Table 1.
Current Medical Aid in Dying requirements around the world.
| Only a limited number of countries or federated states across the world have laws that allow various forms of Medical Aid in Dying (MAID).a AS: Assisted suicide; doctors are permitted to prescribe lethal drugs for self-administration. VAE: Voluntary active euthanasia; in addition to AS, doctors or health care professionals are permitted to also administer the lethal drug. | |
| Country/federal state (legal form: AS or VAE; year introduced) | |
| Terminal Illness Requirement (TIR) | USA (AS): Oregon (1997), Washington state (2008), Montana (2009), Vermont (2013), California (2016), Colorado (2016), Washington D.C. (2016), Hawaii (2019), Maine (2019), New Jersey (2019), New Mexico (AS, 2021) New Zealand (VAE, 2021) Australia (VAE): Victoria (2019), Western Australia (2021), Tasmania (2022), Queensland (2023), South Australia (2023), New South Wales (2023) |
| Terminal Illness Requirement (TIR) as a key criterion when the regulation on MAID was initially introduced; TIR was removed in later revised regulations. | Switzerland (AS, 1942; in 2004, AS was for the first time part of the ethics protocol in the Swiss Medical Association Code of Professional Conduct in selected cases fulfilling the TIR; revised in 2018 and 2022)b Columbia (VAE, 1997; revised in 2021) Canada (VAE, 2016; revised in 2021) |
| No Terminal Illness Requirement. | Netherlands (VAE, 2001) Belgium (VAE, 2002) Luxembourg (VAE, 2009) Spain (VAE, 2021) Austria (AS, 2022) Portugal (AS, 2023)c |
In some countries such as Germany, France, and Italy, there are active discussions about implementing MAID. In Germany and Italy, Federal or Constitutional Courts declared that existing laws which up until now criminalized MAID in the national Criminal Codes are unconstitutional or incompatible with the Basic Law. In both countries, however, the parliaments have not yet passed laws regulating how MAID should be practiced in their countries. In April 2023, a citizen's convention on MAID was held in France, which voted 76% in favour of its legislation. As a consequence, President Macron has indicated the government will draft an end-of-life bill by Autumn 2023.
According to the Article 115 of the Swiss Criminal Code which entered into force in 1942, AS is only illegal in cases where it is carried out “for selfish motives”. The Swiss model of AS arose in the 1980s (the first documented case in 1985) with this background of a comparatively open legal regulation.10, 11, 12, 13 In 2004, the Swiss Academy of Medical Sciences (SAMS) stated for the first time in their guidelines regarding “End-of-life care” that a physician may, on the basis of a personal decision of conscience, assist in suicide if there is a serious disease that will lead to death in the foreseeable future. This terminal illness requirement was abrogated in the revised SAMS guidelines in 2018 and 2022.
VAE is only allowed in cases where AS is impossible due to a physical incapacitation of the patient.