Euthanasia - Legal In Spain

Culturally, Spain is a country of contradictions. There is an element of machismo left over from the days of the dictatorship that ended almost fifty years ago but the country is also one of Europe's most liberal societies. Same-sex marriages were legalised tweny yars ago, there is a high level of involvement of women in senior political office and Spain is only the fourth country in Europe to allow euthanasia. Under strict conditions, obviously.

Euthanasia in the European Context

Spain's legislation aligns it with other progressive European nations but also highlights significant contrasts across the continent.

• The Netherlands, Belgium, and Luxembourg: Pioneers in euthanasia legislation, legalizing it in the early 2000s. Their laws allow euthanasia for adults and, under strict conditions, for minors.

• Switzerland: While euthanasia remains illegal, assisted suicide is permitted under Swiss law, provided there is no selfish motive involved.

• France, Germany, Italy and the United Kingdom: These nations continue to prohibit euthanasia, though public opinion increasingly favours legalization or at least decriminalization in certain cases. The UK parlaiament passed a bill to legalise assisted dying in November 2024 but there are several hurdles to overcome before it can become law. Portugal's bill to do so was thrown out by the Constitutional Court.

Spain’s approach is particularly notable for its explicit legal framework, which contrasts with the ambiguity in some countries where assisted dying exists in a legal grey area. The legislation ensures rigorous safeguards to prevent abuse. Applicants must be Spanish citizens or legal residents, demonstrate their capacity to make informed decisions. A medical team and an evaluation committee review each case to confirm eligibility.

The first person to exercise her right to euthanasia in Andalusia was in our own province of Granada. The patient suffered from a serious and widespread pathology with no cure, which meant that, once the implementation of this right in the autonomous community was approved  she initiated the procedure. The woman was 63 years old and for five years had been suffering from Parkinson's disease, a degenerative illness that was getting steadily worse and she had been in need of round-the-clock medical care for some time. Although mentally capable, it was becoming increasingly difficult for her to speak.

Spain's Organic Law on the Regulation of Euthanasia (LORE) provides for the right to euthanasia for those who suffer from a serious, chronic and disabling illness or a serious and incurable disease, in both cases causing constant and unbearable physical or psychological suffering. 

The provision of assistance in dying begins with an initial written request from the patient to the responsible physician, who is normally a family doctor. The doctor must talk to the patient about therapeutic alternatives and explain the possibility of palliative care. The law requires a second request at least 15 days after the first request. If the person maintains his or her decision, the professional must consult with a second physician or consultant physician - usually a specialist - who must also meet with the patient.

 If both professionals agree that the request for euthanasia complies with the law, they must submit a report to the Guarantees and Evaluation Commission, a key body set up to assess the request and the reports. This Commission evaluates the case and if its resolution is favourable, it informs the responsible doctor so that the euthanasia can be carried out at the moment the person who requested it decides to do so.

 The passage of this law reflects a significant social and cultural shift in Spain. According to polls conducted by Spain’s Centre for Sociological Research (CIS), around 87% of Spaniards supported the legalisation of euthanasia before the law was enacted. This overwhelming support suggests a growing acceptance of personal autonomy and compassionate end-of-life care in Spanish society as well as a strengthening the move to a more liberal society.

Spain’s law also emphasizes the importance of palliative care, ensuring that patients are informed about all available medical treatments and care options before opting for euthanasia. Additionally, medical professionals who object to euthanasia on ethical or religious grounds are permitted to decline participation, ensuring respect for diverse beliefs within the healthcare system.

Ethical and Legal Debates 

Despite widespread public support, Spain’s euthanasia law has faced opposition, particularly from conservative and religious groups. The Catholic Church, which has historically played a significant role in Spanish society, remains a vocal opponent of euthanasia, arguing that life is sacred and should not be prematurely ended by human intervention. Critics also express concerns about the potential for misuse or coercion, particularly among vulnerable populations.

Nevertheless, proponents of the law argue that it represents a compassionate choice for individuals facing unbearable suffering. They emphasize the importance of personal autonomy and the right to make end-of-life decisions in line with one’s values and beliefs. For many Spaniards, the legalization of euthanasia is seen as a progressive step toward expanding individual rights in the same way as a woman's right to terminate a pregnancy which has been legal in Spain since 2010.

The legalization of euthanasia in Spain marks a significant development in the broader landscape of end-of-life care and further demonstrates that Spain is one on the most liberal societies in which to live.