Euthanasia "trivialized" in Belgium: report by bioethics institute

By July 29, 2013 Recent News

Mercatornet – Michael Cook | Dec 09, 2012 |
Belgium legalised euthanasia in 2002, with a law containing strict controls to protect the vulnerable. (This is the text of the law in English.) The Belgium-based European Institute of Bioethics has just released a study (link to English translation) of the experience of ten years of euthanasia. It claims that the results are far from encouraging.
The central theme of the report is the ineffectiveness and bias of the body established by the legislation to allay the misgivings of the public by monitoring and controlling euthanasia. After 10 years and about 5,500 cases, not one case has ever been referred to the police. It is illusory, says the IEB, to expect doctors to denounce their own failings.
Furthermore, nearly half of the statutory 16-member Commission for Control and Assessment are members or associates of the leading Belgian right-to-die society. This is sufficient to explain, according to the IEB, “the absence of any effective control and the ever‐widening interpretation which the Commission intends to give the law”. A law which permits euthanasia is bad enough, the IEB suggests, but the government is not even enforcing its application.
“As is the case in all penal laws, this law has to be strictly interpreted lest it be of seeing it stripped of any substance. It is not for the Commission, appointed to control and assess the law, to provide an ever‐widening interpretation of its terms, with this going so far as to negate the initial spirit of the text and of doing away with the control of decisive legal criteria.”
As a result, there are on-going abuses in several areas. Here are a few of those which the EIB singles out for criticism:
A written declaration of a desire for euthanasia is required, either by the patient or a surrogate. However, the Commission often waives this obligation.
Initially patients had to have a life‐threatening and incurable illness. Nowadays, the illness need only be serious and debilitating.
The pain is supposed to be unbearable, unremitting and unrelievable. However, a patient can refuse medication to relieve the pain. The Commission, says the IEB, has “decided not to carry out its mission ‐ so central to the law ‐ of verifying the unbearable and unrelievable nature of the suffering”.
The ambit of “psychological suffering” is ever-expanding.
Doctor-assisted suicide is not authorised by 2002 legislation. However, the Commission has ignored this and regularly signs off on such cases.
If a patient is to be euthanased at home, the doctor himself is supposed to fetch the lethal medications at a pharmacy from a registered pharmacist and to return left-over drugs. In practice, family members often get the drugs; unqualified personnel hand them over; and no checks have ever been made about surplus drugs.
According to a recent article published in Current Oncology by Dr. José Pereira, Medical Chief of Palliative Care at Bruyère Continuing Care in Ottawa, so-called safeguards to limit the practice of legalized euthanasia don’t work
1. In the Netherlands, where assisted suicide and euthanasia were made legal in 2001, the law states that individuals must give written consent that they want to die. In spite of this, a 2005 study of deaths by euthanasia in the Netherlands found that almost 500 people are killed annually without their consent. Belgium has the same safeguard, nonetheless, a 2010 study found that in the Flemish part of the country, 32 per cent of euthanasia cases were carried out without request or consent.
2. Another suggested safeguard is mandatory reporting: all cases of euthanasia must be reported to the proper authorities so that they can ensure the other safeguards are being followed. But Dr. Pereira notes that in Belgium, nearly half of all cases aren’t reported. In the Netherlands, at least 20 per cent of all cases aren’t reported.
3. The third safeguard is that assisted suicide or euthanasia be carried out only by doctors. Yet a 2010 study of 120 Belgian nurses found that nurses administered life-ending drugs in 45 per cent of assisted suicide cases. The study also found that this was more likely when the hospital nurse was male and the patient was over 80.
4. The fourth safeguard is a second opinion. But in Oregon, public reports show that a physician tied to a pro-assisted suicide lobby group provided consultations in 58 of 61 cases of assisted suicide in Oregon. Dr. Pereira notes, “in 1998 in the Netherlands, 25 per cent of patients requesting euthanasia received psychiatric consultation; in 2010 none did.”
READ the full summary of the article from the Institute of Marriage and Family Canada

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