Approximately 12 countries now permit some form of medically assisted dying — either euthanasia (physician-administered), assisted suicide (patient self-administered), or both. The legal frameworks vary enormously: some restrict access to terminal illness, others extend it to chronic non-terminal suffering or psychiatric conditions.

This article covers every country with an active legal framework as of 2025, when the law took effect, what is permitted, and key eligibility points.

"The Netherlands and Belgium demonstrated that a well-regulated legal framework does not lead to unchecked expansion — both countries have operated for 20+ years with robust oversight systems."

Countries at a Glance

CountryLegal SinceWhat's PermittedScope
🇳🇱 Netherlands2002Euthanasia + Assisted SuicideTerminal & non-terminal; psychiatric eligible; minors 12+
🇧🇪 Belgium2002EuthanasiaTerminal & non-terminal; psychiatric eligible; minors (no min age)
🇱🇺 Luxembourg2009Euthanasia + Assisted SuicideSerious incurable condition; adults only
🇨🇴 Colombia1997 (expanded 2021)EuthanasiaTerminal & non-terminal (since 2021); adults
🇨🇦 Canada2016Euthanasia + Assisted Suicide (MAID)Track 1 (terminal) & Track 2 (non-terminal); adults
🇪🇸 Spain2021Euthanasia + Assisted SuicideSerious incurable disease or chronic debilitating condition
🇳🇿 New Zealand2021Assisted DyingTerminal illness, 6-month prognosis; adults
🇦🇺 Australia2019–2023 (by state)Voluntary Assisted DyingTerminal illness; all states/territories
🇨🇭 SwitzerlandLong-standingAssisted Suicide onlySerious illness/suffering; non-residents accepted (Dignitas)
🇦🇹 Austria2022Assisted Suicide onlyTerminal or serious long-term condition; adults
🇩🇪 Germany2020 (decriminalized)Assisted Suicide (decriminalized, unregulated)No formal framework; court protection only

The Benelux Model — Most Expansive in the World

The Netherlands, Belgium, and Luxembourg share the most expansive frameworks globally. All three permit non-terminal conditions, and both the Netherlands and Belgium allow psychiatric conditions under strict review. Belgium is unique in having no minimum age for minors — though in practice very few cases have involved children since the 2014 extension.

Canada — Fastest-Evolving Framework

Canada's MAID system has expanded significantly since 2016. Bill C-7 (2021) removed the requirement that natural death be reasonably foreseeable, creating a two-track system. Track 2 (non-terminal) requires a 90-day assessment period and specialist involvement. Canada now records over 13,000 MAID deaths per year — among the highest rates in the world relative to total deaths.

Switzerland — The International Exception

Switzerland is uniquely important for international patients. While euthanasia is illegal, assisted suicide has been decriminalized for decades under Article 115 of the Swiss Penal Code. Organizations like Dignitas operate legally and accept members from countries where assisted dying is not available. Several thousand people from across Europe and beyond travel to Switzerland each year.

See our full guide: Switzerland — Dignitas & Exit

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Australia — State-by-State Success

Australia took a piecemeal approach: Victoria led in 2019, and by late 2023 all six states and both territories had active voluntary assisted dying (VAD) laws. All require terminal illness, but the prognosis window, eligible providers, and waiting periods vary by state. The federal government's repeal of a 1997 law blocking territories from legislating on VAD was a key enabling step in 2023.

Emerging Frameworks — Germany and Austria

Both Germany and Austria arrived at permissive policies through court rulings rather than legislation. Austria enacted a formal regulatory framework in 2022 with strict requirements including two specialist assessments and notarized declarations. Germany remains without a formal statute — access is uncertain and depends on individual physicians and organizations navigating ongoing legal debates.

Countries Where It Remains Illegal

The majority of the world's countries prohibit assisted dying. Notable countries where significant legal debate is ongoing include the United Kingdom, France, Ireland, and Italy — all of which have seen parliamentary proposals in recent years without passage.

Full Country Guides