Forty-two psychiatrists, psychologists and academics published an open letter last week, calling for a "national debate on euthanasia and mental disease" in Belgium. They state that "Euthanasia as a solution to pointless, intolerable psychological suffering poses a real problem". "It involves individuals who, in principle, are not at the end of their lives and who could live longer. Caution should therefore be exercised in resolving clinical and legal issues". Current legislation does not precisely define the exact criteria for intolerable psychological suffering, but leads to a "legal no man’s land". The decision would therefore depend "simply on the way in which psychiatrists interpret or test the patients' symptoms" "based on their own hypotheses". This announcement comes at a time when "international observers are becoming increasingly alarmed about the evolving situation".
According to Ignaas Devisch, a bioethicist at Gand University in Belgium, deciding to administer euthanasia to a person who was once self-determined but is now "incapable of voicing their thoughts in an appropriate manner" highlights "the enormity of the problem". One psychiatrist points out that, "curiously, individuals suffering from less severe mental disorders that can easily be treated request euthanasia more often than those who are seriously ill. Euthanasia has become a new symptom and is often a cry for help, "Is life still worth living or are you giving up on me?" … but this symptom has particularly dangerous consequences". "Ever since the law on euthanasia was passed, there has been a kind of madness in our work. Whilst we have always been vigilant regarding the threat of suicide in psychiatric patients, we are now faced with the threat of euthanasia."
In a recent book published by the Oxford University Press entitled, Euthanasia and Assisted Suicide: Lessons from Belgium, David Albert Jones, Chris Gastmans and Calum MacKellar highlight the system's lack of transparency: "Just sixteen members supervise thousands of euthanasia cases". Only one case has been referred to a prosecutor and it is estimated that "only half of all cases are reported". "In Belgium, death by euthanasia is generally no longer regarded as an exception, warranting specific legal redress. It is often considered a normal death and even a benefit which should not be restricted by specific justifications".
 From the Oxford Anscombe Bioethics Centre in England.
 From the Faculty of Medicine at KU Leuven in Belgium.
 From the Scottish Council on Human Bioethics.
Mercatornet, Michael Cook (07/11/2017)