For many on the eastern side of the Atlantic, end-of-life debates belong within the family or in the doctor's office, and many watched with puzzlement as the United States was thrown into a frenzy over the Schiavo case.

In the Times of London, foreign editor Bronwen Maddox said the Schiavo case "shows just how emphatically the US and Europe are moving on different paths" when it comes to moral and social issues.

That is not to say that Europe has not struggled with its own ethical and medical responses to cases where patients have no chance of recovery, are living in extreme pain or, like Terri Schiavo, have existed for years in a persistent vegetative state.

Debate over regulation

The debate in Europe around euthanasia centers less on whether it is right or wrong than on how it should be regulated. The Netherlands is perhaps the country with the most well-known regulations around euthanasia, which has been legal under very strict conditions since 2002.

Rob Jonquiere, head of the pro-euthanasia group NVVE, said the struggle over whether or not to remove Schiavo's feeding tube would not have taken place since "here it's more accepted that the doctors make those decisions," he told the Washington Post.

"It's terrible, this type of judicial fighting over a person who can't do anything about it," he said. "In the Netherlands, the doctors are making these decisions. The feeding tube and the hydration are considered medical treatments and if they are determined to be futile, they can be stopped."

Belgium followed Holland in passing a law legalizing euthanasia in 2002 and ten other countries in Europe allow some kind of "passive" euthanasia.

In France, the practice remains illegal, although the case of Vincent Humbert, a man who was left blind, paralyzed and mute after an auto accident in 2000, moved lawmakers to draft a draft "right-to-die" law that has passed the National Assembly and will be debated by the Senate later this year.

According to Dr. Jean Cohen, chairman of France's Association for the Right to Die with Dignity, there are large parallels between the Schiavo case and that of Humbert.

"Most here have compassion for the patient, and are in favour of allowing death because they understand there is no point living in this state," he told Time magazine. Although there was a big difference: Humbert asked to die after he was incapacitated, Terri Schiavo could not.

Condemnation

But not everyone in Europe sees euthanasia as a matter that should be removed from the moral sphere. After Schiavo's death on Thursday, the Vatican condemned the removal of the feeding tube strongly, calling it a "violation of the sacred nature of life."

"The circumstances of the death of Mrs. Terri Schiavo have rightly shocked consciences. A life has been interrupted," said chief spokesman Joaquin Navarro-Valls in a statement in the Vatican's first comment on Schiavo's death. The Vatican newspaper had repeatedly called the courts involved in the decisions "executioners."

"A death was arbitrarily brought forward …there can be no exceptions to the principle of the sacred nature of life from the moment of conception until its natural end."

The statement added that the Holy See hoped that case would lead to legal changes.

Italy's Minister for European Affairs, Rocco Buttiglione, who enraged many with his controversial comments on homosexuality and the role of women, has greeted American politicians' involvement in the Schiavo case.

"It will strengthen the position of those opposing euthanasia in Europe and start a debate here," he said.

Not possible in Germany

The Schiavo case could not happen in Germany, however, largely because the country's experience with state-sanctioned euthanasia of the mentally ill and others during the Nazi era.

"The patient's doctors are required to continue to treat her and to feed her because it's not clear what will happen next with her illness," said Dr. Jörg-Dietrich Hoppe, president of the German Medical Association. "If it could be proved that [Schiavo] had expressed a wish that treatment should be stopped, that would be a different matter."