Euthanasia is an unlockable passive item in The Binding of Isaac, added in the Afterbirth+ DLC.

Adds a luck-based chance to fire needles that instantly kill non-boss enemies and causes them to burst into 10 tears in all directions.

Needles deal 3x Isaac's damage to bosses and mini-bosses.

Tears from the burst shot can still become needles, but do not retain their insta-kill capabilities. They still do 3x Isaac's damage.

The chance to fire a needle starts at 3.33% with 0 luck, going up to 25% with 15 luck.

Needles can kill otherwise invulnerable enemies, such as Peep's eyes, Death's Heads and Stoneys & Stone Grimaces.

This page shows the latest information as of the new Repentance+ (Online Co-op) DLC.
To see information about this item for the previous Repentance version, check this page instead.

Defeat Delirium as Lilith.

This item contributes towards the Spun transformation. Collecting 3 items from this set will grant Isaac +2 damage, +0.15 speed and spawn a random pill.

Euthanasia can be found in the following item pools:

The following tags are applied to this item:

Below is the Internal Item Description as shown in-game.
Note that some stat changes are not displayed here. Please see the main description for the full effects.

Euthanasia

• Chance to fire needle shots that deal 3x Isaac's damage
• Chance increases with luck
• Needle shots that strike a regular monster will kill it instantly and launch 10 needle shots in a ring
• Abyss: x1 locust 1.5x Isaac's damage

• Check out the item description on the external Isaac Wiki.