Euthanasia Laws by Country: All 14 Countries in 2026

Some form of assisted dying is legal in at least 14 countries. It is also legal in 13 US states and Washington, D.C. More than 200 million people lived in such places even before the 2026 laws, according to a 2025 review in The Lancet Public Health (Sillitti et al., 2025).

Country by country. This table shows what each law allows, when it started, and where to read the official text. For US states, see the US table below.

Laws in this area change every year. We last checked the legal status in every row on 25 October 2026. Each law has strict conditions, and most cover only adults with a serious illness. The sections below explain them.

Ana Estrada was a psychologist in Lima, Peru. As a teenager, she developed polymyositis, a rare disease that slowly wastes the muscles. By the age of 20 she used a wheelchair. She still earned a degree, worked as a therapist and bought her own flat (AP via NBC).

By 2017 she could no longer get out of bed. A machine helped her breathe. In the end she could move only one finger, her right index finger. With it, she typed a blog whose web address read "Ana seeks a dignified death" (Assisted Lab).

"I am no longer free," she told the Associated Press in 2018. "I am not the same person I was before."

In Peru, ending a life out of mercy is a crime under Article 112 of the Penal Code. So Ana went to court. Peru's Human Rights Ombudsman read her blog and agreed to represent her, filing the case in January 2020. In February 2021, a Lima court ruled that the ban should not apply to her. In 2022, Peru's Supreme Court agreed. Ana told the judges that she valued life and did not want to die right away. She wanted the freedom to decide when, and to say goodbye to her loved ones "in peace and with tranquility".

Notice what changed, and what did not. The law did not change for Peru. It changed for one woman. Everyone else in Peru still lives under the same ban.

That is the legal landscape in one picture. It is not a simple map of "legal" and "illegal". It is a patchwork of laws, court rulings, single exceptions and bills that pass or fail by a few votes. This guide walks you through it, fairly and in plain English.

Most legal systems sort end-of-life choices into three boxes. Think of them as traffic lights.

• Green: refusing or stopping treatment. A capable adult may say no to any treatment, even one that keeps them alive. This is legal in almost every country. Some people call it "passive euthanasia", but most laws treat it as a patient's right, not as euthanasia. India is a clear example. Its Supreme Court allowed withdrawal of life support with a living will in Common Cause (2018), while active euthanasia stays illegal (overview).
• Amber: assisted suicide. A doctor prescribes medicine, and the patient takes it themselves. In the United States this is called medical aid in dying.
• Red in most countries: euthanasia. A doctor or nurse gives the medicine directly, at the patient's request.

The words are confusing. In Canada, MAID means medical assistance in dying, and it covers both euthanasia and assisted suicide. In the US, MAID means medical aid in dying, and the patient must always take the medicine themselves. Our page on types of euthanasia explains each term.

Is the line between "letting die" and "causing death" really so sharp? In 1975, the philosopher James Rachels argued in the New England Journal of Medicine that it is not. Many ethicists still disagree with him. In a 2026 paper in Bioethics, Jukka Räsänen and Matti Häyry argued that his famous argument fails, because his examples do not match real medical cases (Räsänen and Häyry, 2026). The law mostly keeps the line anyway, because it is easy to check. A refusal is a "no". Euthanasia is an act.

Even where euthanasia is legal, it usually stays a crime with a narrow exception. In the Netherlands, it is still an offence under articles 293 and 294 of the Criminal Code. The only exception is a doctor who meets six "due care" criteria and reports the death. Dutch patients also have no right to euthanasia. A doctor may always say no (Government of the Netherlands). Most laws in this guide work the same way: a crime, with a carefully fenced medical exception.

Ten countries allow a doctor or nurse to give euthanasia. Most of them also allow assisted suicide.

Netherlands (2002). The first country to pass a euthanasia law. The suffering must be unbearable, with no prospect of improvement and no reasonable alternative. The request must be voluntary and well considered. A second, independent doctor must see the patient. Children may ask from age 12. Ages 12 to 15 need a parent's consent; at 16 and 17, parents must be consulted. Since February 2024, a separate rule covers terminally ill children aged 1 to 12, with parents' consent and extra review.

A written advance directive can replace a spoken request, for example in advanced dementia. The law does not cover people who feel their life is "completed" without a medical cause (Government of the Netherlands). In 2025, review committees received 10,341 reports, 6% of all deaths. In 499 cases the person had dementia, and in 174 the suffering came mainly from a psychiatric condition. In seven cases, the committees found the doctor had not met the due care criteria (RTE, 2026).

