Almost 4000 Belgian euthanasia deaths in 2024.

Belgian euthanasia deaths more than doubled in the last 10 years.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Brussels Times reported on March 19, 2025 that there were almost 4000 Belgian euthanasia deaths in 2024. According to the Brussels Times report:

The number of patients opting for euthanasia in Belgium rose by nearly 17% in 2024, amounting to 3,991 cases, according to figures by the Federal Control and Evaluation Commission on Euthanasia (FCEE) on Wednesday.

The graph (2014 - 2024) shows that the Belgian euthanasia deaths have more than doubled in the last 10 years.

The Brussels Times stated that euthanasia represented 3.6% of all deaths in 2024 which was up from 3423 in 2023 or 3.1% of all deaths.

It is important to state that Belgium is known for having a significant number of unreported euthanasia deaths. Several years ago Dr Marc Cosyns stated that he does not report euthanasia deaths because he believes that euthanasia is no different than any other medical or palliative care procedure.

The Belgium euthanasia data indicates that there is a much higher rate of euthanasia among Dutch speaking as compared to French speaking citizens.

The figures show a sharp 25% increase in the number of Dutch-speaking patients: at 3,042, they represented more than 76% of cases in 2024. On the French-speaking side, however, there was a decline from 1,001 in 2023 to 949 last year. "The commission has no possible explanation for this," they said.

 The Brussels Times continued:

The bulk of patients were over 70 years old (72.6%) and over 43% were older than 80. "Euthanasia in patients younger than 40 years remains rare," said the FCEE. Last year, there were only 50 cases in this age group. One case involved euthanasia in a minor. "Since the extension of the law in 2014, this brings the total number of registered cases in minors to six."

Belgium expanded their euthanasia law in 2014 to permit child euthanasia. The Brussels Times reported that:

In 76.6% of cases, death was expected in the short term. However, euthanasia in patients who are not terminal did increase, especially among those with multiple chronic conditions. The vast majority of patients experienced both physical and psychological suffering (82%). Just under 16% experienced only physical pain and 1.9% only psychological suffering.

It is concerning that 26.8% of the euthanasia deaths were based on "polypathology", a term that includes people with various chronic and incurable diseases. These deaths are usually people with disabilities who are often not otherwise dying.

Luc Van Gorp, the President of Belgium's largest health insurance fund, Christian Mutualities (CM) stated in April 2024 that Belgium cannot fund its healthcare needs and requires more deaths by euthanasia. 

2020 Belgian euthanasia report. Covid-19 had a minor effect on the number of deaths.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alan Hope reported for the The Brussels Times, that the COVID-19 pandemic had little effect on the number of reported euthanasia deaths in 2020. According to the report, there were 2444 reported Belgian euthanasia deaths in 2020 which was down from 2656 in 2019 but up from 2357 in 2018.

According to the report, the number of euthanasia deaths for psychiatric reasons also dropped from 26 in 2019 to 21 in 2020 which is a significant drop from 57 in 2018.

According to the report, Wim Distelmans, the chair of the euthanasia commission suggested that some people who are not terminally ill but were approved for euthanasia based on polypathology postponed their death by lethal injection to have the opportunity to say farewell to friends and family.

Hope suggests in the article that the dip in euthanasia deaths may have been related to the COVID-19 pandemic, but I suggest that it was connected to the recent controversial court cases dealing with euthanasia for psychiatric reasons.

For instance, in 2019 Europe's top human rights court, in agreed to hear the case of a depressed Belgian woman who died by euthanasia and in 2018 three Belgian doctors were charged in a euthanasia death for psychiatric reasons.

The three doctors were acquitted in the euthanasia death, but in September 2020 a retrial was ordered for one of the doctors in the case. 

Ludo Vanopdenbosch

In 2017, Dr Ludo Vanopdenbosch, a palliative care specialist, resigned from the Belgian euthanasia commission after the commission approved the death of a woman who could not consent to euthanasia. Vanopdenbosch explained in his resignation letter that:

The most striking example took place at a meeting in early September, ... when the group discussed the case of a patient with severe dementia, who also had  Parkinson's disease. To demonstrate the patient's lack of competence, a video was played showing what Vanopdenbosch characterized as "a deeply demented patient."  

The patient, whose identity was not disclosed, was euthanized at the family's request... There was no record of any prior request for euthanasia from the patient.

An Associated Press report, revealed a rift between Wim Distelmans, chair of the euthanasia commission, and Dr. Lieve Thienpont, the psychiatrist who does the most euthanasia's for psychiatric reasons. Distelmans suggested that some of Thienpont's patients might have been killed without meeting all of the legal requirements. After the AP report, more than 360 doctors, academics and others signed a petition calling for tighter controls on euthanasia for psychiatric patients.

I hope that the Belgian people will come to realize how crazy the euthanasia ideology is and recognize the social and human destruction that euthanasia causes.

Belgian euthanasia law is broken, says academic study

This article was published by Mercatornet on February 1, 2021.

Michael Cook

By Michael Cook

Its scope is ever-widening and the safeguards are failing.

