By Michael Cook
Involuntary euthanasia is acceptable medical treatment, according to a recent official statement by the Belgian Society of Intensive Care Medicine. Although voluntary euthanasia is legal in Belgium under some circumstances, involuntary euthanasia is basically illegal. But the Society wants to be able to euthanize patients who do not appear to have long to live.
The Society spells out its policy very carefully. It is not about grey areas like withdrawing burdensome or futile treatment or balancing pain relief against shortening a patient’s life. It clearly states that “shortening the dying process by administering sedatives beyond what is needed for patient comfort can be not only acceptable but in many cases desirable.”
“Shortening the dying process” is a euphemism for administering a lethal injection.
Most dying patients in intensive care have not made advance directives and “are usually not in a position to request euthanasia.” Therefore, “difficulty can arise when the purpose of the drugs used for comfort and pain relief in end-of-life management is misconstrued as deliberate use to speed the dying process.” The Society’s solution to this difficulty is to allow its members to kill the patients.
Effectively the Society has declared itself to be above the law. However, with the backing of the Society, it is unlikely that Belgian doctors would be prosecuted. It will be interesting to see how the government reacts.
The Society also says that intensive care doctors should inform relatives of a decision to euthanize a patient, but it does not instruct them to ask for the relatives’ permission. The policy applies to both adults and children. Furthermore, patients do not have to be suffering; “Shortening the dying process” can actually enhance death, the statement says.
The statement concludes by reassuring intensive care doctors that what they are doing is “not be interpreted as killing but as a humane act to accompany the patient at the end of his/her life.”
In February the lead author of the policy, Jean-Louis Vincent, a former president of the Society, published an op-ed in the leading Belgian newspaper Le Soir explaining the Society’s position. He complained that intensive care doctors were working in a “legal no man’s land” and that Belgium needs a law which bans overly aggressive therapy. He believes that advance directives are worse than useless and that doctors need to be able to give lethal injections to shorten lives which are no longer worth living, even if the patients have not given their consent.
“The first purpose of medicine is to restore or maintain health, that is, the well-being of the individual, not life at all costs,” he wrote.
Editor’s note. This appeared at www.bioedge.org.