Court rulings

European Court of Human Rights in Strassbourg

The European Court of Human Rights (ECtHR) (Link)

European Convention on Human Rights (ECHR) (Link)

HUDOC Database / Search Portal of The Court (Link)

Judgment of 29 April 2002 in the case of Diane Pretty v. the United Kingdom, application no. 2346/02 (Link)

Judgment of 20 January 2011 in the case of Haas v. Switzerland, application no. 31322/07 (Link)

Press Release on this judgement (PDF)

Press release regarding the Chamber Hearing in the case of Koch v. Germany, application no. 497/09 (PDF)

Decision of 31 May 2011 as to the admissibility of the case Koch v. Germany, application no. 497/09 (Link) and Press Release (PDF). The Court of Human Rights has declared the application admissible.

Judgment of 19 July 2012 in the case Koch v. Germany (Link)

Judgment of 14 May 2013 in the case of Gross v. Switzerland, application no. 67810/10 (Link)

Judgment of 30 September 2014 of the Grand Chamber in the case of Gross v. Switzerland, application no. 67810/10, not to pursue the case (Link)

Switzerland had requested that the decision of 14 May 2013 be referred to the Grand Chamber, which was granted by the panel of the Grand Chamber. Shortly prior to a public hearing on the case, set for 2 April 2014, it became known that the applicant had passed away in the meantime.

Judgment of 5 June 2015 in the case of Vincent Lambert and Others v. France, application no. 46034/14 (Link)

When considering the question whether discontinuing measures to keep Mr. Lambert alive would be permissible, the ECtHR decided by 12:5 votes that no violation of article 2 (right to life) would result from this. Therefore, the judgment of the French High Court, the Conseil d’État, can be implemented. This signifies that the life-sustaining measures of Vincent Lambert, who has been tetraplegic, fully dependent, artificially nourished and in persistent vegetative state (PVS) since a road accident on 29 September 2009 can be discontinued.

Judgment of 23 June 2015 in the cases of Lamb and Nicklinson against the United Kingdom, applications nos. 2478/15 and 1787/15 (Link)

In this decision, the ECrHR joined the applications of almost entirely paralysed Paul Lamb and Tony Nicklinson , who had suffered from a locked-in-syndrome and deceased in 2012 – represented by his wife – and declared the applications inadmissible.

Judgment of 13 June 2024 in the case of Dániel Karsai against Hungary, application no. 32312/23 (Link)

In this decision, the ECtHR asserted the right of the applicant, who suffers from amyotrophic lateral sclerosis (motor neurone disease), to be assisted in dying. The court declared the complaint under article 8 alone, and under article 14 in conjunction with article 8 admissible but held that there has been no violation of these articles.

Analysis of the judgment by DIGNITAS - To live with dignity - To die with dignity (pdf)

Switzerland

(generally, availalbe in Swiss/German or French only)

Judgment 6B_393/2023 of the Federal Supreme Court, 13 March 2024 (Link)

Press release of the Court (Link)

Following the Federal Supreme Court judgment 6B_646/2020 of 9 December 2021 and a new acquittal judgment by the Cantonal Court of Geneva (AARP/45/2023 of 6 February 2023), the public prosecutor's office appealed to the Federal Supreme Court again on 20 March 2023: the medical doctor should be punished for violating the Narcotics Act (NarcA). The Federal Supreme Court rejected the appeal: as with the Therapeutic Products Act (TPA), it held that the Narcotics Act was not applicable to the facts of the case.

Review essay on the AARP/45/2023 judgment in the law journal “AJP” (pdf)

Communiqué of DIGNITAS – To live with dignity – To die with dignity (pdf)

Judgment 6B_646/2020 of the Federal Supreme Court, 9 December 2021 (Link)

Press release of the Court (Link)