Every once in a while, a bioethics article appears which is so powerful an indictment of injustice that it sends shivers up the spines of its readers. In 1949 Leo Alexander published “Medical Science under Dictatorship” in the New England Journal of Medicine, about the atrocities committed by Nazi doctors. In 1966 Henry K. Beecher published “Ethics and Clinical Research”, also in the NEJM, whose bland title belied its searing message about ethical catastrophes in contemporary American medicine.

“Euthanasia in Belgium: Shortcomings of the Law and Its Application and of the Monitoring of Practice”, just published in the The Journal of Medicine and Philosophy, may not be as sensational as these landmark articles, but it gives them a run for their money.

Since 2002 euthanasia laws in Belgium and the Netherlands have been models for legal reform elsewhere. Canada has followed them. Portugal is about to. Spain is moving in the same direction. In Belgium euthanasia accounts for an estimated 2.4 percent of all deaths, and much more in Flanders, the Dutch-speaking section of the country.

Yet the authors of the JMP article basically argue that Belgian euthanasia is broken ethically, administratively and legally. Its scope is ever-widening and the safeguards are failing. The commission in charge of overseeing doctors’ compliance with the law is ineffective or even complicit in a pro-euthanasia agenda. To document its stunning claims, it draws not on newspaper scandals but on thoroughly researched academic research over the past 20 years and the reports of the control commission itself.

The authors, Kasper Raus, Bert Vanderhaegen, and Sigrid Sterckx, are all associated with Ghent University. It should be stressed that Kasper Raus and Sigrid Sterckx do not oppose euthanasia as a theoretical possibility. But, to their dismay, they feel that the Belgian model is broken. They make three main assertions.

“First, the scope of the Euthanasia Law has been stretched from being used for serious and incurable illnesses to being used to cover tiredness of life.” Under the 2002 Belgian law, euthanasia for “tiredness of life” is not permitted. But doctors can circumvent the law by diagnosing “polypathology”– a jumble of ailments which nearly every elderly person has – and this will be deemed sufficient for euthanasia. “Polypathology” was the reason cited in 19.4 percent of all reported euthanasia cases in 2019 and a “staggering” 47 percent of all reported nonterminal cases.

“Second, the obligatory consultation of one or two independent physicians may fail to provide a real safeguard. Their tasks are quite limited, and, more importantly, their advice is not binding anyway. The final authority to perform euthanasia lies with the attending physician who can perform it even against the (negative) advice of the consulted physicians.”

Here is one example of how the system can be gamed. If euthanasia is requested for a psychiatric condition, a psychiatrist needs to be consulted. However, if the patient has another condition, the diagnosis can be redefined as “polypathology” and a GP can approve it, eliminating the need for a psychiatric consultation.

Third, “The Commission is unable to check the fulfilment of various legal criteria, and it has substantial authority to (re) interpret the Euthanasia Law as it sees fit.” In fact, “the Commission does not seem to act as a filter between physicians who perform euthanasia and the Public Prosecutor, but instead as a shield that prevents potentially problematic cases from being referred.”

Conflict of interest is baked into the composition of the 16-member evaluation committee. Eight of them must be doctors and many of them, including the chairman, Wim Distelmans, perform euthanasia regularly. So they end up checking each other’s files for irregularities. They are supposed to recuse themselves if one of their own cases comes up – but they don’t.

Nothing illustrates the ineffectiveness — or connivance — of the Commission better than its track record. In the 18 years since legalisation, it has only referred one case to the Public Prosecutor. And this case had been filmed by an Australian broadcaster and was so obviously in breach of the law that referral was needed to keep up appearances. The doctor was acquitted.

Furthermore, research suggests that as many as one in three cases of euthanasia in Flanders are never reported – making the statistics almost meaningless.

The Commission consistently defends the smooth operation of the law, asserting that despite glitches here and there regarding “non-essential’ features, the “essential conditions” are being upheld. But the authors point that there is no legal ground for this distinction. The Commission is arrogating to itself legislative powers which it does not have.

Policy-makers and politicians in Belgium ought to be horrified by the abysmal working of their country’s euthanasia law documented by these academics. But the authors are not optimistic. They conclude by saying that whether anyone will take them seriously remains to be seen.

Amazingly, none of this is news in Belgium. Euthanasia has become so normalised that its critics tend to be regarded as the eccentrics, not the practitioners. So Wim Distelmans has little trouble in batting away condemnation.

A TV station last year gave one of the authors of the JMP article, Sigrid Sterckx, a platform to air her complaints. Distelmans’s response in an op-ed reveals a lot about the smugness of the “euthanasia establishment” in Belgium.

“This does not happen lightly … doctors do a thorough self-check beforehand … When the Committee finds an error, it is almost always a procedural error, such as forgetting to enter the date of death … If, according to the doctor(s) involved in the euthanasia, the conditions are met and this has been confirmed in the registration document, the Commission has confidence in this.”

Belgian doctors are killing thousands of their patients every year and only one of them has ever been referred for prosecution and no one has ever been convicted. Does this sound fishy to Dr Distelmans? Not at all. “There is a huge taboo among doctors about ‘helping someone with their wish to die’. So it is never an ill-considered decision.”

