This study combined with the recent study that was published in the CMAJ in June 2010 that indicated that 32% of all euthanasia deaths in the Flanders region of Belgium were without request or consent suggests that the Belgium euthanasia model is out-of-control.
The authors of the study analyzed the death certificates in the Flanders Region of Belgium. After determining that the death was related to euthanasia, the authors of the study sent a five page questionnaire to the treating physician. The physicians were guaranteed total anonymity and asked to respond to the questionnaire.
The study determined that euthanasia deaths were reported 52.8% of the time, even though reporting is a requirement of the law. The most recent study in the Netherlands indicated that the euthanasia deaths were reported 80.2% of the time.
The study indicates that the reason the euthanasia death was not reported was:
76.7% - the physician did not perceive their act as euthanasia.The study determined that unreported euthanasia deaths represented a different demographic group than the reported euthanasia deaths. The study stated:
17.9% - reporting was considered an administrative burden.
11.9% - the legal, due care requirements, had possibly not all been met.
8.7% - euthanasia is a private matter between the physician and patient.
2.3% - because of possible legal consequences.
"However, in a bivariate analysis there was a significant relation between reporting euthanasia and the patient's age, with deaths of patients aged 80 years or older reported significantly less often than deaths of younger patients."The study that found that 32% of all euthanasia deaths in Belgium were done without explicit request found that these deaths were rarely reported and were also more likely to be done to:
"patients 80 years or older who were mostly in a coma or had dementia."The study then stated that this:
"fits the description of "vulnerable patient groups at risk of life-ending without request."It is interesting that 97.7% of the reported cases were done by the physician, whereas 41.3% of the unreported cases were done by a nurse alone, which is illegal in Belgium. This confirms the result of the other recent study that found that 45% of euthanasia deaths that were done by nurses were without request or consent.
This study strongly challenges the Belgium government official reports. According to these reports, physicians who reported cases practised euthanasia carefully and in compliance with the law, and no cases of abuse were found. But if only 52.8% of all euthanasia deaths are reported and the physicians admitted that in at least 2.3% of the time the euthanasia death was not reported due to possible legal consequences and 11.9% of the cases were not reported because the legal requirements were not met, therefore it is clear that physicians are only choosing to report the cases that are within the parameters of the law.
This study creates significant suspician concerning the administration of the assisted suicide laws in Oregon and Washington States.
In Washington State this type of a study could not even be done because the law requires the physician to lie on the death certificate. The death, is required by law, to be listed as related to the illness the person had (ie. cancer) rather than the cause of death (assisted suicide by lethal overdose).
In Oregon and Washington there is no mechanism in the law to determine whether all assisted sucide deaths were reported. Therefore, similar to the Belgium reports, the official reports are based on reported deaths.
In Oregon, where the assisted suicide law has been in place since 1998, Compassion and Choices, formerly the Hemlock Society, have become the gate-keepers of the law. Last year (2009) 57 of 59 assisted suicide deaths in Oregon were facilitated by Compassion and Choices and in 2008, 54 of 60 assisted suicide deaths were facilitated by Compassion and Choices.
When the group that lobbies governments to legalize assisted suicide are also the facilitators of the current law in Oregon, it is very unlikely that they would self-report cases that fall-outside of the law or cases that do not fit the paradigm that they are promoting throughout the United States and world-wide.
This study indicates that even when legalized and regulated, that abuse and under-reporting in common. The abuse is hidden from the public by the medical practitioners only reporting the cases that are considered acceptable by the law or society.
The only way to protect vulnerable people is to reject euthanasia and improve the care that society offers its dying citizens.