With this judgment, the Federal Supreme Court overturned the conviction of a medical doctor who had issued a prescription for the medication sodium pentobarbital (SoP) to a “healthy” 86-year-old woman in 2017 for use in her accompanied suicide. The woman wished to die together with her terminally ill husband, and she had previously written and notarised a statement that she did not want to outlive him. In April 2017, she ingested the SoP and passed away together with her husband. In October 2019, the Police Court of the Canton of Geneva sentenced the medical doctor to a monetary fine and a fine for violating the Therapeutic Products Act (TPA); the Geneva cantonal court confirmed this judgment in 2020, stating that the doctor had violated the “medical-ethical guidelines” of the Swiss Academy of Medical Sciences (SAMS) by dispensing SoP in her case and thus breached his duty of care. The appeal lodged by the doctor against this judgment was upheld by the Federal Supreme Court, which annulled the contested Geneva Cantonal judgment and referred the case back for review and new decision. In this specific case, so the Court found, there was a so-called “balance suicide” (in the sense of a “completed life decision”) of a “healthy” person, that is, without medical indication, and therefore a conviction on the basis of the Therapeutic Products Act was out of the question and contrary to federal law. It remained to be examined whether the prescription of SoP in this case should be sanctioned under the Narcotics Act (NarcA).

Judgment VD.2017.21 (AG.2017.455) of the Court of Appeal of the Canton of Basel-Stadt as Administrative Court, 6 July 2017 (Link)

In this judgment, the court had to decide on the appeal of a medical doctor and assisted dying organisation employee who objected to the fact that she was only granted a 90-day permit to work in the neighbouring canton of Basel-Stadt under the condition that “the applicable professional rules regarding assisted suicide in the FMH Code of Professional Conduct were complied with”. The court justified its judgement over the length of 18 pages, which seems unusual, but this was probably necessary because various questions of fundamental importance arose, including the question of whether the guidelines of the Swiss Academy of Medical Sciences (SAMS) are binding or not for medical doctors.

Review essay “Assisted suicide – are SAMS guidelines part of medical professional duties? On the interpretation of Art. 40 MedBG in conformity with fundamental rights” in the law journal AJP/PJA 1/2019, p. 115ff (Link)

Judgment BGE 142 I 195 of the Federal Supreme Court, 13 September 2016 (Link)

This case concerned the legal obligation of state-subsidised charitable institutions (such as care homes) to tolerate accompanied suicide in their facilities, which is enshrined in article 35a of the Health Act of the Canton of Neuchâtel, against which the Salvation Army appealed to the Federal Supreme Court. The Court declared, when weighing up the interests at stake, that the freedom of the residents and patients of the care home in question to choose the time and manner of their own end of life outweighed the freedom of religion and conscience of the co-operative that runs the care home. The canton is allowed to impose appropriate conditions when granting subsidies; consequently, the principle of legal equality is not violated if only recognised charitable institutions (but not those which are not recognised and therefore do not receive state subsidies) must allow external supporter for the purpose of assisted suicide. In this respect, the Neuchâtel legislator also intended to establish legal equality between people who still live in their own homes and those who are forced to live in retirement and care homes. The state may impose certain conditions where it supports such homes with subsidies; this is a condition that is intended to ensure compliance with a fundamental right of the residents or patients, which the legislator is authorised to do.

Judgment BGE 136 II 415 of the Federal Supreme Court, 16 June 2010 (Link)

The Chief Public Prosecutor of the Canton of Zurich at the time, Dr Andreas Brunner, drafted an “agreement” between the Public Prosecutor's Office and associations such as 'Exit Deutsche Schweiz' or 'DIGNITAS - To live with dignity - To die with dignity' in order to “subject ‘organised assisted suicide’ to certain framework conditions for the purpose of quality assurance” according to clause 1 of said agreement. The real effect of the agreement was a restriction of the freedom of those persons who wish to make use of assisted suicide through provisions to be observed by the associations regarding conditions and procedures of assisted suicide – for which then only random checks by the prosecution authorities at the place of an assisted suicide were provided as “consideration” (in the sense of a trade-off). One of the associations signed this agreement on 7 July 2009. DIGNITAS rejected it for various reasons. The agreement was challenged by members of a “pro-life” organisation with an appeal to the Federal Supreme Court. However, the appeal was not upheld due to the complainants’ lack of legitimacy. Nevertheless, the Federal Supreme Court felt compelled to state in its judgement, among other things: “In summary, the contested agreement is unlawful. It lacks a legal basis and also violates substantive criminal law and narcotics law. [...] The defect with which the agreement is tainted as a result is not only obvious, but also serious. It is significant that both the right to life and personal freedom are affected in a central area [...] In addition, the agreement appears to be detrimental to legal certainty...”

