Slipping euthanasia in Belgium

Happy New Year billofhealthfans!!

As you all know Belgium legalized euthanasia in 2002 following the path of The Netherlands. The legalization came in the midst of a huge controversy. The influence of the Catholic Church is significant in Belgium. You might recall that in 1990 King Balduino refused to sign an Act legalizing abortion, something unseen in the history of Belgium. The solution could not be more ingenious: the King resigned for a couple of days, the Act was signed by the Prime Minister, and then Parliament restored Balduino in his throne.

According to a recent survey in Flanders, euthanasia and assisted suicide in Belgium follows a classical pattern: cancer patient between 65 and 79 years of age. The cases in which the individual is not in the terminal stage of his illness and requests assistance in dying are rare. Nothing significantly deviant from what is going on in other jurisdictions in which aid in dying (in its various forms) is permitted. At least that was the trend until last December 14th…On December 14th at the Brussels University Hospital two twin brothers, 45 years of age, were given a lethal injection. Neither of them suffered from physical pain, although their psychological distress was unbearable for both: they were born deaf and had been diagnosed with an incurable disease that will make them progressively blind. Neither of them could stand the prospect of not seeing each other again - they had lived their lives together- and therefore decided to die.

It has been hotly debated whether legislation should also allow psychological suffering as a legitimate cause for requesting aid in dying, but, to my knowledge, this is the first case in which euthanasia is administered “in pairs”. And what it strikes me – and maybe you as well- is the fact that, actually, committing suicide collectively is not unusual although the possibility of “collective aid in dying” has been neglected in the public debate, the literature and the legislation, if I am not misinformed.

Many couples, for instance, decide to end their lives together which might seem quite reasonable, at least as reasonable as in the belgian twins’ case. The prospect of one of them dying soon might trigger devastating psychological distress in the surviving partner (friend? son? father? mother?)  who understandably would be willing to die as well. So whenever we consider the possibility of taking a step further and allow psychological suffering as a legal indication for physician aid in dying, chances are that we end up providing collective physician-assisted suicide or a sort of chain of related deaths (one aided death being the cause of another…). This seems to me the “belgian lesson”, but maybe I am wrong. What do you think? More on the case here.

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