Is Assisted Suicide Legal in Japan? Current Laws, Recent Court Rulings & Criminal Penalties
Is assisted suicide legal in Japan? No. Japan’s Penal Code Article 202 criminalizes assisted suicide, solicitation of suicide, and consensual homicide with penalties of six months to seven years imprisonment. No laws or official guidelines govern medical aid in dying in Japan, despite growing public debate following high-profile cases.
In November 2024, the Osaka High Court upheld an 18-year prison sentence for Dr. Yoshikazu Okubo in a landmark case involving the death of an ALS patient, rejecting constitutional arguments about the right to self-determination. This ruling reinforced Japan’s strict prohibition against physician-assisted death and clarified that patients have no constitutional right to seek assistance in ending their lives.
What Does Japanese Law Say About Assisted Suicide?
Japan’s Penal Code Article 202 makes “solicitation of suicide,” “assistance in suicide,” “commissioned murder,” and “consensual homicide” all illegal. The law makes no distinction between physician involvement and assistance by family members or others.
While attempting suicide itself is not criminal in Japan, any person who induces or aids another to commit suicide faces imprisonment with or without work for six months to seven years. This prohibition extends to providing tools, giving instructions, or persuading someone to commit suicide.
The Ministry of Health, Labor, and Welfare does not approve of active euthanasia, placing Japanese physicians in an ambivalent position regarding end-of-life care.
Recent Court Ruling: 2020 ALS Case Establishes Legal Precedent
In July 2020, two physicians were arrested on murder charges for assisting a 51-year-old Kyoto woman with ALS to die in November 2019. The doctors traveled to Kyoto and administered a lethal dose of barbiturates at her home.
The physicians were not the woman’s attending doctors and neither examined her to ascertain the progression of her ALS or assess her mental state prior to carrying out the act. This case differed significantly from legal euthanasia protocols in countries where the practice is permitted.
The Osaka High Court rejected the defense’s argument that finding Dr. Okubo guilty of murder would violate the Constitution’s right to self-determination, stating that the Constitution presumes the right to life but does not recognize a “right to seek assistance from others to end one’s life”.
Criminal Penalties Imposed
Dr. Yuichi Okubo received an 18-year prison sentence for killing the ALS patient following her request, which constitutes the crime of assisted suicide. In a separate conviction, Dr. Okubo was also convicted of killing the father of his fellow accused Dr. Naoki Yamamoto, with prosecution claiming he held beliefs that elderly people and patients with incurable diseases who wish to die should be actively targeted for death.
Prior to her death, the patient transferred ¥1.3 million to Dr. Naoki Yamamoto’s bank account, prompting police to charge both physicians with “murder by contract”.
Historic Legal Framework: The Tokai University Hospital Case
The famous judicial precedent regarding assisted dying is the 1991 Tokai University Hospital Case, in which a physician administered potassium chloride to a patient according to the demands of the patient’s family, resulting in the patient’s death.
On March 28, 1995, the Yokohama District Court established four legal requirements for “physician-assisted voluntary euthanasia”: (1) The patient must be suffering from unbearable physical suffering; (2) the patient’s death must be unavoidable and imminent; (3) every possible palliative treatment and care to ease the patient’s physical suffering must have been provided, and no alternatives must be available; and (4) the patient must have expressed a clear and voluntary desire to have his or her life shortened.
The Tokyo High Court later reversed the Yokohama District Court’s decision and sentenced the doctor to 1.5 years imprisonment with hard labor with a suspension of the sentence of 3 years for homicide under Article 199 of the Criminal Code.
Why These Criteria Don’t Legalize Assisted Suicide
The Yokohama District Court set out four conditions in finding Tokai University Hospital doctor Masahito Tokunaga guilty of murder. These requirements were established to determine when criminal liability might be reduced, not to legalize the practice.
Even in the abstract, these four conditions are problematic. The rapid improvement of drugs to control pain has made unbearable physical pain very rare. Courts continue to convict physicians who assist in deaths, even when some criteria are met.
Criminal Penalties Under Japanese Law
Prison Sentences:
- Assisting or inciting suicide: 6 months to 7 years imprisonment with or without work
- Active euthanasia resulting in conviction: Suspended sentences to significant prison terms
- Recent ALS case: 18-year prison sentence upheld on appeal
Who Can Be Prosecuted:
- Physicians who administer lethal medication
- Physicians who prescribe or provide lethal means
- Family members who assist in suicide
- Anyone who induces, encourages, or facilitates suicide
Since the first judgment of a euthanasia case in the Tokyo District Court in 1949, another five cases reached sentencing by 1990. All six cases involved “active euthanasia” performed by family members, and those accused were found guilty of “homicide upon request” and received suspended sentences.
