ASSEMBLY OF THE REPUBLIC
Law No. 22/2023
May 25th
Summary: Regulates the conditions under which medically assisted death is not punishable and changes the
Criminal Code.
Regulates the conditions under which medically assisted death is not punishable and amends the Penal Code
The Assembly of the Republic decrees, under the terms of paragraph c) of article 161 of the Constitution,
the next:
CHAPTER I
General provisions
Article 1
Object
This law regulates the special conditions in which medically assisted death is not
punishable and amends the Penal Code.
Article 2
Definitions
For the purposes of this law, it is considered:
a) «Medically assisted death», death that occurs by decision of the person himself, in
exercise of their fundamental right to self-determination and free development of personality,
when practiced or helped by health professionals;
b) «Medically assisted suicide», the self-administration of lethal drugs by the patient himself
sick, under medical supervision;
c) «Euthanasia», the administration of lethal drugs by the doctor or health professional
duly qualified for the purpose;
d) «serious and incurable disease», the disease that threatens life, in an advanced and progressive phase,
incurable and irreversible, which causes suffering of great intensity;
e) «Extremely serious permanent injury» means a serious, definitive and largely unreported injury.
patient who places the person in a situation of dependence on a third party or technological support
for carrying out elementary activities of daily living, with certainty or probability
very high that such limitations will persist over time without the possibility of cure or
of significant improvement;
f) "Suffering of great intensity", suffering resulting from a serious and incurable illness
or definitive injury of extreme gravity, with great intensity, persistent, continuous or
permanent and considered intolerable by the person himself;
g) «Supervising physician», the physician indicated by the patient who is in charge of coordinating the entire
information and assistance to the patient, being the patient's main interlocutor throughout the process
care, without prejudice to other obligations that may fall to other professionals;
h) «Specialist doctor», the doctor specializing in the pathology that affects the patient and who does not
belongs to the same team as the guiding physician.
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Article 3
Non-punishable medically assisted death
1 — Medically assisted death is considered non-punishable when it occurs by decision of the
own person, older, whose will is current and reiterated, serious, free and enlightened, in a situation
suffering of great intensity, with definitive injury of extreme gravity or serious illness
and incurable, when practiced or helped by health professionals.
2 — For the purposes of this law, only requests for medical death are considered legitimate.
assistance submitted by national citizens or legally residing in national territory.
3 — Medically assisted death occurs in accordance with the will and decision of the
who is in one of the following situations:
a) Permanent injury of extreme severity;
b) Serious and incurable illness.
4 — Medically assisted death can occur due to:
a) Medically assisted suicide;
b) Euthanasia.
5 — Medically assisted death can only occur by euthanasia when medically assisted suicide
mentally assisted is impossible due to the physical incapacity of the patient.
6 — The request underlying the decision provided for in paragraph 1 follows a clinical and legal procedure,
in accordance with the provisions of this law.
7 — The request may be freely revoked at any time, under the terms of article 12.
CHAPTER II
Procedure
Article 4
Opening of the clinical procedure
1 — The request to open the medically assisted death clinical procedure is made
by a person who meets the requirements set out in the previous article, hereinafter referred to as a patient,
in a written document, dated and signed by him or by the person designated by him in the terms
2 of Article 11, to be included in a special clinical register (SCR) created for this purpose.
2 — The request is addressed to the doctor chosen by the patient as the guiding doctor.
3 — The supervising physician must obligatorily access the patient's clinical history and assume it
as an essential element of its opinion, issued pursuant to Article 5.
4 — Applications from patients subject to judicial proceedings for the application of the
regime of the adult accompanied, while the same is pending, being the procedure
of medically assisted death immediately suspended when the judicial process is initiated
after submitting the application and while it is in progress, regardless of the
phase in which the medically assisted death procedure is found.
5 — Without prejudice to the provisions of this chapter regarding deadlines, the completion of medi-
directly assisted cannot take place without the elapse of a period of two months from the date of the request for opening the procedure.
