No, the “Belgian model” wanted by Emmanuel Macron does not encourage excesses

A law on euthanasia for 2023? At the beginning of September, the President, Emmanuel Macron, announced that he wanted to reopen the debate on “active assistance in dying”, via a consultation of citizens. And by relaunching this sensitive subject, Emmanuel Macron confessed a penchant for the “Belgian model”.

An announcement that caused a lot of reaction. Asked by BFMTV about this, Marion Maréchal, vice-president of Reconquête, expressed her concern about the limits that could be imposed on this framework: “You know when it starts, you don’t know when it stops. […] In Belgium, it is about one in 40 deaths that is affected by euthanasia, so very far from the exceptional situations as we are presented with today and it is only increasing […]. »

According to the former MP for Vaucluse, the practice, which initially only concerned sick people “who had no prospects of redemption”, would now be extended to people with a certain number of pathologies. psychological, including depression, but also autism, people with polypathologies, “therefore pathologies that are not fatal”. Marion Maréchal added that euthanasia would have been extended to minors and that it would soon be a question of people with Alzheimer’s.

Remarks that have strongly reacted to opponents of euthanasia, who have multiplied the publications warning about the excesses of this practice and the risks they entail.

A lot of information that deserves a little contextualization.

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Euthanasia was legalized in Belgium by the law of May 28, 2002, making the country of King Philippe one of the first in the world in this area. Reserved at the time for adults, it was extended in 2014 to minors, with no age limit.

This latest legalization scares many Internet users, who fear that a new eugenics will flourish, with an instrument that would “eliminate imperfect children”. A point that is not observed in practice, since euthanasia performed on minors is extremely rare. For example, the report 2021 of the Federal Commission for the Control and Evaluation of Euthanasia (CFCEE) has not recorded any euthanasia among non-emancipated minors.

No list of authorized pathologies

In all, since 2002, 27,225 people have been euthanized in Belgium, including 2,699 in 2021. A figure up by 10.39% compared to the previous year (2,445 in 2020). This total, compared to the number of deaths recorded in the country, 112,291 (figures from Statbel, the Belgian statistics office), represents well, approximately, one death in 40, as advanced by Marion Maréchal.

Where the ex-MP is on the wrong track is that euthanasia in Belgium is not in a situation of abuse as regards the pathologies concerned, since it has never been reserved for “sick people without prospects of redemption”. to then be gradually opened to more pathologies. “There is no established list, specifies Jacqueline Herremans, lawyer and President of the Association for the Right to Die with Dignity Belgium. There are, for example, already cases of Alzheimer’s patients who have benefited from euthanasia. »

The inappeasable nature of the pathology, an essential condition

On this subject, Belgian law is clear and stipulates that “the patient is in a hopeless medical situation and reports constant and unbearable physical or psychological suffering which cannot be appeased and which results from a serious and incurable accidental or pathological condition”.

“This inappeasable character of pathology is one of the essential conditions of the law. The therapeutic and palliative solution is always sought as a priority, before considering euthanasia”, insists Jacqueline Herremans.

If many Internet users fear seeing a kind of “selection made among children, or among people with mental disorders”, the figures in Belgium show that this is not the case. In 2021, 67.8% of patients were over 70 years old, 40.2% were over 80 years old. Only 1.4% of those euthanized were under 40 years old.

The majority cancer patients

Patients with a tumor or cancer are the vast majority (62.8%) among the recipients of euthanasia, ahead of polypathologies (17.7%), diseases of the nervous system (7.9%) , diseases of the circulatory system (3.7%), diseases of the respiratory system (2.3%), psychiatric conditions (0.9%), cognitive disorders (1%) and diseases of the the digestive tract (0.9%) and traumatic lesions.

In the vast majority of cases (84.1%), the physician considered that the patient’s death was foreseeable in the short term.

Above all, the greatest concerns of Internet users relate to the fact that euthanasia could be imposed on certain patients or according to certain pathologies. However, Belgian law is very strict on this point. The request must be made by the patient “voluntarily, thoughtfully and repeatedly”. It specifies that this request must not result from external pressure.

A long process

“The patient must be capable of discernment and be conscious at the time of his request, explains Jacqueline Herremans, and this request must never be at the doctor’s initiative. To be sure, the patient must meet the doctor in charge of his follow-up several times. The latter must inform him of his state of health, his life expectancy, the therapeutic solutions still possible and can arrive, with the patient, at the conviction that there is no other reasonable solution in his situation and that the patient’s request is completely voluntary.

After this series of interviews, the patient meets another doctor specializing in the pathology from which he suffers, with no connection either with him or with his follow-up doctor, to discuss the file. This doctor may be a psychiatrist, who will also assess the patient’s ability to discern with the entire medical team.

The medical team can also meet the patient’s relatives to explain the process to them and ensure that there is no pressure on their part. “Most often, it’s the opposite that happens, the family does not want euthanasia, and the doctor manages to explain to them the suffering that leads the patient to request it”, specifies Jacqueline Herremans.

The lawyer adds that the length and complexity of the procedures make it possible to ensure the justification and relevance of the choice to end life, as it allows the patient to mature his decision. “Euthanasia is the right to end one’s life, not a ‘right to kill’ as some like to claim. »


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