Assisted Dying Process — the article + the world, ranked

A fuller editorial guide to assisted dying process is coming soon. For now, the ranking below compares every country we have assessed on it — open a country's report for the cited detail behind its score.

The country comparison

Which countries are best for assisted dying process

The destinations ranked high→low under this lens — each with the reasoning behind its score, the cited evidence one click down, and its full report. The verdict is free; the report is the depth.

19 / 19 Countries ranked

Researched and assessed by the Epidaurus editorial pipeline against our published scale. A country below the rule is not yet assessed enough — never ranked last.

1 Spain ES 3.5/5 Moderate Spain's process has excellent structural safeguards and clarity, with multiple review layers, functional appeals, and comprehensive guidance. However, significant implementation gaps prevent a higher score: actual tim... Full report
The evidence behind this score 5 cited points
- Actual average process timeline 82.65 days (median 62 days) significantly exceeds theoretical 35-day minimum and approaches upper bound of acceptable timelines
- Approximately 25–33% of applicants die during processing before any decision is reached, indicating process becomes inaccessible to the patients it serves
- Regional inconsistency: approval rates range from 12% in Aragon to 82% in Basque Country, showing implementation varies substantially by jurisdiction
- Five-layer safeguard structure (two written requests, responsible physician, independent consulting physician, CGE dual-review, retrospective verification) is comprehensive and well-designed
- Appeal mechanism is functional: 26.7% (20 of 75) of 2024 denials that were appealed were overturned, demonstrating CGE decisions are not rubber-stamp
Read the full Spain report →
2 Germany DE 3.0/5 Moderate Germany's assisted dying process is unregulated yet functionally accessible at scale, with working safeguards but significant inconsistency and transparency gaps. Organizations implement 2–4-stage evaluations accommod... Full report
The evidence behind this score 6 cited points
- No statutory regulatory framework exists despite legal constitutional right; regulations delegated entirely to private organizations with self-developed internal protocols
- Timeline variation is extreme: days (Linus Sterbehilfe) to 6+ months (DGHS membership requirement) for identical service depending on chosen organization
- Researchers explicitly confirm safeguard assessment is 'often insufficient' and process lacks 'scientific or transparent standards, binding guidelines, and quality assurance'
- No formal appeal mechanism exists; denied applicants may only approach different organizations; no administrative review right or statutory standards for decision-making
- Process functions at scale (1,200+ cases in 2024) with mature multi-stage evaluation frameworks from established organizations (DGHS, Linus, Verein Sterbehilfe)
- Broad constitutional right accommodates non-terminal conditions, psychiatric cases, and elderly seeking death—circumstances unavailable in most regulated jurisdictions
Read the full Germany report →
3 Colombia CO 3.0/5 Moderate Colombia's assisted dying process is clearly defined with reasonable timelines (25-30 days) and adequate safeguards, including mandatory three-member independent committees and psychiatric evaluation. However, impleme... Full report
The evidence behind this score 5 cited points
- In 2024, only approximately 30% of 1,169 requests were ultimately converted into completed procedures
- 85.5% of all 1,044 procedures through 2024 occurred in just Bogotá and Antioquia; six departments recorded zero procedures
- Of 124 institutions contracted for the service, only approximately 35 have actually performed at least one procedure
- Committees were not activated in 5.4% of all valid requests in 2023, indicating systemic non-compliance
- The three-member Scientific-Interdisciplinary Committee (specialist physician, lawyer, psychiatrist/psychologist) is mandatory and independent, with clear 10-calendar-day decision window and 15-day scheduling maximum
Read the full Colombia report →
4 United States US 3.0/5 Moderate The United States has established assisted dying processes in 13 jurisdictions with solid foundational safeguards, demonstrated by nearly three decades of documented safety with no substantiated cases of abuse or coer... Full report
The evidence behind this score 5 cited points
- Waiting periods vary significantly (48 hours in New Mexico, 7 days in Colorado, 20 days in Hawaii) with Hawaii's length causing patient deaths before completion
- Decades of Oregon experience demonstrates strong safeguard effectiveness: not a single substantiated case of abuse or coercion despite widespread access
- Residency requirements in 10 of 13 jurisdictions create substantial barriers for medical tourists (only Oregon, Vermont, and Montana allow non-residents)
- Federal funding restrictions prevent Medicare and Medicaid coverage, creating significant financial barriers for elderly and low-income patients
