The Czech Bill on palliative care, end-of-life decision-making, and euthanasia in light of Belgian legislative experience

AI Summary

Bill uniquely consolidates palliative care, withdrawal of life-sustaining treatment, palliative sedation, and assisted death within a single statute.
It codifies a right to palliative care and medically inadequate treatment threshold with information, participation, ethics committee mediation, and judicial review safeguards.
Assisted death provisions set strict eligibility, staged requests, independent consultation, final pre-act verification, and mandatory ex post commission review to meet human rights standards.

AI Summary

In 2024, a Bill "On Palliative Care, End-of-Life Decision-Making and Euthanasia" was submitted to the Czech Parliament for consideration. The Bill is unusual in combining, within one statute, conventional end-of-life practices - palliative care, withholding or withdrawal of life-sustaining treatment, and palliative sedation - and "assisted death", covering euthanasia and physician-assisted suicide. With regard to conventional practices, the Bill gives legal form to a right to palliative care, introduces "medically inadequate treatment" as the threshold for limiting life-sustaining interventions, and embeds procedural safeguards (information, participation, mediation by an ethics committee, and judicial review) intended to enhance transparency, patient autonomy, and legal certainty for clinicians.

Basic summary

BMC Med Ethics. 2026 Jun 5. doi: 10.1186/s12910-026-01485-5. Online ahead of print.

ABSTRACT

In 2024, a Bill “On Palliative Care, End-of-Life Decision-Making and Euthanasia” was submitted to the Czech Parliament for consideration. This article evaluates the Bill through doctrinal and ethico-legal analysis and a comparative perspective centred on Belgium, whose model influenced the Czech proposal. The Bill is unusual in combining, within one statute, conventional end-of-life practices – palliative care, withholding or withdrawal of life-sustaining treatment, and palliative sedation – and “assisted death”, covering euthanasia and physician-assisted suicide. With regard to conventional practices, the Bill gives legal form to a right to palliative care, introduces “medically inadequate treatment” as the threshold for limiting life-sustaining interventions, and embeds procedural safeguards (information, participation, mediation by an ethics committee, and judicial review) intended to enhance transparency, patient autonomy, and legal certainty for clinicians. With regard to assisted death, the proposal sets out eligibility criteria (adult legal competence, voluntariness, an incurable and irreversible illness, and permanent and unbearable suffering without any prospect of improvement) and a staged procedure: a preliminary request, independent consultation, a qualified written request, final verification immediately before the act, and mandatory ex post review by a commission based on a non-anonymous report. This article shows that the Czech Bill represents a serious and coherent attempt to bring end-of-life regulation in the Czech Republic into conformity with the human-rights standards developed in the case law of the ECtHR. It also advances several de lege ferenda recommendations that seek to synthesise the strengths of the Czech Bill and the Belgian model while avoiding identified shortcomings. These recommendations aim to ensure that any European end-of-life framework remains firmly anchored in human-rights requirements, while also taking into account the practical realities of clinical decision-making and the accumulated legal experience of European states that have already introduced forms of assisted death.

PMID:42249340 | DOI:10.1186/s12910-026-01485-5

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