What is legal?

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What is legal?

Forecasting human longevity has important public policy implications that influences the rate at which the working population is taxed, the benefits of current beneficiaries and the financial status of future generations.

Within the European Union, life expectancy is 78.6 years (74.7 years for males and 82.5 years for females).

In the European Union, the healthy life expectancy however is 70.4 years for all citizens (68.2 years for men and 72.6 years for women). The Dependency ratio measures how many people are outside the workforce in relation to those who belong to the workforce. The Economic Dependency ratio also takes into account the number of unemployed. In long-term planning, it is naturally much more difficult to estimate the employment rate than demographic trends such as birth rate and mortality.

Before looking at the legal differences between the countries, it is worthwhile comparing the demographic facts and predicted figures between countries.

Find out about the following issues.

What percentage of the population is over 65 and what are the predications for this age group in the future? What is the life expectancy and healthy life expectancy at the moment?
What is the legal retirement age and what is the actual average retirement age (due to early pensions etc.)?
How is the basic income of the elderly guaranteed by law?
Are children liable to give maintenance to their parents?
Is it legal to refuse medical treatment?
Is assisted suicide or euthanasia legal?

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United Kingdom

What percentage of the population is over 65 and what are the predications for this age group in the future? What is the life expectancy and healthy life expectancy at the moment?
In the UK at the moment, 18.1% of the population is over 65. By 2031, nearly a quarter of the UK population (23%) will be over 65. The boom is expected to slow down and by the year 2051 it is estimated that only 24% of the UK population will be over 65.

At the moment, the average life expectancy for a person in the UK is 77.5 years. (75 for men and 79.9 for women). Although the UK has no good measure of healthy life expectancy, preliminary investigations estimate healthy life expectancy to be approximately 10 years less than total life expectancy.

What is the legal retirement age and what is the actual average retirement age (due to early pensions etc.)?
In the UK, there is no fixed age for when you must retire - you can continue working as long as you wish. However, there is a fixed age for when you become entitled to receive a state pension; this is currently 60 for a woman and 65 for a man. Between 2010 and 2020, the state pension age for women will increase. On 6 April 2020, the state pension age will be 65 for both men and women.

Despite the current gender difference at which you can receive a state pension, the average retirement age for both men and women in the UK is around 65. The lowest in the European Union is 59, for Italian women; the highest is 67, for Danish men and women.

Britain has one of the lowest participation rates of older people in the labour market in the industrialised world. Only 5.2% of people over 65 are in paid employment, compared with 10.2% in Sweden, 12.4% in the US and 22.1% in Japan.

How is the basic income of the elderly guaranteed by law?
Currently a full basic state pension is £75.50 per week (119.09 Euros). If a person has not paid into the National Insurance scheme for enough years (perhaps, for example, they have worked abroad for much of their life) they will only be entitled to part of the full state pension.

In these cases, and in cases where a person has no pension other than the state pension, the government will top up their income to £98.15 (154.76 Euros) for a single person or £149.80 (236.21 Euros) for a couple. This is called 'the minimum income guarantee'.

As of April 2003, the Pension Credit will reward pensioners for saving during their working lives, or for carrying on working beyond retirement age.

The National Health Service provides free health care to all UK residents including those on a pension. Where a disability is involved, extra assistance is provided.

Are children liable to give maintenance to their parents?
No. In the UK, if an elderly person has to go into a residential home, he or she is likely to have to sell their house to pay for their care. If an elderly person has no home to sell, the state will pay for all or part of their care.

Is it legal to refuse medical treatment?
In the UK, it is legal for a competent adult to refuse treatment, even if this action would clearly reduce their life expectancy. Exceptions to this include patients being treated for mental disorders and detained under the Mental Health Act, 1983.

The situation with children under 18 is not as clear, and favours children receiving treatment. In some cases, children under the age of 18 can give their consent for a treatment to proceed, even if this is against the wishes of their parents. However, if a child under 18 refuses treatment, it is possible for parents to override that decision. In extreme cases, the court's opinion can be sought to decide whether the doctor should proceed.

Is assisted suicide or euthanasia legal?
The Human Rights Act, 1998, requires that a person's right to life is protected by the law.

