Towards a European End-of-Life Regulation: A Necessary Analysis

Abstract

Background/Objectives: Biomedical progress has extended the lifespan of patients with incurable diseases, sparking debates about their desire to live under certain conditions. This study examines the ethical and legal challenges surrounding end-of-life issues in Europe, including informed consent, the refusal of treatment, the right to health, self-determination, advance directives, assisted suicide, and euthanasia. European countries exhibit different interpretations and regulations of these practices, leading to patient "migrations" seeking favorable legal environments. Methods: This study analyzes end-of-life legislation across European countries in a comparative and qualitative way, highlighting differences, commonalities, and the potential for uniform regulation. The data were collected from the literature published between 2000 and 2024, focusing on the EU member states, Switzerland, and the United Kingdom. Results: The examination of the norms governing end-of-life practices in various European countries revealed significant differences in legislative frameworks, reflecting diverse cultural, ethical, and legal perspectives. These variations have led to patient migrations in search of suitable legal environments to end their lives with dignity. Conclusions: This study highlights the need for a harmonized approach to end-of-life legislation in Europe to ensure equitable access to end-of-life care and to uphold human dignity. Continuous legal updates and comparative studies are essential to balance medical advancements with ethical considerations. The findings emphasize the importance of autonomy and self-determination, which are fundamental human rights that should be respected in the context of end-of-life decisions.

Keywords: advance directives; assisted suicide; bioethics; end of life; euthanasia; informed consent.

Figure 1

Search strategy following PRISMA criteria.