Belgium (2002). The rules are similar to the Netherlands. The person must have constant, unbearable physical or mental suffering from a serious, incurable condition. The illness does not have to be terminal. In 2014, Belgium removed the age limit for children, with strict extra conditions. Seven minors have received euthanasia since then. In 2025, 4,486 people died this way, 4% of all deaths and 12.4% more than in 2024. About half had cancer (49.9%), and 29.6% had several illnesses at once (RTBF).

Luxembourg (2009). The Law of 16 March 2009 allows both euthanasia and assisted suicide. The person must be an adult, conscious when they ask, and free from outside pressure. They must have an incurable condition with no prospect of improvement and constant, unbearable suffering. A second doctor must confirm the condition is serious and incurable (Luxembourg health portal).

Canada (2016, widened 2021). A doctor or nurse practitioner may give the medicine, or prescribe it for the patient to take. The person must have a "grievous and irremediable" medical condition. In 2019, a Quebec court struck down the rule that natural death must be "reasonably foreseeable" (expected fairly soon). Bill C-7 removed that rule nationally in 2021.

In 2024, 16,499 people received MAID, 5.1% of all deaths in Canada and 6.9% more than in 2023. Their median age was 77.9. Most (95.6%) were people whose death was reasonably foreseeable, and 63.6% of this group had cancer. The other 732 (4.4%) were not near death; for them, neurological conditions were most common. Nearly three in four recipients (74.1%) had received palliative care, but in the not-near-death group the figure was only 23.2% (Health Canada, 2025). People whose only condition is a mental illness are not eligible. Under current law, that exclusion lasts until 17 March 2027 (Health Canada). On 7 October 2026, the government said a new bill will keep it with no end date (CBC News). That bill was not yet law on 25 October 2026.

Spain (2021). The law covers a serious, incurable disease, or a serious, chronic and disabling condition, with constant suffering the person cannot bear. In 2024, 426 people received help to die. Of the 929 requests completed that year, 33% ended because the person died while the request was still being processed. Another 15% were refused (Ministry of Health, Spain).

Colombia (court ruling, 1997). The Constitutional Court allowed euthanasia for terminally ill patients in 1997. Formal rules followed in 2015. In 2021, the court ruled that a terminal illness is no longer required. Serious, incurable illness or injury with intense suffering is enough (C-233/21). In 2022, it also allowed medically assisted suicide.

New Zealand (2021). The End of Life Choice Act covers adults who are citizens or permanent residents. They must have a terminal illness likely to end their life within six months, be in significant, ongoing decline, and have suffering that cannot be eased.

Australia (from 2019). Each state passed its own voluntary assisted dying (VAD) law, starting with Victoria. All six states now run a service. The Australian Capital Territory began on 3 November 2025 (ABC News). The Northern Territory passed its law on 27 August 2026, but its service is not running yet. That closes a circle: in 1995 the territory passed one of the world's first such laws, and the federal parliament overturned it two years later (ABC News).

Ecuador (court ruling, 2024). In February 2024, Ecuador's Constitutional Court ruled in the case of Paola Roldán, a woman with ALS (a disease that slowly stops the muscles working). Seven of the nine judges agreed. The court said life "admits exceptions to its inviolability when it seeks to protect other rights". Doctors who follow its conditions cannot be punished for homicide. It told lawmakers and health authorities to write rules (DW).

Uruguay (law of 2025, in use since April 2026). The Senate passed the Dignified Death law (Law 20.431) in October 2025, with 20 of the 31 senators present voting yes. Uruguay became the first Latin American country to legalise euthanasia through a law passed by parliament. A poll by the firm Cifra found 62% public support. The request must be made personally and in writing, by a citizen or resident (BBC). The rules took effect on 21 April 2026. The person must be an adult with capacity to decide, with an incurable and irreversible illness that causes lasting, unbearable suffering. They can change their mind at any point (Presidency of Uruguay).

In these places, the patient must take the medicine themselves. A doctor giving it directly is still a crime.

Switzerland. The Swiss law is famously short. Article 115 of the Criminal Code only punishes someone who helps a suicide "for selfish motives" (Humanists UK, quoting Article 115). So the test is about the helper's motive, not about the patient's illness. Its rules differ from those in other countries and are widely debated.

Austria (2022). The Dying Decree Act covers adults with an incurable illness, or a serious illness that will not go away. Two doctors must inform the person, and one must be qualified in palliative medicine. The person must then wait at least 12 weeks before making a formal "dying decree". In the final phase of illness, the wait is two weeks. The decree is made before a notary or a patient advocate (Gesundheitsportal).