In the UK, it is illegal to assist someone in taking his or her life. In a recent case, Diane Pretty, a severely disabled woman, was refused permission from the courts to let her husband help her to end her own life. The nature of her disability meant she was unable to end her life without assistance. Under English law, she could choose to die only if she were physically capable of carrying it out herself.

Euthanasia is a criminal act and treated as murder, punishable by a possible life sentence. However, it is lawful for a patient to refuse life-prolonging treatment.

In some cases, medical treatment can legally and ethically be withdrawn by doctors when it is futile to continue, or when it cannot accomplish any improvements.


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Denmark

What percentage of the population is over 65 and what are the predications for this age group in the future? What is the life expectancy and healthy life expectancy at the moment?
In Denmark, 15% of the population is at the moment over 65. By 2020, 19% of the Danish people will be over 65 years, by 2030 the share will be 21 % and by 2040 there will be 23%.

Life expectancy is 76,7 years; 74,3 for men and 79,0 for women.
Healthy life expectancy is 63,5 years; 62,9 for men and 64,1 for women.

What is the legal retirement age and what is the actual average retirement age (due to early pensions etc.)?
In Denmark, the legal retirement age is 65 years. But if you turned 60 before the 1st of July 1999, you cannot retire before you turn 67. The actual average retirement age is 61-62 years.

How is the basic income of the elderly guaranteed by law?
The national Danish pension law (Lov om social pension) from 2001 guarantees flat-rate benefits for everyone over 65. The national pension is based on a residency criterion and is paid to anyone, who has lived in Denmark for at least ten years between the age of 15 and 65. Five of these ten years must be immediately before the pension is paid.

In addition there is a supplementary Labour Market Pension Fund (ATP) according to the national Danish law on supplementary pension (Lov om Arbejdsmarkedets Tillægspension) from 2001. It is a compulsory social insurance scheme for employees with benefits depending on the duration of affiliation and on the contributions paid.

Are children liable to give maintenance to their parents?
No.

Is it legal to refuse medical treatment?
The national Danish law on patient rights (Lov om patienters retsstilling) from 1998 states that no treatment can begin or be continued without the patient's consent. It is possible for a person to make a living will, where they write their desires according to treatment.

There are two exceptions in Denmark where patients cannot refuse treatment. In cases of epidemics the Minister of the Interior can, on recommendation from the National Board of Health, order that compulsory treatment is initiated. That is stated by the national Danish law on order of the authorities against catching illnesses (Lov om foranstaltninger mod smitsomme sygdomme) from 1979.

The other exception is the case of a person who is mentally ill and a danger to himself or his surroundings. This person can be forced to receive treatment. This is stated by the national Danish law on loss of liberty and other compulsions in Psychiatry (Lov om frihedsberøvelse og anden tvang i psykiatrien) from 1998.

Is assisted suicide or euthanasia legal?
The national Danish law on patient rights (Lov om patienters retsstilling) from 1998 states that passive euthanasia, such as stopping a terminally ill patients treatment, is legal. Active euthanasia and assisted suicide is not legal.


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Finland

What percentage of the population is over 65 and what are the predications for this age group in the future? What is the life expectancy and healthy life expectancy at the moment?
In Finland, 15% of the population is over 65. By 2030, every fourth Finn will be over 65 years and by 2050, their share is likely to go down closer to the EU average. At the moment, the average life expectancy for a Finnish person is 77.4 years (73.7 years for men and 81.2 years for women). The healthy life expectancy for a Finnish person is 68.8 years (66.1 years for men and 71.5 years for women).

What is the legal retirement age and what is the actual average retirement age (due to early pensions etc.)?
65 years is the legal and 59 years the actual average retirement age.

How is the basic income of the elderly guaranteed by law?
The National Pensions Act (1956) guarantees a basic income for everyone over 65 together with social assistance and a constitutional right for services. Additionally, all economically active persons are covered by an insurance system. When this employment pension exceeds a given limit, no national pension is paid.

Are children liable to give maintenance to their parents?
No.

