International Chair - Euthanasia Prevention Coalition
A study on the practise of euthanasia in Belgium that was recently published in the British Medical Journal found that nearly half of all assisted deaths in the Flanders region of Belgium were not reported.
This study combined with the recent study that was published in the CMAJ in June 2010 that proves that 32% of all euthanasia deaths in the Flanders region of Belgium were done without explicit request suggests that the Belgium euthanasia model is out-of-control.
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 reasons for euthanasia deaths not being reported were:
- 76.7% - the physician did not perceive their act as euthanasia.
- 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 CMAJ study found that 32% of all euthanasia deaths in Belgium were done without explicit request also indicated that these assisted 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 concluded that this:
"fits the description of "vulnerable patient groups at risk of life-ending without request."It is interesting that 97.7% deaths that were done by a physician were reported, 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 challenges the findings from the Belgium official reports. According to the data, physicians who reported the euthanasia death were more likely to practise euthanasia carefully and in compliance with the law. Since the data indicates that only 52.8% of all euthanasia deaths were reported and since physicians admitted that in at least 2.3% of the cases 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 reporting the euthanasia deaths that comply with the parameters of the law.
This study creates suspician concerning the administration of the assisted suicide laws in Oregon and Washington States.
In Washington State this study would be difficult to do because the law requires physicians 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 state there is no mechanism to determine whether all assisted sucide deaths are reported. Similar to the Belgium reports, the official reports are based on the reported deaths only and it is unknown how many assisted deaths are not reported.
In Oregon, where the assisted suicide law has been in place since 1998, Compassion and Choices, formerly the Hemlock Society, are 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 to legalize assisted suicide is also the facilitators of the assisted suicide 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 is common. The abuse is hidden from the public by the medical practitioners who only report the deaths that are considered acceptable or legal by society.
The only way to protect vulnerable people is to prohibit euthanasia and assisted suicide and to improve the care that society offers its citizens.