End-of-life (EOL) regulations vary significantly across countries, not only in terms of legal frameworks and ethical principles but also in the societal processes and public debates that shape them. This paper explores these dynamics in five countries—Belgium, Germany, Hungary, Israel, and the Netherlands—each of which offers a distinct perspective on EOL decision-making, shaped by its unique historical, cultural, religious, political, and legal contexts. A central theme in this paper is the role of the medical profession in shaping EOL policy. For over five decades, the World Medical Association has maintained a firm stance against physician-assisted dying (PAD), often placing it at odds with more liberal national debates. This paper offers both a detailed account of national developments and a comparative analysis of the five countries. We examine how historical trajectories, public debates, and professional attitudes have shaped EOL policies, and how tensions between public opinion and medical ethics continue to influence the implementation of these laws. Ultimately, we reflect on how societies with moral pluralism navigate the complex terrain of end-of-life decision-making.
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