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The unfolding logic of euthanasia

  • 06 October 2014

A Belgian court recently granted permission for a psychiatrically ill prisoner to be euthanised. The prisoner, 50 year old Frank Van Den Bleeken, is serving a life sentence for rape and murder and has requested euthanasia due to his 'unbearable psychological anguish'.

The psychological anguish component is nothing new: in 2013 a Belgian man was euthanised due to the psychological burden of a failed sex-change operation, while earlier that same year deaf identical-twin brothers were euthanised for reasons of psychological suffering when they discovered they were losing their eyesight.

This is, however, the first time a prisoner has been granted permission to be euthanised, and with at least nine and as many as 15 other cases set to follow, a whole new set of ethical issues and problems must now be carefully considered and painstakingly scrutinised before further action is taken.

But Belgium has achieved its own momentum in such matters and as the co-chair of the Belgian euthanasia commission, Wim Distelmans, explained in regard to the sex-change case:

'The case of Nathan Verhelst, for instance, who met all the conditions of the law, we didn’t discuss about the case for one minute. It was just passed like that…We already have a tradition of 10 years. Should Nathan’s case have been 10 years ago, maybe we would have discussed some time about the case. Now, it’s like [just] another one.' 

Euthanasia advocates tend not to speak about tradition in relation to their cause. There’s usually plenty of talk of safeguards and the most difficult medical cases that naturally elicit our compassion, but no one seems to imagine, despite bountiful evidence from Belgium and the Netherlands, that euthanasia could take on a momentum of its own. The weight of tradition is, naturally, not something we associate with euthanasia in this country where, despite persistent efforts, the practice has never become established. 

Having worked in bioethics, it’s hard to avoid a morbid fascination with the gradual unfurling of euthanasia in nations where it has had a chance to become firmly established. While members of the public are usually shocked to hear of each new milestone, from an ethical perspective there are no real surprises in the unfolding logic of euthanasia. Euthanasia for children, euthanasia for those ‘tired of life’, euthanasia to stay out of a nursing home, double-euthanasia for loving couples wanting to end their lives together; once euthanasia is introduced the imperative to develop it to meet