6 — The patient is always guaranteed, if he so wishes, access to palliative care.
7 — The patient is ensured, throughout the entire procedure, access to follow-up
by a specialist in clinical psychology.
8 — For the purposes of the preceding paragraph, within a period of 10 working days from the beginning of the
procedure, the patient has access to a clinical psychology appointment, whose appointment is up to the
responsibility of the guiding physician, in order to guarantee the full understanding of his/her decisions, in the
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that respects himself and those around him, but also the clarification of relationships and
communication between the patient and family members, as well as between the patient and health professionals
that accompany it, in order to minimize the possibility of undue influence on the decision.
9 — Follow-up by a specialist in clinical psychology referred to the previous numbers is mandatory, unless the patient expressly rejects it.
Article 5
Advising physician's opinion
1 — The supervising physician issues, within 20 working days from the opening of the procedure,
ment, reasoned opinion on whether the patient meets all the requirements referred to in Article 3.
and provides you with all the information and explanations about the clinical situation that affects you, the treatments
applicable, viable and available, namely in the area of palliative care, and the respective
prognosis, after which it verifies whether the patient maintains and reiterates his will, and the decision must
of the patient be recorded in writing, dated and signed by the patient or the person designated by him
pursuant to paragraph 2 of article 11.
2 — The information and opinion provided by the doctor and the patient's declaration, signed
for both, are part of the ECR.
3 — If the advisor's opinion is not favorable to the medically assisted death of the
patient, the procedure in progress is canceled and terminated and the patient is informed of this
decision and its grounds by the guiding physician, and the procedure may be restarted
with a new request for opening, under the terms of article 4.
Article 6
Confirmation by specialist doctor
1 — After the favorable opinion of the supervising physician, he consults another physician,
specialist in the pathology that affects the patient, whose opinion confirms or not that the
conditions mentioned in the previous article, the diagnosis and prognosis of the clinical situation and the nature
serious and incurable disease or the definitive and extremely serious condition of the injury.
2 — The reasoned opinion of the specialist doctor is drawn up within 15 working days,
in writing, dated and signed by the person and forms part of the RCE.
3 — If the specialist doctor's opinion is not favorable to the medically assisted death of the
patient, the procedure in progress is canceled and terminated and the patient is informed of this
decision and its grounds by the guiding physician, and the procedure may be restarted
with a new request for opening, under the terms of article 4.
4 — In the case of a favorable opinion from the specialist doctor, the guiding physician informs the patient
of the content of that opinion, after which it checks again whether the patient maintains and reiterates his
will, and the patient's decision must be recorded in writing, dated and signed by the patient himself.
or by the person designated by him in accordance with paragraph 2 of article 11 and, together with the opinion or
alternative opinions issued by the doctor or medical specialists, integrate the RCE.
5 — If the patient suffers from more than one permanent injury of extreme severity or
serious and incurable illness, the guiding physician decides which medical specialty to consult.
Article 7
Confirmation by a specialist in psychiatry
1 — The opinion of a doctor specializing in psychiatry is mandatory, whenever there is a
one of the following situations:
a) The guiding physician and/or the specialist physician have doubts about the capacity of the person
sounds to request medically assisted death revealing a serious, free and enlightened will;
b) The guiding physician and/or the specialist physician admit that the person has a
mental disorder or medical condition that affects your ability to make decisions.
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2 — If the specialist doctor in psychiatry confirms any of the situations referred to in
previous number, the procedure in progress is cancelled, and the patient is informed of this decision
and its grounds, and the procedure may be restarted with a new request for opening,
pursuant to article 4.
3 — The opinion of the specialist doctor in psychiatry is drawn up within 15 working days,
in writing, dated and signed by the person himself, and forms part of the RCE.
