Euthanasia Regulations: Emerging Trends Around the Globe

One of the most debated issues in the field of medical law and bioethics is euthanasia. In the contemporary era, medical science is advancing at a tremendous rate and is capable of increasing the span of life through advanced medical technology such as ventilators and life-support machines. Although such advancements in medical technology have undoubtedly saved a number of lives, the question of legal and ethical validity surrounding euthanasia is a critical issue in the field of medical law and bioethics. As a result, the entire world is increasingly asking the question of whether an individual has a legal right to die when his life is full of suffering and pain.¹

The legal regulation of euthanasia is a complex issue that balances two different principles: the sanctity of life and individual autonomy and dignity. First and foremost, the law traditionally views the deliberate taking of life as a criminal offense. However, on the other hand, the law also recognizes the principle of individual autonomy and dignity, which grants individuals the right to do as they please regarding their own lives and bodies. The question of balancing both of these principles is a critical issue in the field of medical law and bioethics. In the contemporary era of constitutional democracies, the question of legal regulation of euthanasia is increasingly centered on the question of the role of human dignity and individual liberty in medical decision-making in situations where an individual is suffering from irreversible medical conditions and terminal illness.

The word euthanasia is derived from the Greek words eu and thanatos, which mean a good death. In contemporary law, euthanasia is defined as the deliberate ending of a patient’s life by a physician to end his or her suffering due to serious illness or injury. However, it is also a common practice to classify euthanasia in different forms. Active euthanasia is when a physician deliberately acts to end a patient’s life. This is usually done by administering a lethal injection to the patient. Passive euthanasia is when a physician stops treatment to a patient, allowing him or her to eventually die a natural death due to his or her illness.² A closely associated concept with euthanasia is physician-assisted suicide, which is when a physician gives a patient a means to end his or her own life. However, it is the patient who performs the final action.

For instance, throughout history, euthanasia was banned in most countries in the world and was considered to be a form of homicide. This was mainly because most religions and philosophies emphasized the sacredness of life, leading to strict laws against homicide. In fact, medical ethics and the Hippocratic oath taken by medical practitioners to heal and protect life had remained unchanged for many centuries. However, in the latter part of the 20th century, there was a significant change in the legal and medical approach to euthanasia with the increased recognition of patient autonomy and the right to refuse treatment. As medical science and life-prolonging technology became more sophisticated, the legal test on whether to allow patients to refuse treatment and thus end their lives became more difficult. The first country to legalize euthanasia was the Netherlands, with the Termination of Life on Request and Assisted Suicide (Review Procedures) Act 2002. This law allows doctors to perform euthanasia and assisted suicide under strict conditions, including a voluntary and carefully considered request by the patient, unbearable suffering with no prospect of relief, consultation with at least one independent doctor, and referral to a review committee. This approach to euthanasia in the Netherlands is considered to be the most pioneering and effective in balancing the rights of patients with the need to protect life. The Belgian Euthanasia Act 2002 legalized euthanasia in Belgium for adults with serious and incurable medical conditions that cause constant and unbearable pain. In 2014, Belgium extended its euthanasia laws to minors under strict conditions, requiring parental consent and medical evaluation. This extension of euthanasia to minors was met with controversy and debate and is an example of the dynamic nature of euthanasia laws. Some argued that the extension of euthanasia to minors undermines the rights of vulnerable individuals, while others argued that to refuse euthanasia to minors on the basis of their age alone was unfair.

The country has joined the list of nations that have adopted euthanasia by passing the Organic Law on the Regulation of Euthanasia in 2021. The law allows for both physician-assisted euthanasia and medically assisted suicide for persons suffering from serious and incurable diseases or chronic health problems causing them unbearable suffering. This is just the beginning of the European trend towards accepting the practice of assisted suicide as a legitimate medical practice, not a crime. There are still ongoing debates about the issue in other European nations, like France and the UK, where the issue has been raised several times.

