Belgium 2025 euthanasia report: a record number of euthanasia deaths.

Belgian 2025 report: There were 4,486 reported euthanasia deaths up by 12.4% in 2024.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The European Institute of Bioethics (IEB-EIB) reported that the 2025 Belgian euthanasia report indicated that there were 4,486 reported euthanasia deaths in 2025 representing a 12.4% increase from 2024. According the IEB-EIB (Google translated from French):

On March 20, the Belgian Federal Commission for the Control and Evaluation of Euthanasia (CFCEE) released figures on euthanasia cases reported for 2025. 

The number of officially recorded euthanasia deaths last year reached a new record: 4,486 were reported to the Commission. This represents a 12.4% increase compared to 2024, a 51% increase over three years, and almost a doubling in just five years. 

Euthanasia now accounts for 4% of all deaths registered in Belgium, and this upward trend could intensify, judging by the reasons given on euthanasia registration forms. 

Multiple pathologies, the second most frequently cited condition after cancer, have increased by 67% in two years and now represent nearly a third of all reported euthanasia cases. More specifically, the proportion of euthanasia done on individuals who were not terminally ill due to multiple chronic conditions has literally increased tenfold in five years, rising from 5.9% to 57.3%. 

These percentages, which have been steadily increasing since the decriminalization of this practice in Belgium, raising serious questions: has old age become a sufficient reason to resort to euthanasia? 

Multiple chronic conditions: a vague category akin to the weariness of living.

In its latest biennial report published in 2025, the Control Commission highlighted this continued rise in euthanasia based on the criterion of multiple chronic conditions and explained that:

"this percentage will continue to increase, as multiple chronic conditions are associated with the aging process that patients undergo." 

Indeed, multiple chronic conditions, according to the Commission, refer to "a combination of conditions caused by several chronic illnesses that are progressing towards a terminal stage." In practice, these conditions can include end-stage heart failure, hemiplegia due to a stroke, as well as cognitive impairment, vision or hearing loss, rheumatoid arthritis, or incontinence. 

While some of these conditions are life-threatening, they primarily affect quality of life, which explains why, in 2025, more than half of the euthanasia deaths in this category (57.3%) were done when death was not expected in the short term. Is the fear of dependency becoming sufficient to shorten life? 

To understand what justifies euthanasia based on these conditions, that do not directly threaten life, one must bear in mind the subjective logic followed by the Oversight Commission in its verification of the legality of euthanasia, according to which the patient's perception of suffering is considered authoritative. 

In cases of multiple chronic conditions, the chronic progression of illnesses extends over several years and can cause significant psychological suffering, according to the Commission. Based on the scientific research of Marianne Dees, the Commission reports that:

"feelings of hopelessness, dependence on care, fear of further deterioration, and fear of increased physical suffering are determining factors in requests for euthanasia." 

In this context, it is also understandable that in 86% of all reported cases of euthanasia, both physical and psychological suffering were mentioned simultaneously. This finding underscores the vital need for better support for the elderly and at the end of life in general, so that weariness of living and fear of dependency do not become sufficient reasons to shorten a person's life.

The IEB-EIB refer to reported euthanasia deaths since previous studies indicate that there is a significant number of euthanasia that are simply not reported. Therefore the actual number of euthanasia deaths is likely much higher.

Some recent articles on Belgium's experience with euthanasia.

• Belgian bioethics committee supports eugenic euthanasia (Read). 
• Belgium debates expanding euthanasia to people with dementia (Read). 
• Almost 4000 reported Belgian euthanasia deaths in 2024 (Read). 
• The President of Belgium's largest health insurance fund promotes euthanasia as an answer to healthcare funding. (Read). 
• Belgian doctor completes euthanasia with a pillow (Read).
  

What's in the plan to legalise assisted suicide in France?

The following article was published by the European Institute of Bioethics on June 30, 2025.

France National Assembly

The plan to authorise assisted suicide and euthanasia in France, which has been supported for some time by a number of political and media figures in France, has been the subject of numerous initiatives in recent years, despite some political upheavals.

Since the majority opinion in favour of authorising euthanasia issued by the French National Consultative Ethics Committee in September 2022 (in contradiction with previous opinions that had been largely unfavourable), the political timetable on this issue has accelerated. This was followed by a citizens' convention on end-of-life issues in December 2022, and the examination of a government bill in May 2024, halted by the dissolution of the National Assembly a few weeks later. The draft bill that has been before the public since 12 May is based on the text adopted at first reading by the Social Affairs Committee.

Towards a right to "use a lethal substance

Article 1 of the bill establishes a ‘right to assistance in dying’, i.e. authorising a person who so requests to ‘have recourse to a lethal substance [...] in order to administer it or have it administered by a doctor or nurse’. Under the heading of ‘aid in dying’, this means that the person requesting it can commit suicide after being given the means to do so, or be euthanised by a carer if he or she is no longer capable of administering the lethal substance.

Subjective conditions for access

In addition to the conditions of majority and French nationality (or residence in France), the text provides, as does Belgian law, for a condition linked to medical condition and a condition linked to the state of suffering:

• The person must be ‘suffering from a serious and incurable disease, whatever its cause, which is life-threatening, in an advanced or terminal phase’;
• They must also be ‘suffering physically or psychologically as a result of this condition, which is either refractory to treatment or unbearable according to the person when he or she has chosen not to receive or to stop receiving treatment’.