Judgment CPEN.2013.75/dhp of the Criminal Law Division of the Canton of Neuchâtel, 8 May 2014 – Review essay in the law journal AJP/PJA 9/2015, p. 1308ff (Link / PDF)

On the basis of his medical history, which was based on descriptions provided by his 88-year-old patient, who was capable of judgement, the appellant medical doctor came to the conclusion that the patient was probably suffering from an anorectal tumour. The patient flatly refused to undergo or even consider the slightest diagnostic or therapeutic treatment and subsequently contacted Exit Suisse romande to request an assisted suicide. The appellant issued the prescription to obtain the medication. In its judgement of 8 July 2013, the Police Court found the appellant guilty of violating Art. 26 in conjunction with Art. 86 para. 1 lit. a of the Federal Act on Medicinal Products and Medical Devices (TPA). This offence was based on the fact that he had prescribed a lethal substance without knowing his patient's state of health. The appellant challenged the judgement of the police court in its entirety. He accused the court of failing to take due account of the patient's previous suicide attempt, his obvious and repeated intention to take his own life, his irrevocable refusal of any diagnostic intervention other than the medical history, and his persistence in asking the appellant to be allowed to die in the face of his unbearable suffering. In its appeal judgment of 8 May 2014, the Cantonal Court of Neuchâtel overturned the contested judgement and acquitted the appellant entirely of guilt and punishment. The appellate court stated that the lower court's interpretation of the wording of Art. 26 para. 2 TPA was so formalistic and extensive that the wording of this legal provision could theoretically also mean that any unfavourable act by a doctor could be sanctioned by accusing him of not having obtained reliable ‘knowledge’ of his patient's state of health through inadequate clarification.

Judgment ES.2011.210 of the Criminal Court of the Canton of Basel-Stadt, 5 July 2012 - Review essay in the law journal AJP/PJA 6/2013 (PDF)

In this judgment, the Basel Criminal Court acquitted a medical doctor of the charge of having violated the Therapeutic Products Act by issuing a prescription for sodium pentobarbital for the purpose of assisting the suicide of an 82-year-old woman who was almost completely blind and therefore depressed, thereby jeopardising the health of this person. The court held that the medical-ethical guidelines by the Swiss Academy of Medical Science (SAMS) “Care of patients at the end of life” were not applicable to such a case, and that a request for a psychiatric report due to the depression would probably have been too high a hurdle in this case. It also contradicted the view that a prescription for a medication for the purpose of assisted suicide is only permissible in cases when someone would die in the near future anyway due to an illness.

Judgment BGE 133 I 58 of the Federal Supreme Court, 3 November 2006 (Link)

In this judgment, the Swiss Federal Supreme Court recognised the right of a person to determine how and when to end their own life as a fundamental right on European level, guaranteed by the European Convention on Human Rights, and at the same time granted people with psychiatric/mental illness the same right as others, provided they are capable of judgement. Furthermore, the court rejected a request to remove the prescription requirement for the medication required for an assisted suicide.

United Kingdom

Judgment of 30 July 2009 by the House of Lords (Link)

Additional information by Debbie Purdy's lawyer (Link)

Mrs. Debbie Purdy, an UK citizen suffering from multiple sclerosis, brought a case against the Director of Public Prosecution (DPP), Keir Starmer, to the Law Lords: she wanted to know whether or not her husband would be prosecuted by the Crown Prosecution Service (CPS) if he would help her to travel abroad to have an assisted suicide. The ruling forced the CPS to state exactly when it would take action against those who help their loved ones end their lives abroad.

Judgment of 25 June 2014 of the Supreme Court in the cases of Nicklinson, Lamb and Martin (PDF).

Even though their appeal has been rejected, the Court finds that both Parliament and the Director of Public Productions (DPP) should reconsider the law and prosecuting policy on assistance to die. Though divided on the issue of whether the UK Suicide Act’s universal prohibition on assisted suicide is incompatible with the human right to private and family life – protected under Article 8 of the European Convention on Human Rights (ECHR) – a majority of the justices ruled that the Court could in theory declare the universal ban on assisted suicide incompatible unless Parliament acts to reform it.