Is it legal to refuse medical treatment?
The Patient law entered into force in Finland in 1993. It includes regulations about a patient's right to medical treatment, as well as their right to refuse treatment if they wish. It is possible to make a written treatment will which can, for example, guarantee that the patient will not be resuscitated against his or her will.

Is assisted suicide or euthanasia legal?
The Patient law also includes regulations about euthanasia. In Finland, a distinction is made between active and passive euthanasia. Active euthanasia is not legal. Passive euthanasia on the other hand, such as stopping a terminally ill patient's treatment, is allowed.


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France

What percentage of the population is over 65 and what are the predications for this age group in the future? What is the life expectancy and healthy life expectancy at the moment?
16% of French people are over 65 (21% are over 60, i.e. 12.1 million people). This figure may reach nearly 30% in 2050. There could be 4 million people over 80 in 2020 and up to 7 million in 2040.

In France, life expectancy is 74.9 for men and 82.4 for women (1999 INSEE figures). This gap between the sexes is the highest of any country in the Union. The life expectancy of French women is the highest in the world after the Japanese. However, life expectancy for men is average for the European Union.

Women spend a little less than 8 years in a state of disability or dependency and men around 5.5 years. 1,417,000 people over the age of 60 are in a situation of physical or mental disability / dependency. This figure could increase by 6 to 14 % by 2010 and by 50 % by 2040.

What is the legal retirement age and what is the actual average retirement age (due to early pensions etc.)?
Since 1983, the legal retirement age in France has been 60. However, this age is lower for certain public sector employees (for example, armed forces personnel or railway workers) and women who have raised three children or more.

The true average retirement age is actually 61.8. Women retire at 62.5, men at 60.5.

Around 10% of the population retire before the age of 60, 57.3% between 60 and 64 and 33.2 % at 65 or more. The average age of retired persons is 72.

Today, the French live an average of 20 years after retirement, compared with 10.6 years in 1975.

How is the basic income of the elderly guaranteed by law?
In France, the general retirement scheme guarantees a full pension (50%) for persons who have contributed for 40 years. If not, the rate is lower. There is a minimum benefit of 6,800 Euros per year and a minimum income, called RMI, of around 400 Euros per month for a single person. In addition, social services grant many supplementary benefits for elderly persons on low income: housing benefit, payment of medical costs, home helps, nursing auxiliaries for home care, etc.

Are children liable to give maintenance to their parents?
No, there is no law that forces children - even if they have a large income - to provide for their parents, whatever their age or state of dependency. On the other hand, children can ask a judge to place their parents under guardianship and so manage their parents' property when their parents are no longer capable of doing it themselves.

Is it legal to refuse medical treatment?
In France, a patient can refuse treatment but a doctor cannot. According to the principles laid down in the Civil Code (articles 16-1 and 16-3) related to the inviolability and integrity of the human body, a doctor cannot force a person in a position to express their wishes to accept medical examinations or treatment. But the doctor must inform the patient of all the consequences of their refusal and attempt to persuade them otherwise (article 35 of the Code of Medical Ethics). If, exceptionally, a doctor decides to stop treating a patient, they must ensure continuity of care by entrusting the patient to another doctor. Doctors can only act without taking a patient's wishes into account if there is extreme urgency, the patient's life is at stake or the patient is mentally ill and a danger to themselves or others. Any doctor who refuses to help an injured or sick person at risk can be prosecuted.

Is assisted suicide or euthanasia legal?
No. Euthanasia is forbidden in France, whether it is carried out by a carer or anyone else, since'"no person has the right to deliberately cause death' (Code of Medical Ethics, article 38). Euthanasia is judged to be incompatible with the law, medical practice and ethics, and lays the carer open to criminal and disciplinary proceedings. In practice, 'therapeutic abstention' (also known as 'passive' euthanasia) is tolerated. This consists of withdrawing treatment (such as heart or respiratory support) from terminal patients.


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Germany

What percentage of the population is over 65 and what are the predications for this age group in the future? What is the life expectancy and healthy life expectancy at the moment?
In Germany today, more than 16% of the population are age 65 or older (19.97 % of the women and 13.17 % of the men). This means that currently in Germany more people are 65 or older than are 15 or younger.

