End-of-life healthcare decisions, ethics and law: the debate in Spain.

The debate on euthanasia in Spain has been ongoing from the beginning of the 20th century and remains extant. Three periods can be identified: prior to 1978, 1978-2002, and after 2002. The debate increased significantly after the Ramon Sampedro case (1995-1998), and was fuelled with new, although very different cases, such as those of Leganés (2005-2008), Jorge Leon (2006) or Inmaculada Echevarria (2006-2007). As a consequence of these cases in 2008 the Regional Government of Andalusia started a legal process to pass a law regulating end-of-life decisions, excluding euthanasia and assisted-suicide, which was finally enacted in 2010. Two other Spanish regions (Navarra and Aragón) passed similar laws. The central government also initiated a legal process to approve a national law, excluding euthanasia and assisted-suicide. The project failed because of the dissolution of the Parliament in June 2011. The new government will have to decide how to continue the process.