Austria

Judgment G 139/2019-71 of 11 December 2020 of the Constitutional Court of Austria in Vienna (Link-PDF, abstract in English)

Judgment full version in German (Link-PDF)

Communique by DIGNITAS (PDF)

On 11 December 2020 the Austrian Constitutional Court judged over a constitutional complaint (Individualantrag, Individual Application) against the prohibition of assistance in suicide and voluntary euthanasia.
§ 78 “participation in self-murder” (sic!) of the Austrian criminal code, which was set up in the Austro-fascist 1930s, said: “Any person who incites another to commit suicide [literally: “kill himself”], or provides help in this, is liable to a custodial sentence of six months to five years.”
The Court found the second fact of § 78 („or provides help in this”) unconstitutional, to effect as of 1 January 2022.
The application against voluntary euthanasia, § 77 Austrian Criminal Code, was rejected by the Court.

Germany

Judgment(s) 2 BvR 2347/15, 2 BvR 2527/16, 2 BvR 2354/16, 2 BvR 1593/16, 2 BvR 1261/16, 2 BvR 651/16 of 26 February 2020 by the Federal Constitutional Court of Germany (Link to press release by the Court and abstract of the judgment)

Communiqué by DIGNITAS (PDF)

The Federal Constitutional Court of Germany (Bundesverfassungsgericht) in Karlsruhe found that article § 217 of the Criminal Code (Strafgesetzbuch – StGB) “Geschäftsmässige Förderung der Selbsttötung” – de facto a prohibition of professional and dignified advisory work and help for a self-determined end of life – is unconstitutional. § 217 violates the Basic Law and is void. Quote: “The general right of personality (Art. 2(1) in conjunction with Art. 1(1) of the Basic Law, Grundgesetz – GG) encompasses a right to a self-determined death. This right includes the freedom to take one’s own life and, as the case may be, resort to assistance provided voluntarily by third parties for this purpose. Where, in the exercise of this right, an individual decides to end their own life, having reached this decision based on how they personally define quality of life and a meaningful existence, their decision must, in principle, be respected by state and society as an act of autonomous self-determination.”

Judgment BVerwG 3 C 19.15 of 2 March 2017 by the Federal Administrative Court (Supreme Court) of Germany (Link, English translation based on an edited version of the original ruling, provided by the Court)

Press release by DIGNITAS – To live with dignity – To die with dignity (PDF)

The Federal Administrative Court of Germany (Bundesverwaltungsgericht) in Leipzig issued a landmark decision in regard of access to the means for ending one’s suffering and life by one’s own action, and the right to die in general. This case concerned the wife of the claimant who, after an accident, had been almost totally paralysed (quadriplegic), needed 24/7 ventilation and suffered from pain and cramps. In 2005, she ended her ordeal by an accompanied suicide at DIGNITAS – To live with dignity – To die with dignity, however, before this, she started litigation continued by her husband which led to the now decision. In 2004, she tried to obtain the preferable means for an accompanied suicide from the German Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte BfArM) so that she could end her life at home, instead of having to do a practically and emotionally challenging journey to DIGNITAS in Switzerland. However, to little surprise, the Institute rejected her plea. Mr. Koch took over the fight for the right to die at home from his wife and appealed to the decision of the Institute. However, all German Courts rejected his arguments by stating that he was neither entitled to the claim brought up by his now deceased wife nor to own rights. In conclusion, he brought the case to the European Court of Human Rights, which, on 19 July 2002, decided that based on article 8 (Right to respect for private and family life) of the European Convention on Human Rights, the German Courts at least should have looked into whether Mr. Koch’s plea had been reasonably justified. The case went back to square one, however, this time with the German Courts being forced to deal with the matter. Finally, in this second court case round, the Federal Administrative Court corrected the decisions by the Lower Courts and acknowledged that the decision of the German Federal Institute for Drugs and Medical Devises had been unlawful. The general right to personality article 2,1 (right to life) in connection with article 1,1 (protection of human dignity) of the Basic Law (Constitutional Law) of Germany comprises the right of a severe and incurably ill patient to decide how and at what time his or her life shall end, provided that he or she is in a position to make up his or her own mind in that respect and act accordingly. The Court found, even though it was generally not possible to allow purchasing a narcotic substance for the purpose of suicide, there had to be exceptions. This, if a severe and incurably ill patient, due to his or her unbearable suffering, freely and seriously decides to wish an end to his or her life, and if there was no reasonable alternative available – such as to end treatment accompanied by palliative care. Such patients should not be barred from accessing prescribe narcotics for a dignified and painless suicide. The Court found that the Institute at least should have assessed whether such a case had been given with Mrs. Koch.