By the year 2030 more than 26 % of the Germans will be 65 plus (almost 29 % of the women and 23.4 % of the men). And in 2050 it is expected that almost every third woman (32 %) and every fourth man (25 %) in Germany will be 65 or older.

At the moment, the average life expectancy in Germany is 77.5 years (74.4 for men and 80.6 for women). Statistically, a man who today is 60 will live an additional 19 years while a woman of the same age will live ab additional 23.3 years.

According to the World Health Organisation (WHO), the healthy life expectancy in Germany is 69.4 years (67.4 years for men and 71.5 years for women).

What is the legal retirement age and what is the actual average retirement age (due to early pensions etc.)?
The legal retirement age in Germany is 65 but there are several aberrant regulations for special occupational groups. Due to the way in which old-age provision is organised in Germany there is no data available for a general average retirement age.

In the year 2000, the average retirement age for people whose pensions are paid by the state was 57. The average retirement age for people whose pensions are paid by the statutory pension insurance ('gesetzliche Rentenversicherung'; mainly employees) in 2000 was 60.2 (59.8 for men, 60.5 for women).

How is the basic income of the elderly guaranteed by law?
In Germany, many people who work directly for the state or in organisations under public law ('Beamte', e.g. civil servants, public servants, soldiers, judges etc.) are eligible for pensions paid by the state ('öffentlich-rechtliches Altersicherungssystem').

Most ordinary employees are legally bound to invest in a system of statutory pension insurance ('gesetzliche Rentenversicherung') which after their retirement will pay a monthly sum in correlation to their prior wages. In this system, the people currently in a job have to earn the money which pays for retirement pensions of the elderly in the same time period. Due to the changing age pattern of the population and the resulting growing strain on the people in work, this system has been one of the most discussed political issues in Germany in recent years in Germany. Self-employed people are not legally bound to invest in this system but can do so on a voluntary basis.

In addition, many Germans have private old-age provision to secure an appropriate monthly income once they are retired.

Are children liable to give maintenance to their parents?
At the moment in Germany, under certain circumstances children are in fact legally obliged to support their parents. Elderly people who are not eligible for pensions of any kind and don't have any private old-age provision or any assets can - like anybody else who is in need - apply for social welfare. In this case, the authorities will reclaim the money paid from these people's children, if their monthly income exceeds a specific amount.

From 1st January 2003 a new law will guarantee a basic income for everyone over 65 who needs it. However, if a child of such a person earns more than 100,000 Euros per year, he or she will be liable for the support of the parent.

Is it legal to refuse medical treatment?
In Germany, any patient has the right to choose the amount and comprehensiveness of medical treatment given to him or herself. Any person capable of consent can make a 'living will' which regulates medical treatment in cases where the patient might not be in a condition to tell doctors what he or she wants. This can be done in writing or by naming another person as a confidant. People under 18 can also make a living will but in this case, doctors have to obtain the consent of their legal guardian.

However, active euthanasia is illegal in Germany and can't be given, even if the living will of the patient asks for it.

Is assisted suicide or euthanasia legal?
Since suicide is not a statutory offence in Germany, assisted suicide in general is not considered a crime sol as long as the last step of the killing (e.g. the swallowing of poison) is done by the person. However, if the person assisting is a close relative or a doctor he or she makes him or herself liable to prosecution because such a person is considered to be a guarantor of the patient's or relative's life.

Any kind of active euthanasia is illegal in Germany, even if a person insists on it. However, euthanasia has been discussed in Germany every now and then, especially since active euthanasia became legal in the Netherlands.


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Italy

What percentage of the population is over 65 and what are the predications for this age group in the future? What is the life expectancy and healthy life expectancy at the moment?
At the moment, 18% of Italian population is over 65. According to most expectations, in 2030 this age group will account for the 30% of total population. In particular, between 2000 and 2050 there will be a sensitive shift of the age profile toward ages over 65. In fact, in this period the population over 65 will increase more than 75%, especially around 2030. Viceversa, the number of young people and adults will decrease of 28%.
Presently, the average life expectancy in Italy is 79.12 years, being the second best Country in Europe. Moreover, it has the longest healthy life expectancy (71.20 years).

