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Medically assisted dying in Western Europe: legislation review – what has changed in 5 years?
  1. Liesbet Van Bulck1,2,3,
  2. Jean Pierre Quenot4,5,
  3. Marie France Seronde2,6 and
  4. Fiona Ecarnot2,6
  1. 1 Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium
  2. 2 EA3920, Université de Franche-Comté, Besancon, France
  3. 3 Research Foundation Flanders - FWO, Brussels, Belgium
  4. 4 Service de Médecine Intensive-Réanimation, University Hospital Centre Dijon Bourgogne, Dijon, France
  5. 5 INSERM Research Centre LNC-UMR1231, University of Burgundy, Dijon, France
  6. 6 Department of Cardiology, Besançon Regional University Hospital Center, Besancon, France
  1. Correspondence to Dr Fiona Ecarnot, EA3920, Franche-Comte University, Besancon 25000, France; fiona.ecarnot{at}

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The field of ethics and end-of-life legislation (eg, euthanasia, physician-assisted suicide and medically assisted dying) is rapidly changing in Western Europe due to shifting cultural and religious values.1 Moreover, the COVID-19 pandemic has brought death and end-of-life questions to the fore, thereby fuelling the debate further.2 There is increasing support for the idea that patients should be able to make their own choices about how they would like to die. Indeed, in the past years there have been important advancements regarding euthanasia and physician-assisted suicide in numerous Western European countries.2

No recent update on the legal status of medically assisted dying in Western Europe has been published, with previous overviews dating from several years ago.1 3 Therefore, the objective of this paper is to provide a summary of recent developments in the end-of-life legislation, focusing on the changes and parliamentary discussions that have taken place in the last 5 years in a selection of 11 Western European countries.


The following countries are included in the overview: Belgium, France, Germany, Ireland, Italy, Luxembourg, Portugal, Spain, Switzerland, the Netherlands and UK. We reviewed the official websites of the health authorities, legislative texts, court decisions, publications from official authorities and news items, and consulted experts from the different countries.

Overview of the legislation

An overview of the legal status of medically assisted dying in Western European countries is provided in table 1. Euthanasia can be defined as ‘a physician (or other person) intentionally killing a person by the administration of drugs, at that person’s voluntary and competent request’.1 Assisted suicide is defined as ‘a person intentionally helping another person to terminate his or her life at that person’s voluntary and competent request’.1

View this table:
Table 1

Overview of legislation in Western Europe

Changes in last 5 years

Countries in which medically assisted dying is legal


In 2020, two minor adaptations were made to end-of-life law.4 First, the …

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  • Contributors LVB and FE set up the research protocol and drafted the manuscript. JPQ and MFS critically revised the intellectual content of the manuscript. FE is guarantor.

  • Funding This work is supported by Research Foundation Flanders and European Society of Cardiology.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.