Another country where the role of the judiciary was critical in shaping the policy of euthanasia is Canada. In the Carter v. Canada (Attorney General) case, the Supreme Court held that the ban on assisted suicide was a violation of the right to life, liberty, and security of the person under the Canadian Charter of Rights and Freedoms. As a result, the Canadian Parliament passed a law that created a Medical Assistance in Dying (MAiD) system, allowing persons to seek the assistance of a doctor to end their lives under strict circumstances.

Coming to Latin America, there are changes in the legal sphere as well. In the case of Colombia, it was one of the first countries in the region to do so, with its Constitutional Court ruling in Decision C-239 in 1997 that “physicians should not be criminally punished for assisting terminally ill patients who wish to end their lives.” In the last few years, guidelines to operationalize this ruling have been introduced. In 2025, Uruguay took a significant step in the region by passing laws that allow for euthanasia. This shows that even in places with high degrees of religiosity, there is a move towards rethinking the laws on euthanasia.

While there are some countries that allow for active euthanasia, many others are taking a more cautious approach by allowing passive euthanasia. Passive euthanasia is justified on the basis of the “right to refuse treatment even when it leads to death.” This approach respects the autonomy of the patient while avoiding the complexities associated with active euthanasia.

India is a notable example of the judicial interpretation of the concept of passive euthanasia. The issue was first dealt with by the Supreme Court of India in the case of Aruna Ramachandra Shanbaug v Union of India, where the court was called upon to decide whether life support should be withdrawn from a patient who had been in a persistent vegetative state for decades. The court permitted passive euthanasia under strict guidelines, including the opinion of a medical board and judicial oversight.

The law has been further clarified in the case of Common Cause v Union of India, where the Supreme Court held that the right to die with dignity was a part of the fundamental right to life under Article 21 of the Indian Constitution. The court has also recognized the validity of living wills, where patients have the right to decide their wishes regarding the course of action to be taken at the time of their death.

The law has been put into practice by the courts in recent times, with the Supreme Court allowing passive euthanasia in the case of Harish Rana, where the patient was in a persistent vegetative state for a long time, and the court permitted the withdrawal of life support from the patient in the year 2026.¹³

The United States offers a different approach to euthanasia law. Although active euthanasia is illegal in all parts of the country, several states allow physician-assisted suicide under strictly regulated laws that are referred to as ‘Death with Dignity’ laws. The debate has been brought to the fore through a landmark case in which the United States Supreme Court ruled that there is no fundamental right to assisted suicide under the Constitution.¹⁸ However, states such as Oregon, Washington, and California have passed laws allowing physician-assisted suicide under strict circumstances. The Oregon Death with Dignity Act 1997 is considered to be the first law that allows physician-assisted suicide in the country.¹⁹

Switzerland is another country that offers a different approach to euthanasia law. In Switzerland, euthanasia is not explicitly allowed under law. However, assisted suicide is allowed if the person assisting does not have selfish motives. This law has been used to allow individuals to end their lives under certain circumstances through organizations such as Dignitas.²⁰ This is a clear example of how a country can allow assisted dying through specific provisions under its criminal law.

Australia is another country that has seen a number of significant changes to its euthanasia law in recent times. Several states in Australia have passed laws allowing assisted dying for individuals who are terminally ill. The Voluntary Assisted Dying Act 2017 (Victoria) is considered to be one of the first laws that allow assisted dying in Australia.²¹ Several other states in Australia have also passed similar laws, which is a clear indication that assisted dying is becoming more acceptable in the country.

In contrast to other countries, Japan has strict laws against euthanasia. Under Japanese law, euthanasia is considered to be homicide. However, a few cases have been brought to establish guidelines under euthanasia law.²² Cultural and religious reasons have been a significant factor in determining Japan’s approach to euthanasia law.

