Euthanasia has become normalised in Belgium. Accounting to official figures, about 1 death in 50 is due to euthanasia – and a large proportion are not officially reported. The picture conveyed by the media and by the Belgian euthanasia commission is melancholy but positive – miserable people are released from their suffering, supported by their loved ones. All the doctors comply fully with the law and there are no difficulties or abuses.
This is changing. A complaint about the euthanasia of a woman named Tine Nys in 2010 has cast shadows over this placid panorama. Her two sisters pursued three doctors through the courts for ten years until they were put on trial in 2020 for unlawfully poisoning her. The sisters contended that she was not terminally ill, even though she was suffering from serious depression. All three doctors were acquitted.
That might seem like a happy outcome for doctors involved in euthanasia. However, it showed that euthanasia doctors were not invulnerable. This has apparently emboldened the relatives of other people who were euthanised – and their lawyers. There has been an explosion of lawsuits which is intimidating doctors.
This week a doctor spent a night in jail following a complaint that he had unlawfully euthanised a 91-year-old man in the Jan Palfijn hospital in Ghent. Who lodged the complaint is unknown.
An article in the Belgian magazine Knack a couple of months ago describes the case of Karel (a pseudonym), a Belgian man in his 50s who was severely handicapped after a brain haemorrhage. He asked for euthanasia on the basis of physical and mental suffering and the doctors agreed. However, on the appointed day, the euthanising doctor received a letter from a lawyer acting on behalf of Karel’s two estranged sons and his ex-wife in the United States. It demanded that the doctor desist. It said, in part, “If you nevertheless proceed to perform this euthanasia, I have been ordered by my clients to immediately file criminal charges for murder.”
This had never happened before. The doctor and Karel’s carer were shocked. But they complied. Karel still wants to proceed with the euthanasia, but the doctor is unwilling to help him in this state of legal uncertainty.
Knack interviewed Christophe Lemmens, a health law specialist and a member of Belgium’s euthanasia commission. Mr Lemmens says that families often oppose requests for euthanasia and engage lawyers to dispute the issue. This is a new development after the Tine Nys case – and it has gone unnoticed in the international media. Knack gives no figures. Mr Lemmens says that there are not “hundreds” of cases – but even a few dozen are probably enough to spook doctors.
The threat of prosecution for murder is a powerful one. According to Dr Wim Distelmans, who is both Belgium’s leading euthanasia doctor and the co-chair of the Federal euthanasia commission, 78% of euthanasia doctors are less willing to perform euthanasia or even give advice nowadays, especially for psychiatric disorders.
Most of the threats involve patients who want to be euthanised because of “unbearable” psychological suffering. Their relatives believe that the doctors’ assessment is wrong – and it is very difficult to prove either way, which makes for a lawyer’s breakfast.
Mr Lemmens contends that the law is clear: the only voice that counts in choosing euthanasia is the patient’s. His relatives have no authority whatsoever to stop him. “It may be appropriate in some cases to involve relatives, but only the patient decides and no one else,” he told Knack.
While that may be true, it has not stopped lawyers from harassing doctors. They can always claim that the patient was not mentally competent. And in the case of euthanasia for psychological suffering, this can be quite plausible.
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