Never? That’s right, never. The catchphrase “Trust me, I’m a doctor” has never sounded more paternalistic and more sinister.

Belgian authorities investigating alleged illegal euthanasia deaths

This article was published by Bioedge on November 29, 2020.

Michael Cook

By Michael Cook
Editor of BioEdge 

Officials in the Belgian city of Leuven are investigating about ten euthanasia cases which may not have been done legally.

The public prosecutor was tipped off by an anonymous letter to the De Standaard newspaper. comes from a letter sent anonymously to the paper’s editorial desk. Until the investigation has been completed, police are keeping mum.

The letter says: “Our family member passed away two years ago, and we were told that euthanasia was presumed to have been carried out without the doctors informing us or following the necessary procedure. This is a very traumatic experience for us.”

Doctors are not required to notify the family if a person wants to be euthanised, but various medical associations strongly recommend it.

Two doctors were named in the letter, both of them associated with nursing homes in the Emmaus group. The head of the group, a former federal minister, Inge Vervotte, confirmed that the two doctors work with the homes, but she insisted that stressed that the cases being investigated involved patients in their private practice, and not residents of the nursing homes.

Professor Wim Distelmans, Belgium’s chief euthanasia overseer, said that his committee is supposed to be informed about every case of euthanasia, but it doesn’t always happen. “Some doctors are happy to admit that,” he admitted.

“What doctors write down, we naturally take for granted as true,” he said. “Apart from that, and rightly so, everyone is free to file a complaint with the public prosecutor’s office if they think they have reason to.”"

This article was published by Mercatornet on November 30, 2020.

Belgium’s complacent euthanasia regime under threat

More complaints have been made about doctors who break the law with impunity

By Michael Cook

Editor of Bioedge

In northern latitudes the sound of spring begins with the booming of snow-covered ice cracking in frozen rivers. Is something like that happening in Belgium?

Officials in the Belgian city of Leuven are investigating about ten euthanasia cases which may not have been done legally.

The public prosecutor was tipped off by an anonymous letter to the De Standaard newspaper. Until the investigation has been completed, police are keeping mum.

The letter said: “Our family member passed away two years ago, and we were told that euthanasia was presumed to have been carried out without the doctors informing us or following the necessary procedure. This has been a very traumatic experience for us.”

Doctors are not required to notify the family if a person wants to be euthanised, but various medical associations strongly recommend it.

Two doctors were named in the letter, both of them associated with nursing homes run by the Emmaus group. The head of the group, a former federal minister, Inge Vervotte, confirmed that the two doctors work with the homes, but she insisted that stressed that the cases being investigated involved patients in their private practice, and not residents of the nursing homes.

Professor Wim Distelmans, Belgium’s chief euthanasia overseer, said that his committee is supposed to be informed about every case of euthanasia, but it doesn’t always happen. “Some doctors are happy to admit that,” he admitted.

“What doctors write down, we naturally take for granted as true,” he said. “Apart from that, and rightly so, everyone is free to file a complaint with the public prosecutor’s office if they think they have reason to.”

In other words, according to Belgium’s Grand Poobah of Euthanasia, move along please, there’s nothing to see here.

But there is.

 

Wim Distelmans

Regulation of euthanasia in Belgium would not pass the smell test for conflict of interest in countries like the US or the UK.

Dr Distelmans, a photogenic, charismatic oncologist, is the most egregious example of a bizarre euthanasia Mafia which appears to set the agenda for euthanasia in Belgium. He is the head of the regulatory body; he is perhaps the country’s best-known practitioner of euthanasia (he has reportedly killed hundreds of people); he is the chairman of the country’s leading euthanasia lobby, LEIF; and he is the media’s go-to man for comment on euthanasia.

Conflict of interest, anyone?

The European Court of Human Rights is currently considering the case of a Belgian woman, Godelieva De Troyer, who was euthanised in 2012. Wim Distelmans was her doctor. Her son, Tom Mortier, claims not only that he was left out of the process, but that there were legal irregularities in the way that the euthanasia was carried out.

“The facts of this case, and the requirements of the law in Belgium, are so far apart that it demonstrates that if you legalize euthanasia, you cannot control it,” says Robert Clarke, an English barrister acting for Mortier.

Local authorities have dismissed the long-running case as a smear campaign. A leading Belgian intellectual, the late Etienne Vermeersch, the former president of the Belgian Advisory Committee on Bioethics, defended Distelmans in a 2014 newspaper op-ed. In it he declared, in a baffling display of chauvinistic delusion, that Belgium, together with the Netherlands and Luxembourg, where euthanasia is also legal, “stands, ethically, at the top of the world.”

Now it appears that the tragic death of Godelieva De Troyer may not have been an outlier.

Stay tuned.

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.

A retrial is ordered in the belgian euthanasia death of Tine Nys, who was diagnosed as autistic.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Tine Nys (center) with sisters.

Belgium news is reporting that a retrial has been ordered into the euthanasia death of Tine Nys who died in 2010. HLN news reported:

The Court of Cassation has decided that a new trial will be brought against the doctor who performed the euthanasia on Tine Nys. The Court has ruled that the acquittal of doctor Joris van Hove was not sufficiently motivated. There will be no retrial for the two other doctors who were also acquitted.

