Assisted suicide is the process by which a person, with the assistance of a medical professional, takes actions to end their life.
This practice is strictly regulated by the laws and rules of the state or country that a person lives in. The physician's assistance is usually limited to writing a prescription for a lethal dose of drugs. This practice falls under the concept of the medical right to die (i.e., the right of a person to choose when and how they will die, either through medical aid in dying or refusing life-saving medical treatment).
While assisted suicide is not legal in all countries, it is legal under certain circumstances in some countries including Australia, Austria, Belgium, Canada, Germany, Jersey, Luxembourg, the Netherlands, Portugal (law not yet in force, awaiting regulation), Spain, Switzerland, and parts of the United States. The constitutional courts of Colombia, Estonia and Italy have legalized assisted suicide, but their legislatures have not yet legislated or regulated the practice.
Terminology
Depending on the territory and the legislation, this practice is referred to using a variety of terminologies. In some specific legal frameworks, these terms refer exclusively to assisted suicide, although the same terms are used in other jurisdictions to refer to other related practices, such as voluntary euthanasia. These include:
medical aid in dying (MAID) medical assistance in dying (MAiD) physician-assisted death (PAD) physician-assisted suicide (PAS) assisted dying (AD) assisted suicide (AS)
However, all of these terminologies in their legal framework refer to the same medical practice, in which a physician indirectly assists another person to end their own life. It involves a physician "knowingly and intentionally providing a person with the knowledge or means or both required to [end one's life], including counseling about lethal doses of drugs, prescribing such lethal doses or supplying the drugs". This is a regulated practice in which the patient must meet strict criteria in order to receive medical assistance in dying.
Related terms Assisted suicide should not be confused with the practice of euthanasia, which occurs when somebody directly takes actions to end the life of another (either a person or animal). It can occur with or without consent, and can be classified as voluntary (the person consents), non-voluntary (the person is unable to provide consent) or involuntary (the person does not give consent).
Assisted suicide on the other hand, includes only the indirect involvement of a medical professional, as the dying individual is responsible for completing the action that ends their own life.
Concerns about use of the term "assisted suicide" Some advocates for assisted dying strongly oppose the terms "assisted suicide" and "suicide", and prefer terms such as "medical aid in dying" or "assisted dying". The motivation for this is to distance the debate from suicides commonly performed by those not terminally ill, as they believe that the use of "suicide" is not an accurate representation of the medical practice.
In 2022, the World Federation of Right to Die Societies adopted the term "assisted dying" as the preferred terminology.
Restrictions and criteria
To qualify for medical aid in dying, individuals must typically meet strict criteria, which may include:
they have a terminal (i.e. likely to die in 6 months or a year) or incurable illness or disability, they are of sound mind, they voluntarily and repeatedly express their wish to die, they take the specified, lethal dose by their own hand.
Laws vary in scope from place to place. In the United States, medical aid in dying is limited to those who have a prognosis of less than six months to live. Additionally, it is required in the United States that a physician offer alternative methods to limit a patient's suffering or discomfort, such as hospice or palliative care, before allowing them to agree to medical aid in dying.
In Canada and most European countries where the practice is permitted, eligibility also includes 'unbearable suffering' (i.e. the person does not need to be terminally ill). Switzerland has some of the least restrictive criteria for medical aid in dying. In order to qualify, a medical diagnosis is not required. Any person of sound mind can seek assistance to commit suicide. The Federal Supreme Court affirmed in 2023 that in case of mental illness, several intensive discussions with the individual, questioning the patient's relatives and obtaining a medical second opinion is sufficient for a doctor to prescribe a lethal drug to a mentally ill person. An opinion written by a psychiatric specialist is not necessary. The Swiss association Dignitas requires that the person: have a disease which will lead to death (terminal illness), and/or an unendurable incapacitating disability, and/or unbearable and uncontrollable pain, be of sound judgement, be able to commit the last stage – to swallow, administer the gastric tube or open the valve of the intravenous access tube – by themselves.
Methods
Ingestion method In the majority of cases, medical aid in dying is performed through the ingestion of pills that are swallowed (either whole or in powdered form), with the patient becoming unconscious after approximately 20-30 minutes and then dying within about 1-2 hours. On average, the median time to death is approximately 45 minutes.
Intravenous method In some places such as Canada, the medications may be taken by intravenous infusion, with dying normally occurring within a few minutes.
Inhalation method Ingestion of nitrogenous gas has been used in a few cases in Switzerland.
Medications commonly used Some common medications include Propofol, Midazolam, Diazepam, Digoxin, Rocuronium or various Barbiturates, particularly secobarbital (brand name Seconal) and pentobarbital.
Medications are typically given in combinations, such as:
DDMAPh: diazepam, digoxin, morphine sulfate, amitriptyline, and phenobarbital DDHAPh: diazepam, digoxin, hydromorphone, amitriptyline, and phenobarbital DDMA: diazepam, digoxin, morphine sulfate, and amitriptyline DDMP: diazepam, digoxin, morphine sulfate, and propranolol
Other medications and medication combinations have been considered, and typically vary by state or country.