4 — The assessment necessary for drawing up the opinion referred to in paragraph 1 involves, whenever
the specific condition of the patient so requires, the collaboration of one and specialist in clinical psychology.
5 — In the case of a favorable opinion from the physician specialized in psychiatry, he, accompanied by
of the supervising physician, must inform the patient of the content of that opinion, after which he verifies
again if the patient maintains and reiterates his will, and the conscious and express decision must
of this being registered in a written document, dated and signed by him or by the person for him
designated pursuant to paragraph 2 of article 11, which forms part of the ECR.
Article 8
Opinion of the Verification and Evaluation Commission
1 — In cases where favorable opinions are presented under the terms of articles
previously confirmed, the patient's will is reconfirmed, the supervising physician sends a copy of the ROSC to the
Commission for Verification and Evaluation of Medically Assisted Death Clinical Procedures
(CVA), provided for in article 24, requesting an opinion on compliance with the requirements and phases
procedure, which is prepared within five working days.
2 — When the CVA has doubts as to whether the conditions set out in this present law for the practice of medically assisted death, must summon the doctors involved in the
permission to provide statements, and may also request the submission of additional documents that you deem necessary.
3 — In the event of an unfavorable opinion by the CVA, the procedure in progress is cancelled, and may
be restarted with a new opening request, under the terms of article 4.
4 — In the event of a favorable opinion from the CVA, the supervising physician must inform the patient of the
content of that opinion, after which it checks again whether it maintains and reiterates its will,
their conscious and express decision must be recorded in a written, dated and signed document
by himself or by the person designated by him under the terms of paragraph 2 of article 11, which is part of the ECR.
Article 9
Implementation of the patient's decision
1 — Upon approval by the CVA, the supervising physician, in accordance with the will of the
patient, agrees on the day, time, place and method to be used for medically assisted death.
2 — The guiding physician informs and clarifies the patient about the methods available for
practicing medically assisted death, namely the self-administration of lethal drugs by the patient himself or the administration by the duly qualified doctor or health professional. designated for this purpose, but under medical supervision, when the patient is physically incapacitated to self-administer lethal drugs.
3 — The decision referred to in the previous number must be recorded in writing, dated and signed
by the patient, or by the person designated by him/her under the terms of paragraph 2 of article 11, and included in the
CERs, without prejudice to the provisions of paragraph 7 of article 3.
4 — After consigning the decision, the supervising physician sends a copy of the respective ECR
for the General Inspectorate of Health Activities (IGAS), which can monitor in person
the procedure for implementing the patient's decision.
5 — In the event that the patient becomes unconscious before the date set for carrying out the procedure,
medically assisted death, it is interrupted and not carried out, unless the
patient regains consciousness and maintains his decision.
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Article 10
Administration of lethal drugs
1 — In addition to the guiding physician and another health professional, who are obligatorily present
when administering lethal drugs, other health professionals may be present.
indicated by the supervising physician, as well as persons indicated by the patient, provided that
the guiding physician considers that there are adequate clinical and comfort conditions.
2 — Immediately before starting the administration or self-administration of drugs fatalities, the supervising physician must confirm whether the patient still wishes to request death
medically assisted, in the presence of one or more witnesses, duly identified in the RCE.
3 — If the patient does not expressly confirm his wish to request assisted death,
namely if you express any doubt, the procedure in progress is canceled and given by closed, which is entered in a written document, dated and signed by the guiding physician, including the RCE, and the procedure may be restarted with a new opening request, under the terms
of Article 4
4 — In the case provided for in the previous number, the respective CER must be delivered to the patient,
a copy must be attached to your clinical file and another sent to the CVA with the Petive Final Report of the supervising physician, pursuant to article 17.
Article 11.
Personal and non-delegable decision
1 — The patient's decision at any stage of the medically
assistance is strictly personal and non-delegable.