Joris van Hove

On January 31, 2020 a Belgian court cleared three doctors in the euthanasia death of Tine Nys (38). The Nys family of continue to argue that Tine didn't qualify for euthanasia and that she was falsely diagnosed as autistic to qualify for euthanasia.

A BBC news article from January reported:

Nys's family argue that her reason for seeking to end her life was because of a failed relationship, far short of the "serious and incurable disorder" as required under Belgian law.

Michael Cook reported for Mercatornet during the first trial that:

Dr Joris van Hove’s seamy background was highlighted in the media coverage. He has been in court before over offenses like drink driving and forgery. In 2017 he was convicted of molesting young male patients. Was his troubled background the reason why he had turned his hand to euthanasia? (On that fateful evening he had to rush off to do another euthanasia after Tine Nys.) Perhaps more testimony will shed light on this. The Dutch medical council has begun disciplinary proceedings against him.

Dr van Hove admitted that he had never done a euthanasia for psychological suffering before and that he had been clumsy. He had not completed his “end of life” training and he failed to administer the lethal injection properly. He did not have a stand for the infusion and the bag plopped onto Tine’s face as she was saying goodbye to her family. He neglected to bring a blank death certificate.

With respect to van Hove, HLN news reported:

Van Hove continues to work as a general practitioner. He was finally convicted in 2017 for indecency assault of patients, but the Order of Doctors only started a disciplinary investigation after a report by the prosecution in connection with the euthanasia process. “I have not heard from the Order of doctors anymore. I am currently at work and have no additional stress for a retrial. I have nothing more to say about the other case (the moral case, ed.). ”

Van Hove's new trial will probably be brought before a civil court early next year, but if it is concluded extensively, the case could drag on for a long time.

Tom Mortier's case concerning the euthanasia death of his depressed mother in Belgium also continues.

The family of Tine Nys have battled the Belgian legal system for 10 years.

Similar to Canada, when a euthanasia is approved by the doctors, even if the assessments are wrong, the death is considered lawful.

Hopefully justice will be done.

• Belgium court clears doctors in euthanasia death of a woman diagnosed as autistic (Link).
• Three Belgian doctors go on trial in the euthanasia death of a woman diagnosed as autistic (Link).

Belgian Catholic hospitals that provide euthanasia will cease being Catholic.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

In April, 2017; 15 Belgian psychiatric hospitals that are operated by the Belgian Brothers of Charity, announced that they would allow euthanasia in their institutions.

Soon after, Br Rene Stockman, the superior general of the Brothers of Charity, said he was devastated by the news and asked the Vatican to intervene in this case.

According to Zenit news, in August 2017, the Vatican sent a letter to the Belgian Brothers of Charity condemning euthanasia and ordered them to stop euthanasia in their psychiatric institutions.

The Congregation for the Doctrine of the Faith (CDF) has ordered the Belgian Brothers of Charity to cease identifying the psychiatric hospitals as Catholic institutions now that they permit euthanasia.

According to CNA news the letter from the CDF from March 30, 2020 stated:

"with deep sadness" the "psychiatric hospitals managed by the Provincialate of the Brothers of Charity association in Belgium will no longer be able to consider themselves Catholic institutions."

CNA news also reported that Brother René Stockman the superior general of the Brothers of Charity, said that "with a heavy heart" the religious congregation "must let go of its psychiatric centers in Belgium."

More information on this topic:

• Article: Is euthanasia psychiatric treatment? (Link).
• Article: Why legalizing medical assistance in dying for people with mental illness is misguided (Link).
• Article: Psychiatrists must prevent suicide, not provide it (Link).
• Article: Dr Mark Komrad: Why psychiatrists should oppose euthanasia (Link).

Three Belgium doctors will go on trial in the euthanasia death of a woman diagnosed as Autistic.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Tine Nys's sisters, Sophie and Lotte

The trial of three Belgian doctors who participated in the euthanasia death of Tine Nys on April 27, 2010 will begin on Tuesday, January 21 in Ghent. A BBC news article reported: 

Nys's family argue that her reason for seeking to end her life was because of a failed relationship, far short of the "serious and incurable disorder" as required under Belgian law. 

The three doctors from East Flanders who are going on trial have not been named, but they include the doctor who carried out the lethal injection and Nys's former doctor and a psychiatrist.

Tine Nys (center)

The Associated Press (AP) article from November 2018 provides more information about the charges. The AP article states that Nys (38) had been diagnosed as having a form of Autism known as Asperger's.

A International Business Times article reported in November 2018 that the family believes that Tine was falsely diagnosed as Autistic so that she would qualify for euthanasia. The family claimed that the law was broken because Tine never received treatment. The IBTimes reported:

Her sisters, however, told investigators that her suffering was caused by a broken heart after a failed relationship and not by autism. They also accused the doctors of making a rushed decision. They said the law was broken because Nys was never treated for autism and hence it had not been proven that she was suffering “unbearably and incurably.”

