Belgium is one of only a few countries where euthanasia is a legal medical option for a terminally ill person over the age of 18. However, Belgium lawmakers are set to vote on an amendment to that law that will remove any age restriction on the practice of euthanasia. The amendment is expected to pass the lower house of parliament, be approved by the King and its passage will effectively give sick children the right to die.
The euthanasia of a child would require the child’s consent in addition to the parent’s but there is much controversy over whether children have the cognitive understanding to make such a decision. At what age does a child truly understand death? Further, there is some concern that the practice of euthanasia might be abused by parents seeking to end their child’s life for reasons that, while not nefarious, are perhaps more practical than empathetic.
The issue is clearly an emotional one for parents, doctors and to the extent that they are aware of the debate, terminally ill children. For some, allowing the euthanasia of these children represents an opportunity for “mercy” to end their suffering whereas for others euthanasia has spiritual connotations and sends a mixed message about the value of life.
Adults in Belgium have the right to die provided they meet the dictates of the 2002 Belgian Act on Euthanasia, which requires they be near death with “a medically futile condition” that cannot be alleviated. The condition must be the result of an “incurable disorder” cause by illness or an accident and the patient deemed to be suffering physically or mentally.
Under the amended law, children would have to meet the same requirements as adults although they cannot petition for euthanasia based on mental suffering alone, their suffering must be physical in nature. In addition, they would have to demonstrate to a psychiatric doctor that they have the “capacity for discernment.” In other words, the child must prove that they fully understand the ramifications of their request to die. There are concerns about the ability of doctors to be fully objective when determining a child’s level of discernment and that if enough doctors are petitioned, eventually one will approve the right to die request even if others have refused.
Although polls indicate a majority of support for the amendment, there have been protests by the people of Belgium in which some carried signs that read, “Care! Do Not Kill” and 160 pediatricians have signed a petition requesting that the Belgium Parliament delay any vote on the law to allow for further debate. These pediatricians claim that palliative care for children is highly effective and greatly reduces suffering thus even in terminal cases there is no need to euthanize children.
Many pediatricians have come out against amending the law, but some have expressed strong support claiming that children have witnessed the suffering and ultimate death of ill children around them and have requested a different outcome. Pediatrician Gerlant Van Berlaer of University Hospital Brussels claims he has received requests from children that they not go “in a terrible, horrifying way”. He says they want to die while they are “still a human being” and still have their personal dignity.
Carine Brochier of the European Institute of Bioethics in Brussels has spoken out strongly against changing the current euthanasia law and questions whether extending the right to die to terminally ill children will allow doctors to reconsider their ethics when it comes to dementia in the elderly or handicapped people. Last fall Brochier commented, ”We’re becoming the world’s euthanasia laboratory.” Another statement made by Brochier might seem flippant, but considering in 2012 alone 1,432 people were euthanized in Belgium, it is likely that her intention was to underline a grave national concern when she said, “Euthanasia is becoming a Belgian trademark, just like waffles.”
By Alana Marie Burke