Italy

Judgment 242/2019 of 25 September 2019 by the Constitutional Court of Italy (Link)

Information about the case provided by the Ialian human rights organization Associazione Luca Coscioni (Link, in English)

The Constitutional court dealt with the case of criminal prosecution against Marco Cappato who had been accused of assisting in the suicide of Fabiano An-toniani – a man paraplegic, blind and on life-support after a car accident in 2014 – and found article 580 of the Italian Criminal Code (prohibiting to help or convince someone to commit suicide) unconstitutional insofar as it did not make an exception for assisting in the suicide of a person fully capable of making free and conscious decisions with a condition such as Mr. Antoniani, that is, an irreversible pathology causing physical or psychological suffering which the person considers intolerable.

Canada

Judgment of 6 February 2015 of the Supreme Court of Canada in the case Carter v. Canada (Attorney General) (Link): In a unanimous 9:0 decision Canada’s Supreme Court has struck down the country’s Criminal Code laws prohibiting physician-assisted suicide. The rule will not come into force for another 12 months; however, it means it will no longer be against the law, under certain circumstances, for a doctor to help someone who is terminally ill to end their life.

Judgment of 10 August 2012 of the British Columbia Supreme Court (Link): Madam Justice Prowse of the BC Court of Appeal has denied the Attorney General of Canada’s attempt to prevent Gloria Taylor from exercising her court-approved right to die.

Gloria Taylor, who is terminally ill, received in June a constitutional exemption allowing her to receive a lethal prescription, under very stringent conditions. At the same time, BC Supreme Court Justice Lynn Smith also ruled that Canada’s law banning assisted suicide was unconstitutional and she gave parliament 12 months to fashion a new law. Since Ms Taylor was unlikely to live to benefit from any change in the law, Justice Smith afforded her an interim remedy to receive a doctor’s assistance.

Judgment of 15 June 2012 of the British Columbia Supreme Court (Link): The BC Supreme Court has declared the absolute prohibition against assistance with suicide to be constitutionally invalid. In a 395-page decision, Madam Justice Smith gives the federal government 12 months to fashion a new law that allows assistance with suicide, subject to protecting the vulnerable from coercion and undue influence.

During the 12-month period and pending appeal, Gloria Taylor and any other person can apply for a constitutional exemption to receive lethal medication from a physician to end his or her life. The applicant must meet certain conditions, including requirements that he or she make a written request, be terminally ill and near death, of sound mind, and fully informed of treatment options such as palliative care.

United States of America

Settlement of 28 March 2022 in the case of Gideonse v. Brown, et al., a lawsuit filed at the US. District Court of Oregon

In this case, Dr. Nicholas Gideonse, a physician practicing in Oregon who regularly also attends to patients from the neighbouring State of Washington, alleged that the residency requirement contained in the Oregon Death with Dignity Act is unconstitutional as it unlawfully prevents his out-of-state patients from seeking medical aid in dying. He had to disrupt the continuum of care for his non-resident patients who want the option of assisted dying and refer such patients to another provider in Washington who will agree to support the patient’s wishes.
In result, Dr Gideonse and the State of Oregon defendants reached the settlement that the Oregon Health Authority (OHA), Oregon Medical Board, and the Multnomah County District Attorney all agreed not to enforce the residency restriction. Further, the OHA has agreed to initiate a legislative request to permanently remove the residency restriction from the Oregon Death with Dignity Act.

Details of the case provided by Compassion & Choices (Link)

Judgment of 31 December 2009 by the Supreme Court of the State of Montana (PDF): Under the Constitution of Montana, Article II, paragraph 4 and 10, terminally ill Robert Baxter has the right to a dignified death and at the same time his physician has the right to being protected from prosecution. Even though the right to physician assisted dying was not guaranteed by the Constitution of Montana, such assistance, taking into consideration court cases and the law, was not in conflict with public interests and therefore not illegal. The decision was done by 5 : 2.

