Welcome to my latest installment about traveling, death rituals, and more – this time in Spain.
Even in a largely secular country, death still arrives with religious weight and reverence. There’s a certain unspoken choreography. While modern life has accelerated many of the customs around grieving, the Spanish view of death retains something communal and deeply rooted in Catholicism.
In more individualistic societies, I notice grief unfolding privately with some distance to it. Spaniards hold death closely. Families gather, neighbors notice, and the rituals still matter.
A Spanish Farewell
Catholicism, though less dominant than in earlier generations, still informs many Spanish death practices. I was raised Irish Catholic, but Spanish Catholicism is different in many ways.
For example, they hold wakes mostly at funeral homes rather than in the home. Spanish mourning is traditionally visible, meaning that women wear black for months or even a year. The community gives the bereaved space and support without rushing them back into routine.
Unlike the songs and keening of Irish Catholic funerals, Spanish funerals are sparsely embellished, quiet affairs. Iberian grief isn’t performative, but shared.
Limited Access to Hospice
Spain has not embraced hospice care in quite the same way as other European countries. While they make palliative services available, especially in urban hospitals, the country lags behind in fully integrating hospice into standard end-of-life care.
While around 55–60% of Spaniards die in hospitals, there is a growing cultural and medical push to enable more home deaths. I saw this especially in Catalonia and the Basque regions, where home-based palliative programs are gaining traction.
Why do Spaniards resist hospice?
Caring for ill or dying relatives has long been seen as a family responsibility. Multi-generational households are common, and there’s a cultural expectation that loved ones, especially elders, will be cared for at home. This tradition makes institutional hospice care feel unnecessary, or even like abandonment.
Similar to America, Spanish physicians treat and prolong life rather than focus on comfort. This sidelines the hospice philosophy. Unlike America, Spain has a national healthcare system, but the availability of hospice varies widely between regions.
Some autonomous communities, like Catalonia and Navarre, have more advanced programs, but rural areas and many parts of southern Spain have far fewer resources. Though lovely and welcoming, many people in these regions had never heard of death doulas, advance care directives, or palliative care.
Lots of work to be done there.
Too many rural Spaniards are simply unaware of what end-of-life care actually entails. They confuse it with “giving up,” and some families fear it means hastening death. As a result, patients and families accept comfort care very late, if at all.
LAUGH BREAK: Things I Shouldn’t Have Said in Spain
That said, there’s a slow but visible shift underway. National health authorities have identified end-of-life care as an area needing improvement. Regional efforts are building awareness and expanding services.
Spain’s legalization of assisted dying has also catalyzed broader conversations about how people want to die. I’m hoping this leads to greater acceptance of hospice, too.
Legalized Assisted Death
Traveling and learning about all the cultural taboos around death and dying, I was shocked to learn that Spain legalized physician-assisted death in 2021. How bad ass is that? Let’s hear it for Spain! It’s one of the few countries in the world to permit both euthanasia and assisted suicide.
The law reflects a growing demand for autonomy at the end of life, especially among younger, more secular Spaniards. It faced significant opposition from conservative, religious groups, but they lost out.
And this law also sparked a new, more open public conversation about dignity in dying.
Here’s an overview of how it works. To qualify for physician-assisted death in Spain, an individual must:
- Be at least 18 years old.
- Possess Spanish nationality, legal residency, or have resided in Spain for over 12 months with appropriate documentation.
- Be fully aware and conscious at the time of the request.
- Suffer from a serious and incurable illness or a chronic, debilitating condition causing intolerable physical or psychological suffering.
- Submit two voluntary and informed written requests, spaced at least 15 days apart.
Then the process involves multiple steps:
- The patient submits the first written request to their physician.
- After a minimum of 15 days, they submit a second written request.
- The attending physician assesses the patient’s condition and eligibility.
- A second independent physician reviews the case.
- The case is forwarded to a regional Commission of Guarantee and Evaluation, which includes medical and legal professionals. They have seven days to make a decision.
- If approved, the patient chooses the timing and setting for the procedure, administered in a medical facility or at home.
Healthcare professionals have the right to conscientious objection, but must refer the patient to another provider to ensure access is not impeded.
Applicability to Non-Citizens
Individuals who are not Spanish nationals can access physician-assisted death if they have legal residency in Spain or can provide proof of continuous residence for at least 12 months. This provision aims to prevent “euthanasia tourism” by ensuring that applicants have established ties to the country.
Implementation and Cultural Context
Since the law’s enactment, the number of assisted deaths remains relatively low compared to countries like the Netherlands or Belgium. This is due to cultural attitudes, regional disparities in implementation, and the rigorous procedural requirements.
What else can I tell you about this lovely country?
Eco-friendly burial options are still rare, but interest is growing. Cremation has become more common, especially in cities. There’s curiosity about natural burials and sustainable funeral practices.
That’s a plus because when I visited Almudena Cemetery (one of Spain’s largest burial grounds with 5 million bodies), I noticed miles and miles of cement-lined tombs.
There’s a better way.
Spain’s Mediterranean climate and historical architecture pose challenges to developing green cemeteries. I was glad to see several pilot projects, like woodland burials near Madrid and biodegradable urns along the coast. As climate awareness rises, younger generations may push these options further into the mainstream.
What Spain illustrates, perhaps more than anything, is that the line between tradition and progress is not a clean divide. A country that still honors the procession, the silence, and the family meal after a funeral is also one where people are beginning to claim more agency in how they die.
Death is still a family matter here, but increasingly, it is also a personal one. To learn more about traveling in Spain and learning about death rituals there and everywhere, reach out to me anytime.
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