What is the legal retirement age and what is the actual average retirement age (due to early pensions etc.)?
In Italy, there are two kinds of pensions: the old-age and the seniority pension. In the first case, the pension is guaranteed if three conditions are satisfied: the age minimum (65 years for men, 60 years for women), a minimum number of years paid into the National Insurance scheme (INPS), and the conclusion of any working activity. The latter is not necessary for independent workers who can retire and continue their work.
The seniority pension is obtained before reaching the age necessary for the old-age pension. In this case, workers need 35 years of payments to INPS and 57 years of age if subordinate workers; 35 years of payments to INPS and 57 years of age if independent workers (craftspeople, tradespeople and farmers). In addition, in case subordinate and independent workers have, respectively, 37 and 40 years of payments to INPS, they can retire independently from their age.
In 2008 the number of years of payments required to subordinate workers to retire will equal that required to independent ones.

How is the basic income of the elderly guaranteed by law?
In Italy, there is a basic state pension.This kind of income is guaranteed through the INPS, the "National Insurance Institute", if a person did not pay enough into the National Insurance scheme. In this case, the Institute tops up the current pension to the minimal pension, which is fixed yearly (in 2003, it is € 402.12).
In Italy, a pension for chronic infirmity and inability to work is also available.

Are children liable to give maintenance to their parents?
Yes. In Italy, parents in need have the right to receive alimonies from their children, or to be welcome in their houses. If they have more than one child, all of them must contribute to their support, according to their financial possibilities.

Is it legal to refuse medical treatment?
Yes. The article 32 of the Italian constitution, section "Duties and Rights of Citizens", protects the right to life, stating that nobody can be forced to receive medical treatments, if not under the provisions of the law.
For minors (under 18 years old), the decision of medical treatment denial is up to their parents. If such a denial leads to a worsening of their children's health conditions, or death, the Juvenile Court, called by the family physician, assumes the temporary responsibility of the minors.

Is assisted suicide or euthanasia legal?
No, the Italian legislation considers active euthanasia (assisted suicide) as a criminal act, punishable by imprisonment (from 5 to 16 years). This principle is the expression of the article 5 of the Italian Civil Code. Euthanasia is possible only in specific cases, such as in cerebral death. If that occurs, however, it is considered passive euthanasia, therefore not punishable by law.


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Portugal

Today, the average life expectancy for a Portuguese is 76.9 years
(73.47 years for men and 80.30 years for women).

Today, the healthy life expectancy for a Portuguese is 65.8 years (62.2 years for men and 69.4 years for women).

What is the legal retirement age and what is the actual average retirement age (due to early pensions etc.)?
In Portugal, the legal retirement age is 65. However, people can take early retirement from the age of 55 so long as they have worked for 30 complete years. In this case there is a reduction in the amount of the pension.

In Portugal, the actual average retirement age is 65 for men and 62 for women.

10.7 % of the total Portuguese population over 64 years still work.

How is the basic income of the elderly guaranteed by law?
In Portugal, the Constitution explicitly states that all Portuguese have the right to social security, and that the responsibility for protection of the elderly lies with the State. All employers, including the State itself, make monthly contributions to a fund that later in life reverts to the employee in the form of a pension.

Apart from this system, individuals are free to complement these pensions in the private sector (such as banks and insurers). The demand for these complements (generally called PPR's) is increasing.

Are children liable to give maintenance to their parents?
No.

Is it legal to refuse medical treatment?
Yes. However, if life is endangered, refusal of immediate treatment may only be undertaken by the patient or by their family, if the patient is incapable of expressing his or her will. In such cases, doctors are entitled to refuse continuing their care of the patient.

Portugal has no specific legislation on Patient Wills. However, there is nothing to prevent someone from making a Living Will stating, for example, that he or she wants to be allowed to die if in a chronic vegetative state.

Is assisted suicide or euthanasia legal?
In Portugal, the debate about euthanasia is not particularly active. A distinction is made between active and passive euthanasia (also designated assisted suicide). Both are illegal in Portugal, and both are, if confirmed, punished with imprisonment of up to 3 years.


