The case of Noelia Castillo, a 25-year-old Spanish woman who received euthanasia after a long legal battle, has reignited the debate over end-of-life care.
Castillo, who was paraplegic after attempting to take her own life in 2022 following a sexual assault, received euthanasia on Thursday, 26 March, at a healthcare centre near Barcelona.
The case has sparked controversy across Spain as her father started a legal challenge backed by the conservative group Abogados Cristianos (Christian Lawyers), arguing the woman did not have the mental capacity to make this decision.
After a 20-month legal procedure, including rulings by the Spanish Supreme Court, the Constitutional Court, and the European Court of Human Rights, all upheld Castillo’s decision.
In Spain, euthanasia and assisted suicide were legalised in 2021. Patients must be suffering from a serious and incurable illness, or a serious, chronic, and debilitating condition certified by the responsible physician.
They are required to submit two requests, voluntarily and without any external pressure, with a gap of at least 15 calendar days between the two.
Other countries in Europe that allow euthanasia to be administered by physicians are Belgium, Luxembourg, and the Netherlands.
How is assisted dying regulated across Europe?
The Netherlands
The Netherlands was the first country in the world to legalise euthanasia in 2002.
The law allows euthanasia when a patient is experiencing unbearable suffering with no prospect of recovery. This applies to both psychiatric and physical illnesses.
The Dutch legislation requires physicians to meet certain criteria before administering euthanasia: they must be sure that the patient's request is voluntary and well considered and that the patient's suffering is unbearable, with no prospect of improvement.
They also have to inform the patient about their situation and prognosis, and conclude that there is no reasonable alternative, and to seek a consultation from an independent physician.
Belgium
Belgium decriminalised euthanasia under specific circumstances in 2002.
The procedure must be requested by the patient, who at the time of the request must be of sound mind and conscious. The patient must suffer from a terminal medical condition and have persistent and unbearable physical and/or psychological suffering that cannot be alleviated.
Luxembourg
In 2009, Luxembourg adopted legislation on euthanasia and assisted suicide, offering patients the option to die if their suffering is considered unbearable.
To request the procedure, the patient has to have an incurable medical condition resulting from an accident or illness.
The request must be made while the patient is conscious, of legal age, and capable of making their own decisions without outside pressure.
Austria
Austria has permitted assisted dying since 2022. The Austrian model strictly allows only voluntary assisted dying, in which the patient must self-administer the medication, which is dispensed by a pharmacy after a rigorous validation process.
Access is limited to adults with decision-making capacity who suffer from a serious, incurable, and permanent illness causing a “permanent impairment of the way of life.”
Which countries are considering legalising assisted dying?
In France, President Emmanuel Macron pledged to introduce legislation on assisted dying upon reelection in 2022.
Controversy has surrounded the bill since it was first officially proposed in 2024. Since then, the text has been in a back-and-forth between the National Assembly and the Senate. The process is still open, and the next step is a second reading in the Senate.
The Portuguese parliament adopted a law concerning euthanasia and assisted dying back in 2023, however, it is still not in effect. It has been vetoed twice by the Portuguese president and challenged by the country's constitutional court.
Last year, the Maltese government launched a public consultation on assisted voluntary euthanasia to decide whether to present a legislative proposal.
In Slovenia, a non-binding referendum in 2024 supported assisted dying, which the National Assembly passed into law in 2025. However, in a second binding referendum at the end of last year, 53 percent of the voters rejected the law. Its implementation will now be suspended for at least one year.