Germany (court ruling, 2020). In February 2020, the Federal Constitutional Court struck down a ban on organised help with suicide. It said the right to a self-determined death includes the freedom to seek help from others (press release). Unusually, the court said this right is not limited to serious or incurable illness. It also said: "No one can ever be obliged to assist in another person's suicide" (judgment). Parliament tried to write new rules. In July 2023, 589 of the 736 members voted for at least one of two bills, yet neither won a majority on its own. So assisted suicide in Germany still has no detailed legal framework, and euthanasia remains illegal (Gerber et al., 2026).

Italy (court ruling, 2019). There is no national law. In Judgment 242 of 2019, the Constitutional Court ruled that helping is not a crime under four strict conditions. The person must have an irreversible condition and intolerable suffering, depend on life-sustaining treatment, and be able to decide freely. Four regions (Tuscany, Veneto, Sardinia and Emilia-Romagna) had set out how to ask by early 2026. They covered about one in four Italians (Il Sole 24 Ore). On 22 October 2026, Umbria became the fifth (Umbria Regional Council). Elsewhere, each case is handled on its own.

Peru (one person only). As Ana Estrada's story shows, Peru's ban still stands. Her court ruling applied only to her.

United States. Thirteen states and Washington, D.C. allow medical aid in dying. The next part covers them.

There is no national law, so each state decides. Two Supreme Court cases set that pattern.

In Washington v. Glucksberg (1997), the Court ruled that there is no constitutional right to assisted suicide. But it left the door open for states. "Our holding permits this debate to continue, as it should in a democratic society," wrote Chief Justice Rehnquist (opinion).

In Gonzales v. Oregon (2006), the federal government tried to stop Oregon doctors from prescribing under the state law. The Court ruled 6 to 3 that the US Attorney General had no power to do this under federal drug law (opinion). Since then, states have been free to pass their own laws.

As of October 2026, 14 US jurisdictions allow medical aid in dying. The year shows when each law took effect:

Oregon was the first state. It covers adults with a terminal illness and six months or less to live, and since 2023 the patient no longer has to live in Oregon. California's law passed in 2015, the year after Brittany Maynard moved to Oregon to use its law.

The three newest laws all began in 2026. Delaware's was signed on 20 May 2025 and took effect on 1 January 2026. A court dismissed a lawsuit against it on 30 December 2025 (Death with Dignity). New York's governor signed its law in February 2026, and it took effect on 5 August 2026 (NY Department of Health).

Illinois is the first state in the Midwest. Its law is known as "Deb's Law", after Deb Robertson, who worked with homeless young people for three decades before a rare, aggressive cancer forced her to retire. She campaigned for the law and lived to see it start. "I believe that people have the right to leave this Earth with dignity and on their own terms," she said, aged 68 (AP via MPR News). It took effect on 12 September 2026. A federal judge refused a request from disability rights groups to block it. Two doctors must agree the person has less than six months to live. Doctors may not raise the subject unless the patient does first (Capitol News Illinois).

In every US state, the patient must take the medicine themselves. Euthanasia by a doctor is illegal everywhere in the country.

What do the numbers show? Oregon has the longest record. In 2025, doctors wrote 637 prescriptions under its law, and 400 people died after taking the medicine. Most (88%) were 65 or older, and 92% were in hospice care. The most common worries were loss of autonomy (89%), being less able to enjoy life (89%) and loss of dignity (65%). Pain was not the top reason. Notably, 24 people (6%) lived longer than six months after getting their prescription. Prognosis, it shows, is an estimate, not a certainty (Oregon Health Authority, 2026).

What happened in 2026? Aid-in-dying bills were active in 15 states. Virginia's failed by a single vote in a Senate committee on 5 February 2026 (Compassion & Choices). In Massachusetts, the bills stayed in committee when the session ended (Death with Dignity). Bills were also introduced in Michigan, Ohio and Pennsylvania. In Illinois, one lawmaker filed a bill to repeal the new law (Death with Dignity).

Yes. In many countries, judges moved before lawmakers did. A court case usually starts with one person, like Ana Estrada, who says the law breaks their basic rights.

