Euthanasia: A matter of life and death

Dateline's special, Allow Me To Die, examines the world's most liberal euthanasia laws in Belgium. Find out more about the debate worldwide.

Which countries allow euthanasia?

Euthanasia is legal in only a few countries, although others including Australia are actively debating the issue and the UK is the most recent to have voted against it.

Zoom in and out and click on the key countries in the debate to find out more, including the kind of cases each euthanasia law covers.

The map is correct at the time Dateline first broadcast Allow Me To Die on 15th September 2015.

How is Belgium most liberal?

Belgium is different to most other countries in that euthanasia is allowed for cases of ‘unbearable suffering’, where the definition of ‘unbearable’ is determined by the patient.

It can be either physical or psychological suffering, such as Simona’s case in Brett Mason’s story where she is unable to cope with the grief following her daughter’s death.

But crucially in the liberal approach of Belgium, the laws also extend to children, although that part of the legislation has not yet been tested in reality.

Leading paediatrician Dr Gerlant van Berlaer believes it should be allowed, while child cancer specialist Dr Eric Sariban (pictured) explains why he opposes child euthanasia.

Peter's Story

Peter Ketelslegers is a 33-year-old father of two boys, Alex and Thomas, and suffers from a rare condition called cluster headaches.

The intense headaches can last up to three hours, several times a day. He’s tried many different treatments, but nothing has worked.

He used to run a farm with 300 cattle near Brussels alongside his wife Conny, but now the animals are gone as he’s no longer able to work.

The headaches won’t kill him, but there’s no known cause or cure. He tells Dateline that the suffering is now so unbearable that he wants to be euthanised.

In October 2015, a few months after Dateline's story was broadcast, Peter had brain surgery in Belgium for his cluster headaches, but it will be some time before he knows whether it's cured or relieved his condition.

What do all the different terms surrounding euthanasia mean?

There are a number of different terms and descriptions used around euthanasia:

Active euthanasia – This means actively ending someone’s life, such as by administering a lethal drug.

Passive euthanasia – This is where someone’s life is ended deliberately, but by withdrawing life-sustaining measures, such as life support, and allowing them to die as a consequence.

Voluntary euthanasia – This is where the person wants to die and says so. They may refuse burdensome medical treatment or ask for medical equipment to be turned off, or ask for someone’s help with dying.

Non-voluntary euthanasia – This applies to cases where the person is in a coma or too ill or mentally unable to make their own decision. It also includes cases where the person is too young to decide for themselves.

Assisted death or assisted suicide – Euthanasia requires a physician or another third party to administer the medication that causes death, but assisted death or assisted suicide require the patient to self-administer that medication to cause their own death and determine whether to do this and when.

This is referred to as physician assisted death or physician assisted suicide if the third party is a physician.

Euthanasia v assisted suicide – These terms are often used interchangeably, but there is a distinction in that assisted suicide requires the person wanting to die to physically take the final medication themselves (see above).

But not all countries make this distinction in their laws – for example, Belgium does not mention assisted suicide in its legislation, whereas in Switzerland, assisted suicide is legal, but euthanasia is illegal.

Sources: BBC/Mindframe

Have Belgium’s laws meant an increase in euthanasia deaths?

All euthanasia deaths in Belgium must be approved by at least two doctors,  but a third doctor must also be consulted in cases of mental suffering or when a minor is involved

Cases are officially recorded, and this graph shows how the number has progressively risen since the law was passed in 2002.

Figures are only currently available to the end of 2013, but they total 8,776 cases.

Dr Marc Van Hoey from Brett's story explains why he believes in and practices euthanasia.

Simona's Story

Simona de Moor is a physically healthy 85-year-old. She lives in a care home in Antwerp, but is still active and on no medication.

However, she’s been unable to accept the death of her daughter Vivian from a heart attack three months earlier, and sees no reason to go on.

In Belgium, such unbearable psychological suffering is enough to be approved for euthanasia.

Dateline’s story follows her final weeks and ultimately witnesses her death, arranged with her doctor, Marc Van Hoey, at 10.30am two days before her 86th birthday.

In October 2015, Simona's case was referred for judicial review - the first such case since Belgium legalised euthanasia in 2002. Dr Marc Van Hoey could face possible criminal charges over it.

Belgian euthanasia doctor could face criminal charges
A leading euthanasia practitioner in Belgium is facing possible criminal charges after performing the voluntary euthanasia of an 85-year-old patient for incurable depression.



Should euthanasia be legal?

The governments of most countries still believe that euthanasia should be illegal, and even in Belgium the laws remain controversial.

Ethicist Theo Boer reviewed around 4,000 cases for the Dutch Euthanasia Commission, but last year he stepped down.

Now, he says the fact the laws extend to people who are simply ‘tired of life’ means that “something is going terribly wrong”.

What do you think? When this story was first broadcast in September 2015, Dateline ran a poll asking if euthanasia should be legal. This is the final result:

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Return to main story pages

Allow Me To Die
Imagine choosing to die when you don’t have a terminal illness. Is it a choice we should have? A powerful Dateline special gets rare access to film the journeys of two people in Belgium – going behind the most liberal euthanasia laws in the world.

‘The hardest story I’ve told’: Euthanasia blog
A woman I have come to know and like has invited me to share and document the final moments of her life, writes Brett Mason about his story on euthanasia for Dateline.