Euthanasia in Europe: Self-determination, protection of life, advance directives

As of July 2026

This article arose from a very specific event. Within a short period of time, the topic of euthanasia has once again prominently resurfaced in public debate: in Austria through the initiative to further develop and professionalize assisted suicide, and in France through the parliamentary initiative for aide à mourir, i.e., legally regulated assistance in dying.

Both developments demonstrate that the question of assisted dying is not settled. It is resurfacing—legally, politically, medically, ethically, and on a profoundly human level. And it demands more than quick slogans. It demands precise definitions, careful comparisons, reliable sources, and a stance that takes seriously both the protection of vulnerable individuals and the self-determination of those capable of making their own decisions.

This article is aimed at people who are not satisfied with buzzwords: those affected, relatives, doctors, caregivers, lawyers, humanists, political leaders — and all those who want to understand what euthanasia, assisted suicide, advance directives and refusal of treatment are really about.

This text is dedicated as a thank you to Ulla Bonnekoh, founder of Infopunkt.Sterbehilfe ( Assisted Dying Infopoint)., and to Dr. Christina Kaneider, President of the Austrian Society for a Humane End of Life, for their difficult, often misunderstood and socially necessary work.

End-of-life education is not an abstract debate; it means not leaving people alone in existential situations, replacing fear with information, taboos with language, and paternalism with responsible self-determination.

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The debate about euthanasia is often conducted with great moral conviction, but with surprisingly imprecise terminology. Yet it is precisely this conceptual precision that determines whether one is talking about punishable killing, permissible alleviation of suffering, lawful withdrawal of treatment, assisted suicide, or binding patient autonomy.

Anyone wishing to seriously compare the legal situation in Europe must therefore distinguish at least five categories: active direct euthanasia , assisted suicide , active indirect euthanasia , passive euthanasia or withdrawal of treatment , and advance directives . In addition, there is the specific question of whether a state has created its own euthanasia or advance directive law, or whether the legal situation is primarily shaped by court decisions, criminal law, medical practice, and case-by-case assessment. [2] [3] [4] [19] [20] [21] [22] [23]

The European Union currently has 27 member states. Within these 27 countries, there is no uniform European regulation on euthanasia. The EU itself is not competent in this matter in the sense that it could prescribe a uniform model to its member states. The European Parliament’s Research Service notes that Belgium, Spain, Luxembourg, and the Netherlands have regulations in place that permit physician-assisted euthanasia. Germany, Italy, and Austria are listed as countries where assisted suicide is possible, with Austria having created its own legal framework for this in the form of the Law on the Right to Dying. [1] [2] [4] [5]

Switzerland and the United Kingdom are not EU member states, but they must be included in any European comparison. Switzerland is the most important European special model for assisted suicide outside the EU. The United Kingdom, on the other hand, presents a different situation: legally binding advance decisions or living wills, continued criminalization of euthanasia and assisted suicide, but at the same time a very active parliamentary reform process in England and Wales and a failed reform attempt in Scotland. [27] [28] [29] [30] [32] [33]

1. The basic concepts

1.1 Active direct euthanasia

Active direct euthanasia means that a third party intentionally brings about death. Typically, a doctor administers a lethal drug. The final act ending life is therefore not performed by the person wishing to die, but by another person.

The JKU diploma thesis “The Right to Life and Death – Euthanasia in the EU” clearly describes this category for Austria: Active direct euthanasia is prohibited there and, depending on the case, can fall under murder, killing on request, or assisted suicide. The crucial difference to assisted suicide lies in who performs the final act. [4]

Active euthanasia remains illegal in Germany. Stiftung Warentest, MDR, November.de, and KSV Polizeipraxis also differentiate between active euthanasia, indirect euthanasia, passive euthanasia, and assisted suicide in their descriptions of the German legal situation. [9] [10] [11] [12]

1.2 Assisted suicide

In assisted suicide, the person wishing to die takes the lethal substance themselves or carries out the final, life-ending act themselves. Other people can provide information, accompany the person, supply the substance, or offer organizational assistance. Crucially, however, the person in question retains control over the final act.

This distinction is central to many legal systems. Austria permits assisted suicide under strict conditions via its Death Decree Act, but not active euthanasia. Following a ruling by the Federal Constitutional Court, Germany recognizes a fundamental right to self-determined death, but to date has not established a comprehensive legal framework for such procedures. [4] [5] [8] [12] [13]

Especially in German law, the “point of no return” is important: Who controls the final act that leads directly and irrevocably to death? This question of control over the act distinguishes between non-punishable assisted suicide and punishable homicide. [12]

1.3 Active indirect euthanasia

Active indirect euthanasia refers to palliative measures aimed at alleviating suffering, even if a shortening of life is a possible unintended or accepted side effect. This typically involves strong painkillers, sedation, or other palliative care interventions.

The crucial distinction lies in the intention. If death is deliberately brought about, it is active direct euthanasia. If, on the other hand, suffering is alleviated and a possible shortening of life is merely accepted as a side effect, it is active indirect euthanasia or palliative care. [4] [9] [10] [11] [12] [19] [21]

1.4 Passive euthanasia / withdrawal of treatment / limitation of treatment

Passive euthanasia means that life-sustaining or life-prolonging measures are not initiated, limited, or discontinued. Typical examples include foregoing resuscitation, discontinuing artificial ventilation, or foregoing artificial nutrition.

