Assisted dying in Spain
Spain legalised assisted dying in 2021 as a right provided free of charge by the public health system, with every request approved by a regional commission before it can go ahead.
- Where the law stands
- Legal
- Since
- 2021
- Who can ask
- Adults (18+)
- Condition
- Serious Incurable or Chronic Condition
- Residency
- Citizens & Legal Residents
What you need to know.
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Legal Status: Legal
The practice is regulated by the Organic Law for the Regulation of Euthanasia (LORE), which entered into force on 25 June 2021.
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Key Legislation: Organic Law 3/2021
Organic Law 3/2021 of 24 March establishes the right to request “aid in dying” as a service included in the National Health System portfolio. The Constitutional Court upheld it in full in 2023.
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Eligibility
Access is available to adults who are Spanish nationals, legal residents, or registered as living in Spain for more than 12 months, and who suffer from a serious and incurable disease or a serious, chronic and incapacitating condition.
Summary
Spain represents a major milestone in the global right-to-die movement. In March 2021, the Spanish Parliament (Cortes Generales) approved the Ley Orgánica de Regulación de la Eutanasia (LORE), making Spain the fourth country in Europe (after the Netherlands, Belgium and Luxembourg) to decriminalise and regulate the practice.
Unlike some jurisdictions that only allow assisted dying, the Spanish model permits both physician assisted dying (administration by a health professional) and assisted dying (prescription for self-administration), with the vast majority of patients opting for the former. The procedure is fully integrated into the public healthcare system and is free of charge.
In 2023 the Constitutional Court rejected challenges to the law from Vox and the People’s Party, upholding it in full and recognising aid in dying as a fundamental right within the limits the law sets. In 2025, 565 people received aid in dying, 0.13% of all deaths in Spain, and 1,668 people have received it since the law came into force.
Quick Overview
Health services in Spain are largely devolved to the 17 autonomous communities. This has resulted in a very mixed picture of access for patients: in 2025, Catalonia had more than twice the national rate of requests.
Spain’s law is distinct because of its “prior control” mechanism. Unlike the Benelux countries, where the review commission evaluates the case after the death, Spain requires approval before the procedure can take place.
Every request is reviewed by a regional Guarantee and Evaluation Commission (CGE). A team consisting of a doctor and a jurist must verify that the patient meets all legal requirements before giving the green light. While this ensures high legal security, it has also been criticised for creating bureaucratic delays in some regions. In 2024 it took a median of 41 days from the request to the commission’s decision, and 62 days to the assisted death itself.
Organic Law 3/2021 on the regulation of euthanasia
Ley Orgánica 3/2021, de 24 de marzo, de regulación de la eutanasia. In force since 25 June 2021.
Article 143 of the Spanish Penal Code
Makes it a crime to induce or cooperate in a suicide. Since 2021, section 143.5 exempts anyone who causes or assists a death in compliance with the euthanasia law.
How the law came about.
The road to legalisation in Spain was paved by high-profile social cases that shifted public opinion.
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January 1998
The Ramón Sampedro Case
The movement gained international attention with Ramón Sampedro, a Galician sailor who was quadriplegic for almost 30 years and spent the last five of them fighting in the courts for the right to die. His story was immortalised in the Oscar-winning film The Sea Inside (Mar Adentro). He eventually died with the help of friends in a clandestine act on 12 January 1998.
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April 2019
The María José Carrasco Case
Decades later, Ángel Hernández was arrested for helping his wife, María José Carrasco, who had advanced multiple sclerosis, to end her life. He recorded the process to prove her consent and challenged the state to prosecute him. His case galvanised public support for a change in the law. In 2021, once the new law was in force, the prosecutor withdrew the charge and he was acquitted.
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March 2021
The 2021 Victory
Supported by a coalition of left-wing and liberal parties, the LORE was passed in the Congress of Deputies on 18 March 2021, with an absolute majority of 202 votes in favour, 141 against and 2 abstentions.
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June 2021
The law comes into force
The LORE entered into force on 25 June 2021 and has been implemented across all 17 autonomous communities.
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2023
The Constitutional Court upholds the law
In March 2023 the Constitutional Court rejected Vox’s challenge to the law (Ruling 19/2023), and in September 2023 it rejected the People’s Party’s challenge (Ruling 94/2023). It found the law constitutional in full.
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2024
Steady growth
426 assisted deaths were recorded, a 27% increase from 2023.
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March 2026
The Noelia Castillo case
A 25-year-old woman in Barcelona received aid in dying after a two-year court battle. Her father, backed by Abogados Cristianos, had challenged the approval of her request, but the Catalan courts, the Supreme Court, the Constitutional Court and the European Court of Human Rights all declined to stop it.
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June 2026
Five years of the law
The Ministry of Health’s provisional figures showed 565 assisted deaths in 2025 (0.13% of all deaths) and 1,284 requests, with 1,668 people having received aid in dying since 2021.
Who is Eligible?
Access is strictly regulated by Organic Law 3/2021. To qualify, a patient must meet the following criteria:
- Residency: must be a Spanish national, have legal residence in Spain, or hold a registration certificate (padrón) showing they have lived in Spain for more than 12 months. This effectively prevents “medical tourism”.
- Age: adults (18+).
- Capacity: the patient must be fully capable and conscious at the time of the request.
- Exception: if the patient is no longer capable (e.g. advanced dementia), they can still access euthanasia if they previously signed a valid living will (testamento vital or instrucciones previas) explicitly requesting it.
- Medical condition: the patient must suffer from:
- a serious and incurable disease; or
- a serious, chronic and incapacitating condition that causes physical or psychological limitations and intolerable suffering.
- Process:
- two written requests, separated by at least 15 days;
- review by the “responsible doctor” and a “consultant doctor”;
- final approval by the Guarantee and Evaluation Commission.
Our members in Spain.
Member societies of the World Federation working for the right to die in Spain.
More country profiles
- Austria Legal
- Belgium Legal
- France Legal
- Germany Legal (Ruling)
- Ireland Illegal (no active bill)
- Italy Decriminalised (Court Ruling)
- Netherlands Legal
- Norway Illegal
- Portugal Legal (In Limbo)
- Switzerland Decriminalized
- United Kingdom Illegal (no active bill)
- Australia Legal
- Canada Legal (Federal)
- Colombia Decriminalized
- Cuba Decriminalised (regulations pending)
- Ecuador Decriminalized
- New Zealand Legal
- United States Legal (State Level)
- Uruguay Legal