Sixth form student Iyla Singh takes a look at the differences in euthanasia legislation in both countries
Euthanasia, the act of deliberately ending a person’s life to relieve suffering, and assisted suicide, which involves deliberately helping another person to end their own life, have recently been the focus of much debate about balancing human dignity and the relief of suffering..
This disagreement exists across many cultures and legal systems worldwide, and no clear answer has been found. This article will look at views on euthanasia in Spain and England. Spain, which has a civil law system, relies more on written laws and statutes, while England, with its common law system, mainly depends on case law and judicial decisions.
I will also look at European euthanasia laws from both civil and common law perspectives, focusing on how England and Spain respond to international medical and legal ethics to understand their different views on assisted dying in the legal field.
Euthanasia in Spanish law
On March 18th 2021, the Spanish parliament, the Cortes Generales, approved the law to legalise euthanasia in Spain, becoming the fourth European country to do so after the lower house, the Congress of Deputies, approved the bill in December 2020.
The debate around euthanasia resurfaced in 2018, when the Spanish Socialist Workers’ Party (PSOE) introduced a bill seeking the regulation of assisted dying. Several regions such as Madrid had existing laws governing palliative care in the latter stages of life, but none considered the legal or ethical impacts of physician-assisted suicide. The intensity of this debate was highlighted by well-known euthanasia cases in Spain, such as that of Ramón Sampedro, who became quadriplegic at 25 after a diving accident and spent the rest of his life campaigning for assisted suicide. His story was widely publicised in the media through Condenado a Vivir (2001), meaning “Forced to Live,” and The Sea Inside (2004).
Although Spain’s Popular Party (PP) opposed the PSOE bill and its leader Pablo Casado called for a debate and an alternative proposal, the law passed in the Congress of Deputies with 202 votes in favour, 141 against, and two abstentions. After the vote, Prime Minister Pedro Sánchez said on social media that Spain had become “more humane, fairer and freer.”
The PSOE bill defined euthanasia as a right available to those suffering from “a serious and incurable disease with a limited life prognosis” or “a serious, chronic and irreversible disability that causes them unbearable suffering”. To access this care, the patient must: have Spanish nationality or legal residence in Spain; have, in writing, all relevant information about the condition and any alternative routes of treatment; made two requests of their own free will with a period of fifteen days between them; been diagnosed with a serious, chronic or incurable disease and given informed consent prior to receiving the provision of help to die.
It also involves both an attending and consultant doctor, legally required to ensure that the patient has given fully informed, conscious and capable consent, as well as oversee the procedure. Euthanasia and doctor-assisted death would be offered through both public and private healthcare, with the criminal code amended to decriminalise them, though medical professionals could register themselves conscientious objectors.
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Find out moreThe bill was supported by the centre and left-wing parties such as PSOE, Podemos, the Basque Nationalist Party (PNV), the Catalan Republican Left (ERC) and the Democratic Party of Catalonia (PdeCAT), representing 178 seats. In a 2018 study by the Spanish Magazine for Sociology Studies, it was noted that 58% of Spaniards supported euthanasia, with 39% in favour of assisted suicide, and 10% and 19% respectively firmly opposing each. The opposition to the law was mainly the right-wing Popular Party and far-right Vox, with its leader Santiago Abascal deeming it ‘a defeat for civilisation and a victory for the culture of death’, arguably due to their Christian sympathies and desire to preserve life.
Euthanasia in English law
While Spain has become more liberal, Britain still prioritises preserving life over personal choice. The Suicide Act 1961 decriminalised suicide but made assisted suicide a crime punishable by up to 14 years in prison. Euthanasia can lead to a life sentence, depending on whether it is treated as murder or manslaughter. The Act defines this as doing something that could encourage or help someone to take their own life, or doing something intended to encourage or help them do so.
As part of the ongoing debate about legalising euthanasia and assisted suicide in the UK, there have been a number of court cases and legal discussions pertaining to the accessibility of intentional death resulting from terminal or life-limiting illnesses. Some examples include Pretty vs UK (2002) and Purdy vs UK (2009).
Pretty vs UK
Diane Pretty was diagnosed with Motor Neurone Disease (MND) and beseeched the government to guarantee that her husband wouldn’t be prosecuted for helping her end her life. The House of Lords rejected her case on the grounds that a right to life is inconsistent with a right to die, and that the privacy of life also fails to warrant this. The European Court of Human Rights agreed, saying that the law protects life, regardless of its quality, so her illness does not warrant her death, maintaining that the Suicide Act is justifiable to protect vulnerable citizens.
