Belgian Brothers to allow euthanasia for nonterminal psych patients

IMAGE: CNS photo/Julien Warnand, EPA

By Simon Caldwell

group of psychiatric care centers run by a Catholic religious order in Belgium
has announced it will permit doctors to undertake the euthanasia of “nonterminal”
mentally ill patients on its premises.

In a nine-page document, the
Brothers of Charity Group stated that it would allow doctors to perform
euthanasia in any of its 15 centers, which provide care to more than 5,000
patients a year, subject to carefully stipulated criteria.

Brother Rene Stockman, the
superior general, has distanced himself from the decision of the group’s
largely lay board of directors, however, and has told Belgian media that the
policy was a tragedy.

“We cannot accept that
euthanasia is carried out within the walls of our institutions,” said
Brother Stockman, a specialist in psychiatric care, in an April 27 interview
with De Morgen newspaper in Brussels.

He told the newspaper that he
intended to raise the matter with Catholic authorities in Rome and with the
Belgian bishops.

Carine Brochier, a Catholic
bioethicist from Brussels, told Catholic News Service in a May 3 telephone
interview she was certain that political and financial pressure was exerted on
the Brothers of Charity Group to allow euthanasia.

The group’s new policy document,
which was drafted in March, comes about a year after a court fined the St.
Augustine Catholic rest home in Diest, Belgium, for refusing to allow the
euthanasia of a lung cancer patient on its premises.

The home was ordered to pay 6,000
euros after it prevented doctors from giving a lethal injection to Mariette
Buntjens, 74, who instead was taken by ambulance to her private address to die “in
peaceful surroundings.”

“The pro-euthanasia
movement is really happy about what is happening,” said Brochier, adding
that she believed internal pressures also influenced the decision.

“The Brothers of Charity
work with laypeople. Those people think that euthanasia should be allowed in
the premises,” she said. “Also, I guess some of the Brothers of
Charity wanted the euthanasia to be permitted within the walls.

“Rene Stockman is
completely the opposite way, but the Brothers of Charity here in Belgium are
very, very progressive,” she said.

The new policy document
harmonizes the practices of the centers in the group with Belgian law on

It sought to balance the
Catholic belief in the inviolability of innocent human life with duty of care
under the law and with the demands of patient autonomy.

The group has promised to take
requests for death seriously, and it expressed the opinion that “a
carefully guided euthanasia can prevent more violent forms of suicide.”

The policy document has
acknowledged the difficulties in providing euthanasia to psychiatric patients,
noting that Belgian euthanasia law was “primarily written for physical
suffering in a terminal situation.”

The suffering of psychiatric
patients must therefore be considered hopeless, unbearable and untreatable if a
request for euthanasia was to proceed, the policy document says, adding that
requests must be voluntarily and repeatedly made by a competent adult for them
to be legitimate.

After three doctors have
assented to the patient’s request, the euthanasia can go ahead on the Brothers
of Charity premises, the document concluded.

“If the euthanasia
procedure takes place in a facility of the Brothers of Charity, a preliminary
review is necessary,” it says. “The reason is that, on the one hand,
we want to respect the physician’s therapeutic freedom, but on the other hand
we want to go about euthanasia being performed in a facility of the Brothers of
Charity with the utmost caution.”

In the Flanders region of
Belgium, the order is considered to be the most important provider of mental
health care services. The order also runs schools, employing about 12,000 staff

About 12 psychiatric patients in
the care of the Brothers of Charity are believed to have asked for euthanasia
over the past year, with two of them being transferred elsewhere to receive the
injections to end their lives.

Raf De Rycke, chairman of the
board of the Brothers of Charity Group, said in comments reported by De Morgen April
25 that the group was guided by three fundamental values in producing the
policy: respect for the patient’s life, the autonomy of the patient and the
relationship between the care provider and the patient.

“The protection of life
remains fundamental,” said De Rycke. “But we also want to respect the
patient’s autonomy, even if he has the desire to live no longer. We do not
approve of the (euthanasia) act as such, but respect the demand and see
(permitting) it as a form of charity.”

Brochier said she suspected the
Belgian bishops were “very embarrassed” by the policy but suggested
they shared some of the blame because, she said, they appeared to give up the
fight against euthanasia, partly by failing to correct some priests and doctors
when they have argued for the procedure while publicly purporting to be

“It is very difficult to
hear a clear message about euthanasia,” Brochier said. “But it should
be condemned very strongly, and doctors who perform euthanasia should have a
clear message from the church, from the pope, from the bishops, so that they
can understand that they are killing somebody.”

“Palliative care is very good
in Belgium. We don’t need euthanasia,” she added.

CNS repeatedly try to reach the
Belgian bishops’ conference for comment.

Belgium legalized euthanasia in
2003, a year after the Netherlands became the first country since Nazi Germany
to introduce the procedure.

Technically, euthanasia in Belgium
remains an offense, with the law protecting doctors from prosecution only if
they abide by carefully set criteria.

This initially included limiting
euthanasia only to adults who were suffering unbearably and who were able to
give their consent but, in 2014, the law was also extended to “emancipated

Despite safeguards, critics have
argued the law is interpreted so liberally that euthanasia is available on
demand, with doctors also increasingly giving lethal injections to people who
are disabled, demented or mentally ill.

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