The term “passive euthanasia” is widespread, but not always precise. Legally, “withdrawal of treatment , ” “limitation of treatment,” or “refusal of treatment” are often more accurate . This is because the aim is not to kill a person, but rather to prevent the continuation of medical treatment against their will. The JKU study describes that in Austria, passive euthanasia is permissible if it is in accordance with the express or presumed will of the person concerned. For Germany, KSV Polizeipraxis outlines the development from the older concept of passive euthanasia to the justified withdrawal of treatment in accordance with the patient’s wishes. [4] [12]

1.5 Advance directive

An advance healthcare directive is not active euthanasia. It is also not assisted suicide. It is an instrument of patient autonomy.

In an advance healthcare directive, a person specifies in advance which medical treatments they refuse if they later become incapacitated. This does not protect a right to be killed, but rather the right not to have to undergo medical treatment against their will.

In Austria, the Patient Decree Act is the governing law. The current eight-year period for legally binding advance directives is important, unless a shorter period has been specified. Earlier or inaccurate secondary information stating five years must therefore be corrected to reflect the current Austrian legal situation. [6]

International comparisons also show that advance directives, living wills, or directives anticipées are often significantly more widespread than active euthanasia or assisted suicide. Advance directives are therefore not merely a fringe issue, but rather the norm for legal self-determination at the end of life. [22] [23] [24] [29]

2. The core European situation

Of the 27 EU member states, five currently have a clear, valid law on euthanasia or assisted dying in the narrower sense:

Belgium, Luxembourg, the Netherlands, Spain and Austria.

Of these , Belgium, Luxembourg, the Netherlands, and Spain permit active physician-assisted suicide or euthanasia. Austria does not permit active direct euthanasia but has created its own legally regulated path for assisted suicide with the Law on the Right to Decide on Dying. [2] [4] [5] [7]

Germany does not have a comprehensive law on assisted suicide. According to the jurisprudence of the Federal Constitutional Court, assisted suicide is fundamentally legal; however, the necessary legal framework is lacking. In 2023, the Bundestag rejected several draft laws to reform assisted suicide, but at the same time strengthened suicide prevention measures. [8] [12] [13]

Italy is also not a country with comprehensive euthanasia legislation, but it does have, under strict conditions, a legal framework for assisted suicide. [2] [3] [19] [23]

France is not yet formally a law permitting active euthanasia or assisted suicide, but is in advanced stages of legislation on aide à mourir . At the same time, France already recognizes legally binding advance directives and a right to continuous deep sedation under certain conditions. [14] [15] [16] [17] [18] [24] [25] [26]

Portugal is a borderline case: Parliament has passed relevant legislation, but according to the European Parliament’s classification, it has not entered into force due to presidential vetoes and constitutional court rulings. [2]

Slovenia is a unique case: a law on assisted suicide was passed by parliament, but later rejected in a referendum. [31]

3. Extended overview table: EU member states, Switzerland and the United Kingdom

No.	State	Active euthanasia	Assisted suicide	Euthanasia Act	Advance directive / refusal of treatment	Classification
1	Belgium	Yes	Yes, within the framework of the regulation	Yes	PV binding	Liberal Benelux model; active euthanasia is legally regulated.
2	Bulgaria	No	No	No	Unclear / Detailed review required	No assisted suicide law was found in the evaluated sources.
3	Denmark	No	Criminal / no legal access	No	PV mandatory; register model based on comparative sources	No euthanasia, but advance healthcare directives are highly developed.
4	Germany	No	Yes, legally possible.	No, not a comprehensive new law.	PV binding	Theoretically open, but practically uncertain under the law.
5	Estonia	No	No clear legal regulation	No	Unclear / Detailed review required	No assisted suicide law was found in the evaluated sources.
6	Finland	No	No clear legal access to medical care	No	PV generally accepted / detailed review required	No law on assisted suicide.
7	France	No yet.	Not yet / in process	No, but aid to die in the proceedings	PV binding; palliative sedation regulated	Europe’s central reform project.
8	Greece	No	Criminal / no legal access	No	PV is not binding according to comparison sources.	Restrictive approach.
9	Ireland	No	Criminal / no legal access	No / Reform debate	PV binding	PV yes, euthanasia no.
10	Italy	No	Legally possible in strict cases.	No comprehensive law	PV is mandatory under certain conditions.	A legal model with strict conditions.
11	Croatia	No	No / no clear legal regulation	No	Unclear / Detailed review required	No law on assisted suicide.
12	Latvia	No	No / no clear legal regulation	No	Unclear / Detailed review required	No law on assisted suicide.
13	Lithuania	No	No / no clear legal regulation	No	Unclear / Detailed review required	No law on assisted suicide.
14	Luxembourg	Yes	Yes	Yes	PV binding; provisions regarding the end of life	A particularly clear model of conditional decriminalization with a control commission.
15	Malta	No	No	No / discussed	Unclear / Detailed review required	No current law on assisted suicide.
16	Netherlands	Yes	Yes	Yes	PV binding	European core model with medical due diligence criteria and control committees.
17	Austria	No	Yes, via a death directive	Yes: Death Directive Act	PV binding; generally valid for eight years	Independent special path: no active euthanasia, but regulated assisted suicide.
18	Poland	No	Punishable	No	PV is not binding according to comparison sources.	Particularly restrictive policy; assisted suicide is a criminal offense.
19	Portugal	Legally provided	Legally provided	Borderline case: decided upon, but not effectively implemented	PV / Testamento vital with register model	Politically decided, legally/practically blocked.
20	Romania	No	No / no clear legal regulation	No	Unclear / Detailed review required	No law on assisted suicide.
21	Sweden	No	No legal medical access	No	PV situation restrictive / detailed review required	No law on assisted suicide.
22	Slovakia	No	No / no clear legal regulation	No	Unclear / Detailed review required	No law on assisted suicide.
23	Slovenia	No	No	No; reform attempt stopped by referendum	Unclear / Detailed review required	Legislative attempt failed.
24	Spain	Yes	Yes	Yes	PV binding	Since 2021, one of the clear EU euthanasia models.
25	Czech Republic	No	Criminal / no legal access	No	PV is generally recognized	No euthanasia, but the patient’s wishes are legally relevant.
26	Hungary	No	No clear legal access	No	PV under conditions / detailed review required	No law on assisted suicide.
27	Cyprus	No	No / discussed	No	Unclear / Detailed review required	No current law on assisted suicide.
28	Switzerland	No, active killing on request is a criminal offense.	Yes, under certain conditions	No EU model; criminal law model according to Art. 115 of the Criminal Code.	PV / treatment waiver recognized	Special case: Assisted suicide for non-selfish motives is not punishable; relevant because of death tourism.
29	United Kingdom / England & Wales	No	Currently a criminal offense; reform is politically pending or a new attempt is being made.	No current assisted suicide law	Advance Decision / Living Will is binding if valid and relevant.	A highly dynamic reform case; no law currently in force.
30	Scotland	No	Punishable; legislative attempt failed in 2026	No applicable law	Advance decision / patient will relevant	The reform attempt was rejected in 2026.

