Belgium : Increase in the number of euthanasia and extension of cases
The Belgian federal commission for the control and evaluation of euthanasia issued its report at the end of January 2025 providing the details of euthanasia conducted during 2022-2023. This 11th report, required by law in Belgium on euthanasia, indicates beyond the pure statistics, an evolution in the number of requests for euthanasia.
The raw statistics for 2023 had already been published in February 2024. The number of euthanasia has increased more than tenfold over the last ten years. 3,423 euthanasia were registered in 2023, a 15% increase compared with 2022, which represents 3.3% of all deaths.
Extension of euthanasia cases
Among the most notable evolutions, it was found that after the cases of cancer sufferers, which account for 57.5% of all cases, the proportion of age-related incapacitating poly-pathologies is ever increasing and reached 23% of cases in 2023. In its statement, the commission indicates that this percentage is due to increase since poly-pathologies are associated with the ageing process of patients. This leads to the question: How can one consider it to be obvious that the aged should seek euthanasia due to the normal accumulation of their pathologies?
78% increase in cases of psychiatric and cognitive disorders
Euthanasia for psychiatric conditions (recurrent depression) and cognitive disorders (such as Alzheimer cases) represent 2.5% of cases, i.e. 161 people euthanised, which mostly had no short-term life-threatening condition. This is a considerable increase relative to 2020-2021 when 91 cases were recorded.
Those euthanised were as follows:
• 36 people suffering from mood disorders (depression, bipolarity etc.);
• 83 people suffering from cognitive conditions (dementia, Alzheimer’s etc.);
• 10 people suffering from personality and behaviour disorders;
• 9 people suffering from post-traumatic stress syndromes, dissociative disorders and anxiety;
• 6 people suffering from schizophrenia, schizo-affective conditions and delirium;
• 3 people suffering from organic mental disorders such as autism;
• 1 person suffering from post-concussion syndrome;
• 3 people suffering from concussional behaviour syndromes such as anorexia.
In their comments, the authors underline the fact that psychiatric conditions concern a limited group of patients, and an age band which may be younger than “euthanasia for people suffering from psychiatric disorders” still gives rise to controversy, not only in the media, but also within the psychiatric profession.
Many questions are being raised concerning the evaluation of the ability of such patients to express their wishes, the definition of the insoluble nature of their situation, as well as the determination of their condition as incurable or resistant to treatments. They do not however challenge them.
In 40% of cases, the patients had attempted suicide, 22% of people had a history of sexual assault and/or violence during childhood.
During 2022-2023, 19% of euthanasia (1126) were conducted on people whose life expectancy was not threatened in the short term. Moreover, among the doctors consulted for euthanasia requests for deaths evaluated as “short-term”, only 4.9 % were trained in palliative care. One third of doctors consulted (33%), had received LEIF-EOLE specialist “end of life” training, in collaboration with ADMD (the Association for the right to die with dignity), which actively militates for euthanasia.
As observed in previous years, through the reports by the commission, there is a clear sliding towards the acceptance of euthanasia cases for mental pathologies or poly-pathologies with an ever-widening interpretation of incurability and the notion of suffering which cannot be relieved. Psychiatrists have warned about this trend which impacts suicide prevention policies.
In view of the increasing number of euthanasia requests, the control Commission has called for an increase in staff and remuneration, as if the increase in euthanasia is inevitable.
Further reading:
Detailed analysis of the 11th report by the European Bioethics Institute
