Assisted dying around the world: a status quaestionis
Open accessAbstract
Assisted dying practices, which include euthanasia and physician-assisted suicide (PAS), have expanded significantly around the world over the past 20 years. Euthanasia refers to the act of intentionally ending the life of a patient by a health care practitioner through medical means at that patient's explicit request while PAS involves the provision or prescribing of drugs by a health care practitioner for a patient to end their own life. The growing global aging population accompanied by higher levels of chronic disease and protracted illnesses have sharpened the focus on end of life issues and societal and legislative debates continue to address related moral and ethical complexities. Assisted dying practices are now legal in 18 jurisdictions, increasing the number of people with access to euthanasia and/or physician-assisted suicide (PAS) to over 200 million. New legislation is being crafted or considered in Portugal, Spain and 16 US states. Germany has recently overturned a ban on assisted dying services and New Zealand will put legalization of euthanasia to a vote in 2020. Assisted dying practice characteristics differ and there is also considerable variation in the terminology and labels used for assisted dying, which can add to the confusion and controversy around the practices. Frequency of use also varies greatly by jurisdiction, though a consistent increase has been seen in European countries including Belgium, the Netherlands and Switzerland as well as some jurisdictions with long-standing physician assisted dying laws, such as Oregon and Washington. All assisted dying legislation includes substantive and procedural requirements, such as minimum age, waiting period, health condition, physician consultation and reporting procedure, however, some are extensive and detailed while others are more limited. As access to assisted dying expands in new and existing jurisdictions, research must also expand to diligently examine the impact on patients, specifically among vulnerable populations, as well as on health care practitioners, health care systems and communities. This article will provide a thorough investigation, or 'status quaestionis' of the terminology, evolution and current legislative picture of assisted dying practices around the globe and contribute to the ongoing ethical, regulatory and practice debate, which have become increasingly important considerations for medical practice, end-of-life care and public health.
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Regulations often require unbearable and irremediable suffering caused by an incurable disease as a further condition for legitimate suicide assistance.
“Interestingly, regulations often require unbearable and irremediable suffering caused by an incurable disease as a further condition for legitimate suicide assistance (2).”
From Assisted suicide in persons with mental disorders: a review of clinical-ethical arguments and recommendations (2024) · cites this paper as [2]
Consequently, several countries broadened their laws to permit prescription and/or administration of lethal medication in such cases as well.
“As a result, several countries expanded their laws to allow prescription and/ or administration of fatal doses of medication in these cases as well 221 .”
From Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs (2024) · cites this paper as [221]
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- Authors
- Mroz, S., Dierickx, S., Deliens, L., Cohen, J., & Chambaere, K.
- Affiliations
- Vrije Universiteit Brussel (BE)
- Corresponding author
- Mroz, Sarah
- Venue
- Annals of Palliative Medicine
- Publisher
- AME Publishing Company
- Published
- 2021-03
- Volume
- 10
- Issue
- 3
- Pages
- 3540-3553
- ISSN
- 2224-5820 (ISSN-L)
- 2224-5839
- OpenAlex
- W3083040688
- Cited by
- 264
- References
- 34
- Citations by year
- 2026: 34 · 2025: 62 · 2024: 70 · 2023: 50 · 2022: 35 · 2021: 12 · 2020: 1
- FWCI
- 18.37
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Annals of Palliative Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, cc-by-nc-nd)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- assisted dying, euthanasia, physician-assisted suicide, assisted dying legislation, end-of-life care, vulnerable populations, healthcare workers
- MeSH terms
- Aged, Europe, Germany, Humans, Netherlands, Portugal, Spain, Suicide, Assisted
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