4. Country groups and models

4.1 Benelux and Spain: the countries with active euthanasia

The Netherlands, Belgium, Luxembourg, and Spain form the liberal core group within the EU. In these countries, not only assisted suicide but also active physician-assisted euthanasia is permitted under certain legal conditions. [2] [3] [4] [7] [19] [20] [23]

The Netherlands was the first country to legally regulate active euthanasia. Since 2002, it has had a legal framework for ending life on request and assisted suicide. Key elements include medical due diligence criteria, verification of the voluntary and well-considered wish, the requirement of unbearable suffering, and subsequent review by regional commissions. [4] [20] [22]

Belgium followed suit with its own euthanasia law. Here, too, the key elements are capacity to make decisions, a serious and repeated request, written documentation, unbearable suffering, and a medical assessment. Belgium is also notable for allowing minors access to active euthanasia under very strict conditions. [4] [19] [22]

Luxembourg is particularly useful for comparison because the official brochure clearly explains that the law does not simply legalize euthanasia. It is a conditional decriminalization : outside the legal framework, euthanasia and assisted suicide remain criminal offenses. Only medical interventions under the legal conditions, subject to review by the National Commission for Control and Evaluation, are exempt from punishment. [7]

A particularly important aspect of the Luxembourg model is that euthanasia and palliative care were not pitted against each other. Luxembourg adopted parallel regulations on palliative care, advance directives and end-of-life care, as well as on euthanasia and assisted suicide. The legislature aimed to strengthen palliative care on the one hand, and to respect the freedom of choice of terminally ill people at the end of their lives on the other. [7]

Since 2021, Spain has been among the EU member states with legally regulated euthanasia. Current EU overviews therefore list Spain, along with Belgium, Luxembourg, and the Netherlands, as a country with physician-assisted euthanasia. [2] [3] [19]

4.2 Austria: the regulated special path

Austria is not among the countries that permit active euthanasia. Active killing on request remains prohibited. Nevertheless, Austria is a „yes“ country in the category of „euthanasia/determination law“ because, since 2022, the Determination Act has provided a legally regulated avenue for assisted suicide. [4] [5]

This process is highly formalized. The person wishing to die must be of legal age and capable of making their own decisions. The decision must be made freely and autonomously. A serious or incurable illness with unavoidable suffering must be present. Two medical consultations are required, one of which must be with a palliative care specialist. Waiting periods, documentation, and notarization or the establishment of a patient advocacy document are intended to prevent abuse. [4] [5]

The Austrian advance directive is distinct from this. It does not concern assisted suicide, but rather the refusal of medical treatment in the event of future incapacity to make decisions. It is a classic instrument of patient autonomy. Current legislation generally provides for an eight-year period for legally binding advance directives, unless a shorter period is specified. [6]

4.3 Germany: Fundamental rights without procedure

Germany is not a state with a legally binding assisted suicide law in the strict sense. At the same time, however, Germany is no longer a classic prohibition state either.

In 2020, the Federal Constitutional Court declared the ban on the commercial promotion of suicide unconstitutional and recognized the right to self-determined death. This also includes the possibility of seeking assistance from third parties. [8] [12]

The practical weakness lies in the lack of procedural law. Doctors, patients, relatives, and organizations do not have sufficient clarity regarding the required counseling, waiting periods, documentation, assessments, and access to medication. Stiftung Warentest, MDR, November.de, and KSV Polizeipraxis demonstrate, to varying degrees, that active euthanasia remains prohibited, but passive and indirect euthanasia may be permissible, guided by the patient’s wishes. [9] [10] [11] [12]

In 2023, the German Bundestag rejected several draft laws regulating assisted suicide. At the same time, a motion to strengthen suicide prevention was adopted. This clearly illustrates the situation in Germany: the fundamental right to assisted suicide is open, but a coherent political and legal framework is lacking. [13]

4.4 France: from a state of „no“ to a case for reform

France was long a state that rejected active euthanasia and assisted suicide. French law treated active euthanasia as a strict criminal offense; the consent of the person concerned did not justify active killing. [4] [25]

