The Union of Rights

Bioethics in EU Member States

End of life and in vitro fertilization: European laws put to test between science and moral issues

Thiriet Claudius

Who determines our life

by Susanna Turco

Dealing with assisted procreation, all EU Member States have slowly brought their laws into line, legislating on the matter after the application of new techniques in clinics and hospitals. In practice, this is one of the fields in which the developments in medicine responded to a need long before the law gave precise rules regulating both. Among the forerunners, the liberal Netherlands (the first child had after an IVF treatment was born in 1983), among the last ones, Ireland and Lithuania.

Tendance Floue - LUZ photo

What changes is, essentially, the possibility of undergoing the heterologous in vitro fertilization, forbidden in States such as Austria, the Czech Republic and Portugal, and the possibility for singles to access these medical practices. It is quite interesting, with reference to the latter, to note that single women have generally a more open way in Eastern Europe (Croatia, Bulgaria, Latvia, Estonia, Hungary), States with a legislation which is only apparently similar to other countries such as Sweden, where the access for single women has been granted only recently – but solely because it had been granted to couples of any sexual orientation for a long time. Only two States allow the controversial figure of “surrogate mothers”: the U.K. and Greece.

Assisted procreation

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Source: The Evolution of Legislation in the Field of Medically Assisted Reproduction and Embryo Stem Cell Research in European Union Members
Only 4 Member States out of 28 allow or tolerate euthanasia

Looking at an overview on 28 EU Member States, with regard to laws regulating the end of life, a certain level of macro-areas uniformity emerges. Northern Europe is more advanced: in fact, Belgium, the Netherlands and Luxembourg are the only States in which euthanasia and assisted suicide are regulated by law, while in other countries of the Central-European bloc (such as Germany), even in the absence of a dedicated law, hidden forms of assisted suicide are tolerated de facto. On the Mediterranean side, Italy and Greece are the States lagging furthest behind together with the Catholic Ireland. The former Soviet bloc countries are lagging behind as well, with the exception of Hungary, where the end of life is fully regulated, and partially of Poland that, notwithstanding the lack of a law, has always been at the cutting edge of the Soviet bloc with regard to palliative care.

Valerie Winckler - Gamma-Rapho - Getty Images

It is worth noting that Italy is partially a class of its own. From one side, for the delay in having the matter widely discussed by the public opinion (about ten years after the U.K., for instance). On the other, for the fact that the debate, triggered by the case of Eluana Englaro, is still focused on the details connected with that case, concentrated on what is it possible to ask doctors (for instance, the interruption of artificial feeding and hydration), while in other States the matter of the living will is just one aspect of a wider issue concerning palliative care – which in Italy is regulated by a specific law.

End of life

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Sources: Associazione Luca Coscioni; Lack, Peter, Biller-Andorno, Nikola, Brauer, Susanne, "Advance Directives", Springer Science & Business Media, 2013; Andorno, European Journal of Health Law 16, 2009; Elaboration by Espresso; "Survey on chaplaincy and quality of end of life" , ENHCC; Research Department of the European Parliament, “Palliative care in European Union”, 2008; Kiejna, Rymaszewska, Hadryś, Practice of competence assessment in dementia, Poland. In Ed. Gabriela Stoppe, 2008