The case of a young Spanish woman who received euthanasia after a lengthy legal process has reignited debate across Europe about how assisted dying is regulated.
Noelia Castillo, a 25-year-old woman from Spain who became paraplegic after a suicide attempt following a sexual assault in 2022, died through euthanasia in March at a healthcare centre near Barcelona. Her case sparked national controversy after her father challenged the decision in court, arguing she lacked the mental capacity to choose assisted death.
After a legal process lasting nearly two years, several courts upheld her decision, including Spain’s Supreme Court, the Constitutional Court and the European Court of Human Rights.
The case has renewed discussion about assisted dying laws across Europe, where legislation varies significantly between countries.
Spain: legal since 2021
Spain legalised euthanasia and assisted suicide in 2021, becoming one of the few European countries where doctors may actively assist a patient in ending their life.
Under the law, patients must suffer from a serious and incurable illness or a severe chronic condition causing intolerable suffering. Two formal requests must be submitted voluntarily and without pressure, with at least 15 days between them.
Each request is assessed by medical professionals and an independent review commission before the procedure is approved.
The Netherlands: the first country to legalise euthanasia
The Netherlands became the first country in the world to legalise euthanasia in 2002.
The law allows physicians to perform euthanasia when a patient experiences unbearable suffering with no prospect of improvement. The legislation applies to both physical and psychiatric illnesses.
Doctors must confirm that the patient’s request is voluntary and carefully considered, inform the patient about their medical condition and alternatives, and consult an independent physician before proceeding.
Belgium: extending eligibility beyond terminal illness
Belgium also legalised euthanasia in 2002.
The country allows the procedure for patients suffering from constant and unbearable physical or psychological pain resulting from a serious and incurable condition. Unlike some countries, the law does not require the illness to be terminal.
Belgium later expanded the law to include minors under strict conditions, making it one of the most permissive euthanasia frameworks in Europe.
Luxembourg: legal since 2009
Luxembourg adopted legislation allowing euthanasia and assisted suicide in 2009.
Patients must suffer from a serious and incurable condition resulting from illness or an accident and must be adults capable of making their own decisions. The request must be voluntary and confirmed through a strict medical review process.
Austria: assisted dying allowed under strict conditions
Austria introduced legislation permitting assisted dying in 2022.
However, the Austrian model allows only voluntary assisted suicide. Patients must self-administer the medication, which is provided through pharmacies following a detailed evaluation and consultation process.
Access is limited to adults with decision-making capacity who suffer from a serious and incurable illness that permanently affects their quality of life.
Countries where legislation is still debated
Several European countries are still debating or revising their laws on assisted dying.
In France, President Emmanuel Macron pledged to introduce legislation on assisted dying after his re-election in 2022. The proposed bill has been under parliamentary debate since 2024.
In Portugal, parliament passed a law on euthanasia and assisted dying in 2023, but it has not yet entered into force after being vetoed twice by the country’s president and challenged before the constitutional court.
Meanwhile, Malta launched a public consultation on assisted voluntary euthanasia to determine whether the government should introduce legislation.
In Slovenia, a non-binding referendum in 2024 supported assisted dying and parliament adopted legislation in 2025. However, a binding referendum later rejected the law, suspending its implementation for at least one year.
Cyprus: Assisted dying remains illegal
In Cyprus, euthanasia and assisted suicide remain illegal under current law.
There is no specific legislation regulating assisted dying, meaning that any act intended to deliberately end a person’s life – even at the patient’s request – can fall under criminal offences such as homicide or assisting suicide under the country’s penal code.
Cypriot law therefore allows only palliative care and the withdrawal or withholding of medical treatment under certain circumstances, when this is in line with medical ethics and the wishes of the patient or their family. The aim of these practices is to relieve suffering rather than intentionally cause death.
A deeply divided issue
Across Europe, the debate around euthanasia remains complex and highly sensitive.
Supporters argue that assisted dying provides dignity and autonomy to people suffering from severe illnesses. Opponents, however, warn that legalising the practice could expose vulnerable individuals to pressure and raise serious ethical questions.
As more countries reconsider their laws, the issue of assisted dying is likely to remain a central topic in Europe’s public health and human rights discussions.
Source: Euronews