At the same time, France already has important instruments at the end of life: withdrawal of treatment, indirect euthanasia, legally binding advance directives , and, under certain conditions, continuous deep sedation until death. The scholarly article on the French legal situation describes the development of the Claeys-Leonetti Law and the significance of deep sedation; the official public service website presents French advance directives as an expression of the will to continue, limit, discontinue, or refuse medical treatment. [24] [26]

The current reform process regarding assisted suicide is well advanced. The National Assembly is conducting a separate legislative dossier on this; Welt, Tagesschau, Ärzte Zeitung, and Der Standard all report on the parliamentary steps and the proposed requirements. These include, in particular, legal adulthood, capacity to make decisions, serious and incurable illness, an advanced or terminal stage, persistent physical or psychological suffering, medical examination, and, in principle, self-administration of the lethal substance. [14] [15] [16] [17] [18]

France is therefore not simply „no“, but rather „no“ / in the process : no valid euthanasia law in the sense of the Benelux models, but a concrete, politically advanced reform project.

4.5 Portugal and Slovenia: what is decided is not always valid law

Portugal shows that a parliamentary decision does not automatically create effective legislation. Although the Portuguese parliament passed a law on euthanasia, according to the European Parliament’s EPRS, it has not entered into force due to presidential vetoes and constitutional court rulings. [2]

Slovenia presents a different form of deadlock: a law on assisted suicide was introduced politically but rejected in a referendum. Reuters reported the majority rejection of the law in 2025. Slovenia is therefore an important case study regarding the extent to which existential rights to self-determination are made dependent on majority decisions. [31]

4.6 Poland: restrictive, but not one-dimensional socially

Poland represents a particularly restrictive approach. The JKU study describes Poland as a state that rejects euthanasia in all its forms and prosecutes it under criminal law. [4]

In terms of criminal law, Article 151 of the Polish Penal Code is central: Anyone who induces or assists a person to commit suicide is liable to imprisonment. [34]

The Polish Constitution protects life; the official German version of the Constitution is relevant as a source, but was technically only accessible to a limited extent and should therefore not be used as the sole authoritative source. [35]

Nevertheless, Polish society is not one-dimensional. The article from Das Parlament shows that while the social debate is reserved, the attitude of the population cannot necessarily be completely equated with a strictly church-conservative line. [36]

4.7 Switzerland: Special model outside the EU

Switzerland is not an EU member state, but it is indispensable for the European euthanasia debate.

Switzerland does not permit active, direct euthanasia. Killing on request remains a criminal offense. At the same time, assisted suicide is not punishable if it is not carried out for selfish reasons. This is a fundamentally different model than in Belgium, Luxembourg, the Netherlands, or Spain. There, statutory medical procedures exist for euthanasia and assisted suicide; in Switzerland, a criminal law framework is central. [27]

SRF reports that the number of people using assisted suicide in Switzerland has increased; in 2022, there were almost 1,600 people residing in Switzerland. SRF also points out that Switzerland is relevant for foreign nationals due to its legal situation. [27]

Swissinfo explores this issue of so-called „death tourism“ in greater depth. People from more restrictive countries travel to Switzerland to access assisted suicide. From a humanist perspective, this is important because it highlights social inequality: those with money, mobility, information, and organizational support can avoid it. Those who are poor, immobile, alone, or poorly informed remain at the mercy of the restrictive national system. [28]

4.8 United Kingdom: legally binding advance directives, but euthanasia remains controversial

The United Kingdom is no longer an EU member state since Brexit, but it is relevant to European comparisons. In England and Wales, Advance Decisions to Refuse Treatment are legally binding if they are valid and applicable to the specific situation. The NHS also clarifies that a refusal of treatment is different from a request to be killed or to receive assistance with suicide. [29]

Politically, the United Kingdom is in a state of flux. The Terminally Ill Adults (End of Life) Bill for England and Wales was debated in the British Parliament. Reuters reported in 2026 on a renewed attempt after the previous legislative effort stalled in the House of Lords. [30] [33]

Scotland must be considered separately. A bill on assisted dying was rejected there in 2026. Reuters reports the vote result: 57 in favor, 69 against, and one abstention. [32]

The United Kingdom thus represents an intermediate position: advance directives are recognized and legally relevant, but assisted suicide remains controversial and has not yet been legalized.

5. Why advance healthcare directives belong in every overview

The public debate almost always focuses on active euthanasia and assisted suicide. However, for the practical realities of many people’s lives, advance directives are at least as important.

The crucial question is often not: „Is someone allowed to actively end my life?“ but rather: „Am I allowed to prevent my body from receiving further medical treatment against my will?“

This question affects many situations: artificial ventilation, artificial nutrition, resuscitation, intensive care treatment, stressful operations, chemotherapy, dialysis, antibiotic treatment at the end of life or sedation.

