BRUSSELS—Tom Mortier received a message at work last year saying his 64-year-old mother had died the day before, and he quickly found out she'd been euthanized. Mr. Mortier, who teaches college chemistry, was shocked. Though estranged from his mother, he knew she was depressed and had spoken of euthanasia. But he had no idea this could happen, he said, especially since she wasn't physically ill, and her children weren't informed. "This is irreversible," he said. "One day my mother is dead." In the past 10 years since the country legalized the practice, more than 5,530 Belgians have signed up for ... FULL TEXT AVAILABLE VIA PROQUEST NEWSPAPERS DATABASE (FROM IALS/SAS)
Some background information about the context of euthanasia in Belgium is presented, and Belgian law on euthanasia and concerns about the law are discussed. Suggestions as to how to improve the Belgian law and practice of euthanasia are made, and Belgian legislators and medical establishment are urged to reflect and ponder so as to prevent potential abuse. This study is based on a critical review of the literature supplemented by interviews I conducted in Belgium with leading scholars and practitioners in February 2003 and February 2005 about the practice of euthanasia. I first provide background information about euthanasia in Belgium and then discuss its law on euthanasia and voice some concerns, suggesting some constructive ideas to improve the practice of euthanasia.
A Belgian man has chosen to die by euthanasia, after his sex change operation turned him into “a monster”. Nathan Verhelst, 44, was administered legal euthanasia on Monday afternoon, on the grounds of “unbearable psychological suffering”
Belgium is set to debate this week whether or not it will extend its laws allowing euthanasia to include children and those suffering from long-term “diseases of the brain” like Alzheimer’s.
AFP - Belgium is considering a significant change to its decade-old euthanasia law that would allow minors and Alzheimer's sufferers to seek permission to die. The proposed changes to the law were submitted to parliament Tuesday by the Socialist party and are likely to be approved by other parties, although no date has yet been put forward for a parliamentary debate. "The idea is to update the law to take better account of dramatic situations and extremely harrowing cases we must find a response to," party leader Thierry Giet said. The draft legislation calls for "the law to be extended to minors if they are capable of discernment or affected by an incurable illness or suffering that we cannot alleviate." Belgium was the second country in the world after the Netherlands to legalise euthanasia in 2002 but it applies only to people over the age of 18.
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Rurik Löfmark, Tore Nilstun, Colleen Cartwright, Susanne Fische, Agnes van der Heide, Freddy Mortier, Michael Norup, Lorenzo Simonato and Bregje D Onwuteaka-Philipsen for the EURELD Consortium
Johan Bilsen, Robert Vander Stichele, Bert Broeckaert, Freddy Mortier, Luc Deliens, Changes in medical end-of-life practices during the legalization process of euthanasia in Belgium, Social Science & MedicineVolume 65, Issue 4, , August 2007, Pages 803-808. Keywords: Belgium; Euthanasia; Legalization; End-of-life decisions; Health policy
Surveys in different countries (e.g. the UK, Belgium and The Netherlands) show a marked recent increase in the incidence of continuous deep sedation at the end of life (CDS). Several hypotheses can be formulated to explain the increasing performance of this practice. In this paper we focus on what we call the ‘natural death’ hypothesis, i.e. the hypothesis that acceptance of CDS has spread rapidly because death after CDS can be perceived as a ‘natural’ death by medical practitioners, patients' relatives and patients. We attempt to show that the label ‘natural’ cannot be unproblematically applied to the nature of this end-of-life practice. We argue that the labeling of death following CDS as ‘natural’ death is related to a complex set of mechanisms which facilitate the use of this practice. However, our criticism does not preclude the view that CDS may be clinically and ethically justified in many cases.
Van den Block and colleagues’ paper about end of life decision making and end of life care provides important data to support the debate about physicians’ role in death and dying. Their finding that end-of-life decision making seems to be associated with a high use of palliative care is not surprising, because a protracted dying process with much suffering may be expected to result in both a high use of palliative care and a high frequency of end-of-life decisions, especially for assertive patients with clear preferences concerning the end stage of their lives. More importantly, the study’s results suggest that palliative care is not able to prevent physicians and patients from making medical decisions that hasten death. This may be due to insufficient quality, that should be further improved, but it may also be indicative of principal limitations of palliative care, that apparently cannot address all suffering at the end of life.
In the linked study (doi:10.1136/bmj.b2772), Van den Block and colleagues report a national mortality follow-back study of end of life care in Belgium conducted during 2005 and 2006. The findings are a valuable contribution to understanding the context of dying in Belgium. They detail the frequency of team based palliative care; involvement of generalists; use of intensive alleviation of symptoms, which can extend to palliative sedation (termed continuous deep sedation); and the incidence of euthanasia and physician assisted suicide. However, the authors’ interpretation of the data and the conclusions they reach raise questions. Their conclusion that life shortening decisions, including euthanasia and physician assisted suicide, are not related to a lower use of palliative care in Belgium and often occur within the context of multidisciplinary care, misrepresents the frequencies they report and is tangential to the main findings.
