Proposed changes to Belgian euthanasia law may affect freedom of conscience

By Alex Schadenberg, executive director
Euthanasia Prevention Coalition

Alex Schadenberg3Today I received an email from the Protection of Conscience Project concerning the proposed changes to the Belgian Euthanasia Law that would allow children and people with Alzheimer’s to be killed by euthanasia.

This update was published on December 19 under the title: “Proposed changes to Belgium euthanasia law may affect freedom of conscience.”

The Protection of Conscience Project has been following the Belgian Euthanasia Law for many years. In 2003 they alerted us that euthanasia was being regulated and funded through the palliative care system in Belgium. (See http://alexschadenberg.blogspot.ca/2008/09/belgium-policy-statement-on-end-of-life.html.)

The following article also informs us of something we missed last July. Belgium is also proposing that medical students be trained to kill their patient.

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Proposed changes to Belgian euthanasia law may affect freedom of conscience

December 19, 2012

The Belgian Socialist party has submitted proposals to amend the country’s euthanasia law to permit euthanasia of children and persons suffering from dementia. According to news reports, children would have to be suffering from an incurable illness to qualify. The text of the proposed legislation does not yet appear to be available.

However, two bills submitted by Marleen Temmerman to the Belgian Senate in May, 2012 made the same kind of proposals.  Draft law No. 4-431/1 makes euthanasia available to children who are able to “discern” that they want it if they otherwise meet the legal criteria for euthanasia of adults.  Alternatively, their parents can make the request.

Draft Law No. 4-676/1 makes euthanasia available to patients with dementia.  This bill also appears to impose a requirement on conscientious objectors to refer patients to physicians willing to kill them by modifying the existing protection of conscience provision in the Belgian euthanasia law.  The existing law requires an objecting physician to transfer a patient’s medical file to another physician if requested to do so by the patient or surrogate decision maker.  The onus remains on the patient or surrogate decision maker to find a willing physician.  Draft Law. No. 4-676/1 would add the following provision to the law:

“If no physician has been designated by the patient or by his surrogate decision maker, the physician who refuses to comply  with a request for euthanasia must transfer medical records to another  physician to ensure continuity of care.”

On the face of it, this does not appear to add anything new.  However, the commentary on the section provided by Temmerman indicates that what she has in mind is the addition of a requirement that an objecting physician find a colleague willing to kill the patient:

“The law on euthanasia does not offer a solution for the case in which the doctor refuses to grant the request for euthanasia, where the patient is no longer  able to appoint another doctor and did not appoint a surrogate decision maker. The patient is nevertheless entitled to enforce his advance directive and ensure continuity of care. This is why the doctor who refuses to comply with the request for euthanasia must transfer the medical file to a  medical doctor who is willing to implement the wishes of the  patient.”

In July of this year, the Belgian Federal Commission for the Monitoring and Assessment of Euthanasia recommended that medical students should be taught how to kill patients properly, and that continuing medical education should include such instruction:

The Committee recalls that it considers that the curriculum of  medical education should  include training  preparing future physicians to deal with the problems  posed by the management of the end of life, including the practice of palliative care and the proper implementation of ‘euthanasia. Similarly, the various cycles of postgraduate education and recycling activities should be encouraged to include such training. (Machine assisted translation)

The Commission did not appear to recognize that some medical students might have conscientious objections to a requirement that they be required to kill a patient as a condition of graduation.  On the other hand that Commission may have intended only that medical students be provided with information about how to kill patients properly, without a requirement that they actually demonstrate their competence.