An advance healthcare directive protects individuals from undue medical control. It compels doctors to respect the previously expressed wishes of the patient. This applies, albeit in varying forms, in several European legal systems. It is particularly evident in Austria, Germany, France, and the United Kingdom. [4] [6] [9] [12] [24] [29]

International guides also point out that advance directives can encounter practical and legal limitations at national borders. A German or Austrian advance directive is not automatically binding in the same way abroad. Translations, country-specific documents, and knowledge of national regulations are therefore particularly important for people who travel or live permanently abroad. [22] [23]

6. Scientific and political lessons from the comparison

6.1 Euthanasia is not a simple yes/no issue

The sources show that the simple „allowed“ or „forbidden“ dichotomy is insufficient. A state can prohibit active euthanasia but allow passive euthanasia. It can make advance directives legally binding but prohibit assisted suicide. It can legally permit assisted suicide but not create a procedural law. It can pass a law that is practically ineffective. [2] [4] [9] [12] [19] [20] [21]

6.2 Legal certainty is itself a protected interest

Germany demonstrates that a constitutionally recognized right to self-determination without a procedure creates uncertainty. If it is unclear who is allowed to help, who conducts the assessment, what counseling entails, what waiting times apply, how decision-making capacity is determined, and how doctors are legally protected, then the right remains abstract. [8] [12] [13]

6.3 Palliative care and euthanasia must not be played off against each other

Luxembourg and France demonstrate that it would be wrong to treat palliative care and euthanasia as opposites. A humane system must provide both: the best possible care, pain management, psychosocial support, and hospice work—while simultaneously respecting a free, persistent, and considered wish to die in extreme situations. [7] [14] [16] [17] [26]

6.4 The final act is legally decisive

Many legal systems differentiate based on who performs the final act ending life. If the patient acts herself, it is called assisted suicide. If a third party administers the lethal substance, it is called active euthanasia. This distinction is particularly prevalent in Austria, Germany, Switzerland, and the United Kingdom. [4] [5] [8] [12] [27] [29]

6.5 Restrictive laws do not eliminate the desire to die.

Switzerland shows that restrictive national regulations do not make the desire to die disappear. They can simply shift it abroad. Those who are mobile, informed, and financially able can exploit a legal loophole or alternative. Those who cannot are left behind. [27] [28]

From a humanistic perspective, this is not a marginal problem, but a problem of justice.

7. An unequivocally humanistic position on euthanasia

From a humanist perspective, the debate does not begin with the state , not with a church, not with a medical code of conduct , and not with the fears of relatives . It begins with the individual .

Man belongs to himself.

This is the crux of the matter. The state does not own the individual. No religious community owns them. Medicine does not own them. The family does not own them. Not even an abstract idea of ​​“protecting life“ owns them. The individual is not the property of an institution and not merely an object of others‘ care. It follows unequivocally from this that a competent adult has the right to decide about medical treatment. They may accept treatment. They may refuse treatment. They may refuse life-sustaining measures. They may stipulate in an advance directive what should not happen to them. And they may demand that their will be respected even if others find it morally, religiously, or emotionally difficult to bear.

This is the first humanistic principle:

No person may be medically detained against their free will.

The second principle is equally important:

No one should be driven to their death.

A humane society must never misuse euthanasia as a substitute for care, palliative care, social support, pain management, psychotherapy, or human connection. No one should have to want to die because they are poor. No one should have to want to die because they lack care. No one should have to want to die because they feel like a burden. No one should have to want to die because relatives, institutions, or insurance companies exert pressure. Therefore, a humanistic position is not: „Assisted dying as quickly and easily as possible.“ It is:

Self-determination, yes — but protected, verified, informed and free from pressure.

Anyone who is of legal age, capable of making their own decisions, informed, free from coercion, and who, after serious counseling, arrives at a stable wish to die, must not be declared legally incompetent. Such a person must not be forced to continue a state of suffering that they themselves experience as unbearable and for which, after being informed, they see no acceptable alternative. A protection of life that forces a person to continue suffering against their clear will no longer protects dignity. It then only protects biological continuation. But dignity is more than pulse, respiration, and metabolism. Dignity means being taken seriously as a person—even at the end of life.

Humanistically, therefore, a clear line is:

Yes to legally binding advance directives.
Yes to the right to refuse treatment.
Yes to comprehensive palliative care.
Yes to suicide prevention where weariness of life is an expression of crisis, loneliness, depression, or social hardship.
Yes to strict safeguards against abuse.
Yes to the freedom of conscience of physicians.
But equally clear: Yes to the free, informed, permanent, and verified wish to die of a competent person in situations of extreme suffering.

This is not a contempt for life. This is respect for the person who lives this life. Euthanasia must never be a cheap answer to inadequate care. But prohibiting all assistance must also not be the cheap answer of a society that fears the autonomy of dying people.

Humanism is not about calling for death.Humanism is about fighting against a degrading death.Humanism is not about letting people die because they become a nuisance.Humanism is about not making people suffer against their will because others cannot bear their death.

The standard is therefore not religious dogma, not state paternalism, and not medical pride in feasibility. The standard is the free, informed, and sincere will of a person—embedded in protection, care, guidance, and the best possible treatment.

Self-determination at the end of life is not an attack on human dignity. It is its final test.

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Sources

[1] European Union: EU countries.
Official overview of the 27 EU member states.
https://european-union.europa.eu/principles-countries-history/eu-countries_en

[2] European Parliamentary Research Service: Euthanasia legislation in the EU. Briefing, 11 September 2025.
Central current overview of euthanasia legislation in the EU; in particular Belgium, Luxembourg, the Netherlands, Spain, Austria, Germany, Italy, Portugal and France.
https://www.europarl.europa.eu/thinktank/en/document/EPRS_BRI(2025)775914

[3] Cornelia Kolbeck: Euthanasia: What Germany could learn from other countries. Medical Tribune, June 30, 2026.
Comparison of Germany, the Netherlands, Canada, and other countries; helpful for understanding the legal uncertainty in Germany and for comparison with regulated models.
https://www.medical-tribune.de/politik/gesellschaft/sterbehilfe-was-deutschland-vom-ausland-lernen-koennte

[4] Nina Bauer: The Right to Life and to Death – Euthanasia in the EU. Diploma thesis, Johannes Kepler University Linz, September 2025.
Uploaded work; central scientific basis for the conceptual system, Austria, Germany, France, Poland, Benelux and comparative legal conclusion.