Through this single-case decision, Montana became the third US-State which, in theory, has legalised physician-assisted-suicide

Judgment of 6 February 2012 of the Supreme Court of the State of Georgia (PDF): Under the Constitutions of the State of Georgia and the United States of America, the State’s assisted-suicide law violates the free speech clauses. Said law held that anyone could face up to 5 years in prison “who publicly advertises, offers or holds himself or herself out as offering that he or she will intentionally and actively assist another person in the commission of suicide and commits any overt act to further that purpose.”

Writing for the court in a unanimous decision, Justice Hugh Thompson said: “The State has failed to provide any explanation or evidence as to why a public advertisement or offer to assist in an otherwise legal activity is sufficiently problematic to justify an intrusion on protected speech rights. Absent a more particularized State interest and more narrowly tailored statute, we hold the State may not, consistent with the United States and Georgia Constitutions, make the public advertisement or offer to assist in a suicide a criminal offense.”

Judgment of 3 April 2014 by the Second Judicial District Court, Albuquerque, New Mexico (PDF): New Mexico State law provides a fundamental right to a terminally ill, competent patient to choose a physician’s aid in getting prescription medications that will allow a peaceful death, Second Judicial District Judge Nan Nash ruled on April 3, 2014. The Court ruled that two oncologists at the University of New Mexico Hospital could not be prosecuted under the state’s Assisted Suicide Statute, which is defined as the act of “deliberately aiding another in the taking of his own life" and makes such assistance punishable.

An overview of past (link) and active (link) cases as of 18 May 2022, provided by the legal team at Compassion and Choices

Latin America

Ecuador

Judgment of 5 February 2024 of the Constitutional Court of Ecuardor (Link): In this landmark case brought forward by Paola Roldan who suffers from ALS, seven of the nine judges decided in favor of Roldan having the right to an expedited process for assisted dying. Furthermore, the court gave lawmakers 12 months to draft the regulatory frameworks for implementation.
This judgment positions Ecuador de facto as the second country in Latin America to legalize assisted dying after Colombia.

Colombia

Several court judgments have set a frame for medical aid in voluntary euthanasia and assisted suicide.

Overview of all the judgments (Link)

C-239/97 of 20 May 1997 - Decriminalization of voluntary euthanasia (Link)

T-970/14 of 15 December 2014 - Setting rules for practicing voluntary euthanasia (Link)

T-544/17 of 25 August 2017 - Voluntary euthanasia for minors (Link)

C-233/21 of 22 July 2021 - Abolishing the “terminally ill” requirement (Link)

C-146/22 of 11 May 2022 - Decriminalization of assisted suicide (not yet published online)

Reports by the Colombian human rights organization DescLAB | Laboratorio de Derechos Económicos, Sociales y Culturales (Link):

Muerte Digna en Colombia. Activismo judicial, cambio social y discusiones constitucionales sobre un derecho emergente / The Right to Die in Colombia. Judicial activism, social change and constitutional discussions on an emerging right, analysing how the right has emerged and strengthened (Link / PDF)

De Muerte Lenta #1. Informe sobre las cifras y las barreras para ejercer el derecho a morir dignamente en Colombia / A slowly death. A report on the data and the barriers to access a dignified death in Colombia (Link / PDF)

Peru

In March 2021, a court judgment in the case of Ana Estrada, a woman suffering from a paralysing illness, ruled that state health insurer should provide everything necessary for her to be able to have a medically assisted end to her life. The judgment took effect after the Ministry of Justice and Health decided not to appeal against the verdict.

South Africa

Judgment of 4 May 2015 of the High Court of South Africa (North Gauteng High Court) in the case number 27401/15 of Robert James Stransham-Ford v. the Minister of Justice and others (PDF)

In a Court Order of 30 April 2015 (PDF) and subsequent judgment of 4 May 2015, Judge Fabricius ruled that Robert James Stransham-Ford, who was dying of prostate cancer and who had asked the Court to determine whether a doctor could legally assist him to end his life, should be permitted to do so.

In its judgment of 6 December 2016, the Supreme Court of Appeal of South Africa overturned the High Court order. There is a possibility to now take the case to the Constitutional Court.