Protection of Conscience Project
Protection of Conscience Project
Service, not Servitude

Service, not Servitude
name flag



Regulates the conditions under which medically assisted death is not punishable and amends the Penal Code


Decree No. 109/XIV is a law that authorizes physicians and nurses to assist in suicide or provide euthanasia for eligible patients.  Eligible patients are adult nationals or legal residents of Portugal who experience intolerable suffering as a result of an extremely severe and permanent injury or incurable terminal illness.  Eligible patients must also demonstrate a serious, voluntary, informed, continuing and reiterated decision to seek euthanasia/assisted suicide.  Physicians who are satisfied that a patient is eligible must obtain the approval of  the Committee for the Verification and Evaluation of Clinical Procedures for Advancing Death (CVA) before providing the procedure.

The law includes a protection of conscience provision.  Any health professional may decline to "practise or assist in the act of antecipação da morte de um doente", which, literally translated, means the act of "anticipating the death of a patient."  However, from the context it appears that this is more correctly translated as "advancing the death of a patient."  To assist in "advancing the death of a patient" is broad enough to encompass diagnosis, evaluation and facilitation by referral or other means.

An objection can be based upon clinical, ethical or other grounds.  An objecting professional must advise a patient of the objection and reasons for it within 24 hours, presumably within 24 hours of a request from the patient.  Objectors must also give written notice to the person in charge of the health establishment where they work and to their professional orders.  Such an objection is permanently and universally valid and "does not need to be justified" (e não carece de fundamentação).  This appears to mean that objectors are not required to demonstrate that their clinical, ethical or other reasons for refusing to participate are correct.

The law is not clear about the freedom of health care facilities to refuse to be involved with euthanasia and assisted suicide or to prohibit the procedures on their premises. Article 12.1 states that it is up to the patient to determine the location for the procedure (“A escolha do local para a prática da morte medicamente assistida cabe ao doente.”). However, nothing in the law requires a facility to comply with a patient’s choice. The rest of Article 12 simply describes places where the services can be provided.

Lack of clarity on this point is likely to cause problems, especially if Portuguese euthanasia/assisted suicide advocates are as aggressive as those in Canada. See, for example:

The Portuguese parliament passed the law on 29 January, 2021.  It has been referred by the President of Portugal for a review by Portugal's Constitutional Court.

Sean Murphy

Source Caution: machine assisted translation
Artigo 20.º
Article 20
Objeção de consciência
Conscientious objection

1 – Nenhum profissional de saúde pode ser obrigado a praticar ou ajudar ao ato de antecipação da morte de um doente se, por motivos clínicos, éticos ou de qualquer outra natureza, entender não o dever fazer, sendo assegurado o direito à objeção de consciência a todos os que o invoquem.

1 – No health professional may be obliged to practise or assist in the act of advancing the death of a patient if, for clinical, ethical or other reasons, he understands that he must not do so, the right to conscientious objection being guaranteed to all who invoke it.

2 – A recusa do profissional deve ser comunicada ao doente num prazo não superior a 24 horas e deve especificar a natureza das razões que a motivam, sem prejuízo do disposto nos números seguintes.

2 – The refusal of the professional shall be communicated to the patient within a period of not more than 24 hours and shall specify the nature of the reasons for it, without prejudice to the provisions of the following paragraphs.

3 – A objeção de consciência é manifestada em documento assinado pelo objetor, dirigido ao responsável do estabelecimento de saúde onde o doente está a ser assistido e o objetor presta serviço, se for o caso, e com cópia à respetiva ordem profissional.

3 – The conscientious objection is expressed in a document signed by the objector, addressed to the person in charge of the health establishment where the patient is being assisted and the objector provides service, if applicable, and with a copy to his professional order.

4 – A objeção de consciência é válida e aplica-se em todos os estabelecimentos de saúde e locais de trabalho onde o objetor exerça a sua profissão.

4 – The conscientious objection is valid and applies in all health establishments and workplaces where the objector exercises his profession.

5 – A objeção de consciência pode ser invocada a todo o tempo e não carece de fundamentação.

5 – The conscientious objection can be raised at all times and does not need to be justified.