Euthanasia has long been one of the most sensitive medical and legal issues. While some states allow it under precise conditions, active euthanasia is still a criminal offence in the Czech Republic. What procedures are legal in this country? What can a patient refuse? What are the differences between euthanasia, assisted suicide and palliative care? And in which countries is euthanasia allowed?
Euthanasia is usually defined as the deliberate ending of a person’s life at his or her own request, either by a doctor or another person. It is a topic in which fundamental issues of human dignity, autonomy of the will, medicine, ethics and criminal law intersect. In practice, there are two basic types of euthanasia:
While active euthanasia is subject to criminal liability in many countries (including the Czech Republic), passive euthanasia is legal under certain conditions because it respects the patient’s right to make decisions about his or her body.
Czech law does not directly recognise the term “euthanasia”, but it addresses the consequences of an active act aimed at ending life through the offences of murder or participation in suicide. From a legal perspective, therefore , the decisive factor is not a moral or medical perspective, but whether the person acted intentionally with the aim of causing the death of another person.
Although the topic of euthanasia in the Czech Republic regularly appears in discussions among experts, doctors and politicians, there is still no proposal that has been realistically discussed at a level that could lead to a change in legislation. Thus, the Czech Republic is one of the countries where active euthanasia is still unacceptable.
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Euthanasia is not permitted in the Czech Republic and active termination of life at the patient’s request is a criminal offence. The legislation is primarily based on the Criminal Code, which considers active euthanasia a form of intentional killing, the Health Services Act, which gives patients the right to refuse treatment, andthe Charter of Fundamental Rights and Freedoms, especially the right to personal integrity (Article 7) and human dignity (Article 10).
Active euthanasia in the Czech Republic is considered a crime of murder or participation in suicide. Thus, even in the case of good intention, compassion or the patient’s wishes, ending life through another person remains illegal. The rate varies according to the circumstances, but it can be a prison sentence of many years. The legal system does not allow any exception even for terminally ill patients who ask for a quicker and more dignified death.
In contrast,passive euthanasia, or refusal of treatment , is perfectly legal. This is a situation where a patient refuses treatment that no longer has any hope of improving their condition or fundamentally reduces their quality of life. This may include, for example, withdrawal from machines, refusal of chemotherapy, refusal of resuscitation or the administration of life-prolonging drugs without any realistic hope of recovery.
The law addresses this through informed consent and its opposite, informed non-consent. If a patient refuses treatment in writing (or with witnesses), the physician may not provide it, even if the patient would die without it. This is not about euthanasia, but about respecting the patient’s right to autonomy.
In addition, Czech patients can make use of the so-called advance directive, a legal instrument that allows them to determine in advance what medical procedures they do not wish to undergo in the future, should they find themselves in a state where they are no longer able to make their own decisions. The document is made in writing, often in the presence of witnesses or a doctor, and the hospital must respect it if it meets the legal requirements. It is most often used by patients with severe neurological, oncological or degenerative diseases who want to avoid unwanted interventions such as artificial lung ventilation, resuscitation or aggressive life-prolonging treatment with no realistic prognosis for improvement.
However, the advance directive must not in any way include a request for active termination of life – such a formulation would be legally invalid and unenforceable. Its purpose is to ensure respect for patient autonomy, not to replace euthanasia. The document thus serves to preserve the patient’s view of dignity and quality of life even in situations where he or she can no longer speak for him or herself.
Tip: The crime of murder is one of the most serious crimes and the Criminal Code treats it with extreme severity. Read what it entails in the Czech Republic and how the courts treat it.
The international view on euthanasia is very diverse. While the Czech Republic strictly prohibits active euthanasia, several countries allow it under strict conditions. In terms of legal practice, it is essential to distinguish between:
Countries where euthanasia is permitted (various forms) include:
The Netherlands: the first country in the world to legalise euthanasia (2002). The conditions are: permanent and unbearable suffering with no hope of improvement, repeated and voluntary request by the patient, consent of two independent doctors, the patient must be competent. The law also applies to minors aged 12 and over (with restrictions). In 2024, 9958 people underwent it.
Belgium: also allows euthanasia since 2002. Since 2014, it even allows euthanasia for minors without an age limit if strict conditions are met and parents consent.
Luxembourg: Legalised in 2009. Conditions similar to the Netherlands.
Canada: Since 2016, allows assisted dying (MAiD, Medical Assistance in Dying). It is gradually expanding the range of persons who can benefit from it.
Colombia: Exceptional case where euthanasia has been allowed by the courts. Legal since 1997, the practice is gradually being regulated.
Spain and Portugal: Spain legalised euthanasia in 2021, Portugal in 2023. Both countries have a highly formalised process.
Switzerland: does not allow active euthanasia, but allows assisted suicide if not motivated by selfishness. This practice has led to the development of so-called “suicide tourism”. The term refers to a situation where persons travel to another country because assisted suicide (or euthanasia) is not legal in their home country, whereas it is in the destination country.
Most countries require that the request be voluntary, repeated, and that the patient be self-determined and informed. The process tends to be multi-step, involving a committee, several medical assessments and detailed documentation.
It follows that in the European context, the Czech Republic is one of the more conservative countries that do not allow active euthanasia.
Tip: Have you made an appointment to see a doctor and received a negative answer? Did you ask for a spa proposal and the doctor asked for a fee? Or did the emergency room just recommend you see a GP and charge you £90? Find out what patient rights apply in the Czech Republic.
Although euthanasia is not permitted in the Czech Republic, patients have several legal and medical options available to them to affect the end of their lives in a dignified manner and without breaking the law. One of them is the right to refuse treatment, i.e. to give informed consent in a situation where the patient considers certain procedures ineffective, burdensome or undignified. The law respects this decision even when it may lead to the death of the patient.
Another tool is the advance directive, which allows the patient to specify in advance which procedures he or she does not wish to undergo in the future, and health professionals are obliged to comply with such a document if it meets the legal requirements.
Palliative and hospice care also plays an important role, aiming to relieve pain, promote quality of life and help the patient and their loved ones in the final stages of the disease. In the Czech Republic, such care is becoming more widespread and accessible.
In extreme situations, doctors may also use analgosedation, i.e. deep sedation of the patient in cases where unbearable suffering cannot be relieved in any other way. These legally permissible procedures allow the patient not to remain in pain or helpless, even though active euthanasia is still prohibited in this country.
Euthanasia is the deliberate ending of life at the patient’s request and is strictly prohibited by Czech law in its active form, making it a criminal offence to commit murder or to participate in suicide. On the contrary, passive euthanasia is legal, i.e. refusal of treatment or its termination through informed consent, as well as the use of a prior expressed wish, which allows the patient to determine in advance what procedures he or she does not wish to have in the future. Czech patients thus have a range of options available to ensure a dignified end of life in accordance with the law, including palliative and hospice care or analgosedation. However, active euthanasia remains unacceptable in the Czech Republic, while abroad it is permitted under strict conditions, for example in the Netherlands, Belgium, Luxembourg, Canada, Spain, Portugal or by assisted suicide in Switzerland
It’s not. Active euthanasia is a crime.
Yes, the patient has the right to refuse treatment. The doctor must respect the decision.
No. This is a legal exercise of patient autonomy.
E.g. the Netherlands, Belgium, Spain, Postugalia, Canada, Switzerland or Luxembourg (with varying conditions).
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