April 16, 2024
end of life issues euthanasia

Call for Belgium to revise euthanasia legislation

Michael Cook

Doctors and ethicists protest “death as therapy”.

Although legalised euthanasia is widely accepted amongst Belgian doctors and politicians and a pet cause of the media, many medicos still have misgivings. This week a group of psychiatrists, psychologists, philosophers and others published a letter in De Morgen, a Flemish newspaper, asking the government to remove the option for euthanasia on the basis of psychological suffering alone. 

This is probably the first time that a professional group has pushed back against the ever-widening circle of eligibility for euthanasia. The trigger for the letter was two vivid documentaries in the English-speaking media. The first, which appeared on the Australian SBS network, showed a doctor euthanizing an elderly woman without seeking a consultation with a psychiatrist, as he is supposed to do under current legislation. For the first time in the history of the legislation, the euthanasia commission decided to press charges. The second documentary was a video produced by The Economist about a 24-year-old woman suffering from severe depression who applied for euthanasia.

Here are some excerpts from the dissidents’ letter (translation here):

Mental suffering is real and can be at least as severe as physical suffering.

What is unique, however, is that you can only rely on the word of the person who is suffering to evaluate it. And this is clearly a good thing, because he or she is the only one who knows how much it hurts at that precise moment. At that moment indeed … because when we suffer psychologically, we are often convinced that no other future is possible.

It is often precisely these thoughts that push a person into the abyss, since as long as there is perspective, one can usually tolerate a great deal. We see that some people who were first declared terminally ill eventually abandon euthanasia because new prospects appear. In a paradoxical way, this proves that the disease cannot be called incurable …

Some also defend the thesis that the mere offering of death as an option can cause a positive change and can therefore also be considered a component of good care.

In our view, however, this inevitably entails the radical failure of the mental health sector. The use of “death as therapy”, possibly up to the point of actually even performing the requested euthanasia, implies a priori renouncing what therapy still can and should be offering: the inexhaustible opening up of new perspectives.

As representatives of the various directly-involved professional groups, from different parts of the country and from across the different ideological fault lines, we are alarmed by the increasing trivialisation of euthanasia on the grounds of mental suffering alone.

We believe that this situation is intrinsically linked to the concept of an act which is based on subjective criteria. That is why we insist that allowing euthanasia based on purely psychological suffering should be removed from the current legislation.

Supporters of euthanasia, of course, responded with their own letter, also signed by dozens of doctors and ethicists, including the chairman of euthanasia evaluation commission, Wim Distelmans. They described their colleagues’ letter as “well intentioned but nonetheless misguided” because it was paternalistic and demonstrated a profound lack of empathy. “The suffering of some patients is so unfathomably deep, that granting their request for assisted medical and painless death, from a certain moment, the best thing the health sector has to offer,” they write. 

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