Portugal becomes the fourth country in Europe to move to decriminalise euthanasia, but only for national citizens and legal residents in order to prevent people from travelling to Portugal to get medical help to end their life.
Portugal's Parliament has voted to legalise euthanasia, with the country set to become the seventh in the world to allow terminally ill patients to seek assistance from a doctor to end their life.
According to the legislation that passed on Friday, people aged over 18 will be allowed to request assistance in dying if they are terminally ill and suffering from "lasting" and "unbearable" pain – unless they are deemed not to be mentally fit to make such a decision.
The process will only be open to national citizens and legal residents in order to prevent people from travelling to Portugal to get medical help to end their life.
The law is now in the hands of President Marcelo Rebelo de Sousa, a conservative, for a final stamp of approval. He previously said he would respect parliament's vote.
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Some have criticised the timing of the vote, with opposition party PSD saying due to the coronavirus pandemic raging across Portugal there was "great anxiety, great fear among people that has to do with issues of life and death."
In a letter to parliament, two groups managing the majority of Portugal's care homes, which were hit hard by the pandemic, said "the approval of euthanasia represents a disrespect for all these people."
But parliamentary leader of the People-Animals-Nature party, Ines Real, said, "It is dishonest to invoke an extremely difficult moment in the country ... to confuse deaths related to Covid-19 with the legislative process that aims to allow euthanasia to those suffering."
Portugal, a Catholic-majority country that spent a large part of the 20th century until the 1974 Carnation revolution ruled by a fascist regime, has since made strides in liberal reforms upholding human rights.
It legalised abortions in 2007 and allowed same-sex marriage in 2010.
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Euthanasia: Where it's legal in Europe
The Netherlands has legalised active and direct euthanasia since April 2002. Requested administration of a drug in lethal doses is authorised if patients make the request while lucid.
They must also be experiencing unbearable suffering from a condition diagnosed as incurable by at least two doctors.
In 2020, the country's highest court ruled that doctors will be able to conduct assisted suicides on patients with severe dementia without fear of prosecution, even if the patient no longer expressed an explicit death wish.
The Netherlands also moved towards making euthanasia legal for terminally ill children aged between one and 12.
Belgium lifted restrictions on euthanasia in 2002 for patients facing constant, unbearable, and untreatable physical or psychological suffering.
They must be aged 18 or over and request termination of life in a voluntary, deliberated, and repeated manner free from coercion.
In 2014, Belgium became the first country to authorise children to request euthanasia if they suffer a terminal disease and understand the consequences of the act.
In Luxembourg, a text legalising euthanasia in certain terminal cases was approved in 2009. It excludes minors.
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Switzerland is one of the rare countries that allows assisted suicide with patients administering a lethal dose of medication themselves. It does not allow active, direct euthanasia by a third party but tolerates the provision of substances to relieve suffering, even if death is a possible side-effect.
Other ways of assisted death
Spain's Parliament voted in 2020 to approve a bill that will allow euthanasia under strict conditions despite fierce opposition from the Catholic church and conservative parties. It still faces a vote in the Senate early in 2021.
Italy's Constitutional Court ruled in 2019 it was not always a crime to help someone in "intolerable suffering" commit suicide. Parliament is set to debate a change in the law banning the practice.
The halting of medical procedures that maintain life, called passive euthanasia, is also tolerated.
In France, a 2005 law legalises passive euthanasia as a "right to die." A 2016 law allows doctors to couple this with "deep and continuous sedation" for terminally ill patients, while keeping euthanasia and assisted suicide illegal.
Sweden authorised passive euthanasia in 2010.
Britain has allowed medical personnel to halt life-preserving treatment in certain cases since 2002. Prosecution of those who have helped a close relative die, after clearly expressing the desire to end their lives, has receded since 2010.
In Austria and Germany passive euthanasia is permitted if requested by the patient.
Austria's constitutional court ruled in October the country was violating fundamental rights in ruling assisted suicide illegal and ordered the government to lift the ban in 2021.
Since 1992 Denmark has allowed people to file written refusal of excessive treatment in dire situations, with the document held in a centralised register.
In Norway, passive euthanasia is permitted if requested by the patient or by a relative, if the patient is unconscious.
In Hungary, people with incurable diseases can refuse treatment.
It is also legal to end treatment of terminally ill people in Lithuania and Latvia.