‘She should not have died...’

The day before Christmas 2009, 38 year old Tine Nys went to her family doctor to inform him she wanted to end her life. Tine had a long history of psychological problems, probably dating to her childhood and she indicated the situation had become unbearable.

After several suicide attempts (that failed) in the previous years, she now asked for euthanasia. That day the doctor started the process legally required to perform euthanasia – an intervention which happened 4 months later.

Tine got what she longed for, but her sisters were convinced that this case of euthanasia was not justified and that she should not have died. Half a year later they filed a complaint with the investigating judge and legal proceedings started.

Their main argument was that Tine’s disease was not incurable, her request to die was in the first place a consequence of a failed relationship. In their opinion there were treatments available which could help Tine to overcome her depression.

Moreover, Tine’s relatives are convinced that the euthanasia was performed in an amateurish manner.

This month the trial started. The three doctors involved in the euthanasia are facing the accusation of having poisoned their patient – making them murderers.

EUTHANASIA IN BELGIUM

Belgium is one of the few countries in the world where euthanasia is legal. The law permitting to end a human life by medical means was adopted in 2002.

Together with the Netherlands and Luxemburg, Belgium allows euthanasia not only in case of physical diseases but also for mental – or psychological reasons. This latter option has caused many discussions in society as well as in the medical world. There is a deep division between proponents and opponents of euthanasia, although in this trial the law itself is not at stake.

Tine’s sisters do not necessarily disapprove euthanasia itself, but they state that the law is vague and leaves too much room for personal interpretation. The result is that lives are ended where appropriate help could have prevented dramas ...

According to the current law, euthanasia is only legal under strict conditions. A patient must be legally compentent and conscious at the moment he makes the request. The request has to be voluntary, well considered and repeated. Most of all, the disease has to be incurable and the suffering unbearable. The extent of the suffering is up to the appraisal of the patient, the question whether the disease is curable or not, is to be judged by doctors.

If a patient files a request for euthanasia, the doctor is obliged to consult a colleague in order to give a second opinion – if it concerns a mental disease, the advice of a psychiatrist is also required. The problem with mental diseases is the difficulty to state the illness cannot be cured – in cases of physical diseases this usually appears to be easier.

A VERY IMPORTANT TRIAL

Even before the trial started, there has been a lot of commotion. Walter Van Steenbrugge, a renowned solicitor in Belgium, defending one of the accused doctors, announced that he wanted to challenge each member of the jury who appeared to be Roman-Catholic. He considers every Catholic believer to be preoccupied and unable to give unbiased judgement.

Van Steenbrugge’s way of thinking is followed by many who believe this trial was instigated by the Roman-Catholic church. Despite of the declining numbers of attendance, this Church is still very influential in Belgium – and has always been vocal about its opposition to the euthanasia law.

Nevertheless, it seems very unlikely that Catholic leaders are involved in this trial. The magistrates therefore did not follow the vision of Van Steenbrugge - and there has been a lot of evidence that shows that not all Catholics disapprove euthanasia.

But the thesis of the doctors’ lawyer brings in a religious aspect and illustrates the high symbolic value of the trial. Many Christians have protested the law as of the moment the first time the question to allow euthanasia was raised. In spite of all protests, the law was passed 18 years ago, and since then gradually extended.

The most recent modification of the law granted the possibility of euthanasia to minors – Belgium is the only country in the world having no minimum age to ask for the intervention. Recent discussions have focused on the possibility to euthanise people suffering from dementia. At this moment, there is no consensus yet to change the law, but this trial might lead to new discussions – and actions.

WEAKNESSES OF THE LAW

The trial that is now taking place in Belgium is the first of its kind in the country. If Tine’s euthanasia is considered illegal, the three doctors can be sentenced for murder. On the other hand, if they are discharged, this will make it hard to prevent new similar cases of euthanasia.

One of the weaknesses of the law is there is no preliminary judicial check whether the application of euthanasia in a specific case is legal. There is a commission in charge of the evaluation of each incident, but since death cannot be ‘undone’, the significance of the investigation is very limited.

AN IMPORTANT SOCIAL DEBATE

The discussions in Belgium’s society illustrate the ongoing shift from Biblical values to extreme liberal points of view. Yet, many people seem to be quite indifferent when it comes to ethical debates. Although most people would not consider euthanasia for themselves, they don’t mind the existence of the option for others.

Increasingly, euthanasia is considered to be an act of compassion. Or, as the doctor who performed the intervention that is subject of the actual trial stated at the moment Tine died: one can consider this as an injection you give to a pet in order to end its suffering.

The family doctor of Tine and her sisters was more thoughtful. He admitted he was not really happy with the way things went and stated that the Christmas in 2009 was not merry at all. His way of thinking is much closer to the opinion of many doctors in Belgium who do not support euthanasia and still see it as their mission to save a life rather than to end it.