In 2015, Canada’s top court struck down a doctor-assisted suicide ban, and in 2016, lawmakers passed legislation to make medically assisted dying—by clinician-administered lethal injection or by lethal prescription—legal for incurably ill adults. In the first six months after legalization, at least 744 people died this way—only a handful through self-administration, while the rest have elected for the injection.
Medical aid-in-dying for terminally ill adults became legal in Oregon in 1997, and several states have since followed suit. (See US map.)
Although Colombia’s Supreme Court had removed penalties for mercy killing and ruled that euthanasia be permitted back in 1997, the ruling wasn’t implemented until 2015, when the Health Ministry finally issued a court-required protocol for physicians carrying out the practice. Before performing euthanasia, doctors must obtain authorization from a committee comprised of a psychologist, a doctor specialized in the patient’s condition, and a lawyer.
Although helping somebody take their own life had been considered legal in “exceptional circumstances” since 1994, the Netherlands passed legislation to regulate both medical aid-in-dying and euthanasia in 2002 after two decades of court cases. Since then, the number of assisted deaths has nearly tripled; In 2014 and 2015, more than 5,000 patients each year chose to end their lives by one of these means, accounting for about 4 percent of total deaths.
Euthanasia was legalized in 2002 for adults even without terminal illnesses. More than 1,800 people died with assistance (by euthanasia or prescription) in 2013. A 2014 amendment included patients under age 18, provided the child was deemed able to understand the meaning of euthanasia. In 2016, a 17-year-old became the first to make use of this amendment.
Medical aid-in-dying is legal provided it is carried out with “altruistic motives,” according to legislation passed in Germany in late 2015. In March 2017, the government ruled that while purchasing lethal drugs remains generally illegal, exceptions should be allowed for patients who are incurably ill and suffering.
By a 1942 Swiss law, assistance in dying (not only by a doctor) can be prosecuted only if the person assisting has “selfish motives.” The country is home to Dignitas and other organizations that provide end-of-life services to residents and, controversially, to nonresidents, leading to what some critics have termed “suicide tourism.” Switzerland also does not require patients to be terminally ill to qualify. The number of confirmed cases is on the rise; one of the largest organizations, Exit, reported 782 cases in 2015, up from 583 the previous year.
In 2009, Luxembourg enacted legislation legalizing both medical aid-in-dying and euthanasia. The law applies to patients with “grave and incurable” conditions who have indicated a preference for the procedure in a living will or advance directive. In the first five years after legalization, 34 deaths were registered.