More than 1,000 people have been granted assistance in dying in Spain since the Euthanasia Law came into force four years ago. Specifically, while a total of 1,034 euthanasias were performed up to last year, according to the Right to Die with Dignity association, this figure has already exceeded 1,300 so far in 2025. At this time, more than 40% of requests for assistance in dying are reportedly being approved.

“We are at the beginning of the slippery slope phenomenon,” says Julio Tudela, director of the Bioethics Observatory at the Catholic University of Valencia, who explains that “we have already passed the initial legal resistance to making it illegal to deliberately kill someone.”

Once the “first red line” of legal approval has been crossed, “what awaits us is a gradual process of relaxation,” something already observed in nations with more experience in this field, such as the Netherlands and Belgium. “Little by little, the scope is being expanded to include more cases than initially permitted, and thus we are now reaching patients without intractable pain, who are not at the end of their lives, with mental illness, without consent, with depression, those tired of living, or patients without any pathology, and euthanasia is even being applied to minors,” says Tudela.

In Spain, we are “at the point of initial relaxation” when it comes to defining criteria for the application of euthanasia, which is why the president of the Bioethics Observatory warns that “the weight of the decision is increasingly placed on the patient, so what matters is what they say autonomously.”

After this first step, “social contagion, the mimetic effect,” occurs, whereby “if an initially socially reprehensible attitude is repeated with increasing frequency, it will alter the moral perception of the rest of the population.” This phenomenon is already affecting the medical sector, since “if the number of doctors who are permissive of euthanasia increases, this will spread to their colleagues.”

All of this happens “the less ethical education society has, because it limits itself to uncritically repeating the behavior of the surrounding herd.” For Tudela, “this is the underlying problem, both among people in general and among physicians,” calling it “bioethical illiteracy.”

Third, Julio Tudela denounces “the failure of palliative care in Spain,” estimating that 70,000 patients in Spain are dying from intense, avoidable pain because the palliative care they need is not provided. “This is the fuel for euthanasia, the neglect regarding this issue,” he laments, explicitly mentioning ALS patients and a law announced for them that has yet to be passed. “Where are we pushing them?” he concludes.

• Article published in Alfa y Omega