BELGIUM – The government in Belgium is considering new legislation that would allow for children under the age of 18 and adults with early dementia to request euthanasia. Euthanasia is already legal in Belgium for people over the age of 18 but no other country has ever extended the law to children. Advocates believe that euthanasia for children, with parental consent, gives families an option in a desperately painful situation. Opponents are skeptical that children are not equipped to make the decision to end their own lives.
Belgium legalized euthanasia for adults in 2002 and has seen a drastic increase in the number of cases; 235 deaths in 2003 to 1,432 in 2012. The method used by doctors typically involves giving patients a powerful sedative before injecting another drug to stop their heart.
Only a few countries have legalized euthanasia. It is legal in the Netherlands under specific circumstances and for children over the age of 12 with parental consent. The only other country in Europe to legalize euthanasia has been Luxembourg. Assisted suicide, a practice where doctors help patients to die without actively killing them, is legal in Sweden. In the United States, assisted suicides are allowed in Oregon, Washington, Vermont and Montana.
In Belgium, the ruling Socialist party is behind the movement to expand the right of euthanasia while the Christian Democratic Flemish party vowed to oppose the legislation and to challenge it in the European Court of Human Rights, if it passes. Parliament must approve the final decision, a process that could take months.
The Senate has already heard testimony on both sides of the issue. Catholic Archbishop Andre-Joseph Leonard testified, “It is strange that minors are considered legally incompetent in key areas, such as getting married, but might (be able) to decide to die.” Leonard went on to say that alternatives like palliative sedation make euthanasia unnecessary. Palliative sedation is a process by which patients are sedated and life-sustaining support is withdrawn such that they starve to death; a process that can take days.
The debate has extended far beyond the borders of Belgium. Charles Fostr, who teaches medical law and ethics at Oxford University, believes children could not possibly have the capacity to make an informed decision about euthanasia citing that even adults struggle with the concept.“It often happens that when people get into the circumstances they had so feared earlier, they manage to cling on all the more,” he said. “Children, like everyone else, may not be able to anticipate how much they will value their lives if they were not killed.”
Those in favor of the law’s expansion believe it unjust to deny children the right when it’s already approved for adults. John Harris, a professor of bioethics at the University of Manchester, said, “The principle of euthanasia for children sounds shocking at first, but it’s motivated by compassion and protection. It’s unfair to provide euthanasia differentially to some citizens and not to others (children) if the need is equal.”
And Dr. Gerlant van Berlaer, a pediatric oncologist at the Universitair Ziekenhuis Brussels hospital said, “Children have different ways of asking for things, but they face the same questions as adults when they’re terminally sick. Sometimes it’s a sister who tells us her brother doesn’t want to go back to the hospital and is asking for a solution. Today if these families find themselves (in that situation), we’re not able to help them, except in dark and questionable ways.”
Expanding the law to cover those with dementia is also controversial. As of right now, people can request in writing to be euthanized if their health deteriorates but that request is only valid for five years and patients must be in an irreversible coma. The new law would do away with the time limit and the requirement that a patient be comatose. This would allow someone diagnosed with Alzheimer’s to be put to death years later.
According to Dr. Patrick Cras, a neurologist at the University of Antwerp, people with dementia often change their minds about wanting to die: “They may turn into different people and may not have the same feelings about wanting to die as when they were fully competent,” he said. “I don’t see myself killing another person if he or she isn’t really aware of exactly what’s happening simply on the basis of a previous written request (to have euthanasia). I haven’t fully made up my mind but I think this is going too far.”
In the past year, there have been several cases of Belgians who weren’t terminally ill but were euthanized, including a pair of 43-year-old deaf twins who were going blind and a patient in a botched sex change operation.
These cases along with the proposal for expansion of the law, have raised concerns the country is becoming too willing to euthanize its citizens.
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