The decision followed two requests for successive scrutiny of the decree: the first submitted in November 2023 by a group of PSD deputies, and the second initiated by the Ombudsperson, Maria Lúcia Amaral, in March of the previous year.
The issue has faced four vetoes: two political ones from the President of the Republic, Marcelo Rebelo de Sousa, and two for unconstitutionality declared by the Constitutional Court.
Although the parliament confirmed the decree in May 2023, and the law was promulgated, the regulation was not approved, which impeded its application. The Assembly of the Republic is dissolved, which prevents any attempt to purge these unconstitutionalities until the next legislature.
The debate on the decriminalization of medically assisted death began in parliament in 2016 and has since experienced various advances and setbacks.
The first proposals
The parliamentary discussion on the issue began with a petition in favor of decriminalization in 2016. Another text opposing the regulation of medically assisted death was submitted a few months later.
Between 2017 and early 2018, the first bills were presented in the Assembly of the Republic by the PS, Bloco de Esquerda, the People–Animals–Nature (PAN) party, and the Ecologist Party “The Greens” (PEV).
On May 29, 2018, in a parliament still including CDS-PP but without Chega and Iniciativa Liberal, the projects did not pass as none achieved the necessary 116 votes.
First approved diplomas
Following the 2019 legislative elections, which elected deputies from Chega, Iniciativa Liberal (IL), and Livre to the Assembly of the Republic, PS, BE, PAN, “The Greens”, and IL submitted initiatives on the matter.
On February 20, 2020, amid a protest outside the Assembly of the Republic, deputies approved euthanasia projects in general terms for the first time.
At the time, a popular initiative by the Portuguese Federation for Life, signed by over 95,000 people, called for a referendum, forcing deputies to pause their committee work.
The proposal for a referendum was rejected, and committee work resumed. The final global vote on the substitute text took place in January 2021, when it was approved by a majority from the PS, BE, PAN, PEV, IL, and 14 PSD deputies, against CDS, Chega, and PCP votes.
Constitutional Court rejection and first veto
On February 18, 2021, the President of the Republic requested the Constitutional Court to conduct a preventive review of the constitutionality of the diploma, arguing that it relied on “highly indeterminate” concepts to define legal criteria for euthanasia: “intolerable suffering” and “extreme severity permanent injury” in scientific consensus.
The law was declared unconstitutional on March 15, 2021, in a majority decision of seven judges against five. The Court agreed with the President on the second expression, declaring the respective article unconstitutional for “insufficient normative density”.
In his request, Marcelo Rebelo de Sousa emphasized that the issue was not whether euthanasia, as a concept, conforms to the Constitution.
Nevertheless, the Court took a stance on this fundamental issue, stating that the inviolability of human life in the Constitution does not preclude the decriminalization under certain conditions of medically assisted death.
The President of the Republic vetoed the diploma and returned it to parliament.
In July, the five parties with euthanasia projects informally agreed on a “base text” to overcome the lack of “normative density” criticized by the Court.
Amendments to the decree included, among other things, a new article defining concepts—eight in total—ranging from medically assisted death to “permanent injury”, severe or incurable disease.
On November 5, 2021, the new decree was approved in parliament with a similar majority as before, with 138 votes in favor, 84 against, and five abstentions.
The vote took place a day after the President of the Republic announced the dissolution of the Assembly of the Republic and called early elections for January 30, due to the rejection of the 2022 State Budget.
The first political veto by the President of the Republic
On November 29, 2021, Marcelo Rebelo de Sousa politically vetoed the law, highlighting that the new text used different expressions to define the types of diseases required for the procedure: “serious disease”, “serious and incurable disease”, and “incurable and fatal disease”.
If the Assembly of the Republic indeed chose to abandon the requirement that the disease be fatal, thus broadening the permission for medically assisted death, Marcelo Rebelo de Sousa suggested that it would adopt a “more radical or drastic vision”, questioning whether this would “correspond to the dominant sentiment in Portuguese society”.
The parliament was dissolved on December 5, 2021, and the euthanasia dossier was postponed to the next legislature.
The third approval of a diploma
The early elections in January 2022 began a new legislature, with deputies resuming the process in a parliament now without the Ecologist Party “The Greens” and CDS-PP.
PS, BE, PAN, and IL submitted new projects approved in general on June 9. On the same day, a resolution project by Chega calling for a referendum on the topic was rejected by deputies, with a large PSD majority in favor of the referendum.
The final text was finalized in mid-October in the working group on medically assisted death and approved in a final global vote on December 9.
On January 4, 2023, the President of the Republic sent the diploma to the Constitutional Court for a preventive review of its constitutionality.
The Constitutional Court rejects it for a second time
On January 30, 2023, the Court declared some norms of the third decree approved in parliament regarding euthanasia unconstitutional again.
