LIANE HANSEN, host:

Two right-to-die controversies have dominated headlines in Europe in recent weeks. The cases have highlighted sharp divisions over how the continent deals with its terminally ill.

NPR's Sylvia Poggioli has this letter from Europe.

SYLVIA POGGIOLI: In Italy, the highest court ruled that feeding tubes could be removed from Eluana Englaro, a woman who had been in a vegetative state for 17 years. But the government, pressed by the Vatican, defied the ruling and tried to pass an emergency law that would prevent doctors from removing all life support from ailing patients. Englaro died during the senate debate.

In Britain, Debbie Purdy, a woman with multiple sclerosis who wants to travel to Switzerland to undergo assisted suicide, this past week lost her case seeking legal immunity for her relatives who want to accompany her on her final trip.

Whatever you call it - euthanasia, mercy killing or assisted suicide - the right to a kindly death is of intense concern in Europe, a continent with a rapidly growing aging population. But European laws are in conflict. In 2002, the Netherlands and Belgium became the first countries in the world to legalize euthanasia under very strict rules.

The law covers only patients with incurable conditions facing unbearable pain. The average number of Dutch cases has been about 2,000 per year, a few hundred in Belgium. Switzerland has become a favored destination for terminally ill people.

Dignitas, an organization that helps the terminally ill get suicide assistance, has hundreds of Europeans on its waiting list. Luxembourg followed the Dutch and Belgian examples, and parliament last year voted to legalize euthanasia. But Grand Duke Henri, who holds executive power and signs all laws, refuses to endorse the bill, raising the possibility that he'll be stripped of his powers through a change in the constitution in order to legalize euthanasia.

The situation is different in the rest of Europe. Legislation is vague in some countries like Germany and Sweden and restricted in Spain, France and Italy. In Germany, euthanasia is a word hardly ever uttered. It carries the stigma of the Third Reich, when the Nazis killed hundreds of thousands of handicapped or mentally ill persons. And the law on assisted suicide is murky. While not illegal, it cannot involve a doctor.

In Spain, the governing socialists who had defied the Catholic Church by legalizing same-sex marriage, have been dragging their feet on a campaign proposal to legalize euthanasia. And in England, Wales and Scotland, anyone assisting a suicide is liable for murder.

Behind all the legal restrictions in some countries, there is another reality. European societies are increasingly secular as well as rapidly aging. And polls show a majority of Europeans favor a right to die. It is precisely because of this gap between some laws in public opinion that many courts are increasingly refraining from handing down convictions in cases of assisted suicide - a de facto recognition that helping achieve a kindly death is becoming a silent, accepted practice.

Sylvia Poggioli, NPR News, Rome.

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