Patients must also be considered as ‘capable of expressing their wishes in a free and informed manner’.

Following the example of Belgian law, the text therefore does not stipulate that the patient's death must be expected in the near future in order for his or her life to be terminated. Some people, such as the French National Authority for Health, have stressed the vague and non-objective nature of the notion of ‘advanced or terminal phase’, as well as that of ‘life-threatening prognosis’.

Non-binding opinion of other healthcare professionals

The doctor asked by the patient to end his or her life must obtain the opinion of another doctor (who is not obliged to consult the patient), as well as the opinion of another medical auxiliary or care assistant (if necessary from a distance), without these opinions being binding.

A minimum period of a few days between the request and death by lethal injection

If, within the two-week period, the doctor decides in favour of the patient's request, the patient may be euthanised or die by assisted suicide after a period of reflection of at least two days. In practice, this means that the time between the patient's initial request and death by lethal injection can be reduced to a handful of days. This will depend on how quickly the doctor makes his or her decision and how soon the person chooses to have their life ended.

Carers involved in all cases

Insofar as it is envisaged that the person will in principle administer the lethal substance themselves, the programmed death provided for in the text under discussion corresponds to assisted suicide. Only in the event that the person is unable to self-administer the lethal cocktail would euthanasia be carried out by the doctor or nurse.

However, even if they do not administer the lethal substance to the person, the doctor or nurse ‘responsible for accompanying’ the person is required to ‘supervise the administration of the lethal substance by the person’, in addition to having obtained the lethal substance and, where applicable, having taken responsibility for authorising the person's assisted suicide beforehand.

Assisted suicide is a "natural death

The bill also stipulates that the death certificate will state that the person is ‘deemed to have died a natural death’. This echoes an equivalent provision in Belgian law. Justified as a means of guaranteeing access to certain life insurance cover, this legal fiction nonetheless seriously misleads the public about the very reality of the act of death - unnatural death - involved in euthanasia or assisted suicide.

Limited conscience clause

While the text gives doctors, nurses and healthcare assistants the right to refuse to take part in this procedure, pharmacists are excluded from the protection provided by this specific conscience clause, even though they are required to be involved in preparing and dispensing the lethal substance. Furthermore, the freedom of health establishments and retirement homes not to provide for euthanasia or assisted suicide within their walls is explicitly excluded: the staff of these institutions will not be able to oppose the carrying out of programmed death within their walls.

Monitoring compliance with the law after the patient's death

The text establishes a control commission, tasked in particular with assessing compliance with the conditions of the law once the patient has died, on the sole basis of information declared by the carers concerned.

Offence of obstruction for attempting to prevent assisted suicide

The only criminal provisions introduced by the bill concern preventing (or attempting to prevent) others from practising assisted suicide or euthanasia, or from obtaining information on the subject, ‘by any means, including electronically or online, in particular by disseminating or transmitting allegations or information likely to intentionally mislead, with a view to dissuading, as to the characteristics or medical consequences of assisted dying’.

The text grants associations campaigning in favour of euthanasia and assisted suicide (‘whose statutory purpose includes the defence of the rights of persons to have access to aid in dying’) the right to bring a civil action to prosecute on this basis.

More articles on France:

• France's National Assembly votes to legalize euthanasia and assisted suicide (Link). 
• Dutch ethicist urges France to reject euthanasia (Link).
  

Belgian euthanasia deaths increase by 15% in 2023.

The European Institute of Bioethics published the following report:

On Tuesday, February 27, the Federal Commission for the Control and Evaluation of Euthanasia in Belgium (CFCEE) published the figures relating to euthanasia's declared during 2023. The number of euthanasia's officially practiced reached a new record with 3,423 euthanasia's declared to the Commission in 2023.

While the year 2022 had also been marked by an increase in cases (+10%), see. IEB news, this year marks an increase of 15% compared to 2022.

To these euthanasia's officially declared to the Commission, scientific studies estimate that approximately 25 to 35% of undeclared euthanasia's should be added (JPSM, 2018).

If the majority of reported euthanasia's concern elderly people, note that almost a third (30%) of people officially deceased by euthanasia were under 70 years.

Euthanasia's carried out at home represent 48.6%. We observe a confirmed increase in euthanasia carried out in rest and care homes (16.4% in 2022 and 17.4% in 2023). 32% of euthanasias were carried out in hospitals and palliative care units. This proportion is up slightly compared to the previous year.

The figures for 2023 also confirm the increase in euthanasias carried out due to multiple pathologies (+3% compared to 2022, i.e. the second type of condition mentioned, after cancer). Euthanasia for multiple pathologies thus represents 23.2% of euthanasia, of which almost half (47%) were carried out when death was not expected in the short term. As the Commission indicates, polypathologies designate “a combination of suffering caused by several chronic conditions which progress towards a final stage”. In practice, these conditions can notably consist of terminal heart failure, hemiplegia due to a stroke but also loss of vision or hearing, polyarthritis or incontinence.

Finally, in 76.2% of cases, physical and psychological suffering were mentioned simultaneously. Additionally, 89 people were euthanized due to psychiatric conditions (such as personality disorders or depression) or cognitive disorders (such as Alzheimer's disease). A figure again increasing compared to 2022.

Portugal's Constitutional Court rejects another euthanasia bill.

Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

Portugal's Constitutional Court has once again rejected, a euthanasia bill that was passed by Portugal's parliament. President Marcelo de Sousa vetoed another euthanasia bill last year before the election.

André Ventura, who is the leader of the Chega party, is calling for a referendum on euthanasia.

The Portugal News reported:

The Constitutional Court considered that “an intolerable lack of definition as to the exact scope of application” of the decree on medically assisted death had been created, noting that the parliament went “further”, changing “in essential aspects” the previous bill.

This was the third decree approved by parliament to decriminalise medically assisted death in a period of about two years.

The first was also declared unconstitutional by the TC, in March 2021, following a request for preventive inspection by the President of the Republic, due to insufficient normative densification.

In November of the same year, Marcelo Rebelo de Sousa used the political veto in relation to the second parliamentary decree on this matter, as it contained contradictory expressions.

The current bill passed on December 9. Similar to the previous two bills, the bill uses vague language, as the Constitutional Court stated, the bill had "an intolerable lack of definition as to the exact scope of the application."

The European Institute of Bioethics reported on January 12 on the concerns with the text of the bill (google translated):

In the new text adopted at the end of 2022 by the parliament, the “intolerable” character of the suffering is no longer required in the patient; henceforth, only “great intensity” suffering would suffice. This condition is not, moreover, required in the case of “permanent damage of extreme gravity”. In addition, the term “fatal disease” is removed in favor of “serious and incurable diseases”, thus positioning the act of euthanasia as a means of causing death and not of accelerating it.

More broadly, the Portuguese law in itself raises serious ethical concerns, because it entails, in the words of Marcelo Rebelo de Sousa, a "considerable change from the point of view of the balance between the value of life and the right to self-determination", authorizing euthanasia even when the patient is not at the end of life.

On January 29, 2021, Portugal's parliament passed the first euthanasia bill. On February 19, President de Sousa referred the bill to Portugal's Constitutional court for evaluation. President de Sousa stated that the bill was:

"excessively imprecise," potentially creating a situation of "legal uncertainty."

On March 15, the Portuguese American Journal reported that the Constitutional court rejected the first bill and stated:

“the law is imprecise in identifying the circumstances under which those procedures can occur.” The court stated the law must be “clear, precise, clearly envisioned and controllable.” The law lacks the “indispensable rigor."

On November 30, 2021, President de Sousa vetoed the second euthanasia bill because of contradictions in it's language. The Associated Press reported:

This time, the president is returning the reworded law to the national assembly, according to a statement posted on the Portuguese presidency’s website late on Monday, arguing that further clarification is needed in “what appear to be contradictions” regarding the causes that justify resorting to death with medical assistance.

Whereas the original bill required “fatal disease” as a pre-requisite, the president’s argument followed, the renewed version mentions “incurable” or “serious” disease in some of its formulation. No longer considering that patients need to be terminally ill means, in De Sousa’s opinion, “a considerable change of weighing the values ​​of life and free self-determination in the context of Portuguese society.”

The Associated Press reported in June 2022 that the new euthanasia bills, that were being debated, did not fulfill President de Sousa's concerns. According to the article:

...none of the four new bills addresses Rebelo de Sousa’s specific concerns. Instead, they attempt to simplify circumstances where euthanasia and physician-assisted suicide are justified by referring to “a situation of intolerable suffering, with a definitive injury of extreme seriousness or a serious and incurable disease.”

A new concerns is that André Ventura, the leader of the Chega, has called for a referendum. The Portugal News quoted Ventura as stating:

"this process can only be resolved with a referendum", maintaining that "an issue of this importance, twice declared unconstitutional by the TC, can only be resolved with the direct participation of Portuguese citizens."

All three euthanasia bills were either declared unconstitutional or vetoed based on the imprecise language of the bill. The euthanasia lobby appear to be following Canada's lead by passing euthanasia bills that lack definition. Legislation that are not sufficiently defined will naturally expand over time.

Euthanasia directly and intentionally causes the death of a person by lethal injection. Portugal needs to commit to a culture that cares for its citizens in need, not kills.

Portugal's President believes that the euthanasia bill is unconstitutional

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

President de Souza

Portugal's President, Marcelo Rebelo de Souza, has sent the euthanasia bill that was passed in Portugal's parliament on December 9 to be examined by Portugal's Constitional Court. This is the third euthanasia bill passed Portugal's parliament with the previous two bills being reviewed by the Constitutional court or rejected by President de Souza.

The European Institute of Bioethics reported on January 12 that (google translated):

Once again, the text adopted by the Portuguese Parliament concerning the decriminalization of euthanasia is submitted to the control of the Constitutional Court by President Marcelo Rebelo de Sousa. The latter doubts the constitutionality of the text voted last December and wants to ensure that it complies with the requirements formulated by the Court in 2021.

Alison Roberts reported for BBC News on December 9, 2022 that Portugal's parliament passed a bill that would legalize euthanasia. Roberts reported:

Once the president receives the final text, he can sign it into law, send it to the Constitutional Court within eight days, or exercise his veto within 20 days. A veto can, however, be overturned by a majority of members of parliament.

The European Institute of Bioethics reported that there are concerns with the text of the bill (google translated):

In the new text adopted at the end of 2022 by the parliament, the “intolerable” character of the suffering is no longer required in the patient; henceforth, only “great intensity” suffering would suffice. This condition is not, moreover, required in the case of “permanent damage of extreme gravity”. In addition, the term “fatal disease” is removed in favor of “serious and incurable diseases”, thus positioning the act of euthanasia as a means of causing death and not of accelerating it.

