Right to die / R1
Terminal illness, lethal medication
A competent adult with a terminal illness and under 6 months to live asks their doctor for lethal medication to take themselves.
What we score
Can the doctor lawfully provide it, and what risks does the doctor face?
Default assumptions: Unless a vignette says otherwise, the person is a 30-year-old citizen of sound mind with no criminal record, acting alone, on their own behalf and not for profit, in an ordinary residential area. Where subnational units (states, provinces, cantons, Länder) make their own law, each unit is scored and the result is weighted by population. 'The state' includes police, prosecutors, courts, regulators, tax authorities and anyone acting on their orders, including platforms obeying takedown orders.
Score anchors
Both the law score and the practice score use these anchors. Half points are used when a country sits between two of them.
| Score | What it means for this vignette |
|---|---|
| 10 | Lawful on the patient's request alone. |
| 8 | Lawful with procedural safeguards (two doctors, a waiting period). |
| 6 | Lawful under narrow criteria or burdensome procedures. |
| 4 | Not formally lawful, but not prosecuted in practice. |
| 2 | Assisting is a crime: fine or under 1 year. |
| 1 | Assisting is a crime: 1 to 5 years. |
| 0 | Assisting is a crime: over 5 years, or treated as murder. |
Evidence used: Assisted-dying statutes or court rulings; criminal-code provisions on assisting suicide; prosecution policy.
How each country scores
| Country | Law | Practice | Process | Score | Why |
|---|---|---|---|---|---|
| Switzerland | 8 | 8 | 0 | 8.0 | Assisting suicide is a crime only if done for 'selfish motives' (Criminal Code Art. 115, up to 5 years), so a doctor may prescribe sodium pentobarbital. The doctor must follow narcotics prescribing law and SAMS professional guidelines: capacity, a well-considered wish, alternatives explored, and two detailed discussions at least two weeks apart. Organisations such as Exit and Dignitas carry out the practice openly. |
| Netherlands | 8 | 8 | 0 | 8.0 | Under arts. 293(2) and 294(2) Sr and art. 2 of the euthanasia act (WTL), a doctor may lawfully provide assisted suicide if the due-care criteria are met: a voluntary, well-considered request, unbearable suffering with no prospect of improvement, no reasonable alternative, and consultation of an independent second doctor. Each case is reported to the regional review committees (RTE). In 2025 there were 10,341 notifications and only 7 were found not to meet due care. |
| Germany | 9 | 8 | −0.5 | 7.9 | Since the BVerfG voided § 217 StGB in 2020, helping a competent person end their own life is lawful, with no statutory procedure. A new cross-party bill was still being drafted in 2026. Doctors provide drugs, typically through associations (DGHS reported about 900 assisted suicides in 2025). Prescribing the narcotic pentobarbital remains blocked by the BtMG. Each death is investigated, and doctors were convicted of manslaughter where the patient lacked capacity (BGH 5 StR 520/24, Aug 2025). |
| New Zealand | 7 | 7 | 0 | 7.0 | The End of Life Choice Act 2019 (in force November 2021) allows assisted dying for a citizen or permanent resident aged 18+ with a terminal illness likely to end life within 6 months, an advanced state of irreversible decline in physical capability, unbearable suffering and decision-making competence (s5). Two practitioners must agree, and the medication is administered or ingested with the practitioner available. More than 1,200 people had used it by August 2025, though the 2024 statutory review flagged workforce shortages. |
| United States | 3 | 3.5 | 0 | 3.3 | Medical aid in dying is lawful with safeguards (6-month prognosis, waiting periods, 2 requests) in 13 states plus DC with about 100 million people, about 29% (scored 8): OR, WA, MT, VT, CA, CO, HI, NJ, ME, NM, DC, DE (Jan 2026), IL (Sept 2026) and NY (Aug 2026). In the other states a doctor who supplies lethal medication commits assisted-suicide or manslaughter offences carrying 1 to 15 years, e.g. a felony under Cal. Penal Code 401 outside the End of Life Option Act. Those are scored 1, though doctors are rarely prosecuted because they do not provide it. |
| Czechia | 1 | 2 | 0 | 1.6 | Assisted suicide is not legal. Criminal Code § 144 punishes anyone who helps another commit suicide with up to 3 years in prison if the suicide is at least attempted. A doctor who administers the drug faces murder charges. Euthanasia bills have repeatedly failed, and in January 2025 the Health Ministry said it had no plans to introduce assisted dying. No prosecutions of doctors were found because doctors do not openly provide it. |
| Mexico | 1 | 2 | 0 | 1.6 | LGS art. 166 Bis 21 prohibits euthanasia and assisted suicide. Federal Penal Code art. 312 (and matching state codes) punishes aiding suicide with 1-5 years, or 4-12 years if the helper performs the killing. The 'Ley Trasciende' bill was filed in October 2025 and was still in committee in 2026. Only passive measures (advance directives, palliative sedation) are lawful. No physician prosecutions were found, but doctors do not provide lethal medication. |
| Denmark | 1 | 2 | 0 | 1.6 | Assisted dying is not legal. A doctor who provides lethal medication commits assisting suicide under § 240 straffeloven (fine or up to 3 years), and administering it would be killing on request under § 239 (up to 3 years). The November 2025 consolidated code and the 2026 penal reform left both provisions unchanged. Prosecutions are rare, but a doctor also risks losing their authorisation. |
| United Kingdom | 0 | 1 | 0 | 0.6 | Assisting suicide carries up to 14 years (Suicide Act 1961 s2, E&W and NI). The Terminally Ill Adults (End of Life) Bill fell when the session was prorogued in April 2026, and its reintroduced version was defeated at Commons second reading on 11 September 2026. Scotland's bill was rejected at Stage 3 on 17 March 2026, and assistance there risks culpable homicide. Under DPP policy, a doctor acting in a care relationship is a factor in favour of prosecution, so doctors do not do this. |
| Ireland | 0 | 1 | 0 | 0.6 | Criminal Law (Suicide) Act 1993 s2(2) makes aiding, abetting, counselling or procuring a suicide punishable by up to 14 years, and the Supreme Court upheld the ban in Fleming v Ireland (2013). The Joint Committee on Assisted Dying recommended legislation in March 2024 and the Dáil 'noted' its report, but no bill has passed or advanced in the current Dáil. Doctors do not provide lethal medication. |
| Singapore | 0 | 0 | 0 | 0.0 | Singapore has no assisted-dying law. A doctor who supplies lethal medication abets suicide under Penal Code s306 (up to 10 years plus a fine). The Advance Medical Directive Act only permits withholding extraordinary life-sustaining treatment. No doctor has been prosecuted because none is known to have done it; in the closest case a layperson who helped an adult's suicide was sentenced to 66 months for the s306 offence. |