DALLAS, February 14, 2014— Yesterday, the Belgium House voted to extend legal euthanasia to children who are terminally ill. The Senate passed the bill in December, which now awaits only the formality of King Phillipe’s signature to become law.
Although the bill passed both houses with strong majorities, many lawmakers and groups voiced their concerns. In addition to opposition from the Christian Democrat party, religious communities and pro-life groups, 160 pediatricians signed an open letter in opposition to the bill, arguing there is no urgent need for the measure and that current palliative treatments are meeting the needs of these children.
While euthanasia of minors is legal in the Netherlands, that law has a minimum age of 12 years. The Belgium law does not have an age limit, but requires parents or legal guardians to be in agreement and requires the child “to possess the capacity of discernment.” Children must also be terminally ill and present their request in writing.
As has been the case in other areas where the practice of euthanasia outpaced law, Dr. Gerlant van Berlaer, a pediatric oncologist at the Universitair Ziekenhuis Brussels hospital, said that the controversial law would only legalize the secret practice child euthanasia that is already happening.
John Harris, a professor of bioethics at the University of Manchester says the move is motivated by compassion. “It’s unfair to provide euthanasia differentially to some citizens and not to others (children) if the need is equal.”
However Charles Foster, who teaches medical law and ethics at Oxford University, said, “Children, like everyone else, may not be able to anticipate how much they will value their lives if they were not killed.”
Testifying before the Belgium Senate, Catholic Archbishop Andre-Joseph Leonard said, “It is strange that minors are considered legally incompetent in key areas, such as getting married, but might (be able) to decide to die.”
The move to legalize child euthanasia is in line with the general trend in legalized euthanasia, where there is both an expansion of the numbers of patients killed and in circumstances where the practice is allowed. In 2002, Belgian became the second European country to legalize euthanasia. As in the case with the push for child euthanasia, the rationale behind the was to regulate the already widely practiced clandestine practice of euthanasia. Since then, the rate of reported euthanasia has grown by nearly 500%.
A report by the European Institute of Bioethics assessing Belgium’s euthanasia law after ten years notes that the safeguards and strict conditions of the law were almost immediately cast aside. It reports that requirements for written requests, that the patient suffer from a life-threatening and incurable illness and from unrelievable, unremitting and unbearable pain were also quickly abandoned within the first few years following the laws passage.
In The Netherlands, where euthanasia was tolerated for decades before becoming the first country to officially legalize the practice in 2001, three percent of all deaths are now attributed to euthanasia. In one year, the rate climbed 13%, possibly due to “mobile euthanasia units” that allows patients to be killed when their family doctor refuses according to Jennifer Popik, legislative counsel for the National Right to Life Department of Medical Ethics. Moreover, those numbers aren’t the full picture, she notes. “In a 2010 Lancet study there were 3,859 euthanasia deaths and moreover, at least 23% of all euthanasia deaths were unreported in the Netherlands,” Popik said.
Recent cases in Belgium including 43-year-old deaf twins who requested euthanasia after learning they were going blind and the case of patient euthanized after a botched sex change highlight the expansiveness of the practice. “There is nothing in the law to protect those with mental illness – in fact Belgium, Luxembough, and the Netherlands permit euthanasia for those suffering with mental condition,” said Popik.
Popik notes that legal precedent in the United States virtually guarantees that euthanasia would go beyond any initial safeguards if legalized because of the well-established doctrine of substituted judgment. “Dangerously, in the United States, under the equal protection clause of the 14th amendment, it might be impossible to restrict the practice the way that proponents claim.” Once established in law, “state courts (and perhaps the Supreme Court) are virtually certain to rule that the right to be killed by lethal prescription or lethal injection cannot constitutionally be withheld from incompetent people who have never asked to die.”
The Associated Press contributed to this article.