More broadly, the Portuguese law in itself raises serious ethical concerns, because it entails, in the words of Marcelo Rebelo de Sousa, a "considerable change from the point of view of the balance between the value of life and the right to self-determination", authorizing euthanasia even when the patient is not at the end of life.

On January 29, 2021, Portugal's parliament passed the first euthanasia bill. On February 19, President de Sousa referred the bill to Portugal's Constitutional court for evaluation. President de Sousa stated that the bill was: 

"excessively imprecise," potentially creating a situation of "legal uncertainty."

On March 15, the Portuguese American Journal reported that the Constitutional court rejected the bill and stated:

“the law is imprecise in identifying the circumstances under which those procedures can occur.” The court stated the law must be “clear, precise, clearly envisioned and controllable.” The law lacks the “indispensable rigor."

On November 30, 2021, President de Sousa vetoed the second euthanasia bill because of contradictions in the language of the bill. The Associated Press reported:

This time, the president is returning the reworded law to the national assembly, according to a statement posted on the Portuguese presidency’s website late on Monday, arguing that further clarification is needed in “what appear to be contradictions” regarding the causes that justify resorting to death with medical assistance.

Whereas the original bill required “fatal disease” as a pre-requisite, the president’s argument followed, the renewed version mentions “incurable” or “serious” disease in some of its formulation. No longer considering that patients need to be terminally ill means, in De Sousa’s opinion, “a considerable change of weighing the values ​​of life and free self-determination in the context of Portuguese society.”

The Associated Press reported in June 2022 that the new euthanasia bills did not fulfill President de Sousa's concerns. According to the article:

...none of the four new bills addresses Rebelo de Sousa’s specific concerns. Instead, they attempt to simplify circumstances where euthanasia and physician-assisted suicide are justified by referring to “a situation of intolerable suffering, with a definitive injury of extreme seriousness or a serious and incurable disease.”

We hope that Portugal's Constitutional court once again rejects the bill.

Belgium euthanasia (2020-21 report). 2700 euthanasia deaths in 2021. 27,726 euthanasia deaths since legalization.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The 2020-21 Belgium euthanasia report was recently released indicating that there were 2445 reported euthanasia deaths in 2020 and 2700 reported euthanasia deaths in 2021. From legalization in 2002 until the end of 2021, there has been 27,726 reported euthanasia deaths.

Thank you to the European Institute of Bioethics (EIB) for providing a summary of the report.

I refer to reported euthanasia deaths because there is a significant percentage of unreported euthanasia deaths in Belgium. The Belgian report acknowledges the problem by stating:

As in its previous reports, the Commission “does not have the possibility of evaluating the proportion of the number of euthanasia's declared in relation to the number of euthanasia's actually performed. In other words, these figures only reflect part of the reality of euthanasia in Belgium.

New categories of information in the report including that 31 of the euthanasia deaths were approved based on an advanced request, meaning these people were incompetent at the time of death and 172 died by euthanasia while in palliative care and 79 of the euthanasia deaths were foreign citizens.

The European Institute of Bioethics (EIB) reported that:

The conditions at the origin of euthanasia were in a large majority of cases generalized or seriously mutilating cancers (63%). Among the other reasons for requesting euthanasia, multiple pathologies (18% or 900 people), diseases of the nervous system (8%), diseases of the circulatory system (4%), diseases of the respiratory system (3%), psychiatric conditions (1% or 45 people) and cognitive disorders (dementia) for 49 people (1%).

The report indicates that 29 people died by euthanasia based on variable symptoms related to Long Covid. 

One may suggest that only 45 people with psychiatric conditions and 49 people with dementia died by euthanasia. Euthanasia for psychiatric conditions and dementia is an acceptance of killing people with questionable competency and ability to consent.

The Belgian report indicates that of the 45 people who died by euthanasia based on psychiatric conditions, 18 people had mood disorders (depression, bipolarity, etc.); 10 people had personality and behavioral disorders; 6 people had neurotic disorders, stressor-related disorders and somatoform disorders; 3 people had schizophrenia, schizotypal disorder and delusional disorder, and 4 people had organic mental disorders such as autism; 2 people had behavioral syndromes such as anorexia.

I have an autistic son. I am always shocked when someone is killed by lethal injection based on Autism. 

The EIB summary indicates that the euthanasia report stated:

The report states that in young psychiatric patients, "the unbearable and persistent pain was frequently associated with past experiences" such as abuse sexual, abandonment as a child, rejection by parents, behaviors self-harm and suicide attempts. The Commission added that “failed suicide attempts have made those affected aware that there is another, more dignified way to end one's life. We may be surprised at this presentation of euthanasia as a “more dignified” form of suicide.

The multiple pathologies category includes people who are not terminally ill but have chronic conditions. Nearly one-third of these deaths were people who were diagnosed with cancer, but were not terminally ill. Many of these people died by euthanasia but had treatable conditions.

The EIB summary indicates that the report stated:

However, rehabilitation and recovery are very limited in the elderly. Many patients could not accept living with severe and permanent disabilities. Dependence, loss of autonomy and the feeling of futility to wait for death were important factors that triggered their request euthanasia.

