The European Court of Human Rights has ruled against Belgium for failing to conduct a proper investigation into the circumstances of Godelieva de Troyer’s euthanasia. She was a 64-year-old woman who died by euthanasia in 2012 after being diagnosed with incurable depression. Unbeknownst to her relatives, and after 20 years of psychiatric treatment, an oncologist administered the lethal injection to her, even though her psychiatrist doubted that she met the requirements of the Belgian euthanasia law.
Troyer’s son then took the case to court, since he was not informed that his mother was going to be euthanized, and he was only called after her death. According to him, nobody warned him that they were going to end the life of his mother.
Now, the court has determined that Belgium violated article 2 of the Human Rights Convention, which establishes that the right to life of every person shall be protected by law, due to deficiencies in the subsequent control of euthanasia practiced. This ruling refers to the way in which the Belgian Federal Commission for the Control and Evaluation of Euthanasia handled the events surrounding Godelieva de Troyer’s death.
More specifically, the sentence determines that there was no effective investigation into the circumstances of the euthanasia, since the investigation should have been carried out by people independent of those who were involved in it.
However, the doctor who performed the euthanasia was the co-chair of the Belgian Federal Commission for Euthanasia Control and Evaluation, which is in charge of establishing whether the act in question had complied with the requirements of the law. Therefore, the control system established in the case did not ensured its independence.
Nevertheless, it has not considered that there has been any violation of the Belgian legislative framework that allows the practice of euthanasia.
More than 20 years of euthanasia in Belgium
Since 2002, when euthanasia was approved in Belgium, 24,000 people have died by this method, which represents 2% of deaths each year.
Until now, it was understood that certain requirements must be met in that country for a person to request euthanasia: The law contemplates physical and psychiatric conditions.
People must suffer constant and unbearable physical or psychological suffering that cannot be cured. When death is not expected in the short term, there is an additional application process, a third doctor must be consulted, and there must be a one-month waiting period between the application and the act itself.
Whoever meets any of the above conditions must request euthanasia in writing twice. If the doctor determines that the applicant has no chance of improvement and decides that euthanasia is appropriate, one month after the second request, the injection with the drugs thiopental, morphine, a neuroparalytic or barbiturates is administered.
The Federal Commission for the Control and Evaluation of Euthanasia publishes each year a statistical report on the number of euthanasias carried out. However, according to Léopold Vanbellingen, a researcher at the European Institute of Bioethics, there are between 25 and 35% of euthanasias that are not declared and therefore would be illegal.
Any application of euthanasia or assisted suicide, regardless of the circumstances, constitutes an attack against human dignity and good medical practice.
The case that concern us is not an isolated incident. As published in 2015 by the prestigious Journal of Medical Ethics, in patients aged 80 or over, in Belgium the percentage of involuntary euthanasia, that is, not requested by the patient, rose to 52.7%. In those with diseases other than cancer, it reached 67.5%, and up to 77.9% of the cases of euthanasia, this was not discussed with the patient.
To the bad act of deliberately ending the life of a human being, we should add doing it with someone who has not requested it or does not have the capacity to make free and responsible decisions and who, therefore, could not give his consent. And this is exactly what happens with minors and psychiatric patients, to whom euthanasia laws grant the right to end their lives.
The case of psychiatric patients is even more serious. According to some psychiatrists, severely depressed patients may show suicidal tendencies as a symptom of their mental illness.
The non-provision of adequate palliative care in incurable patients and the non-provision of psychiatric treatment in patients with an autolytic tendency, constitutes a violation of the right to medical assistance that protects them. If, in addition, euthanasia is applied to them, it is irreversibly attacking their dignity and the first of their rights: the right to life.
The approval of unjust laws promotes injustice, as occurs with euthanasia.
Julio Tudela and Cristina Castillo
Bioethics Observatory – Institute of Life Sciences
Catholic University of Valencia