National vs. Regional Law: No Legal Variations Across Japan
Japan operates under a unified national penal code with no regional variations in assisted suicide laws. A legislative bill on the termination of life-sustaining measures has yet to be sent to deliberations at the Diet due to strong opposition that has prevented it from debating in either the House of Representatives or the House of Councillors.
No prefecture, municipality, or regional jurisdiction in Japan permits medical aid in dying or physician-assisted suicide under any circumstances.
Healthcare Provider Liability and Legal Protections
Under the Japanese Penal Code, assisting suicide is considered a criminal offense, placing Japanese physicians in an ambivalent position regarding end-of-life matters.
Physicians in Japan face:
- Criminal prosecution under Article 202 (assisted suicide) or Article 199 (homicide)
- Problems left to legal interpretation by judicial precedents since there are no specific provisions or official guidelines on euthanasia
- Professional consequences including license revocation
- Civil liability for damages to surviving family members
Pure euthanasia (palliative care without hastening death) and indirect euthanasia (analgesic drugs that incidentally hasten death) are lawful in Japan when provided as medical treatment. Passive euthanasia (withholding life-prolonging measures) is generally lawful when complying with the patient’s wishes.
Death with Dignity vs. Assisted Suicide: Critical Legal Distinction
Japan sees euthanasia and “songenshi” (death with dignity) as distinct concepts, though euthanasia is seen by some as belonging to the broader discussion of dying with dignity in the West.
Death with Dignity (Legal):
- Withdrawing or withholding life-sustaining treatment
- Palliative sedation to relieve suffering
- Following advance directives from conscious patients
- Allowing natural death without aggressive intervention
Active Euthanasia/Assisted Suicide (Illegal):
- Administering lethal medication directly
- Providing lethal means for self-administration
- Any affirmative act to hasten death
- Commissioned killing even with patient consent
The Japan Society for Dying with Dignity advocates for legislation on “death with dignity,” but there has been a trend among members of Parliament to resist such measures.
Public Opinion vs. Medical Community
A January 2025 study revealed Japanese physicians did not display support for euthanasia (2%) and assisted suicide (1%); however, the general public supported euthanasia (33%) and assisted suicide (34%).
Among the general public, males exhibited significantly higher support for physician-assisted suicide than females.
At least 1 in 20 Japanese people are estimated to desire active euthanasia, and recent studies suggest 18.0% of Japanese surveyed prefer the active ending of life if they would become terminally ill.
Despite this public interest, there is no appetite among the political classes in Japan for a debate on assisted dying, with strong resistance among members of Parliament.
Recent Legislative Developments and Debates
A 2023 study published in BMC Medical Ethics argued that Japan should initiate discussion on voluntary assisted dying legislation, referring to Victoria, Australia’s Voluntary Assisted Dying Act 2017 (VADA2017) as a model with stringent safeguards.
In 2016, acclaimed scriptwriter Hashida Sugako caused a stir with an essay titled “I Want to Be Euthanized,” stating she intended to travel to Switzerland, where assisted suicide is legal, rather than face losing control of her faculties. Then in June 2017, national broadcaster NHK ran a documentary following a Japanese woman with MSA and her family to Switzerland for an assisted death.
However, no formal legislation has been introduced in the Diet, and strong opposition has prevented any bill on the termination of life-sustaining measures from reaching deliberations.
Constitutional Arguments and Court Interpretations
The Osaka High Court’s November 2024 ruling rejected constitutional arguments, stating that the Constitution presumes the right to life but does not recognize a “right to seek assistance from others to end one’s life”.
Japanese courts have consistently held that:
- The right to self-determination does not extend to assisted death
- Patient autonomy has limits when it conflicts with criminal prohibitions
- Constitutional protections for life preclude state sanction of assisted dying
- Healthcare professionals have no constitutional protection when assisting suicide
The Tokyo High Court questioned whether the patient’s determination regarding terminal care treatment constitutes constitutional self-determination and whether Article 202 of the Criminal Code prohibiting aiding and abetting suicide can be consistently explained.
What Happens If You Travel Abroad for Assisted Suicide?
Japanese citizens who travel to countries like Switzerland, Belgium, or Canada for legal assisted dying face no criminal penalties upon return, as the act occurs under foreign jurisdiction. However, anyone who assists them in traveling, making arrangements, or facilitating the process could face prosecution in Japan.