2 — Without prejudice to the provisions of the previous number, if the patient requesting medical death
directly assisted person does not know how or is physically unable to write and sign, he/she can, at all stages of the procedure where it is required, be replaced by a person of your trust, designated by itself only for this purpose, applying the rules of recognition
of signature by request in the presence of a legally competent professional, and the signature must
be performed in the presence of the supervising physician, with express reference to that circumstance, and
in the presence of one or more witnesses.
3 — The person appointed by the patient to replace him under the terms of the previous number cannot
to obtain direct or indirect benefit from the death of the patient, namely patrimonial advantage,
nor have a succession interest.
Article 12
Revocation
1 — The revocation of the medically assisted death request cancels the clinical procedure
in progress, and the decision must be entered in the RCE by the supervising physician.
2 — Upon revocation of the request, the respective CER is delivered to the patient, which must be
Attached a copy to your clinical file with the final report from the supervising physician.
Article 13
authorized locations
1 — The choice of location for medically assisted death is up to the patient.
2 — The medically assisted death procedure may be carried out in establishments
of the National Health Service and the private and social sectors that are duly
licensed and authorized to practice health care, have hospitalization and
adequate location and with reserved access.
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3 — If the patient chooses a location other than those referred to in the previous number, the guiding physician must certify that he or she has adequate clinical and comfort conditions squares for this purpose.
Article 14
Follow-up
In addition to the guiding physician and other health professionals involved in the medically assisted death, may be present, also for the purposes provided for in paragraph 2
of Article 10, the persons indicated by the patient.
Article 15
Death verification and death certification
The verification of death and the certification of death comply with the legislation in force, and the respective copies to be filed in the RCE.
Article 16
special medical record
1 — The ECR begins with the request for medically assisted death written by the patient, or by the person designated by him/her under the terms of paragraph 2 of article 11, and it must include the following elements:
a) All clinical information relating to the ongoing procedure;
b) The opinions and reports presented by doctors and other health professionals
actors in the process;
c) The opinion of the CVA;
d) The patient's decisions regarding the continuation of the procedure or the revocation of the order;
e) The patient's decision on the method of medically assisted death;
f) Other occurrences considered relevant.
2 — Once the procedure is completed or canceled due to revocation of the patient's request, decision
physician or following the opinion of the CVA, the CER is attached to the final report, which must be attached
a copy of the patient's clinical file.
3 — The supervising physician is responsible for the RCE, integrating the documents to which
refers to paragraph 1.
4 — The patient has access to the ECR whenever requested by the supervising physician.
5 — The CER model is established in regulations to be approved by the Government.
Article 17
Final report
1 — The supervising physician prepares, within 15 working days after the death, the respective report
final, to which the CER is attached, which is sent to the CVA and the IGAS.
2 — The obligation to present the final report remains in cases where the procedure
procedure is terminated without medically assisted death of the patient having occurred, either by medical decision, unfavorable CVA opinion or revocation.
3 — The final report must contain, among others, the following elements:
a) The identification of the patient and the doctors and other professionals involved in the process, including those who practiced or assisted in medically assisted dying, and people consulted ted during the procedure;
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b) The elements that confirm compliance with the requirements demanded by this law for medically assisted death;
c) Information on the clinical status, namely on the diagnosis and prognosis, with explanation of the serious and incurable nature of the disease or the definitive condition and severity
extreme of the injury and the characteristics and foreseeable intensity of the suffering;
d) The method and lethal drugs used;
e) The date, time and place where the medically assisted death procedure was carried out and the identification of those present;
f) The grounds for closing the procedure.
4 — The final report model is established in regulations to be approved by the Government.
CHAPTER III
Rights and duties of health professionals
Article 18
Qualified health professionals
1 — Health professionals registered with the Order of Doctors or the Order of Nurses
may practice or help in the medically assisted death procedure, excluding those ones
who may derive any direct or indirect benefit from the patient's death, namely equity advantage.
2 — For the purposes of carrying out the act of medically assisted death, healthcare professionals
referred to in the previous number must previously verify the existence of prescription of the necessary drugs, carried out in the applicable legal terms.
