Euthanasia and assisted suicide cases have risen rapidly in Belgium and the Netherlands since the practices were legalized in 2002, according to a bioethics institute.
The Vienna-based Institute for Medical Anthropology and Bioethics (IMABE) noted on Feb. 12 that cases had increased in Belgium from just 24 in 2002 to 2,656 in 2019. In the same period, cases had surged in the Netherlands from 1,882 to 6,361.
IMABE, which was founded in 1988 and is linked to the Austrian Catholic bishops’ conference, cited a study published last month by the ethicist Kaspar Raus from Ghent University, which concluded that safeguards intended to govern euthanasia in Belgium had failed in practice.
Raus and his co-authors offered three reasons for this failure, said CNA Deutsch, CNA’s German-language news partner.
First, the scope of application of the Euthanasia Act of 2002 has expanded. According to the law, assisted suicide is only permitted in the case of serious, incurable, and unbearable diseases. But in practice, being “tired of life” is also an accepted reason.
Doctors are also reportedly able to bypass the law by diagnosing so-called “polypathology.” This refers to multiple complaints that occur in old age, such as loss of vision and hearing, chronic pain, rheumatism, weakness, and fatigue.
The study said that in 2019, “polypathology represented 17.4 percent of all reported euthanasia cases and a staggering 47 percent of all reported nonterminal euthanasia cases.”
Second, the study suggested that the mandatory consultation with one or two independent doctors does not offer any real security. The doctors’ competencies are limited and, above all, their assessment is not binding.
In the end, “The final authority to perform euthanasia lies with the attending physician who can perform it even against the (negative) advice of the consulted physicians.”
Third, the authors criticize Belgium’s Federal Control and Evaluation Commission for Euthanasia. 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,” they write. Just one case has been referred to the prosecutor so far.
Several commission members have reportedly left the body in protest at what they say is a lack of transparency and coherence. One report suggested that in Flanders, the Dutch-speaking northern part of Belgium, only one in three euthanasia cases is officially reported.
In the Netherlands, too, the number of euthanasia cases among seniors suffering from the effects of old age is increasing, according to IMABE.
A team of ethicists and scientists from Utrecht University has investigated the phenomenon known as “multiple geriatric syndromes.” A total of 1,605 cases of assisted suicide were officially reported between 2013 and 2019 and were classified in this category.
In a study published in December in the Journal of the American Medical Association (JAMA), the scientists concluded that suffering in old age is not just due to physical limitations. Older people perceive their life as “unbearable” when existential crises and loneliness call into question the meaningfulness of their life.
The question of what is unbearable is difficult to answer in this “complex interplay of physical, psychological, and existential suffering that changes over time,” according to the authors.
Susanne Kummer, managing director of IMABE, said that the developments in Belgium and the Netherlands should give Austrian legislators food for thought.
Austria’s top court ruled in December that assisted suicide should no longer be a criminal offense, ordering the government to lift the prohibition in 2021.
Last month Portugal’s parliament backed a bill approving euthanasia. If the bill is signed into law, Portugal will become the fourth country in Europe to legalize the practice, alongside the Netherlands, Belgium, and Luxembourg.
Earlier this month, Catholic leaders and human rights advocates in Ireland expressed concern over a bill that would legalize physician-assisted suicide.
In September 2020, the Vatican’s doctrinal congregation reaffirmed the Church’s perennial teaching on the sinfulness of euthanasia and assisted suicide.
“The image of a freely chosen, self-determined death is thrown into doubt when elderly people choose killing on demand or assisted suicide because they are socially isolated and increasingly anxious about their own frailty,” Kummer said.
Calling for “more realism” in the assisted suicide debate, she said: “Older people are increasingly being taught that growing old is a disease and that therapy for existential needs means killing. We are on the wrong side of the road.”