Some Japanese patients have traveled to Switzerland with the help of organizations like Lifecircle to obtain assisted dying, which has received media attention in Japan.
Guidelines for Terminal Care
In May 2007, the Ministry of Health, Labour and Welfare established an Official Guideline on the Process of Decision-Making in the Field of Life-Sustaining Care. These guidelines address:
- Withdrawing life-sustaining treatment
- Advance directives
- Family involvement in medical decisions
- Palliative care standards
The guidelines do not authorize active euthanasia or physician-assisted suicide under any circumstances.
Comparison With Other Asian Countries
Japan’s prohibition places it among most Asian nations that ban assisted suicide:
- South Korea: Illegal with criminal penalties
- China: Illegal under homicide statutes
- Taiwan: Illegal though debated after natural death legislation
- Singapore: Illegal with strict enforcement
- Thailand: Illegal with cultural opposition
Only Thailand has limited natural death legislation allowing treatment refusal.
How This Affects Terminal Patients and Families
Japanese patients facing terminal illness have these legal options:
- Palliative care and pain management
- Withdrawing or refusing life-sustaining treatment
- Advance directives specifying treatment preferences
- Hospice care
- Sedation to relieve suffering
Illegal actions that result in prosecution:
- Requesting physician assistance in dying
- Administering lethal medication
- Providing means for suicide
- Paying someone to facilitate death
In the recent ALS case, the patient had transferred ¥1.3 million to one doctor’s account, allegedly the same amount charged by a Swiss assisted-dying organization.
Cultural and Religious Factors
In Shintoism and Confucianism, death is regarded as the ultimate impurity and considered a serious taboo, and any discussion of death is still highly discouraged and met with great resistance.
There is no definite concept of an afterlife in these traditions, so in many cases, doctors, families, and society still prefer to keep patients alive, regardless of their wishes or suffering.
The disparity between physicians and the general public may be attributed to the influence of the Buddhist view of life and death and family-centeredness in Japanese culture.
FAQs About Assisted Suicide Laws in Japan
Can doctors legally help terminally ill patients die in Japan?
No. Japan’s Penal Code Article 202 criminalizes assisted suicide with imprisonment of six months to seven years. Physicians who assist face criminal prosecution for murder or assisted suicide regardless of patient consent.
Are there any legal end-of-life options in Japan?
Yes. Pure euthanasia (palliative care), indirect euthanasia (pain medication that incidentally hastens death), and passive euthanasia (withholding life-prolonging measures) are lawful in Japan when following proper medical protocols.
What was the outcome of the 2020 ALS doctor case?
In November 2024, the Osaka High Court upheld an 18-year prison sentence for Dr. Yoshikazu Okubo, rejecting constitutional arguments about the right to self-determination. This landmark ruling reinforced Japan’s prohibition against physician-assisted death.
Does Japan recognize the right to die?
No. The Osaka High Court ruled that the Constitution presumes the right to life but does not recognize a “right to seek assistance from others to end one’s life”. Patients can refuse treatment but cannot request active assistance in dying.
Can Japanese citizens travel abroad for assisted suicide?
Yes, but some Japanese patients have traveled to Switzerland for legal assisted dying through organizations like Lifecircle. While traveling abroad is legal, anyone who assists in arranging or facilitating the process could face prosecution in Japan.
What are the penalties for family members who assist in suicide?
Anyone who induces or aids another to commit suicide faces imprisonment for six months to seven years. Historical cases show family members convicted of “homicide upon request” received suspended sentences.
Is there any legislative movement toward legalizing assisted dying?
A legislative bill on the termination of life-sustaining measures has yet to be sent to deliberations at the Diet due to strong opposition. Despite 33% of the general public supporting euthanasia and 34% supporting assisted suicide, there is no political appetite for change.
Disclaimer: This information is for educational purposes only and does not constitute legal advice. Consult an attorney specializing in healthcare law, end-of-life law, or Japanese regulations for specific legal guidance on your situation.
Related Resources:
- Questions to Ask a Healthcare Lawyer
- Understanding Healthcare Power of Attorney
- Legal Issues in Terminal Care
About the Author
Sarah Klein, JD, is a licensed attorney and legal content strategist with over 12 years of experience across civil, criminal, family, and regulatory law. At All About Lawyer, she covers a wide range of legal topics — from high-profile lawsuits and courtroom stories to state traffic laws and everyday legal questions — all with a focus on accuracy, clarity, and public understanding.
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