Dr Lieve Thienpont

The AP article reported that Psychiatrist, Lieve Thienpont, who had approved the death, had tried to prevent thee case from being prosecuted and reportedly stated:

“We must try to stop these people,” 

“It is a seriously dysfunctional, wounded, traumatized family with very little empathy and respect for others,”

Thienpont has been criticized for her handling of other psychiatric euthanasia cases.

It is positive that Belgium is prosecuting this case. I hope that this case is treated as a criminal case rather than using this case to establish a precedent for future euthanasia deaths for psychological suffering.

Euthanasia in Belgium. A son's story

Tom Mortier

Godelieva De Troyer had been suffering from chronic depression for twenty years. The family was unaware when she was euthanised by a doctor who co-chairs the federal euthanasia regulator and who co-founded a euthanasia organisation that De Troyer had just given money to.'

Tom Mortier hadn't given much thought to Belgium's euthanasia laws. He didn't think they affected him. Tom is a university professor in Belgium, where he has lectured since 2006. For Tom, it seemed that if a person wanted to die, who are we to stop him? Why can't that person simply make that choice? Besides, it doesn't affect anyone else.

'Tom's perspective changed forever one day when he received a phone call. The caller was from a hospital, letting him know that he needed to take care of his mother's affairs since she had been euthanized.'

To read more about Tom's story, visit ADF International's 'Affirming Dignity' campaign.

More articles about Tom and his mother's death:

• Europe's top human rights court will hear case of depressed Belgian woman who died by euthanasia (Link).
• Depressed mother died by euthanasia, her son challenges the law (Link).
• Belgian euthanasia promoters attack man whose depressed mother died by euthanasia (Link).

Belgian doctor charged with murder of four patients.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

CHR van Hoei Hospital

A doctor in Belgium has been charged with murder in the deaths of four patients in the palliative care department of the CHR van Hoei Hospital. 

An article published by Nieuwsblad.be stated (google translated):

The court has suspected a doctor from Tihange of four murders. The man, who worked in the palliative care department of the CHR van Hoei Hospital, is believed to have killed at least four patients with a syringe of morphine mixed with other substances. "Because they were suffering". 

The four victims fell in one weekend in 2017, when the doctor was on duty. The investigation started after an anonymous complaint that had arrived at the hospital. 

The court is also investigating four other "irregular deaths that did not proceed according to the law on euthanasia". Two cases of patients who survived the deadly syringe are also being investigated. 

The doctor, who has since been dismissed, was arrested but released under strict conditions. He must keep himself available to the judiciary.

Even though Belgium has the most tolerant euthanasia laws, they still have doctors who are killing outside of the law. It also sounds like the doctor is using a "mercy killing" defense to suggest that he had no choice because they were suffering.

The Belgian government has not dealt with the fact that a 2015 study showed that more than 1000 people died by assisted death without request in 2013. In every jurisdiction in the world, data, such as this would create great concern, but in Belgium it is simply a statistic.

Euthanasia is problematic because, what is properly defined as murder becomes a legal act when a doctor follows the protocol. The doctor who doesn't follow the protocol breaks the law. The crime is then breaking the protocol and not murder and yet from the beginning it is murder.

Belgian euthanasia doctor admits that 1000 people die each year by euthanasia without request.

Alex Schadenberg
Euthanasia Prevention Coalition

Belgian 2014 euthanasia protest.

All is not good in the Belgian euthanasia lobby as leaders and advocates argue about organ donation by euthanasia and euthanasia without request.

An article by Simon Demeulemeester and Jeroen de Preter published in The Knack last year concerns comments by euthanasia doctors Marc Cosyns and Wim Distelmans. In response to Ivo Poppe, a nurse who admitted to killing 10 - 20 people, including his mother, Cosyns told the Belgian media that each year there are 1000 assisted deaths without request.

Dr Marc Cosyns

Cosyns only restated the data from a study published in the NEJM (April 19, 2015)  indicating that 1.7%  of all deaths  (more than 1000) in the Flanders region of Belgium, were hastened without explicit request in 2013.

An earlier study found that 1.8% of all deaths in the Flanders region of Belgium were hastened without explicit request, in 2007, meaning that the problem has been consistent.

Distelmans, the chair of the Belgian euthanasia commission, attempts to cover-up the data from the study by stating that ending of life without consent occurred before euthanasia became legal and is only done when a physician has "no choice." Distelmans says (google translated):

Doctors in particular who stood with their backs against the wall. Their decision was always well-considered and well-reasoned. If a nurse was involved, it was purely to provide technical assistance, for example by installing an infusion. It is unthinkable that nurses would administer a euthanatic drug on their own.

Distelmans not only tries to covers-up the data from the  NEJM (April 19, 2015) study, he covers-up the data from a study that was published in the CMAJ (May 17, 2010)  indicating that in 2007, nurses participated in 248 euthanasia deaths with 120 of those deaths being done without the explicit consent of the patient. The data also indicated that nurses participated in 12% of the euthanasia deaths with a request from the patient and 45% of the euthanasia deaths that they participated in were done without the request of the patient.