In relation to euthanasia for symptoms related to blindness/macular degeneration, the EIB stated that the report said:

...All of this created a feeling of loneliness, a feeling of being a burden to others, and the feeling that continuing to exist no longer makes sense.

The EIB summary states that more than a third of those who died for the reason of multiple pathologies, were not expected to die soon. The report indicates that 741 (14.4%) of the people who died by euthanasia, that their death was not expected soon.

The role of the euthanasia clinic (LEIF-EOL) in Belgium. According to the report, 33% of the consultations include doctors who are connected to LEIF-EOL and 19% of the first requests for euthanasia are made to doctors who are connected to LEIF-EOL.

The EIB concludes their summary by stating:

As a reminder, the Commission sticks to the statements given to it by the doctor and therefore has no no means of verifying the veracity of these declarations. In 30% of the files, the Commission decided to lift the anonymity of the declaration in order to ask additional information to the reporting physician. These were imperfections in the responses, errors of interpretation concerning the procedures followed, on several points badly, insufficiently or not completed, procedural points that have not been followed correctly,... Each time, the Commission considered that "the essential conditions of the law (voluntary, considered and of a conscious and capable patient, constant, unbearable and unrelievable suffering, resulting of a serious and incurable condition, the medical situation being hopeless)” seemed to have been respected.

There are significant issues related to the Belgian euthanasia law beyond the fact that the law gives doctors the right to kill people. 

1. The number and reasons for killing by euthanasia continues to rise. 
2. The law lacks significant oversight because the Commission includes several euthanasia doctors and in fact the Chair of the Commission, Dr Wim Distelmans, also operates the LEIF-EOL euthanasia clinic. 
3. The Commission admits that there are unreported euthanasia deaths, but the Belgian government has not done anything to rectify this problem. When I wrote my book, Exposing Vulnerable People to Euthanasia and Assisted Suicide, I was able to prove that the unreported euthanasia deaths tended to be the deaths that were more controversial, such as euthanasia without request or consent.

Similar to the Netherlands and Canada, the expansion of euthanasia is not a slippery slope, but rather it is inevitable. If it is acceptable to kill someone with one condition, it is hard to justify why you can't kill someone else for a similar but different condition. The report even referred to euthanasia as a "more dignified form of suicide."

Once again I thank the European Institute of Bioethics (EIB) for providing a summary of the report.

Brussels Symposium (November 16): Euthanasia and assisted suicide world-wide

Attend the Symposium on Euthanasia and Assisted Suicide Worldwide at the European Parliament in Brussels on Wednesday November 16 from (9:30 am to 4:30 pm). 

No cost to attend. (Registration link)

Watch online at no cost (Live link). The link will be live during the Symposium (Brussels time).

Schedule: 

9:30-10:00 Registration (Registration link)

10:00-10:10 Welcome

10:10-10:30 Comparing the euthanasia regimes Internationally
Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition, Canada

10:30-10:50 Euthanasia and the care professional
Dr. Manuel Martinez-Selles; President of the Spanish College of Physicians

10:50-11:10 The secular case against assisted suicide.
Prof. Kevin Yuill; professor of history at the University of Sunderland, England

11:10-11:30 Coffee break

11:30-11:50 A new holistic-evolutive approach to pediatric palliative care.
Carlo Belleini. Associate Professor of Pediatrics, University of Siena.

11:50-12:00 Care for children with life-threatening illness and their families in children hospices. Helmund Geuking, Member of the European Parliament (Group of the European People's Party (Familien-Partei Deutschlands). Online contribution

12:00-12:10 Considerations regarding euthanasia and palliative care.
Bert-Jan Ruissen, Member of the European Parliament (European Conservatives and Reformists Group). Online contribution.

12:10-12:30 Euthanasia in Belgium; How the slippery slope is turning into reality.
Dr. Leopold van Bellingen, lawyer at the European Institute of Bioethics.

12:30-12:50 Legalizing Euthanasia: What we can learn from the Netherlands: a case study of a slippery slope
Leo van Doesburg, Director for European Affairs for the European Christian Political Movement (ECPM)

12:50-13:10 Euthanasia law and practical guidelines and protocols.
Tista Bobbink-Kaper, President of the Dutch association of lawyers defending life. (JPV).

13:10-13:40 Panel discussion with speakers

13:40-15:00 Lunch

15:00-15:20 A doctor’s personal experience who opposes euthanasia
Dr Paul Saba, family physician in Canada and founder of the Coalition of Physicians for Social Justice (Quebec, Canada)

15:20-15:40 Assisted suicide in America. Catherine Glenn Foster.

15:40-16: 10 Panel discussion with the speakers

16:05- 16:35 General Conclusions

Watch online at no cost (Live link).

Belgium: Euthanasia of Newborns Practiced Outside the Law

This article was published by the European Institute of Bioethics on June 6, 2021.

10% of newborn deaths in Flanders Belgium are euthanasia.

A recent study has brought to light the practice of deliberate euthanasia to newborns for whom the medical team considered that there was "no hope of a bearable future". These practices concerned 10% of the neonates (0-1 year) who died in Flanders, between September 2016 and December 2017 (i. e., 24 babies).

This practice is illegal in Belgium, yet no authority seems to take offense. The law only allows the euthanasia of a minor if he or she is capable of discernment and conscious at the time of the request for euthanasia.

