How Belgium’s euthanasia law has been consistently abused

 

Pro-euthanasia advocates in Ireland, as elsewhere, insist that properly drawn legislation permitting assisted suicide and euthanasia will ensure that such a law will never be abused.  Numerous safeguards, they assure us, can be put in place. A new academic study from Belgium very much indicates the opposite is the case.

The three authors, who are based at the University of Ghent, are not against euthanasia in principle but they admit that “several legal requirements that are intended to operate as safeguards and procedural guarantees in reality often fail to operate as such. We believe this is ethically and legally problematic and should be of concern to everyone, regardless of their stance on the ethical justifiability of euthanasia in general.” (p. 82)

Euthanasia was introduced in Belgium in 2002. Initially it was offered only to adult patients with a medical condition without prospect of improvement. Later, the law was amended to allow euthanasia for minors but, with time, its interpretation and application has become more and more liberal. And while the number of cases continuously rise, it now includes psychiatric conditions or simply being “tired of life”.

When the law was first introduced in 2002, 24 cases of euthanasia were performed. By 2019 this had risen to 2,655.

What has happened in Belgium is typical.

The authors of the Belgian study found shortcomings in the legislation, in its application and in the monitoring of the practice. With regard to the legislation, they claim that the scope of the law “has been stretched from being used for serious and incurable illnesses to being used to cover tiredness of life.”

For instance, it is required that the patient experiences “constant and unbearable physical or psychological suffering that cannot be alleviated”. But the interpretation of this requirement is problematic as it is not clear “whether the incurability criterion refers to the mere existence of possibly effective treatments or to the existence of possible effective treatments acceptable to the patient.” (p. 87). What happens if the suffering cannot alleviated precisely because the patient refuses a treatment that is otherwise available?

The standards are completely subjective as only the patient can determine what suffering is unbearable or not. This changes and alters the role of doctors, who are “reduced to merely meeting patients’ demands”. (p. 87)

The study refers to empirical evidence and reports that in Belgium “euthanasia is performed increasingly frequently in cases of psychological suffering” (p. 87) Also, the Monitoring Commission admitted that cases of “tiredness of life” have been reported.

The opinion of a second physician, beside the one who kills the patient, is required by the law but it is nonbinding. If legal criteria are not met, the physician has no legal means to report this or to prevent the euthanasia from occurring. This makes the second opinion totally irrelevant.

“The obligatory consultation of one or two independent physicians may fail to provide a real safeguard. Their tasks are quite limited, and, more importantly, their advice is not binding anyway. The final authority to perform euthanasia lies with the attending physician who can perform it even against the (negative) advice of the consulted physicians”, the study says (p. 102).

The Belgian law also established a Monitoring Commission with the task of checking reports on euthanasia cases and, if the legal criteria are not met, it must refer the case to the Public Prosecutor. This has happened only once since the law entered into force in 2002.

The study found that “the Commission is unable to check the fulfillment of various legal criteria, and it has substantial authority to (re)interpret the Euthanasia Law as it sees fit.” (p. 102)

Its functioning is undermined by the underreporting of the euthanasia cases. Recent research suggests that one third of cases are not reported. Moreover, the advice of the second consultant does not have to be included, making the report “overly concise”, according to the article.

“Several commentators have observed that the Commission does not seem to act as a filter between physicians who perform euthanasia and the Public Prosecutor, but instead as a shield that prevents potentially problematic cases from being referred”, the study claims.

For instance, a member of the Commission resigned in September 2017 after a case involving a patient suffering from advanced dementia and Parkinson disease was not reported to the Public Prosecution. Not a single criteria was met and euthanasia had not even been requested by the patient.

Other cases where the legal criteria were not met emerged through the years. (Here is an example)

The authors of the study note: “Our concern is that the Commission’s current level of discretion in assessing the legitimacy of euthanasia cases in practice leaves it with considerable powers that would normally be the prerogative of the legislature or the judiciary.” (p. 101)

This academic article confirms what the anti-euthanasia campaigners have always claimed: initial safeguards are removed with time, through a change in the legislation but also through more liberal interpretations of the law by courts, medical committees or monitoring commissions.

“Several of these shortcomings are structural and thus require more than simply increased oversight”, conclude the authors of the study.

