To what extent do the views of religions and religious groups on end-of-life (EoL) issues affect their regulation in Western legal systems? What difficulties do national legislators encounter in regulating end-of-life? What are the peculiarities of the Italian situation? Is it possible to affirm that the privileged position recognized in Italy to the Catholic Church has influenced (and to what extent) the solution settled by the Italian legislator for end-of-life issues? The essay aims to answer these questions. More precisely, it focuses on the analysis of the influence of the views and teachings of religious groups both on individual choices and on the current Western regulatory framework concerning end-of-life decisions (with specific regard to euthanasia and assisted suicide), as well as on extent to which the legal regulation of end-of-life issues at national and supranational level must be consistent with the ideological postulates and positions of the secular state, especially in the context of the growing multi-ethnic, multicultural and multireligious evolution of contemporary Western societies.