Right to die / R2
Non-terminal suffering
A competent adult with unbearable but non-terminal suffering (e.g. advanced multiple sclerosis) asks their doctor for the same.
What we score
Can the doctor lawfully help?
Default assumptions: Unless a vignette says otherwise, the person is a 30-year-old citizen of sound mind with no criminal record, acting alone, on their own behalf and not for profit, in an ordinary residential area. Where subnational units (states, provinces, cantons, Länder) make their own law, each unit is scored and the result is weighted by population. 'The state' includes police, prosecutors, courts, regulators, tax authorities and anyone acting on their orders, including platforms obeying takedown orders.
Score anchors
Both the law score and the practice score use these anchors. Half points are used when a country sits between two of them.
| Score | What it means for this vignette |
|---|---|
| 10 | Lawful on request. |
| 8 | Lawful with safeguards. |
| 6 | Lawful under narrow criteria. |
| 4 | Not formally lawful, but not prosecuted. |
| 2 | Crime: fine or under 1 year. |
| 1 | Crime: 1 to 5 years. |
| 0 | Crime: over 5 years. |
Evidence used: As R1, plus whether eligibility requires a terminal diagnosis.
How each country scores
| Country | Law | Practice | Process | Score | Why |
|---|---|---|---|---|---|
| Switzerland | 8 | 8 | 0 | 8.0 | Art. 115 has no terminal-illness requirement. The SAMS guidelines require 'intolerable suffering' from medically definable severe symptoms or functional impairment, so advanced MS qualifies. The same safeguards apply as for terminal patients (two discussions two weeks apart, independent check of capacity). |
| Netherlands | 8 | 8 | 0 | 8.0 | The euthanasia act (WTL) requires unbearable suffering with no prospect of improvement, not a terminal diagnosis, so advanced MS qualifies under the same safeguards (second independent doctor, review by the RTE committees). Neurological diseases are among the common grounds in RTE reports; RTE 2025 figures also show hundreds of non-terminal cases (dementia 499, multiple geriatric conditions 475, psychiatric 174). |
| Germany | 9 | 8 | −0.5 | 7.9 | German law has no terminal-illness requirement. The 2020 BVerfG ruling covers any freely responsible decision, and the BGH (5 StR 520/24) sets only the limit that the decision must be free. An MS patient with capacity can lawfully receive help on the same terms as R1, with the same police investigation after death. |
| Czechia | 1 | 2 | 0 | 1.6 | As R1. § 144 applies regardless of diagnosis, with up to 3 years in prison for assisting a suicide, and there is no medical exception for terminal or non-terminal suffering. Czech patients travel to Switzerland instead. |
| Mexico | 1 | 2 | 0 | 1.6 | Same rules as R1, with no route for non-terminal patients. LGS art. 166 Bis 21 bans assisted suicide, and CPF art. 312 punishes aiding suicide with 1-5 years. Even the pending 'Ley Trasciende' bill requires a terminal or chronic-degenerative diagnosis. |
| Denmark | 1 | 2 | 0 | 1.6 | The same §§ 239-240 apply with no exception for non-terminal suffering: assisting is a fine or up to 3 years. No lawful route exists. |
| United States | 1 | 1.5 | 0 | 1.3 | Every US aid-in-dying law requires a terminal illness with a prognosis of 6 months or less, so no jurisdiction allows help for non-terminal suffering. A doctor who helps commits assisted suicide, a felony in California under Penal Code 401, and manslaughter or other felonies carrying 1 to 15 years elsewhere. Such cases are rarely charged because doctors do not do it. |
| United Kingdom | 0 | 1 | 0 | 0.6 | Same law as R1: Suicide Act 1961 s2 (max 14 years). Both failed bills were limited to people with under 6 months to live, so there was never any route for non-terminal suffering. A doctor's care relationship counts in favour of prosecution under DPP policy, and GMC erasure would follow. |
| New Zealand | 0 | 1 | 0 | 0.6 | End of Life Choice Act s5 requires a terminal illness likely to end life within 6 months, so non-terminal suffering is excluded. A doctor who helps faces Crimes Act s179 (aiding and abetting suicide, max 14 years); the Act's protection (Crimes Act s48(2)) covers only lawful assisted dying. An ACT member's bill to widen eligibility has been lodged but is not law. |
| Ireland | 0 | 1 | 0 | 0.6 | Same law as R1: Criminal Law (Suicide) Act 1993 s2(2), max 14 years, with no exception for doctors or for non-terminal suffering. The Oireachtas committee's 2024 proposal was limited to terminal illness with a 6-to-12-month prognosis, so there is not even a pending route for non-terminal conditions. |
| Singapore | 0 | 0 | 0 | 0.0 | As in R1: assisting suicide is punished under Penal Code s306 with up to 10 years plus a fine, whatever the patient's diagnosis. There is no exception for unbearable suffering. |