Several years ago Dr Cosyns stated that he does not report the euthanasia deaths that he does because he believes that euthanasia is no different than any other medical or palliative care procedure. The Knack article reports that Cosyns wants the euthanasia law to now be dismantled.

Belgian euthanasia doctor supports euthanasia by organ donation.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Dr Marc Cosyns

A well known Belgian euthanasia promoter, Dr Cosyns, makes the case for euthanasia by organ donation in an article in the Knack. 

In his article, Cosyns refers to a patient "Vera" who is nearing death and wants to donate as many organs as possible. Based on Vera's story, Cosyns argues that the organ donation rules need to change since it is not possible to donate a heart when transplant is done after euthanasia. Cosyns writes (google translated):

In ' Medisch Contact' I read an article about 'donation-after-euthanasia-can-more-than-expected - too little organ donation after euthanasia'. In the Netherlands, organs were transplanted 46 times from a patient who had euthanasia during the 2012-2017 period. 35 times in the period 2005-2017 in Belgium. That can be done much more often, the doctors and researchers calculated. However, according to the 'Directive on organ donation after euthanasia', doctors are not allowed to start talking about the possibility of transplantation because the question cannot be experienced as pressure. 

Nevertheless, patients do benefit from information on this. "For many patients, this way of giving meaning to death is a perspective that unfortunately often remains underexposed," they write, arguing for greater awareness. Nevertheless, some are hesitant about the link with euthanasia, noted with criminal / religious crime. Euthanasia also means a Non Heart Beating donation.

According to Cosyns article in the Knack, he wants the organ donations rules need to be amended because it is not possible to donate a heart after euthanasia. 

Cosyns is consistent. If it is OK to kill someone by lethally injection (euthanasia) why isn't it OK to kill them by removing their organs?

Several years ago Dr Cosyns stated that he does not report the euthanasia deaths that he does  because he believes that euthanasia is no different than any other medical or palliative care procedure. Dr Cosyns was not reprimanded after admitting that he doesn't report euthanasia, making it understandable that around 40% of the euthanasia deaths in 2013 were not reported.

Research: Euthanasia of prisoners in Belgium.

Alex Schadenberg

Executive Director - Euthanasia Prevention Coalition

A Belgian friend and supporter emailed an interesting article, that he translated, concerning research on euthanasia and prisoners in Belgium.

An article by Jan Lippens that was published in the Knack on January 2, 2019 looks at the research by Caroline Devynck concerning euthanasia requests by prisoners in Belgium.

Lippens reports that Between 2011 and 2017, 23 prisoners in Flanders Belgium asked for euthanasia. 18 requests were from men, 5 were from women. There is no indication how many of these requests ended in death. Most of the requests were from prisoners convicted of serious violent or sexual offenses. Criminologist Caroline Devynck contacted 17 of these prisoners for her doctoral research titled "How far can you go before a punishment becomes unworthy?"

Carolyn Devynck

According to Lippens Criminologist Caroline Devynck (VUB) doctoral research, is unique because end-of-life questions from detainees have never been studied scientifically. In November Devynck presented the results of her research at a symposium organized by the Expertise Center 'Worthy End of Life' by Professor Wim Distelmans (VUB), as part of a study tour of the physical and mental impact of life in prisons, but also in hospitals and residential care centers, all institutions where people in extremely dependent situations live.

Distelmans operates a euthanasia clinic in Belgium and he is the chair of the Belgian euthanasia evaluation and control commission.

Frank Van den Bleeken

Lippens explains that euthanasia among prisoners provokes sharp emotional discussions. A few years ago Frank Van den Bleeken asked for euthanasia. Van den Bleeken was convicted of murder and raped several women, but because of a mental illness he had been interned. After thirty years of imprisonment, with no chance of cure, he began a request for euthanasia in 2010 based on unbearable psychological suffering.

Belgium euthanasia and capital punishment.

Lippens interviews Devynck about her research in the article. Devynck explains the characteristics of the prisoners:

There were two requests from people with terminal cancer. The other requests were about unbearable psychological suffering. It was striking that not only the interned but also 'ordinary' detainees applied for euthanasia for that reason.

Most of the prisoners were asking for euthanasia based on a loss of hope or purpose.

With seventeen people who I followed intensively, the question was: what remains of me in life? Some do not stand a chance for penitentiary leave, release on probation or conditional release. After years they come to the conclusion: this is it, my life. They no longer have any perspective, their lives have been reduced to the daily walk and watching TV. They become increasingly isolated. Some do not even go to the walk anymore, because they fear violence from other prisoners, for example. This fear occurred more often among sex offenders.

...The longer people are in prison, the more contacts outside the prison will disappear. Family, friends or acquaintances no longer visit, break all contact or are death. One younger man withdrew his application during my research because he suddenly got another spark of hope from the outside world. I was happy about that.

Devynck states that many of the prisoners were in jail for a long time. She said:

If you have been stuck for more than twenty years, there is not much left. That is existential suffering and also a form of psychological suffering.

Devynck explained that most of the requests for euthanasia came for murders or sexual criminals:

The male applicants were mainly guilty of violent crimes such as murder and manslaughter, or sexual offenses. 