The Belgian examples shows that once euthanasia is introduced, it becomes almost impossible to limit its scope or to avoid abuses.

Euthanasia in Belgium and Netherlands: How the slippery slope is turning into reality

 

This is a talk given on the 1st December by Dr Léopold Vanbellingen of the European Institute of Bioethics (IEB) in Brussels.

Léopold Vanbellingen works as Research officer at the European Institute of Bioethics (IEB) in Brussels. Founded in 2001, the IEB has set itself the goal of contributing to the elaboration of bioethics based on the respect for and protection of each human being, from conception until natural death. The IEB seeks to inform, enlighten and raise the awareness of the general public and political decision makers on bioethical risks and related social issues. It focuses on the situation on Belgium and, more broadly, in Europe, regarding abortion, assisted reproduction, end of life, biomedical research and freedom of conscience.Léopold Vanbellingen is also currently completing a PhD thesis in Law and Religion at the Université catholique de Louvain. His thesis focuses on religious diversity in the workplace, including the issue of conscientious objection by employees.

Growing support among doctors for infanticide

 

Angelo Bottone · Growing Support Among Doctors For Infanticide

Growing support among doctors for infanticide

 

The vast majority of pro-abortion doctors working in neo-natal units in Flanders, Belgium, support being allowed to kill a newborn baby if it has a serious disability. This can only be described as a further descent into barbarism as the culture of death strengthens its grip in that country.

A new survey of 117 physicians and paramedic professionals involved in late abortions (when the foetus is already viable) in Flanders, the Dutch speaking part of Belgium found that almost 90% think that in the event of a serious non-lethal neonatal condition, administering drugs after birth with the explicit intention of ending the newborn’s life is acceptable.(95.6% of the respondents agree with late abortion in case of a serious but non-lethal condition.) 

The percentage is higher among physicians (93.6%) than in paramedics (84.4%). This practice is currently illegal in Belgium but 87.9% of respondents agree that the law should be changed to make it possible.

These shocking results represent not all medical professionals as the survey is limited to doctors who are already involved in abortion. Still, one wonders, what kind of doctor would kill their disabled patients?

According to the survey, most healthcare professionals prefer infanticide above palliative care, in both lethal (57.8%) and in non-lethal foetal conditions (65.9%). Physicians, but not paramedics, prefer foeticide more in case of a serious non-lethal foetal condition (68.1%) than in case of a lethal condition (53.2%).

This could be explained by the fact that if a seriously ill newborn baby does not die, the physicians might be legally responsible for not discovering the disability before the child was born. Paramedics are less confronted with this situation. The introduction of euthanasia for newborns would take the responsibility off those doctors. At the moment, actively ending newborn life is not permitted in Belgium but there are no limitations on ending unborn life in such cases. The only country that has legalised neonatal euthanasia is the Netherlands, with the infamous Groningen protocol.

Last year, the same authors of this study published an article based on a similar survey about the attitudes towards perinatal (before and after birth) end-of-life decisions by all neonatologists and neonatal nurses working the same medical centres.

The study found that “actively administering medication with explicit life-shortening intention was considered acceptable by more than half of the neonatologists and three quarters of nurses and was even considered as a good treatment option in the hypothetical case in a third of neonatologists and two-fifths of nurses. This indicates a high acceptance of an end-of-life decision that currently falls outside the legal framework in Belgium and most other countries.”

In 2013, two Italian ethicists, Alberto Giubilini and Francesca Minerva, published an article defending what they called “after-birth abortion”, which is in practice infanticide. They claimed that the “moral status of an infant is equivalent to that of a fetus in the sense that both lack those properties that justify the attribution of a right to life to an individual.” The article provoked a strong reaction at the time but it is based on robust logic: if a baby can be killed just before birth, there’s no reason why it shouldn’t be killed just after birth. And this makes even more sense if one accepts euthanasia.

What at the time appeared to be just a disturbing theoretical possibility is now something becoming accepted by the medical profession, at least by those involved in abortion, as the survey shows, and probably by part of public opinion.

We tend to think abortion and euthanasia happening at the opposite extremities of human life and they are not connected. What we hear from Belgium, instead, shows that the slippery slope is real and once those terrible things are legalised, soon or later the infanticide of disabled babies becomes more acceptable.