- Vermont's removal of residency requirement led to provider capacity constraints, with physicians unable to responsibly accept additional non-resident patients, demonstrating implementation challenges at scale
Read the full United States report →
5 Israel IL 1.0/5 Poor Israel prohibits active assisted dying entirely. No process exists for physician-administered euthanasia or physician-assisted suicide; the only available end-of-life pathway is passive measures (refusing/interrupting... Full report
The evidence behind this score 5 cited points
- Active euthanasia and physician-assisted suicide explicitly prohibited under Israeli law with no legal framework or pathway
- Only passive end-of-life measures permitted (advance directives, treatment refusal) which are not 'assisted dying' as the factor defines it
- No process, no clinics, no approved pathway exists for assisted dying; any practitioner assisting would face criminal prosecution
- Proposed 2014 Knesset bill would have explicitly required five years of Israeli citizenship, excluding medical tourists entirely
- Israelis seeking voluntary assisted dying must travel abroad to Switzerland's Dignitas organization
Read the full Israel report →
6 India IN 1.0/5 Poor India does not offer assisted dying in the forms covered by this factor. Physician-assisted suicide and voluntary active euthanasia remain criminal offenses under the Bharatiya Nyaya Sanhita (BNS) 2023, with Section 1... Full report
The evidence behind this score 5 cited points
- Active euthanasia and physician-assisted suicide remain illegal and punishable as criminal offenses under the BNS 2023
- Section 108 of the BNS criminalizes abetment to suicide with imprisonment up to 10 years
- Only passive euthanasia (withdrawal of life support) is legal, which is distinct from assisted dying as defined by this factor
- Only two states (Kerala and Karnataka) have implemented operational guidelines; implementation is fragmented
- No reported Supreme Court-approved cases of passive euthanasia have occurred despite legal framework
Read the full India report →
7 United Arab Emirates AE 1.0/5 Poor Assisted dying is entirely prohibited under UAE law with no legal framework, process, or pathway. Federal Decree-Law No. 4 of 2016 on Medical Liability imposes an absolute ban on mercy killing with criminal penalties ... Full report
The evidence behind this score 6 cited points
- Federal Decree-Law No. 4 of 2016 imposes absolute prohibition on mercy killing with penalties of 2–10 years imprisonment plus AED 10,000–1,000,000 fines
- Article 335 of the UAE Penal Code criminalizes suicide attempts (up to 6 months imprisonment) and assisting suicide (up to 5 years)
- No application process, forms, intake offices, or institutions authorized to receive assisted dying requests
- No ethics committee, review board, or approval authority exists for assisted dying
- The prohibition is backed by both statutory law and Islamic jurisprudence with no foreseeable legal reform
- The 2023 amendment to the Medical Liability Law explicitly left the euthanasia prohibition untouched
Read the full United Arab Emirates report →
8 Japan JP 1.0/5 Poor Japan has no legal assisted dying process whatsoever. Active euthanasia and physician-assisted suicide are explicitly prohibited under Article 202 of Japan's Penal Code as criminal offences with penalties of six month... Full report
The evidence behind this score 4 cited points
- Active euthanasia and physician-assisted suicide are prohibited under Penal Code Article 202 with penalties of 6 months to 7 years imprisonment
- Japan's Supreme Court in June 2025 rejected a constitutional self-determination argument and upheld an 18-year prison sentence for Dr. Yoshikazu Okubo who administered a lethal sedative to an ALS patient
- No formal application process, review committee, ethics board, or procedural framework exists for assisted dying
- Only 2% of Japanese physicians support euthanasia and 1% support physician-assisted suicide, while the Japanese Medical Association aligns with international opposition to active euthanasia
Read the full Japan report →
9 South Korea KR 1.0/5 Poor South Korea has no assisted dying process whatsoever. The country explicitly criminalizes euthanasia and physician-assisted suicide, making both illegal and punishable crimes. There is no procedural pathway, timeline,... Full report
The evidence behind this score 5 cited points
- In South Korea, EAS is illegal and considered a crime against life
- Under current Korean laws, if a family member accompanies someone to Switzerland for assisted dying, the person will be punished for aiding in suicide
- South Korea is not a destination for medical tourism related to assisted dying; while at least 204 South Koreans have obtained membership for assisted dying facilities in Switzerland
- Other forms of assisted dying, including assisted suicide or active euthanasia, are not legal in South Korea
- The only end-of-life option available is the withdrawal of life-sustaining treatment, which requires the patient to already be in the dying stage
Read the full South Korea report →