May 28, 2012 marks the 10th anniversary of the legalisation of euthanasia in Belgium, with the Netherlands following suit a year earlier¹ and Luxembourg doing the same in 2009². To date, these three Benelux countries are the only ones to have legalised the act of intentionally killing a person who makes such a request. At a time when legalisation of euthanasia is being debated in several European countries, notably in France, it would appear appropriate to take stock of the last 10 years of implementation of the law on euthanasia in Belgium.
Marlisa Tiedemann Dominique Valiquet Law and Government Division Revised 17 July 2008 PRB 07-03E PARLIAMENTARY INFORMATION AND RESEARCH SERVICE SERVICE D’INFORMATION ET DE RECHERCHEPARLEMENTAIRES
End of life decisions that shorten life, including euthanasia or physician assisted suicide, are not related to a lower use of palliative care in Belgium and often occur within the context of multidisciplinary care.
Lieve Van den Block, Reginald Deschepper, Johan Bilsen, Nathalie Bossuyt, Viviane Van Casteren and Luc Deliens BMC Public Health 2009, 9:79 doi:10.1186/1471-2458-9-79
This article is concerned with the practice of euthanasia in Belgium. Background information is provided; then major developments that have taken place since the enactment of the Belgian Act on Euthanasia are analysed. Concerns are raised about (1) the changing role of physicians and imposition on nurses to perform euthanasia; (2) the physicians' confusion and lack of understanding of the Act on Euthanasia; (3) inadequate consultation with an independent expert; (4) lack of notification of euthanasia cases, and (5) organ transplantations of euthanized patients. Some suggestions designed to improve the situation and prevent abuse are offered.
PUTTE, Belgium—In this small village amid an array of Flemish farms, they were an unusual but seemingly happy pair, two 43-year-olds who were identical, deaf twins. Townspeople recalled seeing Marc and Eddy Verbessem around town frequently, talking animatedly in sign language together, tooling around in a small blue car, and regularly buying two copies of a popular gossip magazine. No one expected them to decide to die on purpose.
A public policy think tank, which aims to promote “rational, evidence-based and measured debate” on the subject of assisted dying, has been launched by two members of the House of Lords. Lord Alex Carlile and Baroness Ilora Finlay, co-chairs of Living and Dying Well, have both fervently opposed any change in the law on this issue. Their new organisation is neither “neutral” nor “a campaigning pressure group,” instead, they want to present “hard evidence” to parliament and the public in an objective and informative manner.
Abstract Objectives Potentially life-shortening medical end-of-life practices (end-of-life decisions (ELDs)) remain subject to conceptual vagueness. This study evaluates how physicians label these practices by examining which of their own practices (described according to the precise act, the intention, the presence of an explicit patient request and the self-estimated degree of life shortening) they label as euthanasia or sedation. Methods We conducted a large stratified random sample of death certificates from 2007 (N=6927). The physicians named on the death certificate were approached by means of a postal questionnaire asking about ELDs made in each case and asked to choose the most appropriate label to describe the ELD. Response rate was 58.4%. Results In the vast majority of practices labelled as euthanasia, the self-reported actions of the physicians corresponded with the definition in the Belgian euthanasia legislation; practices labelled as palliative or terminal sedation lac
In Belgium, where euthanasia was legalized in 2002, we conducted a follow-up study in 2007 to two largescale nationwide surveys on medical end-of-life practices that had been conducted in 1998 and 2001. This follow-up study enabled us to investigate differences in the frequency and characteristics of these practices before and after the enactment of the law.
Background The differential diagnosis of disorders of consciousness is challenging. The rate of misdiagnosis is approximately 40%, and new methods are required to complement bedside testing, particularly if the patient's capacity to show behavioral signs of awareness is diminished. Conclusions These results show that a small proportion of patients in a vegetative or minimally conscious state have brain activation reflecting some awareness and cognition. Careful clinical examination will result in reclassification of the state of consciousness in some of these patients. This technique may be useful in establishing basic communication with patients who appear to be unresponsive.
This article examines the reporting requirements in four jurisdictions in which assisted dying (euthanasia and/or assisted suicide) is legally regulated: the Netherlands, Belgium, Oregon and Switzerland. These jurisdictions were chosen because each had a substantial amount of empirical evidence available. We assess the available empirical evidence on reporting and what it tells us about the effectiveness of such requirements in encouraging reporting. We also look at the nature of requirements on regulatory bodies to refer cases not meeting the legal criteria to either prosecutorial or disciplinary authorities. We assess the evidence available on the outcomes of reported cases, including the rate of referral and the ultimate disposition of referred cases.
One out of two euthanasia cases is reported to the Federal Control and Evaluation Committee. Most non-reporting physicians do not perceive their act as euthanasia. Countries debating legalisation of euthanasia should simultaneously consider developing a policy facilitating the due care and reporting obligations of physicians.