Since the entry into force of Organic Law 3/2021, regulating euthanasia (LORE), knowledge about its practical application has been progressively consolidated. As with any regulation that incorporates a new right and a procedure of high ethical, legal, and care complexity, its implementation has required a significant adaptation effort by the institutions and professionals who make it possible.
This journey has been possible thanks to the commitment of the health administration, the technical teams, the care professionals, and those who promoted the establishment of the Canary Islands Guarantee and Evaluation Commission from its inception. To all of them, I wish to convey my most sincere recognition and gratitude for work carried out with sensitivity, responsibility, and a deep commitment to people at the end of life.
After five years of the Law being in force, the provision of assistance to die has reached a growing degree of organizational maturity in our Autonomous Community. The Canary Islands Guarantee and Evaluation Commission has played an essential role in this process, composed of professionals deeply committed to the functions attributed to it by the LORE, who balance this responsibility with a high care workload in their respective fields of work.
The Commission has managed to consolidate a working dynamic based on deliberation, technical rigor, independence, and permanent availability to advise and support the professionals involved in the procedures provided for by the Law. This collective effort has made it possible to build a collaborative model that strengthens the legal certainty of the procedure and places the applicant at the center.
The implementation of a novel procedure, combined with the need to harmonize clinical, ethical, and legal aspects, makes it essential to maintain permanent spaces for dialogue, deliberation, and shared learning. The different interpretations that may arise during the application of the Law should be understood as an opportunity to improve procedures, reinforce guarantees, and move towards an increasingly homogeneous application of the LORE.
In this process, the work of the Support Units for the Provision of Aid in Dying (UAPAM) has been equally essential. These units constitute the main link between care practice and the Commission, accompanying professionals during the processing of procedures, offering support in the interpretation of the clinical and legal context of the provision, resolving doubts, and facilitating the proper development of the files. The commitment shown by their members has been decisive for the consolidation of this provision in the Canary Islands.
The speed in processing files is not only a procedural requirement but an ethical and care commitment to people who, in most cases, face advanced illnesses and situations of extreme fragility. Streamlining the procedure helps to guarantee the effective exercise of a right recognized by Law and reduces the risk of death occurring before the person can see the process completed according to their will.
The care reality of the Canary Islands
The data collected in the Annual Report 2025 allows for the first time a global view of the application of the LORE in our Autonomous Community. Since the Law came into force until the present moment, 266 people have requested the aid-in-dying provision in the Canary Islands. During 2025, 60 applications were registered, of which 30% culminated in the provision being carried out.
The profile of the applicants reflects a reality clearly linked to advanced chronic illness. 81.6% were of Spanish nationality; approximately 70% were over 60 years old, and the gender distribution was practically balanced between men and women.
The territorial distribution shows an unequal implementation of the provision. 43.3% of the applications corresponded to Tenerife, 26.7% to Lanzarote, 21.7% to Gran Canaria, 6.7% to Fuerteventura, and 1.7% to La Palma, with no applications registered in the rest of the islands during the period analyzed.
Regarding the diseases that motivated the request, oncological pathology represented 43.3% of the cases, followed by neurological diseases with severe functional deterioration, which accounted for 26.7%.
One of the most relevant findings of the analysis carried out is that 95% of the requests were made directly by the person themselves, in free, conscious, and autonomous exercise of a right recognized by the LORE. The remaining 5% were processed through the Advance Directive Document, in cases where the person, having lost the capacity to express their decision, had previously expressly registered their wish to request euthanasia. This data highlights the importance of advance care planning as a tool to guarantee respect for personal autonomy when the capacity to decide can no longer be exercised directly.
The role of Primary Care deserves special relevance. Family doctors were responsible for 41.5% of the applicants, a circumstance that reflects the relationship of continuity and longitudinal knowledge they maintain with individuals and their families during the progression of chronic illnesses and situations of progressive deterioration.
Regarding the procedure times, the average period between the first request and the favorable resolution by the Commission was 40.7 days, while the average time until the provision of the service reached 57.8 days. This difference is largely due to the exercise of the applicant's autonomy, who can freely decide the moment for their assisted death to be carried out.
The analysis of cases also allows for the identification of situations requiring special attention. 18.3% of the requests could not be completed as they did not comply with the assumptions provided by the LORE. Likewise, 26.6% of the applicants died during the procedure, a circumstance closely related to the extreme fragility and advanced progression of many of the illnesses that motivate these requests. On the other hand, 11.7% of individuals decided to withdraw their request during the deliberation process. This data highlights the importance of the dialogue maintained with the attending physician and the consulting physician, as, in numerous cases, the exploration of new therapeutic, palliative, or care alternatives allowed the person to reconsider their decision.
Regarding the place where the provision of assisted dying was finally carried out, 76.9% took place in a hospital setting and 23.1% at home, reflecting the need to continue strengthening the healthcare system's capacity to offer this care in the different settings where the person wishes to be attended.
A look towards the future
End-of-life care constitutes one of the most ethically, clinically, and humanly demanding areas of the healthcare system. Therefore, it is essential to continue reinforcing the training of professionals, consolidating coordination between the Assisted Dying Support Units and the Guarantee and Evaluation Commission, optimizing communication circuits, and providing the Commission with the necessary administrative and technical resources to carry out its functions with greater agility, independence, and legal certainty.
Similarly, it is essential to bring the healthcare right recognized by the LORE closer to citizens. Promoting outreach activities, discussions, and informational workshops in the different Health Areas will contribute to improving knowledge of the assisted dying service, fostering more informed decision-making, and strengthening the population's trust in the guarantees offered by the healthcare system during the end of life.
Only through this institutional commitment, based on trust, training, joint work, and recognition of those who make this service possible, will we be able to continue consolidating a care model that always places the dignity, autonomy, and rights of people at the end of life at its center.
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