The euthanasia law from the perspective of healthcare professionals in Spain

Abstract

Background: In 2021, Spain passed Organic Law 3/2021, which regulates euthanasia and represents an extension of rights to make decisions in the context of health care. According to the Law, the state must guarantee access to Medical Assistance in Dying (MAiD) through health services. Therefore, the involvement of health professionals is crucial. The aim of this work is to analyse the perspectives of health professionals on the provision of MAiD. Particular attention is paid to the social impact of the Law, the conceptual problems it raises, and the distribution of rights and responsibilities of professionals and patients, as well as the procedural aspects included in the regulation, the experiences of professionals regarding MAiD, and the implementation differences observed among regions. Methods: It was an exploratory qualitative research applying a thematic analysis through semi-structured interviews with physicians and nurses from primary care, hospital care, and palliative care, recruited from three Autonomous Communities in Spain (Madrid, Catalonia, and Andalusia) between March and May 2023. Results: A total of 25 interviews were conducted with medical and nursing professionals, 17 women and 8 men. The information collected was organised according to these discursive axes: social impact of the Law; terminological and conceptual problems; rights and responsibilities of professionals and patients; procedure (time limits, role of professionals); experiences of professionals regarding MAiD; and differences in implementation among the regions of the study. For this analysis, the participants’ positions on the provision of MAiD were considered. Conclusions: The professionals interviewed generally express a positive assessment of the legal safeguards of MAiD Law in Spain. However, challenges remain in its implementation, such as perceived legal ambiguities, assessment of suffering, and balancing autonomy. Structural inequalities and limited support may affect access and provider well-being. Strengthening professional training, teamwork, and institutional resources, as well as a relational approach, is essential. The findings offer practice-based guidance for policy and clinical care and highlight the need for further research on real-world impacts.