Title : Public health and the right to die: Spain's euthanasia law (LORE) as a model for future U.S. regulation
Abstract:
This presentation examines euthanasia from a public health, bioethical, and legal perspective, focusing on Spain’s regulatory experience following the implementation of the Organic Law on the Regulation of Euthanasia (LORE) in 2021. The Spanish framework represents one of the most recent comprehensive legal approaches to euthanasia in Europe and establishes a structured, tightly regulated procedure for medical assistance in dying under strictly defined clinical and ethical conditions. The analysis highlights the core principles of the Spanish model, particularly the central role of patient autonomy, informed and repeated consent, and the requirement for multiple independent medical evaluations. In addition, the law incorporates institutional safeguards such as mandatory review by evaluation and guarantee commissions, as well as provisions for conscientious objection among healthcare professionals. These mechanisms aim to ensure that end-of-life decisions are made voluntarily, without external pressure, and within a transparent and accountable healthcare system. Beyond describing the legal framework, the presentation situates euthanasia within broader public health considerations, including the role of healthcare systems in addressing severe suffering, chronic illness, and end-of-life care. It also explores the ethical tensions between protecting vulnerable populations and respecting individual self-determination. A central objective of this work is to assess the potential transferability of the Spanish regulatory model to other jurisdictions, particularly the United States. While acknowledging the structural differences between the Spanish and U.S. healthcare and legal systems, the presentation argues that the Spanish experience demonstrates the feasibility of implementing euthanasia within a robust safeguards-based framework. Importantly, this model opens a potential pathway for legislative development in the United States by providing a concrete example of how euthanasia can be regulated through clear eligibility criteria, procedural safeguards, and institutional oversight. By integrating legal analysis with public health ethics, this presentation contributes to the ongoing international debate on end-of-life legislation and proposes that the Spanish LORE model may serve as a reference point for future policy discussions in the United States and beyond.
