Over the past three decades, active euthanasia and abortion have received increasing international attention. Since both these practices are relevant to the role of the nurse-midwife, it is important to know what influences their attitudes towards them. Therefore, the purpose of this study was: 1, to survey the attitudes of nurse-midwives' to active euthanasia and its legalization; 2, to determine the relationship between nurse-midwives' attitudes toward active euthanasia and its legalization, and attitudes toward abortion, self-reported religiosity and religious affiliation. The study setting was an international midwifery conference and the sample consisted of 139 nurse-midwives attending the conference. The majority of nurse-midwives displayed a positive attitude toward active euthanasia and its legalization. In addition, there was a positive relationship between their attitude to abortion and active euthanasia. Self-reported religiosity and religious affiliation were significantly related to attitudes toward active euthanasia and its legalization. An interesting positive relationship between country of practice and attitudes to euthanasia was also found. Nurse-midwives practicing in countries with more liberal euthanasia and assisted suicide legislation were more supportive of active euthanasia. With the increasing acceptance of active euthanasia's legalization, the results of this study pose some ethical questions that nurse-midwives internationally will have to consider.