Here are the rulings that shaped the map:

Canada shows how fast courts can change their minds. In 1993, the Supreme Court ruled 5 to 4 against Sue Rodriguez (Canadian Encyclopedia). Twenty-two years later, in Carter v. Canada, all nine judges ruled the other way. They said the ban was void for a competent adult who "clearly consents" and has a "grievous and irremediable medical condition (including an illness, disease or disability)". The suffering had to be "intolerable to the individual" (Carter, para. 127). Parliament passed Canada's MAID law the next year.

Colombia's court spoke for the individual. In 1997 it wrote: "Only the holder of the right to life can decide until when it is desirable and compatible with human dignity" (our translation, C-239/97). But the same ruling also asked for very strict rules. Consent had to be genuine, it said, and "not the effect of a momentary depression". It added that the state must offer terminally ill patients palliative care.

The European Court of Human Rights went the other way. Diane Pretty had motor neurone disease and was paralysed from the neck down. She asked that her husband not be prosecuted for helping her. In 2002, the court ruled unanimously that no "right to die" can be derived from the right to life. It accepted the UK ban as "necessary in a democratic society" to protect others (Pretty v UK).

Why do courts and parliaments often disagree? A court looks at the person in front of it. A parliament has to think about everyone the law might reach. A 2026 study of Germany's failed bills found lawmakers split over two kinds of mistake (Gerber et al., 2026). One camp feared "false negatives": eligible people wrongly refused. The other camp feared "false positives": people who should not qualify, getting through.

Think of a smoke alarm. Make it too sensitive, and it rings every time you cook. Make it too dull, and it misses a real fire. No setting avoids both errors. Which mistake would worry you more?

Every law sets conditions. The details vary a great deal, but most laws share the same building blocks.

Safeguards are only as strong as the checks behind them. The Dutch review committees, for example, now stress that the independent doctor should speak with the patient alone. In 2025 they noticed that family members were often present at these talks (RTE, 2026). Small details like this matter. A private conversation is how a doctor can spot quiet pressure.

The table hides a deeper split. Some laws are built around a time limit: you must be dying soon. Others are built around suffering: you must be suffering in a way that cannot be relieved. The first model is narrower and easier to check. The second reaches people with long illnesses and disabilities, and it draws the strongest criticism. To learn about your rights in either case, see patient rights.

In most of the world, helping someone die is still a serious crime.

• England, Wales and Northern Ireland. Encouraging or assisting suicide carries up to 14 years in prison. Prosecutors must weigh factors set out in public guidance. A prosecution is less likely if the person had reached "a voluntary, clear, settled and informed decision" and the helper was "wholly motivated by compassion". It is more likely if the helper was a doctor, nurse or carer acting in that role (Crown Prosecution Service).
• Scotland. There is no specific offence, but a helper can face homicide charges.
• Most US states without a law. Assisting a suicide is a crime.
• Latin America. Many countries have a lesser crime of "mercy killing". In Colombia's Penal Code, it carries 16 to 54 months in prison (C-233/21). Peru's Article 112 is similar.
• Even where it is legal. A Dutch doctor who ends a life on request without meeting the due care criteria can face up to 12 years in prison (Government of the Netherlands).

Health workers can also lose their licence, and families may bring civil claims. Even so, prosecutions of family members who helped a terminally ill loved one are rare, and convictions rarer.

These two years were unusually busy. Some laws passed. Others failed by a handful of votes.

