Euthanasia statistics in Belgium.

The following article was written by Irene Ogrizek and published on her blog on December 15, 2013. Ogrizek is a politically left activist.

Irene Ogrizek

The Belgian population should be aware of the high level of paternalism among their physicians. One study shows that 60% of the surveyed physicians think that they should be able to decide to end the life of a patient who suffers unbearably and is incapable of making decisions…[no mention of terminal illness].
The Canadian media is being unkind to those of us who oppose euthanasia. I suspect a liberal bias is at the root of it. This means I have found myself, a committed leftist, feeling some empathy with Canada’s conservatives. They and many people who believe in God, are, like me, opposed to euthanasia.

This problem reminds me of another problem I saw in Toronto in the 1980s. It was a phenomenon called “not in my backyard” or NIMBY for short. In a Toronto context, this referred to downtown liberals who espoused liberal-sounding beliefs, but behaved quite differently when the people who benefitted from those beliefs wanted to move into their neighbourhoods. These are people I call buffet liberals. They are like Champagne Charlies but with a lot less charm.

I know from whence I speak. I am part of a global network of activists. We are concerned about how our parents are being treated in the Canadian, Belgian and U.K. healthcare systems. We have watched with dismay, disbelief and horror as they have been mercilessly shortchanged. We have seen bad nursing, bad doctoring and certainly bad administering. Our stories are legion in Canada, but you’d never know it from following our nation’s media.

Canada’s Healthcare System

The myth that the Canadian healthcare system is great is persistent: the NIMBY issue is the undesirable news that no, actually, in some places, it’s in tatters. I know bloggers who have simply given up because of the venom Canadians have directed at them for uttering words to this effect. This is what happens to those of us who dare to challenge the accepted wisdom. I really wish the Canadian media would get on board and listen to us and validate our stories. As it is, our absence means we are treated with far less respect than we deserve.

When it comes to euthanasia , proponents make two common refrains: one, that statistics from euthanasia-friendly countries do not support evidence of abuse; two, that reports of abuse – in Belgium and elsewhere – are anecdotal and sensationalist.

The following is mostly a list of facts culled from a series of Belgian studies directed at doctors and nurses. Raphael Cohen-Almagor is the author of “First do no harm: pressing concerns regarding euthanasia in Belgium,” and the text below is a summary of his most salient findings. He’s a euthanasia expert based at the University of Hull in the U.K.

The Situation in Belgium

The Belgium Senate has just passed a bill allowing euthanasia for terminally ill children and patients with dementia. Udo Schüklenk, the Ontario Research Chair in Bioethics, thinks this is a good thing:

If anything this should be a sign the system is working and is well-enough trusted by Belgians for them to change their eligibility criteria. If 75% of Belgians would like assisted suicide available for certain kinds of terminally ill children that surely isn’t a sign of a slippery slope.

Despite Schüklenk’s confidence, statistics complied by Cohen-Almagor tell a very different story.

It is illegal in Belgium for nurses to perform euthanasia; however, a study conducted in 2010, eight years after euthanasia was legalized, showed that 12% of nurses in Flanders, the northern and Dutch-speaking part of Belgium, did so and 86% did so without the presence of a physician. This was in cases where euthanasia was specifically requested.

In cases where euthanasia was not specifically requested, 45% of nurses administered the drugs, and in 82% of those cases, they did so without the presence of a physician. Apparently these nurses were ordered to perform the procedure.

The law about who can perform euthanasia is not being followed and some physicians are shifting the responsibility from themselves onto hospital staff. The implication is that this allows them to bypass regulations requiring them to consult another physician and to report the death to the Federal Control and Evaluation Committee, a committee that even now only sees an estimated 50% of euthanasia cases reported. Non-reporting is important because as the incidents with nursing staff show, it can be indicative of non-compliance.

Defining Euthanasia in Belgium

Even more troubling are the results of a 2009 survey. Seven years after euthanasia was legalized, there was still no consensus about the definition of euthanasia among Belgian clinicians. The survey described hypothetical cases and physicians were asked to define them according to their own practices.

In one scenario, a terminally ill patient explicitly asked for and was given a lethal injection. 20% of physicians failed to define this as euthanasia and 30% did not realize the procedure had to be reported to the Federal Control and Evaluation Committee. Only 21% correctly identified it as euthanasia and stated the procedure had to be reported. The remaining physicians labeled this very clear case of euthanasia as an “intensification of pain and symptom treatment” or as “palliative sedation,” procedures that do not require reporting.

There is a good explanation for this. Despite a law that allows physicians to euthanize patients, many in Belgium have not been trained in palliative care and are wary of coming under scrutiny for not following procedures properly. Handling euthanasia correctly means talking to a patient about other options and calling in a consultant physician as well as a psychologist or palliative psychiatrist. It’s up to the patient’s physician to make sure the patient is fully supported in all aspects of decision-making.

This is a time when physicians must be willing to co-ordinate with colleagues and have “intimate conversations” with their patients. However, many report they find these tasks “burdensome” and “unnecessary.”

Other Secondary Effects

This, combined with what Cohen-Alagor states are dangerous levels of paternalism, may also explain why euthanasia is grossly under-reported. For example, as the opening study shows 60% of Belgian physicians believe they have the right to terminate the life of a patient who is incapable of making decisions, a figure signifcantly higher than physicians in six similar countries.

In instances where disagreements between a physician and a consulting physician did occur, the following reasons were cited: 26% of cases showed that the consultant did not think the patient had unbearable suffering; 31% did not think the patient had a medically hopeless condition; 10% thought the euthanasia was not well-considered; 26% thought palliative options needed to be exhausted first. Flemish physicians who are uncomfortable with euthanasia feel there should be a “palliative filter” in place to stop a rush to the procedure, an option that currently does not exist.

Lastly, Cohen-Almagor points to the fact that in 2007, .49% of deaths in Belgium were euthanasia deaths, and yet these euthanized patients accounted for 23.5%, or almost one quarter of all lung donations. It’s a number he says we should be watching—in Belgium the default position is that every patient donates their organs. The rush to harvest them he feels, via euthanasia, is a distinct possibility.

Cohen-Almagor’s statistics were culled from peer-reviewed articles and his report, in its entirety, makes for chilling reading. It’s clear that the regulations around consent are not being respected in Belgium. With Canada’s shortage of medical expertise, it’s just as likely our physicians will cut corners too, if only because they are so overworked.

I hope the buffet liberals who support euthanasia are taking note: ideologies aren’t always about picking and choosing ideas, not unless, of course, you’re actually following an ideology of narcissism. If you support euthanasia, it logically follows that you support the return of the death penalty too. If we’re willing to foist premature deaths onto unwitting seniors, it’s the least we can do for our criminals.

For more information about the statistics and abuse of the Belgium euthanasia law, purchase the book: Exposing Vulnerable People to Euthanasia and Assisted Suicide that is written by Alex Schadenberg