pharmacist or other specialist, provides some form of medication to assist a patient as they commit suicide. 

EXPLAINED: How foreigners can access assisted suicide in Switzerland

Crucially, it is the patient who takes the final step, i.e. by taking a medication or by pressing a switch through which the medication is administered. 

Euthanasia on the other hand is where the medication which ends someone’s life is administered by a doctor or medical professional. 

Euthanasia is sometimes known as voluntary euthanasia, which references the fact that the patient volunteers for the process by providing consent. 

Other forms of medical intervention which lead to death – for instance turning off life support for someone who has been in a long-term coma – do not fit within the definition of voluntary euthanasia. 

The term ‘assisted dying’ is used as a grouping term to refer to both assisted suicide and euthanasia, although media sources – particularly in the United Kingdom – often use assisted dying when referring primarily to assisted suicide. 

What are the rules for assisted suicide and euthanasia in Switzerland? 

The law in Switzerland recognises the distinction between assisted suicide and euthanasia. 

Euthanasia is not permitted under law in Switzerland, while assisted suicide is allowed for both locals and foreigners. 

While article 115 of the Swiss penal code prohibits assisted suicide for “self-serving reasons” and article 114 prohibits “causing the death” of a person for “commendable motives, and in particular out of compassion for the victim”, assisted suicide for non-selfish reasons is not specifically prohibited as long as certain conditions are met. 

The Swiss supreme court has ruled the following: people must commit suicide by their own hand, for example, by taking medication themselves. A doctor cannot administer a lethal injection without being liable for criminal prosecution.

People must also be aware of actions they are undertaking and have given due consideration to their situation. In addition, they be consistently sure they wish to die, and, of course, not be under the influence of another person, or group of persons.

READ MORE: What you need to know about assisted suicide in Switzerland

Several other jurisdictions across Europe and the globe also make a legal distinction between the two, although euthanasia is legal in some countries including the Netherlands, Belgium, Luxembourg and Columbia. 

What is the medical procedure involved?

Most Swiss associations request that patients drink sodium pentobarbital, a sedative that in strong enough doses causes the heart muscle to stop beating.

Since the substance is alkaline, it burns a bit when swallowed.

A professional prepares the needle, but it is up to the patient to open the valve that allows the short-acting barbiturate to mix with a saline solution and begin flowing into their vein.

A video is shot of the patient stating their name, date of birth and that they understand what they are about to do. The camera keeps rolling as they open the valve and the footage is used as evidence that they willingly took their own life.

It usually takes about 20 to 30 seconds for the patient to fall asleep.

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