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Watching the watchmen: changing tides in the oversight of medical assistance in dying
  1. Sean Riley
  1. Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
  1. Correspondence to Sean Riley, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; sean.riley{at}


The recent wave of medical assistance in dying legalisation raises questions about proper oversight of the practice as new systems for data collection, case assessment and public reporting emerge. Newer systems, such as in Spain, New Zealand and Colombia, are eschewing the retrospective approach used for case assessment in older systems, particularly those in the Netherlands, Belgium and the USA, in favour of an approach requiring more extensive review prior to the procedure. This shift aims to increase compliance with each jurisdiction’s specific safeguards and legal criteria as well as to protect vulnerable patients, but also risks stifling access to the practice and increasing administrative burden on clinicians and patients. Newer systems also tend to favour more extensive data collection than older systems, while failing to be as transparent with public reporting. Inconsistency in data collection and public reporting make it difficult for researchers, policymakers and the public to assess the practice and help achieve a balance between access and compliance. Research on oversight activities is sparse, and there is a need for clarity to determine how best to handle violations of the law and how to create best practices.

  • Euthanasia
  • Ethics
  • Quality of Health Care
  • Right to Die

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  • Contributors SR is the sole author of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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