Cited by 264Palliative and Oncologic CarePalliative Care and End-of-Life IssuesEthics and bioethics in healthcare

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Assisted dying around the world: a status quaestionis

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Mroz, Sarah, Dierickx, Sigrid, Deliens, Luc, Cohen, Joachim, Chambaere, Kenneth·2021·Annals of Palliative Medicine

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Abstract

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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Authors: Mroz, S., Dierickx, S., Deliens, L., Cohen, J., & Chambaere, K.
Affiliations: Vrije Universiteit Brussel (BE)
Corresponding author: Mroz, Sarah
ORCID: Mroz, Sarah
Dierickx, Sigrid
Cohen, Joachim
Chambaere, Kenneth
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
DOI: 10.21037/apm-20-637
OpenAlex: W3083040688
Cited by: 264
References: 34
Citations by year: 2026: 34 · 2025: 62 · 2024: 70 · 2023: 50 · 2022: 35 · 2021: 12
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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