What countries legalise assisted dying
Executive summary
A growing but still limited number of countries and subnational jurisdictions legally permit some form of assisted dying, ranging from clinician-administered euthanasia to physician-prescribed lethal drugs for self-administration; the patchwork includes several European countries, Canada, New Zealand, Switzerland, Colombia, parts of Australia and multiple U.S. states and districts [1][2][3]. Laws differ sharply on who qualifies, whether clinicians or patients perform the final act, and whether non‑terminal suffering or minors are included, so “legal” covers a spectrum of practices rather than a single model [4][5].
1. Who allows assisted dying today: the short list
Countries that have legalised assisted dying in some form include the Netherlands, Belgium, Canada, Colombia, Luxembourg, New Zealand, Switzerland, Spain, Germany and Austria, and several others have statutory or court‑driven regimes; Switzerland has permitted assisted suicide since 1942 and remains distinctive for allowing organisations to help foreigners [1][3][6]. In Australia the law is set by states and all six mainland states have enacted voluntary assisted dying laws between 2019 and 2022, now in effect across the country [1][7]. In the United States, medical aid in dying is legal in multiple states and the District of Columbia — commonly counted as ten states plus DC in recent coverage, with jurisdictions varying slightly depending on timing (examples cited include California, Colorado, Hawaii, Montana, Maine, New Jersey, New Mexico, Oregon, Vermont and Washington, plus DC) [2][8].
2. Not all ‘legalisation’ looks the same: euthanasia vs assisted suicide
Some jurisdictions permit physician‑administered euthanasia (active euthanasia), others permit physician‑assisted suicide (where the patient self‑administers prescribed lethal medication), and some allow both under differing safeguards; the Netherlands and Belgium authorise both euthanasia and assisted suicide under conditions, while many U.S. laws permit only prescribed drugs the patient must take themselves [5][1][2]. Switzerland’s long‑standing model focuses on non‑selfish motives and has allowed third‑party assistance through organisations, a model distinct from the tightly regulated statutory systems elsewhere [3][6].
3. Who qualifies — and who doesn’t — varies sharply
Eligibility rules diverge: several European countries permit assisted dying beyond strictly terminal illness to people with “unbearable suffering,” and Belgium even allows requests in some psychiatric cases and has specific provisions for minors under age thresholds, while many U.S. and Australian laws restrict access to mentally competent adults with terminal prognoses [3][8][9]. Statutory safeguards, residency or citizenship requirements, mental competency assessments and waiting periods all differ by jurisdiction, meaning eligibility in one country would not automatically translate to eligibility in another [7][4].
4. A recent wave, courtroom battlegrounds and political debates
Legal change has accelerated in the 2010s and 2020s via legislation, referenda and court rulings: Canada legalised medical assistance in dying in 2016 through federal law, New Zealand by referendum in 2020, Austria adopted a law after a court process, and courts in Germany, Italy and Austria have recently removed bans or forced legislative responses [6][10][11]. The issue remains politically contested — for example, Britain debated bills and MPs considered assisted‑dying legislation — and campaigns often hinge on competing frames of personal autonomy, medical ethics and protection of vulnerable people [2][4].
5. Practical consequences and why the map keeps shifting
Implementation challenges — from clinician willingness, pharmacy access to lethal drugs, palliative care capacity and the interpretation of safeguards — mean legalisation on paper produces different real‑world access in different places, a point emphasised in comparative analyses [4][7]. Reporting tracks an expanding but still selective global footprint: some countries permit a broad form of euthanasia, others limited MAID (medical assistance in dying), and several jurisdictions remain in active legal or political review [5][12].
Bottom line
Assisted dying is legally available in a growing but specific set of countries and subnational jurisdictions — notably the Netherlands, Belgium, Canada, Colombia, Luxembourg, New Zealand, Switzerland, Spain, Germany, Austria, all six Australian states and multiple U.S. states and DC — but the precise scope, safeguards and eligibility rules differ markedly from place to place, so “legal” does not mean uniform practice or universal access [1][2][3].