By David Jones. On 27 October 1997, ‘physician-assisted suicide became a legal medical option for terminally ill Oregonians’. There are now 25 years of reports on the implementation of the Death With Dignity (DWD) Act. These give some insight into how the practice has changed since it was first introduced. The reports are all available online and an article has just been published analysing all 25 years. What do these reports show? First and most obviously there has been a dramatic increase in numbers from 16 in 1998 to 278 in 2022. At the same time, the proportion referred for psychiatric ev ..read more

By Rebecca Limb. Assisted dying is unlawful in England and Wales. To end or assist in the ending of another’s life out of compassion for and/or at the direction of the victim is not a defence to murder. A suspect will be prosecuted where there is sufficient evidence and it is in the public interest to do so. With regards to the public policy requirement, the policy for ‘prosecutors in respect of cases of encouraging or assisting suicide’ directs prosecutors to carefully consider the facts of each case and weigh up a list of factors to determine whether they tend against or in favour of prosec ..read more

By Juergen Dankwort. The proposal to provide assistance with voluntary assisted dying (VAD) has grown significantly over the past two decades at an accelerating rate. Right-to-die movement societies and organizations now number over 80 from around the world, 58 of which are members of the World Federation of Right to Die Societies. However, most are also increasingly beset with formidable challenges opposing their advances that raise profound ethical, moral and legal considerations. The prevalent approach towards VAD A review of these assisted dying regimes show how they were set up through l ..read more

By Martyna Tomczyk. As is well known, assistance in suicide is allowed in Switzerland. Although this practice is not explicitly regulated by law, Article 115 of the Criminal Code stipulates that assisting someone to commit suicide is only punishable if this is carried out for selfish reasons. Private right-to-die organizations have developed their activity in the country by referring to this article. The role of physicians in suicide assistance is usually limited to assessing the individual’s decisional capacity and prescribing a lethal dose of natrium-pentobarbital. Anyone can assist in a su ..read more

By Tamara Raquel Velasco Sanz, Pilar Pinto Pastor, Beatriz Moreno-Milán, Lydia Frances Mower Hanlon, Benjamín Herreros. Since its entry into force, on 25th June 2021, euthanasia and medically assisted suicide are part of the portfolio of services of the Spanish National Health System. In this way, Spain has become the fourth European country, after the Netherlands, Belgium and Luxembourg, to pass a law to regulate euthanasia; the eighth in the world (Colombia, Canada, Australia and New Zealand also have this regulated), and the ninth, if we also consider medically assisted suicide regulated i ..read more

By Jocelyn Downie and Udo Schuklenk In its 2015 landmark Carter decision, Canada’s Supreme Court ruled that the blanket criminalisation of medical assistance in dying (MAiD) unjustifiably infringes on Canadians’ rights and declared that the prohibitions were: “of no force or effect to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in ..read more

By Nicholas Delva, Anees Bahji Over the last couple of decades, medical assistance in dying (MAiD) has become legal in a few developed countries. Developments in this area have been primarily driven by patients, with general support from the population. Governments have been cautious in the development of legislation, which is not surprising given that such activity used to be both illegal and against prevailing religious and moral beliefs. Patients with a mental disorder as the sole underlying condition (MD-SUMC) have generally been excluded as potential candidates for MAiD. Even where it ha ..read more

By Jodhi Rutherford There is a copious literature on conscientious objection in voluntary assisted dying (VAD), also known as MAID, voluntary euthanasia, physician-assisted suicide, or death with dignity. Yet, there has been relative silence in the bioethics literature on what might motivate ‘conscientious participation’ in VAD, whereby clinicians may actively, morally, and purposively support the practice of VAD. VAD has been legally available in the Australian state of Victoria since 2019 and will soon become legal in a second Australian state in 2021, joining an increasing number of intern ..read more

Eva C.A. Asscher and Suzanne van de Vathorst. On April 21st the Supreme Court passed judgement on the case of the first doctor to be prosecuted since the 2002 Termination of Life on Request and Assisted Suicide (Review Procedures) Act. In September 2019 a Dutch nursing home doctor performing euthanasia on a patient with severe dementia was acquitted of murder charges, which we discussed on the JME blog and in our paper. Subsequently, the case was taken to the Supreme Court for ‘cassation in the interest of the law’. This means that the Supreme Court is asked to clarify the law and judge wheth ..read more

By Jonathan A Hughes. The first doctor to have been prosecuted under the Dutch euthanasia law since it came into force in 2002 was recently acquitted by that country’s criminal court. Disturbing features of the case, in which a woman was euthanised on the basis of an advance euthanasia directive (AED), were reported and discussed in a series of JME articles. These included a lack of clarity in the advance directive, doubts about the woman’s competence at the time it was written, uncertainty about the extent of her suffering when the euthanasia was carried out, and the fact that she was covert ..read more