10 Mexico MX 1.0/5 Poor Mexico has no legal process for assisted dying. Active euthanasia and physician-assisted suicide are explicitly prohibited throughout the country with criminal penalties of 1-12 years imprisonment. No jurisdiction in ... Full report
The evidence behind this score 5 cited points
- Active euthanasia and physician-assisted suicide are illegal throughout Mexico with criminal penalties of 1-12 years imprisonment under the Federal Penal Code
- No jurisdiction in Mexico currently permits active euthanasia or physician-assisted suicide
- At least 19 states have constitutional amendments protecting the right to life from conception until natural death, effectively blocking any assisted dying initiatives
- Euthanasia is practiced secretly by some doctors outside the legal framework with no procedural safeguards, transparency, or legal protection
- Medical tourists seeking assisted dying services have no legal pathway in Mexico
Read the full Mexico report →
11 Malaysia MY 1.0/5 Poor Malaysia has no legal process for assisted dying whatsoever. Both physician-assisted suicide and voluntary euthanasia are categorically prohibited under the Penal Code (Act 574), with active euthanasia prosecutable as... Full report
The evidence behind this score 5 cited points
- Both physician-assisted suicide and voluntary euthanasia are categorically prohibited under Penal Code (Act 574), with no procedural pathway or approval process of any kind existing
- Active euthanasia prosecutable as murder under Section 302, now carrying a discretionary death penalty or 30–40 years imprisonment after the 2023 mandatory death penalty reform
- Abetment of suicide under Section 306 carries up to ten years imprisonment plus a fine
- Malaysian Medical Council Code of Professional Conduct (2019) requires doctors to preserve life and explicitly prohibits any professional from assisting a patient's death
- National Fatwa Council ruled in December 2011 that euthanasia in all forms is unlawful under Islamic law; surveys show 81.3% of Malaysian healthcare professionals oppose legalization, with 85.6% citing religious beliefs as the primary reason
Read the full Malaysia report →
12 Poland PL 1.0/5 Poor Poland offers no assisted dying process whatsoever because both euthanasia and assisted suicide are completely prohibited under Articles 150 and 151 of the Polish Penal Code, with criminal penalties of 3 months to 5 y... Full report
The evidence behind this score 5 cited points
- Articles 150 and 151 of the Polish Penal Code criminalize both euthanasia (mercy killing) and assisting suicide with identical penalties (3 months to 5 years imprisonment)
- Code of Medical Ethics Article 31 explicitly forbids physicians from performing euthanasia or assisting patients in committing suicide
- No formal application process, medical evaluation requirements, psychological assessments, waiting periods, review committees, or appeal mechanisms exist for assisted dying
- The Polish Constitution (Article 38) protects the right to life and the Roman Catholic Church maintains significant political influence opposing euthanasia, precluding near-term legislative change
- Poland is one of only four EU member states without legal euthanasia legislation, distinguishing it from Belgium, Netherlands, Spain, and Luxembourg which each maintain formal control commissions
Read the full Poland report →
13 Singapore SG 1.0/5 Poor Singapore has no functional assisted dying process because the practice is entirely illegal under Penal Code Section 306, criminalizing assistance with suicide with penalties up to 10 years imprisonment. There is no a... Full report
The evidence behind this score 5 cited points
- Penal Code Section 306 criminalizes abetment of suicide with maximum penalties of 10 years imprisonment and a fine
- No government body, hospital, or clinic accepts requests for assisted dying; no physician can legally participate without criminal prosecution
- No application process, review committee, waiting periods, or procedural pathway exists for assisted dying
- Foreign nationals are ineligible for assisted dying and cannot access the practice through any arrangement
- Government's 2008 position that 'Singapore does not think that Singaporeans are ready to accept euthanasia' remains unchanged with no parliamentary bills tabled
Read the full Singapore report →
14 Thailand TH 1.0/5 Poor Thailand receives the lowest possible score because assisted dying is completely illegal and no procedural process exists. Both physician-assisted suicide and voluntary euthanasia are prohibited under Thai law, with c... Full report
The evidence behind this score 5 cited points
- In Thailand, there is no law that allows active euthanasia and physician-assisted suicide
- Under Thai Criminal Code Section 288, whoever assists in causing death shall be imprisoned by death or from fifteen to twenty years
- No formal application or request process exists for assisted dying because the practice is illegal
- There is no review committee or approval mechanism for assisted dying
- Thai nationals seeking assisted dying must travel abroad; 18 Thais are members of Dignitas in Switzerland