• 20 May 2025: Delaware's governor signs its law.
• October 2025: Uruguay's Senate passes the Dignified Death law.
• 3 November 2025: The Australian Capital Territory's service begins.
• 23 November 2025: Slovenians reject an assisted suicide law in a referendum, about 53% to 47% (JURIST). Parliament had passed it in July, after a 2024 referendum in favour.
• 12 December 2025: Illinois's governor signs Deb's Law.
• 1 January 2026: Delaware's law takes effect.
• February 2026: New York's governor signs its law. Jersey's parliament approves its law, 32 votes to 16 (Irish Times).
• 16 March 2026: Portugal's government signals that it will not write the rules for the 2023 law, so the law stays unused. In April 2025, the Constitutional Court had found six of its provisions unconstitutional (Renascença).
• 17 March 2026: The Scottish Parliament rejects its bill by 69 votes to 57 (BBC).
• April 2026: The England and Wales bill, passed by MPs in June 2025, runs out of time in the House of Lords. The UK government also declines to recommend Royal Assent for the Isle of Man's law, citing human rights concerns (Humanists UK).
• 21 April 2026: Uruguay's rules take effect.
• 16 June 2026: The Isle of Man parliament approves the changes the UK asked for and sends the bill back for Royal Assent (Humanists UK). Its first vote had come in March 2025 (Dignity in Dying).
• 9 July 2026: Jersey's law receives Royal Assent, the King's formal approval. The service is planned for late 2027 (Government of Jersey; BBC).
• 5 August 2026: New York's law takes effect.
• 19 August 2026: France's law is published, after approval by the Constitutional Council. It covers adults who are French nationals or long-term residents with an incurable condition causing unbearable suffering. A panel checks each case. The patient takes the medicine, unless they are physically unable to (The Guardian). The government has up to six months to issue the detailed rules. The bill's rapporteur expects it to work from January 2027 (BFM TV).
• 27 August 2026: Australia's Northern Territory passes its law, making VAD legal across the whole country.
• 11 September 2026: MPs reject a new bill for England and Wales by 286 votes to 270 at second reading (The Guardian). Our post on the UK Assisted Dying Bill explains what happened.
• 12 September 2026: Illinois's law takes effect.
• 7 October 2026: Canada says a new bill will keep people whose only condition is a mental illness out of MAID, with no end date. Under current law, the exclusion runs until 17 March 2027. The same bill is expected to allow advance requests for people with illnesses, such as Alzheimer's disease, that will take away their capacity to decide (CBC News). Read more in our post on MAID and mental illness.
• 20 October 2026: The Isle of Man's law receives Royal Assent. No start date has been agreed yet (Isle of Man Government).
• 22 October 2026: Umbria becomes the fifth Italian region with its own rules for assisted suicide (Umbria Regional Council).

Two patterns stand out. First, new laws are mostly narrow: they require a terminal illness, often with a time limit. Second, the debate in older systems is about widening the rules, for dementia, mental illness and advance requests. In Canada, that debate has now led to a firm "not now" on mental illness.

Researchers have studied these laws for more than 30 years. Here is what the best studies show, with an honest label for how strong each finding is.

Strong evidence: assisted deaths are a small share of all deaths, and most involve older people with cancer. A landmark review in JAMA by Ezekiel Emanuel and colleagues looked at data from 1947 to 2016. Assisted deaths made up 0.3% to 4.6% of all deaths where they were legal. More than 70% of cases involved cancer. Typical patients were older, white and well educated. Pain was mostly not the main reason (Emanuel et al., JAMA 2016). Newer numbers are higher in some places: 6% in the Netherlands, 5.1% in Canada and 4% in Belgium.

Mixed evidence: are vulnerable people put at risk? The same JAMA review found no jurisdiction where vulnerable patients were receiving assisted death at higher rates than the general population. A 2007 study of Oregon and the Netherlands checked 10 groups, including older people, women, poor people, disabled people and people with depression. It found no higher risk for any of them, except people with AIDS (Battin et al., 2007). Critics reply that this data relies heavily on doctors' own reports. They also point out that rates keep rising and rules keep widening.

Mixed evidence: do doctors follow the rules? Dutch death-certificate surveys found that 77% of euthanasia cases were reported in 2010. Ending life without an explicit request fell from 0.8% of deaths in 1990 to 0.2% in 2010 (Onwuteaka-Philipsen et al., Lancet 2012). The authors concluded the law had made practice more transparent. But a 2007 survey in Flanders, Belgium, found life-ending drugs used without an explicit request in 1.8% of deaths. Most of these patients were over 80, in hospital, and the decision was usually not discussed with them (Chambaere et al., CMAJ 2010). Supporters and critics read this finding very differently.

Early evidence: newer laws. Spain, New Zealand, Australia and Uruguay have only a few years of data. One early signal is about delays: in Spain, a third of completed requests in 2024 ended because the person died first.

The limits. There is no international disease code for assisted dying. Each country uses different terms and collects different data, which makes fair comparison hard (Sillitti et al., 2025). For the full numbers, see our statistics page. For real stories, see case studies.

Palliative care is care that eases pain and other symptoms and supports the whole person. It does not try to cure the illness. Almost every law in this guide mentions it.

The modern hospice movement began with Dame Cicely Saunders, a British nurse, social worker and doctor who founded St Christopher's Hospice in London in 1967. Her best-known words still guide the field: "You matter because you are you, and you matter to the end of your life" (King's College London).

Colombia's court said in 1997 that the state must offer palliative care to terminally ill patients. Austria requires one of the two doctors to be trained in it. In practice, most people who use these laws already receive it: 92% of Oregon's patients in 2025 were in hospice care, and 74.1% of Canada's MAID recipients in 2024 had palliative care.