3 — To health professionals involved in the medically assisted death procedure
Psychological support is available whenever requested.
Article 19
Duties of health professionals
During the clinical procedure of medically assisted death, physicians and other
Health professionals who intervene in it must respect the following duties:
a) Inform the patient in an objective, understandable, accurate, complete and true manner about the diagnosis, the applicable, viable and available treatments, the predictable results, the pro- diagnosis and the life expectancy of your clinical condition;
b) Inform the patient of his right to revoke his decision to withdraw at any time.
require medically assisted death;
c) Inform the patient about the methods of administration or self-administration of drugs
lethal, so that he can choose and decide in an informed and conscious way;
d) Ensure that the patient's decision is free, clear and informed;
e) Periodically and frequently listen to the patient's will;
f) Dialogue with health professionals who provide care to the patient and, if authorized
for the same, with their relatives and friends;
g) Dialogue with the health care attorney, if appointed and if for
this is authorized by the patient;
h) Ensuring the conditions for the patient to be able to contact the people with whom he/she is concerned.
tent do;
i) Ensure psychological follow-up of the patient.
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Article 20
Professional secrecy and confidentiality of information
1 — All professionals who, directly or indirectly, participate in the death procedure medically assisted are obliged to observe professional secrecy in relation to all acts, facts or information of which they become aware in the exercise of their functions in that scope, respecting the confidentiality of the information to which they have had access, in accordance with the legislation in force.
2 — Access, protection and processing of information related to the procedure of medically assisted death are processed in accordance with the legislation in force.
Article 21
conscientious objection
1 — No health professional may be obliged to perform or assist in the act of death
medical assistance of a patient if, for clinical, ethical or any other reason, understand that it is not a duty to do so, ensuring the right to conscientious objection to all those who
invoke him.
2 — The professional's refusal must be communicated to the patient within 24 hours and must
specify the nature of the reasons that motivate it, without prejudice to the provisions of the following numbers.
3 — Conscientious objection is manifested in a document signed by the objector, addressed to
to the person in charge of the health establishment where the patient is being assisted and the objector pays
service, if applicable, and with a copy to the respective professional order.
4 — Conscientious objection is valid and applies in all health establishments and
workplaces where the objector works.
5 — Conscientious objection may be invoked at any time and does not require justification.
Article 22
disciplinary responsibility
Health professionals cannot be subject to disciplinary liability for their participation in the clinical procedure of medically assisted death, provided that they comply with all
the conditions and duties established in this law.
CHAPTER IV
Inspection and evaluation
Article 23
Oversight
1 — IGAS is responsible for supervising medically assisted death clinical procedures
taken, under the terms of this law.
2 — In the event of non-compliance with this law, the IGAS may determine, with reason,
the suspension or cancellation of an ongoing procedure.
Article 24
Committee for Verification and Evaluation of Procedures
Medically Assisted Death Clinics
In order to comply with the provisions of paragraph 1 of article 8 and assess the application of this law,
the Commission for Verification and Evaluation of Clinical Death Procedures Medically
Assisted.
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Article 25
Composition and functioning of the commission
1 — The CVA is made up of five members of recognized merit who guarantee special
qualification in the areas of knowledge related to the application of this law:
a) A lawyer appointed by the Superior Council for the Judiciary;
b) A jurist appointed by the Superior Council of the Public Ministry;
c) A doctor appointed by the Medical Association;
d) A nurse designated by the Order of Nurses;
e) An expert
in bioethics designated by the National Council of Ethics for Sciences
of life.
2 — Health professionals, referred to in paragraphs c) and d) of the
previous number, who have expressed conscientious objection under the terms of article 21.
3 — The term of office of CVA members is five years, renewable only once.
4 — The appointment of CVA members must be carried out within a period of 20 working days from
the entry into force of this law.