Read the full Thailand report →
15 Turkey TR 1.0/5 Poor Turkey has a complete prohibition on assisted dying under Article 84 of the Turkish Criminal Code and Article 13 of the Patient Rights Regulation. No procedural process exists whatsoever—the service itself is illegal,... Full report
The evidence behind this score 5 cited points
- Article 84 of Turkish Criminal Code explicitly criminalizes assistance in suicide with penalties of 2-10 years imprisonment
- Article 13 of Patient Rights Regulation states: 'Euthanasia is prohibited. The right to life cannot be waived for medical reasons or by any means whatsoever'
- Article 17 of Turkish Constitution prohibits disposal of one's body, further reinforcing the absolute prohibition
- No procedural framework exists for requesting, evaluating, or carrying out assisted dying—the service is completely unavailable
- Even basic end-of-life decisions like do-not-resuscitate orders lack clear legal validity in Turkey
Read the full Turkey report →
16 Jordan JO 1.0/5 Poor Assisted dying is completely unavailable in Jordan. The Medical Liability Law (2018) categorically prohibits intentional life termination regardless of patient consent, with no exceptions, no procedural pathway, and n... Full report
The evidence behind this score 5 cited points
- Medical Liability Law (2018) explicitly criminalizes intentional termination of patient life under any circumstances, including patient request
- Penal Code No. 16 (1960) classifies intentional killing as murder with death or life imprisonment penalties
- Islamic jurisprudence, constitutionally central to Jordanian law, categorically prohibits intentional killing at patient request
- No ethics committee, review board, or approval authority exists for assisted dying requests
- 75% of surveyed Jordanian physicians supported life-sustaining interventions regardless of prognosis, reflecting the cultural context underlying the legal prohibition
Read the full Jordan report →
17 Brazil BR 1.0/5 Poor Brazil criminalizes both euthanasia (Article 121, 6–20 years imprisonment) and physician-assisted suicide (Article 122, 2–6 years imprisonment) under the 1940 Penal Code. No procedural pathway, application mechanism, ... Full report
The evidence behind this score 5 cited points
- Euthanasia prosecuted under Article 121 as homicide, carrying 6–20 years imprisonment, with compassion only marginally reducing sentence as 'privileged homicide'
- Physician-assisted suicide criminalized under Article 122 with penalties of 2–6 years imprisonment if death results
- No application mechanism, eligibility criteria, or designated bodies exist because assisted dying is a criminal offence
- CFM Resolution 2217/2018 explicitly prohibits physicians from shortening patient life under any circumstances, with violation resulting in both criminal prosecution and loss of professional registration
- Recent 2025 Chamber Health Commission bill explicitly bans euthanasia and assisted suicide while expanding palliative care alternatives; 40 years of parliamentary debate (1981–2020) produced no bill ever legalising assisted dying
Read the full Brazil report →
18 United Kingdom GB 1.0/5 Poor The United Kingdom has no legal process for assisted dying whatsoever. Assisted dying is entirely illegal in England, Wales, Scotland, and Northern Ireland, with no clinic, hospital, or legal framework through which t... Full report
The evidence behind this score 3 cited points
- No domestic assisted dying process exists; the practice is entirely illegal and constitutes criminal conduct under the Suicide Act 1961 for both England/Wales and comparable provisions in Scotland and Northern Ireland
- The proposed Terminally Ill Adults (End of Life) Bill failed after the House of Lords tabled over 1,200 amendments and the bill ran out of time before parliamentary prorogation on 24 April 2026
- For foreign nationals, there is no clinic, hospital, or legal framework through which assisted dying could be sought on UK soil under any circumstances; UK residents instead travel to Switzerland (Dignitas) at an average cost of £15,000 with no domestic alternative
Read the full United Kingdom report →
19 Hungary HU 1.0/5 Poor Hungary maintains an absolute prohibition on both euthanasia and physician-assisted suicide under Act C of 2012, Criminal Code Section 162, carrying penalties of 1–5 years' imprisonment. No assisted dying process exis... Full report
The evidence behind this score 5 cited points
- Complete criminalization under Act C of 2012 Section 162 (1–5 years imprisonment for inducing or assisting suicide)
- Constitutional prohibition under Article II of Hungary's 2011 Fundamental Law affirming inviolable human dignity and right to life
- Extraterritorial criminal jurisdiction extending to anyone who assists a Hungarian citizen in accessing assisted dying abroad
- European Court of Human Rights upheld the prohibition in Karsai v. Hungary (June 2024) as compatible with the European Convention
- No legislative trajectory toward legalization; 2012 criminal code reform left prohibition intact
Read the full Hungary report →

See the full ranking, the 1–5 rubric and the reports →