In April 2002, the Netherlands became the first country in the world to legalize euthanasia. If a physician in the Netherlands follows the strict legal requirements for committing voluntary euthanasia or assisted suicide, the doctor will not be prosecuted.

The basics requirements are as follows:

• The patient must have already been in the doctor's care for a period of time.
• The patient's suffering is unbearable, and she or he has no hope of recovery.
• The patient makes a deliberate and voluntary request that she or he has discussed thoroughly with the doctor.
• The doctor consults a colleague who agrees that these criteria have been met.

Belgium became the second country to legalize euthanasia in September 2002. The Belgian law also lays out specific requirements for the doctor and patient, similar to the Dutch law.

But euthanasia is only one option available to terminally ill patients. Voluntary euthanasia means a person ends his or her life through lethal injection administered by a doctor. Assisted suicide is considered to be death by oral ingestion of lethal drugs, usually prescribed by a doctor. Passive euthanasia is when life-support systems are disconnected from a terminally ill patient.

Switzerland allows suicide assisted by doctors and those without medical training, but euthanasia is not legal in the country. Since 1937, the Swiss criminal code has stated that suicide is not a crime, and it may be assisted for altruistic reasons. It's only a crime if someone assists the suicide out of negative motivation or for financial gain.

The U.S. state of Oregon enacted a physician-assisted suicide law in November 1994. This allows doctors to prescribe a lethal dose of medication to terminally ill patients who meet certain requirements, including state residency. The U.S. government has tried to challengethis law but has been unsuccessful so far.

Last month, the Netherlands became the first country to decriminalize voluntary euthanasia. Under new legislation a doctor will not be prosecuted for terminating a person’s life providing he or she is convinced that the patient’s request is voluntary and well considered and that the patient is facing ‘‘unremitting and unbearable’’ suffering.

The doctor must have advised the patient of his or her clinical condition and have reached a firm conclusion with the patient that there is ‘‘no reasonable alternative’’. In addition, at least one other independent physician must have examined the patient and reached the same conclusion.

The legislation reached its final hurdle on 10 April when the Dutch senate voted by 46 votes to 28 to approve the bill. The vote was seen as a formality, after the lower house voted last autumn by 2:1 in favour of decriminalization.