5 — The CVA draws up and approves its internal regulations and elects, from among its members,
a president.
6 — The CVA works with the Assembly of the Republic, which ensures the costs of its
operation and the necessary technical and administrative support.
7 — CVA members are not remunerated for the exercise of their functions, having the right to
to attendance tickets for each meeting in which they participate, in an amount to be defined by order
of the President of the Assembly of the Republic, allowances and transport requests in
terms of general law.
Article 26
Verification
1 — The CVA evaluates the conformity of the medically assisted death clinical procedure,
through a prior opinion, under the terms of article 8, and through an evaluation report, under the terms
of the next number.
2 — Once the final report of the medically assisted death process has been received, which
includes the respective CER, the CVA examines its content and assesses, within five working days after
such receipt, the terms under which the conditions and procedures established in this law
have been fulfilled.
3 — In cases where the evaluation provided for in the previous number does not comply with
the requirements established by this law, the CVA sends the report to the Public Ministry, and to the
respective professional bodies of those involved for the purposes of any disciplinary proceedings.
Article 27
Assessment
1 — The CVA submits to the Assembly of the Republic, annually, an assessment report on the
application of this law, with detailed statistical information on all relevant elements medically assisted death processes and any recommendations.
2 — For the elaboration of the report, they are evaluated, with guarantee of anonymity and confidentiality, the final reports and the respective RCE sent to the CVA by the guiding physicians, who must provide all additional clarifications that it requests.
3 — IGAS provides CVA with the requested information on inspection procedures
carried out in connection with compliance with this law.
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CHAPTER V
Legislative amendment
Article 28
Amendment to the Penal Code
Articles 134, 135 and 139 of the Penal Code are replaced by the following:
«Article 134.o
[...]
1 - [...]
two - [...]
3 — The conduct is not punishable when carried out in compliance with the conditions established
in Law No. 22/2023.
Article 135
[...]
1 - [...]
two - [...]
3 — The conduct is not punishable when carried out in compliance with the conditions established
in Law No. 22/2023.
Article 139
[...]
1 — (Current body of the article.)
2 — A doctor or nurse is not punished who, without inciting or advertising, merely
provide information, at the express request of another person, about medically assisted suicide,
in accordance with Article 135(3)'
CHAPTER VI
Final and transitional provisions
Article 29
Life insurance
1 — For the purposes of the life insurance contract, medically assisted death is not a factor
exclusion.
2 — Health professionals who participate, in any capacity, in the clinical procedure of
medically assisted death of an insured person lose the right to any benefits
contracted.
3 — For the purposes of defining the cause of death of the insured person, the certificate must state
of death to carry out a medically assisted death procedure.
4 — Once the medically assisted death clinical procedure has begun, the insured person
cannot alter the clauses for the designation of beneficiaries.
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Article 30
Dissemination of information on the Internet
The Directorate-General for Health provides, on its website, an area for information
information on non-punishable medically assisted death, with the following fields:
a) Information on clinical procedures;
b) Standardized forms and documents;
c) Applicable legislation.
Article 31
Regulation
The Government approves, within 90 days after the publication of this law, the respective regulation.
lamentation.
Article 32
Deadlines
The deadlines provided for in this law are calculated in accordance with the provisions of article 87 of the Code
of the Administrative Procedure.
Article 33
Transitional provision
In the first two years of validity of this law, the CVA submits to the
Assembly of the Republic the evaluation report referred to in paragraph 1 of article 27
Article 34
Implementation
This law enters into force 30 days after thepublication of the respective regulations.
Approved on March 31, 2023.
The President of the Assembly of the Republic, Augusto Santos Silva.
Enacted on May 16, 2023.
Publish yourself.
The President of the Republic, Mඉකඋඍඔ Rඍඊඍඔ ඌඍ Sඝඛඉ.
Countersigned on May 18, 2023.
The Prime Minister, António Luís Santos da Costa.
