Research publications

Over the last decades, movements have arisen in several jurisdictions around the world to legalize medical assistance in dying. Until recently, only a few jurisdictions permitted medical assistance in dying, including Oregon, Washington State, Vermont, the Benelux countries (Belgium, the Netherlands and Luxembourg) and Switzerland. In the last five years, six United States (U.S.) jurisdictions have legalized the practice, as have the Australian state of Victoria and Canada. In other countries, such as Germany, Spain, Italy and New Zealand, legislative proposals and court decisions on the issue are increasingly common. At the same time, there continues to be vocal opposition to the elimination of criminal sanctions for individuals who either assist in or cause the death of persons who have requested that their life be terminated. In Canada, the term “medical assistance in dying” includes both assisted suicide (the patient self-administers a substance) and euthanasia (someone else, usually a medical practitioner, administers the substance). Some jurisdictions around the world allow one of these options, while others allow for both. According to available statistics, the general trend in the countries that have legalized assisted dying has been for year-to-year increases in deaths by assisted dying. Such deaths, however, remain a small percentage of total deaths, and there have been some recent year-to-year decreases. Regardless of jurisdiction, most patients who receive medical assistance in dying have cancer. Broadly speaking, Australian and North American jurisdictions have more restrictive rules in place for assistance in dying than the European jurisdictions that permit the practice. The nine U.S. jurisdictions where it is legal, for example, generally require a prognosis of six months or less to live and permit only assisted suicide. Only adults are eligible.