However, Belgian academics wondered whether there might be abuses in unreported cases. There were.

The law clearly stipulates that euthanasia is administering, supplying, or prescribing drugs with the explicit intention of hastening the patient’s death. To be legal, several conditions have to bemet. Among these are: it has to be performed after an explicit request from a patient; the doctor himself must administer lethal drugs; another doctor has tobe consulted, and a report must be submitted.

What the authors found is that in 2007 in Flanders,the Dutch speaking part of Belgium, only 52.8% cases of euthanasia were reported to the authorities. Why is the rate so low? It appears that about 77%physicians who did not report cases of euthanasia did not perceive their act as euthanasia, as defined by Belgium’s law. But there were other reasons as well.About 18% said that reporting involves too much paperwork; about 12% feared that not all of the legal requirements had been met; 9% thought that euthanasia is a private matter between physician and patient.

One of the reasons for legalising euthanasia in Belgium was to make it more transparent so that society could control it. However, the authors point out that “legalisation alone does not seem sufficient to reach the goal of transparency”. They recommend more education in medical school and more support for doctors who have to deal with requests for euthanasia.