The most distressing conclusion is that 90 per cent of the applicants - including men and women - were themselves sexually or psychologically abused. It changed their self-image. The majority of euthanasia applicants were already older. ...you also saw in certain men that they consider their sexual offenses almost as normal. There was no guilt.... If they then evaluated their lives, they had nothing but misery and pills... They saw their situation as hopeless.

Devnyck states that Wim Distelmans even questions whether it is possible to determine if the requirements of the euthanasia law has been met by these prisoners.

The interview concludes with Devnyck commenting on the "gap in the law." She states:

The gap is in the whole society because care and therapy for those who suffer psychologically is not accessible to everyone. In the context of the prison, that gap is only much clearer. On the one hand, as a society, we advocate self-determination and a worthy end of life, but on the other hand we expect criminals to be severely punished. I understand that some people find life less terrible than the death penalty, but using euthanasia as a covert death penalty simply does not work. The law was never meant for that.

Devnyck's analysis of prisoners who requested euthanasia helps us understand why the wider population requests euthanasia. Her data indicates that only 2 of the 23 prisoners who requested euthanasia, were actually dying. The other 21 requested euthanasia based on psychological suffering. Many of the 21 requests were from prisoners who were never going to be released from prison and had lost hope in living.

The same reality exists for other people in society who request euthanasia. The person may have a significant medical condition, but the person has lost hope or feel that they have no reason to live, they do not want to be a burden on others, or they feel emotionally or psychologically distressed by their life condition. 

Euthanasia is not a freedom or a "victory for autonomy" but rather a social and cultural abandonment of people at a low time of their life.

A Psychiatrist who visited Belgium comments on euthanasia for psychological reasons.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

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Dr Mark Komrad

r Mark Komrad, a clinical psychiatrist and ethicist, visited Belgium in 2017 to participate in a debate on psychiatric euthanasia. On June 21, the Psychiatric Times published his article uncovering the issues related to euthanasia for psychiatric reasons.

Komrad writes about what led him to become an expert on euthanasia for psychological suffering:

On Sept 8, 2017, I was invited to give the opening lecture in a fairly remarkable symposium in Belgium on their 15-year-old practice of the voluntarily euthanasia of psychiatric patients. I spoke to an audience of Belgian mental health professionals and administrators. My charge was to present to them something of “the outside world’s view” of this issue and to touch on the recently issued Position Statement by the American Psychiatric Association (APA) regarding medical euthanasia: “. . . a psychiatrist should not prescribe or administer any intervention to a non-terminally ill person for the purpose of causing death.”

Komrad then establishes the current situation concerning psychiatric euthanasia in Belgium:

In 2002 Belgium legalized euthanasia by physician (typically by injection) at the request of patients, and removed any distinctions between terminal vs. nonterminal illness, and physical vs. psychological suffering. As long as the condition is deemed “untreatable” and “insufferable,” a psychiatric patient can be potentially eligible for euthanasia. There is a consultative process that basically needs a minimum of two doctors to agree about the patient’s eligibility. Also, the patient gets to weigh-in on whether their condition is “treatable.” Since the patient has the option to refuse treatments, this refusal may create an “untreatable” situation. 

The evaluation pathway even makes it possible for a psychiatric patient to be euthanized with only a single psychiatrist in support. Once approved, some patients are euthanized by their own treating psychiatrist. Alternatively, there are other physicians who will perform euthanasia; though the number of such euthanizers is small (in fact, a large proportion of psychiatric euthanasia's are performed by one particularly zealous Belgian psychiatrist, Dr Lieve Thienpont). 

It was made clear to me on my arrival that the majority of Belgians and their mass media support this practice. I learned that although a number of psychiatrists feel very negatively about this, they are reluctant to speak out for fear of being vilified in the press. Though back in 2002 several individual psychiatrists lobbied against the proposed law, medical organizations did not, and have not expressed objections. Organized medicine has not articulated a stance on this because there isn’t a strong enough consensus among doctors, not even psychiatrists, I was told. Also, I learned there isn’t a strong tradition of ethics activities at the organizational level, or significant focus on an ethics code. The Belgian professionals were quite aware that the majority of the world ’s medical associations disagree with the medical euthanasia in general. It seemed almost a point of honor that they differed in this way, as if they are on higher moral ground in a bold new era of medical ethics.

Komrad then writes about his presentation he gave in Belium on psychiatric euthanasia:

My presentation was titled “Voluntary Euthanasia of Patients with Mental Illnesses: An Inversion of Psychiatry’s Fundamental Clinical and Ethical Values.” I reviewed a great deal of data about psychiatric euthanasias in The Netherlands and Belgium, demonstrating how there has been a profound “mission creep” in both countries, with an ever-widening diameter of eligibility, leading to an appalling slippery slope. I did make mention of the ways that the leading and most celebrated psychiatrists in Nazi Germany lost their ethical moorings, swept along by a powerful social movement, and participated with dedication and relish in the “T4” program to exterminate the mentally ill. 