[5] Republic of Austria, RIS: Death Decree Act – Federal Law Consolidated.
Official Austrian legal source on the Death Decree Act.
https://ris.bka.gv.at/geltendefassung.wxe?abfrage=bundesnormen&gesetzesnummer=20011782

[6] Republic of Austria, RIS: Advance Directives Act – Federal Law Consolidated.
Official Austrian legal source on advance directives; in particular definition, binding nature and eight-year period.
https://www.ris.bka.gv.at/GeltendeFassung.wxe?Abfrage=Bundesnormen&Gesetzesnummer=20004723

PDF

euthanasia assistance suicide questions de

Clicking opens the document in full-screen reading mode.Open in reading mode

[8] Pia Lorenz: Ruling on Section 217 of the German Criminal Code: A right to assisted dying? Legal Tribune Online.
Analysis of the ruling of the Federal Constitutional Court, Section 217 of the German Criminal Code and the commercial promotion of suicide.
https://www.lto.de/recht/hintergruende/h/bverfg-217-stgb-urteilt-ueber-verbot-foerderung-selbsttoetung-geschaeftsmaessig-sterbehilfe

[9] Stiftung Warentest: Euthanasia – What is permitted in Germany.
A generally understandable explanation of the German legal situation: active, passive, and indirect euthanasia, assisted suicide, and advance directives.
https://www.test.de/Sterbehilfe-Was-in-Deutschland-erlaubt-ist-5559399-0/

[10] November.de: Euthanasia in Germany and Europe: Killing on Request.
Secondary source for the definition of terms and a comparison of Germany/Switzerland/Benelux.
https://november.de/ratgeber/sterbehilfe/

[11] MDR: Euthanasia – what is allowed and what is not.
An easy-to-understand overview of the German legal situation, hospices, passive and indirect euthanasia.
https://www.mdr.de/ratgeber/recht/sterbehilfe-aktiv-passiv-erlaubt-verboten-rechtslage-hospiz-deutschland-100.html

[12] Florian Zenger: Euthanasia in Germany – an overview of the current legal situation and recent developments. KSV Police Practice, March 27, 2024.
In-depth legal analysis of control over the act, “point of no return”, Federal Court of Justice case law, withdrawal of treatment and assisted suicide.
https://ksv-polizeipraxis.de/sterbehilfe-in-deutschland-ein-ueberblick-ueber-die-aktuelle-rechtslage-und-neueren-entwicklungen/

[13] German Bundestag: Bundestag rejects draft laws on the reform of assisted suicide. 06.07.2023.
Official source on the rejected draft laws and the adopted motion on suicide prevention.
https://www.bundestag.de/dokumente/textarchiv/2023/kw27-de-suiziddebatte-954918

[14] Assemblée Nationale: Fin de vie – Dossier législatif, 17e législature.
Official French source on the legislative process for aide à mourir .
https://www.assemblee-nationale.fr/dyn/17/dossiers/fin_de_vie_17e

[15] Welt: France’s parliament paves the way for euthanasia.
Journalistic source on the French reform process.
https://www.welt.de/politik/ausland/article256178430/Frankreichs-Parlament-macht-Weg-fuer-Sterbehilfe-frei.html

[16] Tagesschau: France’s parliament paves the way for euthanasia. May 27, 2025.
Source for the vote in the French National Assembly and the proposed conditions.
https://www.tagesschau.de/ausland/europa/frankreich-parlament-sterbehilfe-102.html

[17] Ärzte Zeitung: Euthanasia law in France clears first hurdle.
Medical policy source on the French legislative process.
https://www.aerztezeitung.de/Politik/Sterbehilfegesetz-in-Frankreich-nimmt-erste-Huerde-458715.html

[18] Der Standard: France wants to legalize euthanasia.
Journalistic analysis of the French reform process.
https://www.derstandard.at/story/3000000271490/frankreich-will-sterbehilfe-gelassen

[19] Der Standard: Different approaches to the topic of euthanasia in Europe.
Older European overview; suitable for distinguishing terms and historical contextualization, only supplementary for current counts.
https://www.derstandard.at/story/2000130685056/unterschiedliche-zugaenge-zum-thema-sterbehilfe-in-europa

[20] Euronews: Where in Europe is euthanasia legal? 01.05.2018.
Older overview of euthanasia in Europe; historically useful, but in need of updating.
https://de.euronews.com/gesundheit/2018/05/01/sterbehilfe-in-europa

[21] Federal Agency for Civic Education: Legal situation regarding euthanasia in the European Union. Infographic.
Older overview source on the legal situation in the EU; use as a contextual source.
https://www.bpb.de/fsd/infografik_sterbehilfe/infografik_sterbehilfe.html

[22] Advance Directive.digital: Euthanasia abroad – legal framework and practical advice.
A layperson-friendly secondary source on euthanasia abroad and the cross-border significance of advance directives.
https://www.patientenverfuegung.digital/blog/sterbehilfe-im-ausland/