The continued existence of such laws in various jurisdictions points to the ongoing ethical debates on the issue of euthanasia. For instance, opponents of euthanasia have argued that the legalization of the practice may lead to undue pressure on vulnerable members of society, such as the elderly, the disabled, or the poor, to hasten their death. In addition, there are fears of a “slippery slope” where the law may eventually apply to a wider class of patients.¹⁵

However, the global trend points to a general shift towards the recognition of the patient’s autonomy in the decision-making process on the issue of euthanasia. For instance, various jurisdictions have come up with legislation on the issue of euthanasia, which allows patients to die with dignity in specified circumstances. In other jurisdictions where the practice is illegal, there is a growing acceptance of passive euthanasia. It is therefore evident that the law is seeking a middle course in the regulation of the issue of euthanasia, which balances the value of life with the value of individual dignity.

Another emerging trend in the regulation of the issue of euthanasia globally is the relaxation of the eligibility criteria in jurisdictions where the practice is legal. For instance, the original legislation on euthanasia was only applicable to terminally ill patients who would die within a short period of time. However, there are emerging jurisdictions where the law has been relaxed to include patients suffering from other terminal conditions such as chronic illness or severe psychological disorder. This has led to a heated debate on the ethical limits of the regulation of the practice of euthanasia among legal experts and medical practitioners.¹⁶

Research on the issue of euthanasia published in various medical and legal journals has contributed to the global debate on the issue. For instance, various studies published in the BMJ, Journal of Medical Ethics, and JAMA have examined the ethical implications of the law on euthanasia and the experiences of various jurisdictions where the practice has been legalized.²³

The future of the regulation of euthanasia may thus depend on the continued interplay between the development of the law, medical science, and the evolution of societal values. Advances in palliative care may provide an alternative to euthanasia by alleviating the pain of the terminally ill. On the other hand, the ongoing debate on the values of autonomy, dignity, and human rights may continue to inform the law on the regulation of euthanasia.

In conclusion, the regulation of euthanasia is perhaps one of the most complex areas of law. While some jurisdictions have opted to criminalize euthanasia, other jurisdictions have opted to regulate it. The emerging trend of the law on euthanasism globally is a gradual recognition of the values of autonomy and dignity of patients. The law on euthanasia is thus a dynamic field of law, reflecting the ongoing attempt to balance the value of human life with compassion.

Bibliography:

1. Emily Jackson, Medical Law: Text, Cases and Materials (5th edn, OUP 2019).
2. John Keown, Euthanasia, Ethics and Public Policy (Cambridge University Press 2002).
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4. Termination of Life on Request and Assisted Suicide (Review Procedures) Act 2002 (Netherlands).
5. Belgian Euthanasia Act 2002.
6. Organic Law 3/2021 on the Regulation of Euthanasia (Spain).
7. Carter v Canada (Attorney General) [2015] 1 SCR 331.
8. Criminal Code Amendment (Medical Assistance in Dying) Act 2016 (Canada).
9. Colombian Constitutional Court, Decision C-239/97.
10. Associated Press, ‘Uruguay passes euthanasia law’ (AP News, 2025).
11. Aruna Ramachandra Shanbaug v Union of India (2011) 4 SCC 454.
12. Common Cause v Union of India (2018) 5 SCC 1.
13. Supreme Court of India, Passive Euthanasia Order in Harish Rana Case (2026).
14. Stransham-Ford v Minister of Justice and Correctional Services (2016) ZASCA 197.
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18. Washington v Glucksberg 521 US 702 (1997).
19. Oregon Death with Dignity Act 1997.
20. Swiss Criminal Code 1937, art 115.
21. Voluntary Assisted Dying Act 2017 (Victoria, Australia).
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23. Ezekiel Emanuel and others, ‘Attitudes and Practices of Euthanasia and Physician-Assisted Suicide’ (2016) 316 JAMA 79.
24. Julian Savulescu, ‘Is Physician-Assisted Suicide Ever Justified?’ (2018) Journal of Medical Ethics 44.
25. R Cohen-Almagor, ‘The Right to Die with Dignity’ (2015) BMJ Supportive & Palliative Care.