Euthanasia, a right for 20 years in Belgium
Twenty years ago, Belgium was one of the first countries in the world to legalize euthanasia, a practice that is now increasingly accepted in the medical world and among the population.
In Brussels, Doctor Marc Decroly has accompanied more than a hundred patients until the end of their lives. He recalls the context in 2002: “Several eminent members, in any case from Catholic universities, took a stand and expressed the idea that a law could be humanist, even if it went against certain rules of the Church which perhaps no longer corresponded very much in today’s society.”
In 2021, 2,700 euthanasias were declared in Belgium, mostly for patients aged 60 to 89, and in 84% of cases, death was expected “shortly”.
“What moves me is that the image I can keep of mum is an image which is a beautiful image, which is an image of a combative woman, who is going towards her destiny. She is not a victim, in good conditions in any case. And I would sincerely like other countries to seek the example of Belgium“explains Catherine Rombouts.
In L’European Unionthe legislation of the Member States is varied in the absence of harmonisation.
Country that allows euthanasia
- The Netherlands : it is the first country in the world to have legalized euthanasia, under certain conditions. Lethal drugs can be legally administered by a physician, in cases of incurable disease or intolerable suffering, to patients who knowingly request it.
The law, passed in 2001, also ensures greater security for doctors. They can practice euthanasia without the risk of legal proceedings if they respect certain “criteria of thoroughness”.
In June 2015, the association of Dutch paediatricians publicly came out in favor of extending the right to death to children under 12 years old. To date, the law has not been amended.
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Belgium : a law of September 2002 partially legalized “assisted suicide” by supervising it very strictly. The doctor “will not commit an offence” when the patient, victim of “constant and unbearable physical or psychological suffering” as a result of an “incurable accidental or pathological condition”, “finds himself in a medical situation without publish”.
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Spain : On March 18, 2021, Spain became the sixth country in the world to legalize euthanasia. Parliament has in fact passed a law authorizing not only euthanasia, when the caregiver kills the patient, but also assisted suicide, when the patient himself takes the prescribed dose.
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Luxemburg : euthanasia was legalized in March 2009, in the event of a “dead end” medical situation, but it is prohibited for minors.
Countries where euthanasia is prohibited, but where “a form of assisted” death is possible
Most European countries prohibit active euthanasia. However, some States allow therapeutic abstention: the doctor can then, with the agreement of the patient, or failing that, the family, put an end to the therapeutic relentlessness.
The European framework for passive euthanasia is variable in geometry. Thus, while some countries, such as France, have adopted a law to regulate the end of life of suffering people, others have not legislated and only practice and court decisions provide answers.
- France : euthanasia is illegal, but the penal code distinguishes between active euthanasia – directly causing death (similar to homicide) – and passive euthanasia – “therapeutic abstention” (considered as non-assistance to person at risk). A little over ten years after the Leonetti law of 2005, the French parliament approved in 2016 the Claeys-Leonetti law on the end of life. This text establishes a right to “deep and continuous sedation” until death for terminally ill patients, as well as binding advance directives. On the other hand, it allows neither euthanasia nor assisted suicide, but only the sedation of the patient affected by a “serious and incurable condition”, whose “vital prognosis is engaged in the short term” and who presents “refractory suffering “to treatment”. Concerning the advance directives (by asking the patient to make known his refusal of a relentless treatment), which become binding, the doctor can still derogate from them “in the event of a vital emergency for the time necessary for a complete assessment of the situation. and when they “appear manifestly inappropriate or unsuited to the medical situation”.
- Denmark : “active euthanasia” is prohibited, but an incurable patient can decide to stop treatment. Since October 1, 1992, in the event of incurable illness or serious accident, Danes can make a “medical will” which doctors must respect. Passive euthanasia can then be performed.
- Italy : euthanasia is prohibited. Active euthanasia is considered intentional homicide and assisted suicide a crime. However, the right to refuse care is recognized by the Constitution.
- Germany : “passive euthanasia”, like unplugging a machine, is not illegal if the patient has given his consent. If administering a lethal drug is condemned, case law was established by the Frankfurt Court of Appeal in 1998. If it results from the patients’ will without ambiguity, euthanasia can be decided in its passive form (it is thus considered as suicide). In November 2015, the German Parliament decided that, while passive euthanasia is permitted in the presence of the patient’s consent, this act cannot be traded.
- Hungary and the Czech Republic : incurable patients can refuse their treatment.
- Slovakia : if “euthanasia and assisted suicide are unacceptable”, the medical staff “mitigates the pain of the terminally ill and the dying (…) and respects the wishes of the patient in accordance with the legislation”.
- Portugal : While the Portuguese Parliament voted in favor of the decriminalization of assisted suicide on February 19, 2020, the law was challenged by the Constitutional Court. For the moment, Portugal therefore only authorizes the cessation of treatment.
Countries where euthanasia is strictly prohibited
- Fr Greecejust like in Romania, euthanasia in its various forms is prohibited. Any offender faces a sentence of up to seven years in prison.
- Fr Croatiaeuthanasia is punished in the same way as homicide.
- Fr Polandeuthanasia is punishable by three months to five years in prison, but “in exceptional cases”, the court can cancel the sentence, or even waive the imposition.
- Fr Ireland, the law does not mention euthanasia. Any form of assisted death or suicide is illegal and punishable by up to 14 years in prison.
- Fr Italyassisted suicide was decriminalized in September 2019 but remains prohibited by law.
In 2014, Belgium went further and authorized euthanasia for terminally ill minors who request it and without age limit. This right, unique in the world, is subject to the agreement of both parents and to the assessment of the child’s discernment. Objective: to determine if he is aware of all the consequences of such a choice.