In chronological order, these are The Netherlands, the Northern Territory of Australia, Oregon (USA), Belgium, and Canada.
Legal change was not required to allow assisted suicide in Switzerland.
It is similarly a deliberate act with the express intention of ending life and is not ethically or morally distinguishable from euthanasia.
The performance of assisted suicide by persons other than physicians, as occurs in Switzerland, is ethically and morally equivalent to PAS.
In about 1990, formalized guidelines for the practice of euthanasia and physician-assisted suicide were issued (Walton, 1995).
These were: In 2002, the practices became legally regulated with the passage of the Termination of Life on Request and Assisted Suicide (Review Procedures) Act by the Dutch Parliament (see Parliament of the Netherlands).
In Holland and Belgium, euthanasia is defined as being at the patient’s request, so cases of ‘ending of life without the patient’s explicit request’ have to be counted separately.
It is ethically and morally no different to euthanasia.
Continuous sedation until death (CSD) for the management of severe and refractory symptoms in the last days or week of life may be entirely clinically appropriate therapy, the possibility of life-shortening being acknowledged, but not intended.
In contrast, CSD performed with the intention of hastening death or ending life is no different to euthanasia—these are deaths caused by the active intervention of the physician.