[23] German Society for Humane Dying: A Look Beyond Borders. Regulations on Advance Directives and Euthanasia in Selected Countries.
Comparative overview of advance directives and euthanasia abroad; for Austria, correction by RIS.
https://www.dghs.de/service/selbstbestimmtes-sterben-infocenter/sterbehilfe-ausland/

[24] République Française, Service-Public: Directives anticipées: dernières volontés sur les soins en fin de vie.
Official French source on living wills / directives anticipées.
https://www.service-public.gouv.fr/particuliers/vosdroits/F32010

[25] Cabinet ACI: Le traitement pénal de l’euthanasie.
Französische krimirechtliche Einordnung aktiver Euthanasie.
https://www.cabinetaci.com/le-traitement-penal-de-leuthanasie/

[26] Régis Aubry: End-of-life, euthanasia, and assisted suicide: An update on the situation in France. ScienceDirect.
Article on the French legal and healthcare situation at the end of life.
https://www.sciencedirect.com/science/article/abs/pii/S0035378716301254

[27] SRF: Euthanasia in Switzerland – an overview.
Overview of the Swiss legal situation, assisted suicide and the distinction from active euthanasia.
https://www.srf.ch/news/schweiz/nach-bundesgerichtsentscheid-sterbehilfe-in-der-schweiz-ein-ueberblick

[28] Swissinfo: Assisted suicide – Switzerland no longer wants to pay for foreigners.
Source on assisted suicide tourism, Switzerland as a destination for foreigners wishing to end their lives, and the cost debate.
https://www.swissinfo.ch/ger/sterbehilfe/die-schweiz-will-nicht-l%C3%A4nger-f%C3%BCr-den-sterbetourismus-zahlen/88798638

[29] NHS: Advance decision to refuse treatment / living will.
Official UK health source on Advance Decisions / Living Wills in England and Wales.
https://www.nhs.uk/tests-and-treatments/end-of-life-care/planning-ahead/advance-decision-to-refuse-treatment/

[30] UK Parliament: Terminally Ill Adults (End of Life) Bill.
Official source on the UK legislative process for England and Wales.
https://bills.parliament.uk/bills/3774

[31] Reuters: Majority of Slovenians voted against law on assisted dying. 23.11.2025.
Source on the Slovenian referendum and the rejection of the law.
https://www.reuters.com/business/healthcare-pharmaceuticals/majority-slovenians-voted-against-law-assisted-dying-2025-11-23/

[32] Reuters: Scottish lawmakers vote against allowing assisted dying. 17.03.2026.
Source for the rejection of the Scottish bill.
https://www.reuters.com/business/healthcare-pharmaceuticals/scottish-lawmakers-vote-against-allowing-assisted-dying-2026-03-17/

[33] Reuters: UK to debate assisted dying again after previous attempt to change law failed. 15.06.2026.
Source for the renewed British legislative attempt.
https://www.reuters.com/business/healthcare-pharmaceuticals/uk-debate-assisted-dying-again-after-previous-attempt-change-law-failed-2026-06-15/

[34] LexLege: Kodeks karny, Art. 151.
Polish penal provision on incitement or assistance to suicide.
https://lexlege.pl/kk/art-151/

[35] Sejm: Constitution of the Republic of Poland, German version.
Official Polish constitutional source; technically with access restrictions / human verification, therefore only use as a primary source after manual review.
https://www.sejm.gov.pl/prawo/konst/niemiecki/kon1.htm

[36] The Parliament: Deaf Silence – Euthanasia is not debated in society.
Older analysis of the Polish debate and societal reluctance.
https://www.das-parlament.de/2014/47-48/thema-der-woche/lautes-schweigen

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Assisted dying organizations, patient rights initiatives and right-to-die networks for a self-determined end of life in the EU, UK and Switzerland

