There may not be any more controversial concepts or laws than those regarding euthanasia and assisted suicide. Assisted suicide is when a doctor prescribes lethal drugs to a patient but the patient is responsible themselves for administering them. Euthanasia is when a physician intentionally administers a lethal dose of drugs to a patient in order to end their life. Both have the same noble goal in mind; to end the suffering of a patient, but both the public, and the law have wildly differing opinions on the practices.
There are arguments on both sides of the debate that make strong claims in favor of their respective positions. Those in favor of assisted suicide and euthanasia argue that no one should live with a terminal illness, waiting to die in unbearable pain with no cure or hope. Proponents of assisted suicide and euthanasia argue that the patient should have the legal right to end their life however they see fit, and if that means with the assistance of a medical professional, so be it. Opponents of euthanasia argue that by legalizing the practice, we are disrespecting the sanctity of life. Often religion plays a role in the opinions of those against euthanasia, but not always.
While in most countries assisted suicide and euthanasia remain illegal, some nations are in the process of debating and adopting assisted suicide laws, or have already legalized assisted suicide, while three European nations have outright legalized euthanasia. Here are ten of those nations.
Canada is an interesting case in regards to euthanasia. While active euthanasia is illegal in Canada, the act whereby one willingly participates in the killing of someone to relieve suffering, passive euthanasia is legal. Passive euthanasia is the process by which a family member or caretaker knowingly withholds the necessities of life, such as food and water, in order to help someone die. Assisted suicide is illegal in Canada as well, though there has long been a strong movement to legalize both euthanasia and assisted suicide in the country, with various high profile court cases highlighting the argument in favor of legalizing euthanasia. Numerous provinces have also either struck down federal legislation outlawing doctor assisted suicide as in British Colombia in 2012, or recently passed measures to legalize assisted suicide as Quebec did this past June. The Canadian government debated the merits for and against legalizing euthanasia as recently as this past month.
Assisted suicide and euthanasia remain controversial in Albania, in large part due to the involvement of the church, though assisted suicide has been technically legal in the country since 1999. Passive euthanasia is also legal if a patient is incapacitated from making the decision to die, like being in a coma, as long as three family members all agree on the decision together and give legal consent.
When a terminally ill patient, defined as a patient with "cancer, AIDS, kidney or liver failure… who is in extreme suffering," wants to die in Colombia and that patient can “give clear authorization to do so,” then they have the right to assisted suicide. The Constitutional Court of Colombia ruled in favor of assisted suicide 6-3 in 2010, ruling that no one can be found criminally responsible for aiding in the death of a terminally ill patient. Though the law is progressive in Colombia, some have protested what diseases constitute being terminally ill, as the assisted suicide laws in Colombia also expressly excluded degenerative diseases such as Alzheimer’s to be included in the definition of terminally ill.
Japan has no official policy, or laws for that matter, regarding euthanasia and doctor assisted suicide. There have been cases of both passive and active euthanasia in Japan that have been brought before the courts and had contradictory rulings. De facto assisted suicide generally doesn’t end up in court, but euthanasia has remained a far murkier debate. As such, the Japanese government has finally created a legal outline dictating the appropriate criteria for both passive and active euthanasia to become legal:
“In the case of passive euthanasia, three conditions must be met:
1) The patient must be suffering from an incurable disease, and in the final stages of the disease from which he/she is unlikely to make a recovery.
2) The patient must give express consent to stopping treatment, and this consent must be obtained and preserved prior to death. If the patient is not able to give clear consent, their consent may be determined from a pre-written document such as a living will or the testimony of the family.
3) The patient may be passively euthanized by stopping medical treatment, chemotherapy, dialysis, artificial respiration, blood transfusion, IV drip, etc.
For active euthanasia, four conditions must be met:
1) The patient must be suffering from unbearable physical pain.
2) Death must be inevitable and drawing near.
3) The patient must give consent. (Unlike passive euthanasia, living wills and family consent will not suffice.)
4) The physician must have (ineffectively) exhausted all other measures of pain relief.”
The United States is a wildly divided country on so many controversial issues. Everything from marijuana legislation and the legalization of same-sex marriage to euthanasia and assisted suicide laws spark such incredible debate among American lawmakers and the American population as a whole. Like the aforementioned hot button political issues, state laws, not the federal government, generally decide the legality of euthanasia and assisted suicide as the federal government has been hesitant to wade into the debate on end of life laws. Passive euthanasia is legal throughout the United States as patients are legally entitled to refuse treatment if they want, but active euthanasia is illegal in all 50 states. Assisted suicide is legal in five states: Vermont, New Mexico, Oregon, Washington and Montana.
In Germany an ill patient has the right to refuse, by written order, any treatment that a doctor may believe will prolong or even save their life. Furthermore, assisted suicide is semi-legal in Germany, where a doctor, again upon written order from the patient, is legally able to provide the ill patient with drugs that will shorten their life. Doctors are also permitted to take a patient off life support with consent, but doctors are not permitted to end the life of a patient in any way. Therefore both passive assisted suicide and passive euthanasia are legal, but active assisted suicide and active euthanasia are illegal in Germany.
While assisted suicide has been legal in Switzerland since the 1930s, active euthanasia remains illegal. In Switzerland, it is legal for doctors to prescribe a lethal dose of drugs to a patient, as long as the patient is the one taking the active role in administering the dose. In Switzerland, not only the Swiss can benefit from a doctor’s prescription of lethal drugs to end an ill patient's life, as many terminal foreigners also travel to Switzerland in order to die on their own terms. Furthermore, when it comes to the administration of the lethal drugs to end one's life, a physician does not even need to be involved in the actual suicide, making Switzerland’s assisted suicide laws the most unique on the planet.
Although much of the medical community in Luxembourg was in fact against the legal precedent, in 2009 Luxembourg still became the third nation in the world to fully legalize euthanasia. A patient in Luxembourg has the right to die if they are terminally ill and have asked to do so more than once. After seeking the right to die, the patient’s request must be approved by not only two different doctors, but also a panel of experts who will judge the patient’s understanding and rational ability to undertake such a decision.
Euthanasia has been legal in Belgium for over a decade. The country’s euthanasia laws are extremely comprehensive and to some very progressive; to others Belgium’s euthanasia laws are dangerous. As of now, any patient with a "futile medical condition of constant and unbearable physical or mental suffering that cannot be alleviated" may request euthanasia. In 2013 the government opened a debate, and then voted in favor, to extend the administration of voluntary euthanasia to terminally ill children in unbearable pain who are able to fully comprehend the meaning of euthanasia. The parents of the ill child and the child’s doctors must also support the decision of the young patient in order to uphold the voluntary euthanasia.
The first country in the world to legalize euthanasia, the Netherlands formally passed the law in 2002, though the practice of euthanasia had been tolerated in certain cases since the 1970s. Though anyone 12 years of age or older can request euthanasia, the requirements for euthanasia are very strict in the Netherlands, and only apply to patients with a terminal condition who are living in unbearable suffering. Furthermore, the patient must be in full control of their mental faculties when they request euthanasia. A second doctor also judges each case before the procedure is undertaken. After the death of the patient, a committee consisting of a doctor, a medical ethics expert and an expert in law review the case.