In her thesis, which served as the basis for the study in question, Laure Dombrecht, researcher at the Vrije Universiteit Brussel (VUB), refers to a similar study conducted in 1999-2000. The proportion of euthanasia to new-borns by injection of lethal substances has increased from 7 to 10% since this previous survey.

Among what is considered as "end-of-life medical decisions" involving 61% of these babies, the study distinguishes between decisions not to start or to stop "life-sustaining treatment" (e.g. ventilator), on the one hand, and the administration of certain substances to the baby, on the other hand. Note that the term euthanasia does not appear anywhere in the article.

In terms of the physician's intentions, the study distinguishes three situations. 

In the first scenario, the physician does not intend to cause or hasten the baby's death, but considers the potential effect of hastening death (e.g., decision not to administer antibiotics, administration of morphine or sedatives). 

The second scenario consists in the situation where the potential effect of hastening death is not the primary goal but is partly aimed at by the physician. 

The third scenario is that in which the physician explicitly intends to cause death (e.g., injection of a lethal muscle relaxant).

While the ethical considerations on the medical decision differ substantively depending on whether it refers to the first or second scenario (death not intended vs. intended death), the study classifies the cases neither according to these two categories of intention, nor referring to the withholding/withdrawing distinction, nor underlining the relevant moral factor actively administering substances. The criterion of proportionality (in withdrawing treatment or in the dosage of substances) is not mentioned either, even though it is decisive for judging the physician's intention.

Doctors who euthanized newborns with lethal injection indicated in 91% of the cases that the main reason for their action was that there was no hope of a "bearable future" for the child. In other words, these children had a real chance of survival, but the medical team - no doubt in agreement with their parents - considered that their lives were not worth living to the end.

Why do practitioners deviate from the legal framework when it comes to children who are unable to express themselves?

The authors of the study raise the question of the need for a framework for this "practice", similar to the paralegal framework established in the Netherlands through the Gröningen Protocol. Such a "framework" would in fact mean conditional authorization of physician infanticide.

Report: Concerns about euthanasia in Belgium.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A broadcast from September 30 examines concerns about euthanasia in Belgium. The broadcast in Dutch (Link to the broadcast) examines several euthanasia stories while interviewing a member of the Belgium euthanasia Commission and a well-known researcher concerning the Belgium euthanasia law.

The European Institute of Bioethics reports:

(Concerns about euthanasia) is indicative of the growing unease that reigns in Belgium with regard to euthanasia. Misunderstandings on the part of patients, discomfort of doctors faced with the demands of their patients, disobedience of the law, suffering of families, ... This podcast of about thirty minutes plunges the viewer into the heart of the world of euthanasia, world at the same time bureaucracy of the Commission responsible for controlling euthanasia, and a world full of emotion in the face of the suffering of patients who testify.

The European Institute of Bioethics (Google translated) reports that the broadcast interviews Nancy and Ruth:

Nancy, who is 48 years old and suffers from several pathologies: asthma, weakened immunity, brain tumors… requested euthanasia 4 years ago, but does not meet the criteria for an incurable and hopeless disease. The podcast also gives voice to Ruth, 28, who has suffered from severe psychiatric conditions since being sexually abused at the age of 5.

The broadcast interviews Dr Luc Proot, a long-time member of the Committee who is concerned about the increase in euthanasia deaths. The European Institute of Bioethics reports (Google translated):

The a posteriori control, that is to say once the person has already been euthanized by the doctor. According to Dr Luc Proot, member of the Commission, an a priori check would take too long and would lead to a much lower number of euthanasies ... He is nevertheless worried about the meteoric increase in the number of cases (2,655 in 2019 , ten times more than in 2003). The Commission must process more than 200 euthanasies at each of its monthly meetings, in one evening. “If we reach three or four thousand cases per year, we will no longer be able to do the job,” he says.

The broadcast interviews Belgian euthanasia researcher, Sigrid Sterckx. The European Bioethics Institute reports (Google Translated):

Sigrid Sterckx, professor of ethics at the University of Ghent, assesses at least 1/3 euthanasia not declared to the Commission in Flanders. She drew attention to the lack of transparency in the work of the Commission. Over the course of the report, we learn that the medical members are sometimes called upon to vote on their own euthanasia files. They are then not supposed to take part in the discussion, but must not withdraw when their files are analyzed. These are anonymous, but the members of the Commission often recognize the handwriting of their colleague ... It takes at least 2/3 of the votes to send a file to the Public Prosecutor. This quorum was not reached in the case of a doctor who had given a lethal drink to a lady no longer wishing to live after the death of her daughter. For Dr Proot, this quorum is “too severe.”

It is important that Sterckx upholds the truth, that studies prove least 1/3 of the euthanasia deaths are not declared to the Commission and since the Belgian Euthanasia Commission requires 2/3 of the members to demand an investigation before it is done. The one comment that is missing is the fact that Dr Wim Distelmans both operates the euthanasia clinic and chairs the Euthanasia Commission.

Australian Assisted Suicide Plan: Only the Beginning.

This article was published by HOPE Australia on July 26, 2017

By Paul Russell

The Director of HOPE Australia.

Don’t look to the starting point; look at the finish line.

The ubiquitous figure of Philip Nitschke and his death peddling organisation, Exit, are never far from the news.

Though eschewed by many on the pro-euthanasia movement, Nitschke does do straight-talking well when he exposes the ultimate end of the supposedly limited (Victorian Premier said: conservative) regimens such as that to come before Victoria.