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Spain

What percentage of the population is over 65 and what are the predications for this age group in the future? What is the life expectancy and healthy life expectancy at the moment?
In Spain, 16.2% of the population is over 65. Some 36,000 people cross this age threshold every month. Life expectancy is approximately 74.4 years for men and 81.5 years for women.

Life expectancy for those reaching 65 is 16 years for men and 19.8 years for women. Spain has undergone a real revolution in life expectancy, thanks to improved health care, advances in medical science and improved living conditions. 85% of the population now reaches 'old age'.

Proportionally, there are now more people over 65 because child and general mortality rates have fallen and because there are fewer young people.

What is the legal retirement age and what is the actual average retirement age (due to early pensions etc.)?
In Spain, the general rule is for people to retire at the age of 65. This is the legal requirement, although exceptions exist in the form of early retirement.

Ageing is exercising considerable pressure on social protection systems (pensions and health care expenditure).

How is the basic income of the elderly guaranteed by law?
In Spain, an average old age pension is approximately 555 Euros. The exact amount depends on how long an individual has worked and their social security payments.

Are children liable to give maintenance to their parents?
In Spain, relatives are required to provide maintenance for each other according to the provisions of Title VI, articles 143-144 of the Spanish Civil Code 'On maintenance between relatives'.

Is it legal to refuse medical treatment?
In Spain, it is legal to refuse treatment according to Article 10.9 of General Health Law 14/1986, of April 25:

All have the following rights with regard to the respective public health administrations: (9) To refuse treatment, except in the cases indicated in Section 6; for which they must request voluntary discharge according to the terms established in Section 4 of the following article.

Article 6. On the free election amongst the options presented to them by the medical worker responsible for the case. The user's prior written consent is required for any intervention to be carried out, except in the following cases:

a) When non-intervention entails a risk to public health.
b) When the patient is not capable of taking decisions, in which case the right to decide is transferred to the patient's family or closest relatives.
c) When the urgency of the situation does not permit delays as irreversible injuries might be caused or where there is danger to life.

Is assisted suicide or euthanasia legal?
In Spain, euthanasia or assisted suicide are considered crimes under Article 143.4 of the Penal Code, Organic Law 10/1995, of November 23. This states that 'Anyone who causes or actively cooperates through direct and necessary action to the death of another through the express, serious and unequivocal request of this person, should the victim suffer from a serious illness that would necessarily lead to their death, or that causes serious, permanent suffering which is difficult to withstand, shall receive a punishment one or two degrees lower than those indicated in numbers 2 and 3 of this Article'.


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European Union

Things are more complicated with the average healthy life expectancy for the EU. As life expectancy lengthens, the quality of that longer life becomes a major issue. The concept of healthy life expectancy (also called 'active life expectancy' or 'disability-free life expectancy') refers to the average number of years that people may expect to be free of limitations of function due to one or more chronic disease conditions. It is difficult to precisely compare measures of healthy life expectancy among nations because of computational and conceptual differences. More information can be found at:
http://www.ifa-fiv.org/menu7_demographie/menu7_ageing_ang.htm
http://www.unece.org/stats/links.htm

One in three Europeans is over 50 and one in five is over 60. At the beginning of the 20th century, life expectancy in Europe was 47 years while 100 years later it reached 65 years.
In 2050, the European population is estimated to have a life expectancy at birth of 77 years, on average.

What is the legal retirement age and what is the actual average retirement age (due to early pensions etc.)?
Although the systems vary among the countries, most European countries have a legal retirement age of 65. Today, the actual average retirement age in Europe is 60 years for women and 59.5 for men.
Note: Data related to EU-15.

How is the basic income of the elderly guaranteed by law?
In Europe, social security systems differ from country to country. However, the European Union has recently produced a great number of reports and studies to promote a more common policy.

Are children liable to give maintenance to their parents?
The European Commission or Parliament has not produced any legislation or recommendations on this matter.

Is it legal to refuse medical treatment?
The European Commission or Parliament has not produced any legislation or recommendations on this matter.

Is assisted suicide or euthanasia legal?
The European Commission or Parliament has not produced any legislation or recommendations on this matter.


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