country	Assisted dying organizations and initiatives	Brief review
1. Particularly relevant from an operational or practical perspective
Germany	DGHS – German Society for Humane Dyinghttps://www.dghs.de/Dignitas Germanyhttps://dignitas.de/Association for assisted dyinghttps://www.sterbehilfe.de/Information point. Euthanasiahttps://infopunkt-sterbehilfe.de/	Practically relevant assisted suicide organizations or information platforms.
Netherlands	NVVE – Nederlandse Vereniging voor een Vrijwillig Levenseindehttps://www.nvve.nl/Euthanasia Expertise Centerhttps://expertisecentrumeuthanasie.nl/Stichting De Einderhttps://www.deeinder.nl/Stichting De Vrede Pilhttps://devredigepil.nl/Stichting Levenseinderegiehttps://www.levenseinderegie.nl/Coöperatie Laatste Wilhttps://laatstewil.nu/	A highly developed end-of-life care landscape; implementation is predominantly carried out by doctors in a legal and medical capacity, supplemented by advisory and support structures.
Switzerland	EXIT German Switzerlandhttps://www.exit.ch/EXIT ADMD Suisse romandehttps://exit-romandie.ch/Dignitashttps://dignitas.ch/Lifecirclehttps://www.lifecircle.ch/Pegasos Swiss Associationhttps://pegasos-association.com/Athanasioshttps://www.athanasios.ch/	Classic model of private assisted suicide associations; an internationally highly visible and practically relevant organizational landscape.
2. Strong advocacy, patient rights, or right-to-die organizations
Belgium	ADMD Belgique – Association for the Droit de Mourir dans la Dignitéhttps://www.admd.be/Law on Waardig Die – RWShttps://rws.be/	Strong patient rights and right-to-die organizations; euthanasia is carried out within the statutory health system.
France	ADMD Francehttps://www.admd.org/Le Choix – Citoyens pour une mort choisiehttps://choisirmafindevie.org/AAVIVRENo reliably active direct link found; historically associated with aavivre.fr.Ultimate Libertyhttps://ultimeliberte.net/	Highly active reform and self-determination organizations in a dynamic legal policy debate.
Ireland	End of Life Irelandhttps://www.endoflifeireland.ie/Irish Doctors Supporting Medical Assistance in Dyinghttps://www.maid.ie/Humanist Association of Irelandhttps://www.humanism.ie/	Advocacy and medical reform initiative; not an operational euthanasia organization in the strict sense.
Italy	Associazione Luca Coscionihttps://www.associazionelucacoscioni.it/Legal euthanasiahttps://www.eutanasialegale.it/EXIT-Italiahttps://www.exit-italia.it/	Central civil rights and reform organizations in the area of ​​self-determination at the end of life.
Luxembourg	Mäi Wëllen, Mäi Weehttps://www.mwmw.lu/Alliance of humanists, atheists and agnostics in Lëtzebuerg – AHA Lëtzebuerghttps://www.aha.lu/	National Right-to-Die Organisation; concrete implementation within the legal medical framework.
Austria	Austrian Society for a Humane End of Life – ÖGHLhttps://www.oeghl.at/	Central Austrian organization in the field; advice, information and legal policy work on death directives and self-determined end of life.
Portugal	Direito a Morrer com DignidadeNo reliably active direct link found; often listed as a movement in sources.Associação República e Laicidade / Association for Republicanism and Secularismhttps://www.laicidade.org/	Citizens‘ movement or secular support for dying with dignity; a legally mandated, but practically and politically complex environment.
Sweden	Riksföreningen Rätten Till En Värdig Död – RTVDhttps://rtvd.se/	National Right-to-Die Organisation; focus on reform, education and self-determination.
Spain	DMD España / Asociación Federal Derecho a Morir Dignamentehttps://derechoamorir.org/DMD Catalunya / Dret a Morir Dignament Catalunyahttps://dmd.cat/	Strong patient rights and reform organizations; implementation within the legal framework via the health system.
United Kingdom	My Death, My Decisionhttps://www.mydeath-mydecision.org.uk/Friends at the End – FATEhttps://fate.scot/Dignity in Dyinghttps://www.dignityindying.org.uk/Compassion in Dyinghttps://compassionindying.org.uk/Healthcare Professionals for Assisted Dyinghttps://www.dignityindying.org.uk/take-action/healthcare-professionals-for-assisted-dying/	A broad reform landscape; assisted suicide is not generally legal, therefore the focus is on political and social reform work.
3. Indirect or secular-humanist support structures
Denmark	Ret til at dø / RTDhttps://xn--rettilatd-t8a.dk/	Right-to-die or reform organization; primarily advocacy and political support.
Estonia	NGO Kodanik / MTÜ Kodanikhttps://kodanik.eu/	Advocacy and patient rights environment; not a classic operational euthanasia organization in the narrow sense.
Finland	Oikeus Arvokkaaseen Kuolemaan – OAK ryhttps://oakry.fi/Union of Freethinkers of Finland / Vapaa-ajattelijain Liitto ryhttps://vapaa-ajattelijat.fi/	Reform and self-determination organization; additionally, secular-humanist support.
Greece	Humanist Union of Greecehttps://humanists.international/civi/profile/view/?gid=19&id=5625&reset=1	Not a traditional euthanasia organization, but a secular-humanist supporter of the debate on assisted dying.
Malta	Humanists Maltahttps://humanistsmalta.org/Assisted Dying page of Humanists Maltahttps://humanistsmalta.org/assisted-dying/	Not a traditional euthanasia organization, but a humanist campaign and support in the field of assisted dying.
Poland	Fundacja Wolność od Religii / Freedom from Religion Foundation Polandhttps://wolnoscodreligii.pl/Ateistyczna Fundacja im. Kazimierza Łyszczyńskiego / Kazimierz Łyszczyński Foundationhttps://lyszczynski.com.pl/	No specialized euthanasia organizations, but secular-humanist support structures.
Romania	Asociația Secular-Umanistă din România – ASURhttps://asur.ro/	Not a specialized euthanasia organization, but secular-humanist support.
Slovenia	Srebrna nit / Silver Threadhttps://www.srebrna-nit.si/	Advocacy organization in the field of self-determined end of life and dignified aging.
Czech Republic	Proeutanazii / Society for the Legalization of Euthanasiahttps://proeutanazii.cz/	A small but relevant reform organization working towards the legalization of euthanasia.
4. No national assisted dying organization could be found
Bulgaria	No relevant national organization is known.	The country is not listed in the overviews consulted as having its own relevant organization.
Croatia	No relevant national organization is known.	The country is not listed in the overviews consulted as having its own relevant organization.
Latvia	No relevant national organization is known.	The country is not listed in the overviews consulted as having its own relevant organization.
Lithuania	No relevant national organization is known.	The country is not listed in the overviews consulted as having its own relevant organization.
Slovakia	No relevant national organization is known.	The country is not listed in the overviews consulted as having its own relevant organization.
Hungary	No relevant national organization is known.	What is publicly visible is more of a political and legal case-by-case context than a permanent national organization.
Cyprus	No relevant national organization is known.	The country is not listed in the overviews consulted as having its own relevant organization.

RTDE (Right to Die Europe) is the European association and the global counterpart to the World Federation of Right to Die Societies , also hereCurrently active organizations can be found.