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country profile
Assisted Dying in Ecuador 
Ecuador is the second country in Latin America to decriminalise assisted dying, following a historic Constitutional Court ruling driven by the advocacy of Paola Roldán.
Legal Status
Decriminalised by the Constitutional Court, recognising the right to a dignified death as part of the right to a dignified life.
Key Legislation
The framework currently relies on Constitutional Court Ruling 67-23-IN/24 and regulations issued by the Ministry of Public Health
Eligibility
Access is permitted for patients with serious and incurable conditions or irreversible bodily injuries causing intense suffering.
Summary
Ecuador has recently joined the small group of nations offering end of life options, becoming the second country in Latin America to decriminalize medical assisted dying. This historic shift was not achieved through legislative debate, but through a landmark Constitutional Court ruling in February 2024. The decision established that the state cannot oblige a person to endure intense suffering caused by a serious and irreversible injury or illness, fundamentally changing the interpretation of the “right to life” to include a “dignified death.”
Quick Overview
A Victory for Personal Autonomy.
Ecuador’s journey to allowing assisted dying is defined by the courage of one woman, Paola Roldán, who challenged the country’s penal code from her bed while suffering from ALS. Her legal battle resulted in the Constitutional Court declaring that Article 144 of the penal code (homicide) is unconstitutional when applied to physicians performing assisted dying under specific criteria.
Today, the practice is legal and regulated by interim guidelines from the Ministry of Public Health, while the National Assembly has been ordered to draft and pass a comprehensive law within 12 months to formally regulate the procedure.
Visit the ministry of health
Click to Read more.
History and Legislation
Ecuador’s path to legalization is recent and rapid, driven by judicial intervention rather than legislative initiative.
The Paola Roldán Case (2023-2024): The movement began with Paola Roldán, a 42-year-old woman with Amyotrophic Lateral Sclerosis (ALS), who filed a lawsuit arguing that forcing her to live in constant suffering violated her constitutional rights to dignity and the free development of personality.
Ruling 67-23-IN/24 (February 7, 2024): In a historic 7-2 vote, the Constitutional Court ruled in Roldán’s favor. The Court:
- Decriminalized Euthanasia: It declared that doctors are not criminally liable for homicide when assisting a patient who meets specific criteria.
- Defined “Dignity”: The ruling clarified that the right to life does not imply an obligation to suffer, and that a “dignified life” includes the autonomy to choose a “dignified death.”
Ministry of Health Regulation (April 2024): Following the Court’s order, the Ministry of Public Health issued the “Procedural Rule for the Application of Voluntary and Involuntary Active Euthanasia.” This regulation establishes the protocols, committees, and conscientious objection guidelines for healthcare providers until a formal law is passed.
Pending Legislation: The Court gave the Ombudsman’s Office 6 months to prepare a bill and the National Assembly 12 months (until February 2025) to debate and enact a full statutory law regulating the practice.
Who is Eligible?
Access is currently governed by the Constitutional Court’s criteria and the Ministry of Health’s interim regulations. To qualify, a patient must meet the following strict conditions:
- Medical Condition: The patient must be suffering from a serious and irreversible bodily injury or a serious and incurable disease. (Unlike some jurisdictions, the condition does not necessarily have to be “terminal” in the short term, but must be serious and incurable).
- Suffering: The condition must cause intense physical or emotional suffering that the patient deems incompatible with their dignity.
- Consent: The request must be free, informed, and unequivocal.
- Capacity: The patient must be capable of expressing their will.
- Representation: The ruling and regulations allow for consent to be provided by a legal representative if the patient is unable to express it, provided this aligns with their previously expressed wishes or best interests (though strict safeguards apply).
- Provider: The procedure must be performed by a licensed physician.
Visit the ministry of health
Click to Read more.
Members
Our South American Members
We currently have 63 are members of the World Federation, with 3 based in South America.
latest news
The latest news from our members and from around the world
Our members produce helpful factsheets and newsletters. The Federation is always happy to share other sources of information in favour of our joint mission to advance assisted dying around the world.