In Canada, a sequence of midazolam, propofol and rocuronium is commonly used.
In Oregon, USA, almost all medical aid in dying ingestions were of combination medications. In 2025, 75% of ingestions used the drug combination DDMAPh (diazepam, digoxin, morphine sulfate, amitriptyline, phenobarbital), 13% of ingestions were DDHAPh (replacing the morphine sulfate with hydromorphone), and 12% of ingestions were of DDMA (diazepam, digoxin, morphine sulfate, and amitriptyline). Other US states also use similar drug combinations to facilitate medical aid in dying.
In the Netherlands, very high-dose barbiturates have been recommended by the Netherlands' Guidelines for the Practice of Euthanasia.
In Switzerland, in the Dignitas program, after taking an anti-emetic, the person ingests sodium pentobarbital (NaP, a.k.a. Nembutal), usually 15 grams. This is normally swallowed with water, but may be ingested by gastric tube or intravenously. In the Swiss Pegasos program, sodium pentobarbital is taken intravenously.
Effectiveness The methods that are now widely used have very high success rates, but not 100%. In Oregon, USA, between the years 2001 - 2025, only 9 out of 3,621 cases (0.2%) were ineffective (recipient regained consciousness after ingesting the medication).
Witnessing the act
Medical staff
In most countries, medical staff such as doctors or nurses are permitted to accompany the patient and serve as a witness, so long as the patient is the only person who handles and ingests the medication on their own.
Other witnesses Other witnesses are also typically allowed, such as friends, family, or community volunteers.
In Oregon in 2025, it was found that a medical staff or volunteer were present in 79% of cases when medications were ingested, and in 56% of cases at time of death.
Duo-euthanasia Some countries, such as the Netherlands, allow duo-euthanasia, in which partners die together. In 2023, 66 people (33 couples) chose to die by duo-euthanasia. Former Dutch prime minister Dries van Agt and his wife died this way.
Legality by country and region
Australia
Laws regarding assisted suicide in Australia are a matter for state and territory governments. Physician assisted suicide is currently legal in all Australian states and territories: New South Wales,Victoria,South Australia, Western Australia,Tasmania,Queensland,Australian Capital Territory,and the Northern Territory.
Under Victorian law, patients can ask medical practitioners about assisted suicide, and doctors, including conscientious objectors, should refer to appropriately trained colleagues who do not conscientiously object. Health practitioners are restricted from initiating conversation or suggesting VAD to a patient unprompted.
Physician assisted suicide was legal in the Northern Territory for a short time under the Rights of the Terminally Ill Act 1995, until this law was overturned by the Federal Parliament which also removed the ability for territories to pass legislation relating to assisted dying, however this prohibition was repealed in December 2022 with the passing of Restoring Territory Rights Act 2022. The highly controversial 'Euthanasia Machine', the first invented voluntary assisted dying machine of its kind, created by Philip Nitschke, utilised during this period is presently held at London's Science Museum.
Austria
In December 2020, the Austrian Constitutional Court ruled that the prohibition of assisted suicide was unconstitutional. In December 2021, the Austrian Parliament legalized assisted suicide for those who are terminally ill or have a permanent, debilitating condition.
Belgium The Euthanasia Act legalized voluntary euthanasia in Belgium in 2002, but it did not cover physician-assisted suicide. The Federal Evaluation and Control Commission (Dutch: Federale Evaluatie-en Controle Commissie) the institution that is responsible for checking whether the law has been followed in practice, concluded that physician-assisted suicide is allowed under the same conditions as in the case of euthanasia. The physician needs to be present and is responsible. The professional group representing the doctors shares this stance.
Canada
In Canada, physician-assisted suicide was first legalized in the province of Quebec on 5 June 2014. It was declared nationally legal by the Supreme Court of Canada on 6 February 2015, in Carter v. Canada (Attorney General).Carter v. Canada (Attorney General), 2015 S.C.C. 5, 1 S.C.R. 331.
National legislation formalizing physician-assisted suicide passed in mid-June 2016, for patients facing an estimated death within six months.Bill C-14, An Act to amend the Criminal Code & to make related amendments to other Acts (medical assistance in dying), 1st Sess., 42nd Parl., 2015–2016 (assented to 2016‑06‑17), S.C. 2016, c. 3 . Eligibility criteria have been progressively expanded over time. As of March 2021, individuals no longer need to be terminally ill in order to qualify for assisted suicide. Legislation allowing for assisted suicide for mental illness was expected to come into force on 17 March 2023, but has since been postponed until 2027.
Between 10 December 2015 and 30 June 2017, 2,149 medically assisted deaths were documented in Canada. Research published by Health Canada illustrates physician preference for physician-administered voluntary euthanasia, citing concerns about effective administration and prevention of the potential complications of self-administration by patients.
China