For the Court, the approved text created “an intolerable vagueness regarding the exact scope” of the law, with judges finding that the legislator failed to clarify whether the three characteristics in defining “intense suffering”—”physical, psychological, and spiritual”—required for the act should be read cumulatively or individually.
However, the Court deemed the definitions of “serious and incurable disease” and “extremely severe permanent injury” in the decree constitutional, concepts that raised concerns with the President of the Republic.
The diploma was vetoed and returned to parliament once more.
Fourth version prioritizes assisted suicide and is approved
In a new attempt, the fourth text stipulates that medically assisted death may only occur through euthanasia if assisted suicide is impossible due to the patient’s physical incapacity.
Deputies also removed the reference to “physical, psychological, and spiritual suffering”.
In this text, “intense suffering” is defined as “suffering resulting from a serious and incurable disease or an extremely severe permanent injury, of great intensity, persistent, continuous, or permanent and deemed intolerable by the person”.
The new text was approved in parliament on March 31, 2023, in a final global vote, with the majority of the PS, IL, BE, six PSD deputies, and the single deputies of PAN and Livre voting in favor.
It faced opposition from most PSD, Chega, PCP, and five PS deputies. There were two abstentions from a Socialist and a Social Democratic deputy.
New political veto from the President of the Republic
On April 19, 2023, the President of the Republic vetoed the fourth parliamentary diploma, asking the Assembly of the Republic to clarify “who determines the patient’s physical incapacity to self-administer lethal drugs, as well as who should ensure medical supervision during the act of medically assisted death”.
PS, IL, BE, and PAN expressed their intention to confirm the diploma.
Confirmation of the diploma necessitates promulgation
On May 12, 2023, the Assembly of the Republic confirmed the decree with a total of 129 votes in favor, 81 against, and one abstention, necessitating its promulgation.
The overwhelming majority from the PS, IL, BE benches, as well as representatives from PAN and Livre and eight PSD parliamentarians, voted in favor.
The diploma was promulgated on May 16.
A group of PSD deputies submits a request for successive scrutiny
On November 2, 2023, a group of 56 PSD deputies submitted a request for successive scrutiny of the law decriminalizing euthanasia.
The main focus of the request concerns the unconstitutionality of the legal regulation of euthanasia itself, “based on the principle of the inviolability of human life and the absence of a fundamental right to self-determined death”.
Regulation doesn’t advance
The law required regulation approval by the government within 90 days after publication in the Diário da República for the decriminalization of medically assisted death to take effect 30 days later, which never occurred.
On November 7, 2023, Prime Minister António Costa resigned, triggering a political crisis leading to the President of the Republic’s call for early legislative elections on March 10, 2024.
In this scenario, the PS government decided to include the issue in the transition dossier for the succeeding executive, led by Luís Montenegro of PSD and including CDS-PP.
Ombudsperson requests the Constitutional Court to declare the law unconstitutional
On March 12, 2024, the Ombudsperson, Maria Lúcia Amaral, also requested the Constitutional Court to declare the law unconstitutional, arguing it violates the Constitution in its Article 24(1) [Human life is inviolable] and Article 26(1) [All are recognized for their rights to personal identity, personality development, civil capacity, citizenship, good name and reputation, image, word, privacy, and legal protection against any form of discrimination].
In September 2024, an open letter signed by over 250 personalities demanded the regulation of the euthanasia law. The government led by Luís Montenegro stated they awaited the Constitutional Court’s conclusions on successive scrutiny requests before taking any action on the law, recalling the previous executive did not regulate it.
Constitutional Court again points out unconstitutionality issues in the law
On April 22, 2025, the Constitutional Court again declared some provisions of the law unconstitutional, noting that most of the decree complies with the fundamental law.
The ruling disclosed notes that the Constitution “neither imposes nor categorically prohibits” the legalization of medically assisted death, leaving the legislator “a margin of consideration between individual freedom and human life values”.
However, six provisions were deemed unconstitutional, grouped into three issues by the judges. Firstly, the Court considered that “various segments of the law assume the patient has the right to choose between the two methods of medically assisted death—suicide or euthanasia—when, in its current version, the law only permits euthanasia if the patient is physically unable to self-administer lethal drugs”.
“In the Court’s view, these legislative lapses, on an incredibly sensitive subject, could create unnecessary difficulties for interpreters and generate an avoidable risk of poor application of the law, violating the constitutional principle of legal certainty,” it defended.
The Court also deemed unconstitutional the provision regulating the involvement of the medical specialist in the patient’s pathology, as it does not require the patient to be examined by this professional.
Lastly, the Court declared unconstitutional the provision obligating a health professional who refuses to perform or assist in medically assisted death to specify the nature of their reasons, finding the clause to be “an inappropriate, unnecessary, and disproportionate restriction of freedom of conscience”.
