Euthanasia in Belgium: principal elements of the ongoing debate

Publié le : 26 April 2013

Currently in Belgium several bills being debated in the Senate are designed to extend the field of application of the law on euthanasia. However, two issues predominate: making euthanasia accessible to minors and the legitimacy of the conscience clause.

Reviewing the application of the 2001 law in the Netherlands and the 2002 law in Belgium, a commentator writing in English considers that the country is on a slippery slope. Regarded as an "ultimate option in specific situations," euthanasia "has seen its indications widened over time […] and its application now appears in situations not imagined when it was voted through twelve years ago."
While some senators are calling for a speeding up of the debates on extending euthanasia to minors, others regard this as preventing the expression of all the opinions and creating the risk of obtaining an "imprecise law that does not establish clear landmarks." The bill calls for the extension to minors who are "mentally competent" and to babies "with no chance of surviving." But, in Belgium, experience shows that "thanks to the care given in the hospital and at home with the help of liaison teams, no end of life request has been made in the past ten years by a minor." Moreover, if the pain is properly controlled, given that there are many means available to soothe it, "the child gets the full benefit of the last moments of life remaining, while being fully conscious of what is on the way." Hence, palliative care must be developed more effectively and the teams given more support. But the bill also covers an extension to premature babies of 24 to 26 weeks and "even if the pregnancy lasts longer, the medical team may be convened at the requests of each of the parties in the case of serious complications." But, the article points out, this point is confused and lacks precision. Some critics denounce the use of the notion of "serious complications": if it is loosely interpreted it "could open the door to euthanasia for children born at full term with a disability but perfectly viable," such as newborn babies with Down syndrome. However, others believe that the adoption by the Senate of a bill that authorises euthanasia of the newborn with a disability would contradict the recent adoption of the Senate of "a proposed revision of the Constitution guaranteeing the right of disabled people to benefit from measures that ensure their independence as well as their cultural, social and professional integration."
At the same time, the Senate is debating a bill aimed notably at clarifying the conscience clause. Currently, doctors can defend their right to refuse treatment by citing the conscience clause and many observers affirm that institutions such as hospitals and retirement homes "adopt a policy of incorporating it in their working relations with the medical teams."           
Gilles Genicot, a professor at Liège University and member of the Federal Commission for the Control and Evaluation of Euthanasia, says that "there is no juridical basis that legitimises care ‘institutions’ in having recourse to the conscience clause." And, according to him, this is the point of view that will be adopted by the Consultative Committee on Bioethics in its forthcoming opinion on this issue.
Sylvie Tack, a postdoctoral researcher at Gand University, believes that two limits are being reached here: "that of the ‘right of the patient’ and his/her freedom of choice, and that of the ‘rights of the employees’ of institutions, including doctors, limited by the obligations involving their work" notably. She adds that "the conscience clause laid down by the law on euthanasia is limited to the ‘doctor’ or another ‘person’ " and so the law needs to specify that this means a ‘natural person’.

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