Aims: The study aimed to analyze medical and legal aspects of end-of-life decision-making in Ukraine, focusing on euthanasia, assisted suicide, withdrawal of life-sustaining treatment, and advance directives. The objective was to evaluate arguments for and against legalization and to examine their relationship with patient autonomy and human rights. Material and methods: An interdisciplinary qualitative approach was applied, combining medical, ethical, and legal perspectives. A systematic review of publications was conducted in PubMed, Scopus, and Web of Science. Ukrainian legislation, including the Civil Code, Criminal Code, and Health Law provisions, was analyzed alongside International Human Rights instruments and relevant jurisprudence of the European Court of Human Rights. Conclusions: Ukrainian law prohibits active euthanasia, while assisted suicide and withdrawal of life-sustaining treatment in unconscious patients remain unregulated and may fall under criminal liability. Withdrawal of futile therapy and opioid-based symptom management are permitted forms of terminal care. Comparative analysis shows that judicial practice of European court of human rights increasingly recognizes patient non-property rights and self-determination in end-of-life decision-making. Clarifying the legal status of assisted suicide and advance directives, with appropriate safeguards, may enhance patient rights and harmonize national law with European standards and will also make the legal status of medical workers more certain.