The lesson is how physicians are vulnerable to a social tsunami, which can detach us from core medical ethics with enthusiasm, convinced we are pioneering a virtuous new moral frontier. I reviewed the positions of several international medical and psychiatric bodies that are against some of these practices, including that of the APA. I then addressed a variety of social, clinical, financial, and ethical concerns about psychiatric euthanasia. I particularly emphasized what I called the “fundamental ethos of psychiatry” to prevent suicide and its special skill set to address hopelessness, helplessness, desire to die, and inability to see a better future. Human suffering is our core focus, and we have a skill set to accompany a patient in their suffering, no matter what the diagnosis. Our approach is to address that suffering in various ways, but not by snuffing out the life of the sufferer. We prevent suicide, not provide it.

Komrad then commented on the justification that was made for psychiatric euthanasia:

I went with an open mind to try and grasp the arguments in support of psychiatric euthanasia from the people and clinicians immersed in it as a “treatment” option. What I heard from several other speakers (philosopher, psychiatrist, psychologist, Jesuit priest who was also a physician) was actually very disturbing to me. I was powerfully struck that these professionals, who had been living with this as the law of the land, a fait accompli, were starting with the accepted conclusion that it was OK, and reasoning backwards to create an a postiori justification. The conclusions are a given, so arguments were sought specifically to justify the conclusion, and ideas that would lead to a contradictory conclusion were filtered out. It was a powerful kind of sophistry. Indeed, there was even an apologetic tone by some speakers; they seemed to be apologizing to themselves as many were uncomfortable with the conclusion. 

The speaker who represented the new ethical stance of The (Christian) Brothers seemed to convey in his apologetic tone—“we really don’t want to do this, but the society we live in wants it.” They were justifying literally killing (on request) the very kinds of patients to whose hopelessness and helplessness psychiatrists are devoted to address. My reaction was visceral; I found myself eyeing the exits to bolt out and get some fresh air. It wasn’t hard to imagine that I was at a psychiatric conference in pre-war Germany, listening to learned speakers intellectualize uses of psychiatry that were trying to topple the millennia-old gyroscope of medical ethics in service of radical progressive shifts in social mores. 

Euphemisms abounded that permitted a disengagement from the prior, traditional moral baseline. There was talk of “compassion,” “listening to and respecting the patient’s wishes,” “the end of doctor-knows best,” and an apotheosis of autonomy to the point where it actually seemed fetishized. It was certainly easy to follow the arguments for compassion, not abandoning the patient, taking the patient’s suicidal wishes seriously, exploring the extensive underlying reasons for wanting to die, etc. All of these penultimate approaches sounded like good, solid psychiatry.

Komrad states that Belgium has developed two new areas of psychiatry, that may have positive outcomes. The Belgium Recovery Model uses peer support among psychiatric patients approved for euthanasia. They have also developed "palliative psychiatry" which is a form of intensive psychiatric treatment for psychiatric patients who have requested euthanasia.

I am not an expert but I would suggest that the Belgium Recovery Model may have the opposite effect, meaning, peer support among psychiatric patients approved for euthanasia may in fact create a greater desire to die by lethal injection.

Komrad completed his article by expressing little to no hope for change in the Benelux countries:

I don’t want to say that nobody had problems with it. There were some calls for modification of the law, extending the wait between approval and administration of euthanasia for psychiatric patients to at least a year. The sense was the system needed some “fine tuning” but was fundamentally acceptable. Outrageous cases are “exceptions to an otherwise good system.” There was, however, a small group of professionals who saw the whole situation as very negative, dire, and deeply disturbing. On two different nights they invited me to dinner to ventilate their concerns in a more private setting. 

What was not presented at all was justification for taking the very last step— killing the patient, for the physician him or herself to engage in killing. I had hoped at the very least to hear the Belgian health care establishment support euthanasia, but protest that it should not be occurring in the House of Medicine, by the hand of a physician, and unhappiness that society had come to expect that of them. It was quite clear to me that these professionals who spoke have been living with this for far too long. They are too far down the rabbit hole at this point. Those who became mental health professionals 15 years ago were professionally born into this paradigm, and it’s all they have known their entire careers. The youngest physicians have grown up in this paradigm since childhood. 

Sadly, I left without much hope for Belgium to reverse its stance on psychiatric euthanasia. It has been too many years, there is too much widespread buy-in, the professional societies cannot get sufficient coherence to express a viewpoint or take a stand, and psychiatrists fear being seen as cruel, or retrogressive, or “crypto-Catholic” if they speak out too loudly as individuals. The press will flock to their door with unpleasantly critical, challenging interviews. As of the publication of this article, The Belgian Brothers of Charity remain open to performing euthanasia in their facilities.

The influences of the APA and WPA as prominent voices of organized psychiatry are important. But, unless the medical and psychiatric establishment in Belgium can get its act together and speak coherently against this appalling practice, objecting psychiatrists will have to continue to whisper their worries to each other, and little Belgium will likely continue to convince themselves that they are virtuously righteous in letting their doctors provide suicide to certain non-terminal suicidal patients who are “untreatable” and request death.

I am not so negative about the prospects for Belgium. Similar to any social change, once people come to understand the horrific outcome of permitting euthanasia, overtime they will also come to reject the killing. If not, someday, they will uncover the deception of euthanasia and decide that the killing must stop.