End-of-life doctor recounts 20 years of euthanasia law in Belgium

“Euthanasia is a treatment like any other, the difference is that it’s a final treatment,” argues Marc Decroly, a doctor who has helped more than a hundred patients end their lives.
Decroly, a 58-year-old general practitioner, is one of several doctors in Belgium who help people end their lives at home under a right-to-die law the country adopted 20 years ago, on May 28, 2002.
At the time, Belgium was only the second country in the world to decriminalise euthanasia, two months after its neighbour the Netherlands.
In the ensuing two decades, the procedure — once furiously contested — has become largely accepted. An anti-euthanasia protest held in Brussels a month ago rallied only around 350 people.
Decroly said that “no one can oppose the wish of the patient” if the law’s conditions are met.
Only those with an incurable illness and experiencing constant and intolerable physical or mental suffering that cannot be alleviated qualified. Their clear request has to be expressly repeated, fully thought through and not subject to any outside pressure.
Decroly said he only went ahead with it if a second doctor endorsed it.
“Euthanasia is never easy. But it’s the end point of a process undertaken with the patient and their family. It’s a way to bring closure, with relief,” said the doctor, who practises in Brussels’ well-heeled district of Uccle.
In 2021, Belgium recorded 2,700 euthanasia cases, representing 2.4 percent of total deaths.
Most were carried out for patients aged between 60 and 89, and for eight out of 10 of them death was prognosed to be just around the corner, according to government authorities.
– ‘Very good law’ –
More than half of the procedures were carried out in the patient’s home.
The moment “is extremely rich, on a human level”, Decroly said, with a slight introspective smile.
“We see all sorts of emotions. They make us grow, they make us, they move us forward. We become a little better in ourselves. At least I hope so.”
But, he added, “more than three euthanasias in a month is hard to take”.
As well as his job as a family doctor, Decroly serves in a hospital emergency room.
He sees no contradiction between saving lives and acting to help end one within the scope of Belgium’s law.
“To the contrary — it’s all part of the same,” he said calmly.
“I think that the person to be euthanised is no more or less important than the ones to be saved. They are simply in different situations.”
To his mind, the Belgian statute is “a very good law”, noting that it also ensures that a patient is not left alone in case of an initial denial of their request.
“If a doctor says no, the process doesn’t stop there. They can be transferred to other people who might see their situation differently,” he said.
He also recalled a time he refused to carry out the procedure — on a grandfather with terminal cancer but whose request was made by the family.
– ‘Die in your favourite chair’ –
“He wasn’t suffering. He spoke to me of his granddaughter who came to see him, and of the flowers in the garden. He didn’t want to die. He ended up passing away naturally,” Decroly said.
The most important thing, he said, was to “remain attentive to one’s patient”.
When he goes to someone’s home to carry out a euthanasia procedure, always in the afternoon or the early evening, he talks over the decision yet again with the patient.
“If we need two hours to discuss it, then we take two hours. I always repeat this to them: if today is not the right day, it’s you who decides. It’s not because you arranged my visit that I absolutely have to euthanise.”
He added that, when a patient turns to a doctor, “they are entrusting us with their life — they want their transition from life to their demise to go well, for them and for those around them”.
The act itself unfolds in two phases, after a drip is inserted. First, chemicals to make the patient sleep are introduced. Then the lethal compound.
“You are not required to die in your bed. You can die in your favourite chair. Anywhere you wish to die,” the doctor said.
And then there is the aftermath: speaking with the relatives, calling the funeral service.
“There are many things that are expressed,” Decroly said.
“For me, it lets me thank the family for the trust they have placed in me.” (AFP)