Purdy vs UK
In 1995, Debbie Purdy was diagnosed with Multiple Sclerosis (MD), and argued that it was a breach of human rights to withhold information on whether her husband could be prosecuted for assisting her death. The House of Lords concurred, ordering the Director of Public Prosecutions (DPP) to elucidate the circumstances under which prosecution would be more or less likely. While Debbie Purdy won her case, Pretty was unsuccessful, possibly because Pretty called for a change to the law, whereas Purdy simply sought clarification. Nevertheless, both cases sparked a pertinent discussion on human autonomy and medical ethics in relation to palliative care, as well as attempts to alter the legislation. For example, Lord Joffe, a frontrunner in the House of Lords on the subject of assisted death, presented four bills for the consideration of the House.
In 2002, after appointment to the Lords and joining the Voluntary Euthanasia Society — later renamed Dignity in Dying — he presented an inaugural bill to the House, aiming to enable a competent, suffering adult to access a medically-assisted death. After its failure to pass, he submitted an amended bill, which failed for the fourth and final time in 2006. Similarly, Baroness Meacher’s 2021 Assisted Dying Bill aimed to allow ‘terminally ill’ adults to end their lives with High Court approval. This would also require a signed declaration from the patient in the presence of an independent witness, signed by two medical professionals with no connection to the family.
Moreover, the bill specified that the person must reach the decision ‘voluntarily, on an informed basis and without coercion or duress’. Other unsuccessful attempts include those by Lord Falconer (2014), MP Rob Harris (2015) and Lord Hayward (2016).
These attempts reveal a deep disparity between the protection of autonomy and the right to life. Dignity in Dying, of which Baroness Meacher is chair, argues that current law has insufficient provisions to protect those who want to control their death, citing the significant cost of seeking treatment in countries that do allow assisted suicide. They believe that dying people with six months or less to live should be granted the ‘option to control their death’, promoting reassurance, liberty and prevention of suffering for patients.
Opponents have raised concerns about doctors supplying lethal drugs, asserting that this would significantly undermine both criminal law and ‘the fundamental “do no harm” principle that underpins medical practice’. The legislative proposals thus far have been criticised for lack of safety, with inadequate or non-existent safeguards and doctors who are unwilling to involve the courts, obscuring the clarity as to who receives the responsibility determining accountability and decision-making. Furthermore, critics have argued that the current euthanasia legislation reflects social attitudes: while patients should be treated with compassion and empathy, the act of suicide should not be encouraged.
Christian charities have pointed out that a failure to specify what constitutes ‘suffering’ could result in a situation where someone with six pain-free months to live is entitled to their own death, whereas someone without a terminal diagnosis who experiences chronic pain would not. This undermines the fundamental principle behind legalising assisted suicide — preventing suffering — and could potentially lead to a ‘slippery slope’ where vulnerable groups are at risk of exploitation. It is also noteworthy that ‘Not Dead Yet’ attested that changes in the law could lead to patients feeling pressured to request a premature death to avoid being a burden, and that resources will be more valuable if used to improve care and support rather than altering legislation.
Comparing Legislation
Having explored Spain and the UK individually, these two conflicting attitudes reflect the discrepancies across Europe and the Western World.
One discernible pattern is that countries who have legalised euthanasia tend to be those who follow a civil law system, such as the Netherlands, Germany and Belgium. Whereas, those who don’t, such as the UK and USA, follow a common law system. While there is no stated reason for this, it is probable that traditional cultural and legal attitudes play a role. Due to the importance placed on legislation and procedure, civil law countries tend to prioritise constitutional rights, such as privacy, dignity and autonomy, which can easily be regulated and protected with the due process of law.
Common law countries often place strong value on the sanctity of life, which makes it harder to apply euthanasia laws on a case-by-case basis. However, it would be wrong to say one system is always better than the other. Spain’s legalisation supports personal autonomy, but the slippery slope argument remains important, and the government should ensure patients are not pushed into irreversible decisions by outside pressure, such as feeling like a burden. By contrast, the British system may keep people in long-term mental and physical suffering to preserve life, raising the question of whether this cost is justified.
However, as of June 2025, the Terminally Ill Adults (End of Life) Bill, introduced by Kim Leadbeater MP, has been taken up by the House of Lords after passing the House of Commons by a vote of 314 to 291. While the bill has not yet been passed by the Lords, it can be seen as a step in the right direction for those seeking to preserve dignity and promote autonomy at the end of life. Nevertheless, the bill must guarantee patients the right to sustain their lives should they choose to do so, and the narrow margin in the Commons’ vote offers no clear indication of the House of Lords’ eventual ruling.
Together, these fundamental policies perfectly illustrate the tensions surrounding modern legal and medical ethics: how should the law balance mercy and autonomy in death?
Iyla Singh is a sixth form student hoping to study law with Hispanic law at university. She is particularly interested in medical ethics as well as international human rights law.
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