The research on palliative care is strong. In a landmark trial in the New England Journal of Medicine, Jennifer Temel and colleagues gave early palliative care to people with advanced lung cancer. Compared with standard care alone, they had a better quality of life and fewer symptoms of depression (16% vs 38%). They also lived longer, with a median of 11.6 months against 8.9 months (Temel et al., NEJM 2010). It was one trial, of 151 patients with one cancer, but it changed medical practice.

So which comes first? Critics such as the Catholic Church say some people choose to die when they "needed only to be better cared for and comforted" (Samaritanus bonus, 2020). Supporters reply that the two are not rivals. Good palliative care, they say, should be there for everyone, and a few people will still ask for more. Our palliative care guide explains what it offers.

This is where the law meets deep beliefs. Each side has serious people and serious arguments.

Disability rights groups are among the strongest critics. In January 2021, three UN human rights experts warned against laws that extend assisted dying to disabled people who are not dying. "Disability should never be a ground or justification to end someone's life directly or indirectly," they said (EWTN News). Gerard Quinn, the UN expert on disability rights, worried about "subtle pressure" from a lack of services (CBC). In the US, the group Not Dead Yet opposes these laws as "deadly forms of discrimination" (Not Dead Yet).

Picture a choice offered in a house with half the doors locked. You are free to choose, but only among the doors that open. That is the fear: that people choose death because the support they need to live is missing.

Religious leaders have also shaped the law. The Catholic Church calls euthanasia "an intrinsically evil act, in every situation or circumstance". It asks Catholic health workers not to take part, even where the law allows it (Samaritanus bonus, 2020). In Uruguay, the Archbishop of Montevideo said the law suggests "some lives are disposable" (BBC). Pope Leo XIV urged Illinois's governor not to sign Deb's Law, and later said he was "very disappointed" that his home state approved it (AP via MPR News). The Catholic Church backed the campaign that defeated Slovenia's law in 2025. Many other faiths, including Islam and Orthodox Judaism, also oppose euthanasia. See our page on religious views.

Supporters argue that the law is cruel to dying people who want a choice. Beatriz Gelós, who has lived with ALS for two decades, called Uruguay's law "compassionate, very humane" (BBC). After the UK vote failed, Lauren Edwards, the MP behind the bill, said the current law is "simply too cruel and too unjust to be allowed to stand" (The Guardian). Three Labour MPs who voted against said they did so because this particular bill was "unsafe and unworkable", not out of principle.

Some say the laws do not go far enough. Germany's court ruled that the right to die does not depend on illness at all. In Canada and the Netherlands, there is debate about people with dementia who can no longer ask for themselves.

Where do you stand? Is the most important thing your freedom to decide about your own death? Or is it protecting people who might feel pushed? Can a law do both? Our page on arguments for and against sets out each side in full.

Most people will never face a choice about assisted dying. But everyone faces choices about care at the end of life. These are legal almost everywhere:

• Write down your wishes. An advance directive, or living will, says which treatments you would or would not want. See our guide on how to write a living will.
• Choose someone to speak for you. A healthcare proxy can make decisions if you cannot. See how to choose a healthcare proxy.
• Know you can say no. A capable adult can refuse treatment almost everywhere, including treatment that keeps them alive.
• Ask about palliative care early. It can help from the day of diagnosis, not only at the end.
• Talk to your family. See how to talk to family about end-of-life wishes.

One thing to be clear about. The laws on this page were written for adults with serious physical illness, under strict medical rules. They are not an answer to depression, grief, loneliness or money worries. If you are hurting in that way, help is real and it works. Please visit our resources page to find someone to talk to today.

Ana Estrada kept writing her blog until March 2024. She died in April 2024, aged 47, under the terms of her court ruling. She was the first person in Peru to do so (AP via NBC).

"Ana's struggle for her right to die with dignity has helped to educate thousands of Peruvians about this right," said her lawyer, Josefina Miró Quesada. "Her struggle transcended our nation's borders."

Yet Peru's law is the same today as it was before her case. A court opened a door for one woman. Only a parliament can decide whether to open it for everyone, and under what rules.

That is the real lesson of the legal landscape. Behind every law, and every failed bill, there are people like Ana, Deb Robertson, Paola Roldán and Diane Pretty. There are also disabled people, doctors and families who fear what these laws could become. Lawmakers in Massachusetts, Westminster, Ottawa and Paris will keep weighing both.

The map will change again next year. When it does, the question at the heart of Ana's case will still be there. Who decides, and how do we protect everyone while they do?