In recent days two of his members have said in the press that the Andrews Victorian model simply doesn’t go far enough, but is a ‘good first step’.

In 2010 in the Western Australian debate, mover of the bill, The Hon Robin Chapple, told the local pro-euthanasia lobby that he knew his restricted bill wouldn’t please everyone but that it was a ‘good start’.

In New Zealand in 2013, mover of the bill, Maryan Street, responding to a question about the possibility of euthanasia for terminally ill children said:

"Application for children with terminal illness was a bridge too far in my view at this time. That might be something that may happen in the future, but not now."

In the Canadian debate, euthanasia for children, people with dementia and mental illness were excluded from the bill even though the mandate from the Supreme Court in the Carter case suggested inclusion. The government needed to get the bill through and decided to ‘investigate’ these possibilities later.

The Victorian Ministerial Advisory Panel also wrestled with where to set the initial ‘pitch’.

So what’s this all about?

It is a sales pitch, without question. It is all about securing 50% plus one of the votes in the deliberative chambers of parliament.

Once the door is open, as Director of the European Bioethics Institute based in Brussels, Carine Brochier, observed, ‘it will go wider and wider.’

Belgium nursing home ordered to compensate family for refusing to participate in euthanasia.

Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

A civil court in Leuven Belgium ordered a Belgian nursing home to compensate a family because the nursing home refused to participate in euthanasia.

According to the European Institute of Bioethics report, the civil court ordered the Sint Augustinus nursing home to pay 6000 euros to the family of Mariette Buntjens, "for the harm they suffered from having to move their mother so that she could be euthanized".

Mariette Buntjens (74) died by euthanasia in the family home in August 2011. The family claimed that the the nursing home refused to allow doctors to interview their mother at the nursing home for the purpose of euthanasia.

During the trial (May 18, 2016) the nursing home told the court that the conditions for euthanasia were not met and the nursing home claimed that the doctors had not contacted the nursing home medical team for the interview.

Courts should consider the pressure that is exerted on elderly people to die by euthanasia. The Euthanasia Prevention Coalition hopes that the nursing home will appeal the decision.

Link to a previous article on this case.

Belgian Euthanasia Control and Evaluation Commission broadens euthanasia law.

The European Institute of Bioethics reported on the latest data release on the incidence of euthanasia in Belgium. (Google translated from French)

Belgian Euthanasia Increases by 89% in four years.

The Act of 28 May 2002 concerning euthanasia stipulates that the Federal Committee on Oversight and Enforcement, shall biennially report to the legislature. Here is the sixth report, covering the years 2012-2013.

The report comprises firstly a statistical element, which we note here that the number of reported euthanasia has almost doubled in four years (an increase of 89%), from 953 reported in 2010 to 1,807 in 2013 euthanasia. The Commission considers that this increase is due to the "gradual release of information to the public and physicians." The deaths caused today represent 1.7% of all deaths in Belgium.

More and more people have also asked to be euthanized when their death was not expected in the short term (13% of euthanasia). These figures, however, should probably be revised upward to include some cases of euthanasia practiced, based on early reports of the end of life on irreversibly unconscious people. Indeed, the report ranks arbitrarily all these cases in the category of death in the near future, when the deadline is sometimes indeterminate ("When euthanasia was performed in a patient irreversibly unconscious on the basis of an earlierstatement , the deadline of death was undetermined if it was classified brief.").

Belgian euthanasia promoter admits that there are problems with euthanasia in Belgium. The author of the Belgium law admits it was designed for people with disabilities.

Alex Schadenberg with
Sari Essayah from Finland

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition (EPC) Europe was launched on Wednesday November 13 with a press conference in Brussels Belgium at 2:30 pm at the European Parliament followed by a euthanasia debate in the evening between Dr. Jan Bernheim, an oncologist, medical researcher and biomedical consultant and Alex Schadenberg (myself), the executive director and International Chair of the Euthanasia Prevention Coalition. Bernheim is a physician who lobbied for the legalization of euthanasia in Belgium.

The evening event, known as the 'Great Debate,' started with introductions by the sponsoring groups and then a short speech by Dr Kevin Fitzpatrick, the director of EPC Europe and a leader of Not Dead Yet UK. The evening continued with the debate and then there was a question and answer session with Dr Jan Bernheim and Professor Etienne Vermeersch (an author of the Belgian euthanasia law) with Carine Brochier (the European Institute of Bioethics) and myself.

Bernheim spoke first in the debate. He explained that euthanasia is necessary to eliminate suffering, and that euthanasia was already occurring in Belgium before it was legal and since euthanasia is legal it is now regulated. He stated that the number of euthanasia deaths did not increase after legalization. 

Bernheim used data in his presentation that was limited to 2002 - 2007 statistics and he did not include any of the more recent data that uncovers abuses of the law.

Bernheim also explained that in Belgium, he was a pioneer in palliative care. He stated that: 

Unlike Dame Cicily Saunders who developed palliative care in the UK to prevent euthanasia, Bernheim said he developed palliative care in Belgium in order to legalize euthanasia.

During the debate I went through the data from the recent Belgian studies indicating that: 32% of the assisted deaths are done without request, that 47% of the assisted deaths are not being reported, and that nurses were euthanizing patients, even though the law specifically states that only doctors can do euthanasia.

Alex Schadenberg

I explained that the data proves that assisted deaths that are being done without request, the assisted deaths that are done by nurses and the unreported assisted deaths share a high co-relation with the same demographic group, that being people over the age of 80 and who are incompetent to make decisions for themselves. These people are more likely to die in a hospital and usually had an unpredictable end-of-life trajectory. This vulnerable patient group is at risk of having death imposed on them. Sadly these people are also referred to as bed blockers.

I also spoke about the recent euthanasia cases in Belgium, including: the Belgian twins who died by euthanasia because they feared becoming blind, the woman with Anorexia Nervosa who died by euthanasia after her psychiatrist had sexual relations with her, the depressed woman who died by euthanasia, and the person who died by euthanasia after a botched sex change operation.

All of these euthanasia deaths were done for the reason of psychological suffering, a term which cannot be defined and is being done to an ever expanding group of people. Usually these people are not terminally ill nor physically suffering, who are being abandoned by a system that would rather kill them than provide them with excellent medical care and social support.

I stated that legalizing euthanasia is not safe and that the supposed "safeguards" are often ignored and do not work. 

I then stated that people who do not want euthanasia are not protected by the law, but rather the law protects the doctors who euthanize their patients. There has never been an attempted prosecution for killing a person outside of the parameters of the Belgian euthanasia law.

We then went to the question and answer session.

Bernheim and Vermeersch insisted that the practise of euthanasia has improved since 2002, when euthanasia was legalized in Belgium and they also insisted that similar problems exist in nations where euthanasia is not legal. 

Vermeersch, blaimed the Walloons, the french region of Belgium, for the problems with the euthanasia law, even though all of the studies that I referred to were from the Flanders Region of Belgium and the data shows that the percentage of euthanasia is lower in Wallonia.

Vermeersch suggested that there was not enough euthanasia deaths occurring because Catholic hospitals frowned on euthanasia. A 2011 Belgian study found that only 5% of the requests for euthanasia in Belgium are refused. 

Finally Vermeersch explained that the euthanasia law was specifically designed to allow people with disabilities or chronic conditions to die by euthanasia. When Dr Kevin Fitzpatrick, the director of EPC Europe and a leader of Not Dead Yet UK asked him to clarify his statement, he said: 

Just wait until you are paralysed.

As the questions from the audience became more intense, Bernheim then stated:

There are problems with the Belgian euthanasia law. 

He then stated that there is a study that may be published soon where the data shows other problems with the practise of euthanasia in Belgium.

Then Bernheim, once again, insisted that these same problems occur in nations where euthanasia is prohibited. 

I stated that there are problems in Canada, but doctors do not have access to Barbituates to kill their patients, meaning that we are not comparing apples to apples. 

I also stated that in Canada, if a complaint were filed about a doctor who intentionally kills a patient, that the doctor could be prosecuted with homicide, which is a very serious crime, whereas in Belgium where many euthanasia deaths are done outside of the law, that there has never been an attempted prosecution.

Carine Brochier thanked Bernheim for admitting that the Belgian euthanasia law is abused. She pointed out that the recent 10 year report on the practise of euthanasia and a recent book on the Belgian euthanasia law has received significant attention outside of Belgium but no attention in Belgium.

Bernheim and the euthanasia lobby ignore that euthanasia is the direct and intentional killing of a person. Abuses of the euthanasia law amount to intentional killings, acts that are defined as homicide or manslaughter in nearly every jurisdiction in the world.

It is nice that Bernheim admitted that there are problems with the practise of euthanasia in Belgium but that is cold comfort to people who are dead.

Laws that prohibit euthanasia and assisted suicide are designed to protect people.

The press conference in the afternoon was also a great success. 

The event opened with comments from David Fieldsend, the manager of CARE for Europe, he was followed by Sari Essayah, a member of the European Parliament from Finland who also sponsored the event. I then followed Sari by explaining the how important it is that EPC - Europe is being launched to oppose the legalization of euthanasia in Europe and to push back where euthanasia has already become legal.

The feature of the press conference was Dr Kevin Fitzpatrick, the director of EPC Europe. Fitzpatrick explained how euthanasia was a form of discrimination for people with disabilities and other vulnerable people. He also spoke about how euthanasia is being falsely promoted as a form of personal autonomy.

Dr Fitzpatrick made it very clear that euthanasia is not safe and that judgments that determine that a person's life is not worth living are particularly dangerous for people who have already been socially devalued in society.

Dr Kevin Fitzpatrick

Dr Fitzpatrick concluded, 

‘EPC-Europe brings people from a wide variety of backgrounds together to oppose the legalisation of euthanasia and assisted suicide, promote the best care and support for vulnerable people and to help people to find meaning, purpose and hope in the face of suffering and despair.  We invite others who share our concerns to join us and work alongside us.’

On November 14th I was interviewed by a German TV station.

I would like to thank the many people who organized the press conference and the "Great Debate" on November 13th in Brussels. Several people who attended the debate stated that they never hear about what is really happening with euthanasia in Belgium. Some of those who attended the "Great Debate" stated to me afterwards that they now understand why legalizing euthanasia is not safe. It was a great success and is an incredible beginning for EPC Europe.

Link to a youtube video on the EPC-Europe launch and debate.

Links to similar articles:

• EPC Europe launches ahead of Scottish assisted suicide bill.
• EPC Europe launches to halt 'growing threat' of state sanctioned euthanasia.
• Euthanasia deaths increase by 25% in 2012 in Belgium.