'Slippery slope?' Belgium moves to extend euthanasia rights to children

In the 21st century, when parents the world over worry that children are growing up too quickly, Belgium is poised to hand kids one more responsibility. The Parliament passed a bill today giving terminally ill children the right to request to die.

Belgium is one of only three countries that has legalized euthanasia. The others are Luxembourg and the Netherlands, where terminally ill children older than 12 have a right to request death with parental consent. The law in Belgium goes further, abolishing age restrictions altogether.

The public has widely backed the law, and its supporters call it an act of mercy, as they say everyone should have a right to a dignified death. They say the true scandal is having a child face such difficulties to begin with, not the way he or she chooses to deal with it.

But the bill has provoked intense rebuke in some corners, from religious leaders to doctors to civil society at large. Many of them have been against euthanasia altogether – for philosophical, religious, or personal reasons – since it was legalized in the country in 2002. They say allowing children, who aren't even old enough to drive or vote, to decide when it's time to die is one step too far.  

“As an adult, we have the capacity to judge [the option of] euthanasia, but the child? Who would have talked to the child about it? The grandma? The doctor? The mother? The father?” says Carine Brochier, project manager at the European Institute of Bioethics in Brussels.

But children, especially those facing grave illness, are often mature far beyond their years, says Jan Bernheim, a retired professor of medical ethics at the Free University of Brussels who supports the bill. The legislation extends a policy of compassion to all members of society, Dr. Bernheim says.  “Some of these children are very mature, indeed much more mature than some adults over 18.”

Only children whose illnesses are terminal and who are in pain could request euthanasia. They’d also have to demonstrate they are conscious of what euthanasia is and request it several times, and it would have to be approved by their parents and a medical team, including psychologists.

The bill was passed in the Belgium House of Representatives today, after the nation’s Senate already approved it in December. Now Belgian King Philippe must sign it for it to become law, which is expected to happen.

The issue received global attention after a group of 16 pediatricians wrote a letter to Belgian lawmakers last November stating that some children do have the capacity to make such a definitive choice:  "Experience shows us that in cases of serious illness and imminent death, minors develop very quickly a great maturity, to the point where they are often better able to reflect and express themselves on life than healthy people," the doctors wrote.

An opinion poll cited by the Associated Press showed that 75 percent of Belgians voice favor for the law. It would be the first law of its kind in the world.

But it has split the medical community and stoked a new culture war in Belgium, with the religious community, including Christians, Muslims, and Jews, rallying against it.

Many of them are opposed to euthanasia as a principle, says Bernheim, which he says is “perfectly respectable.” But he disagrees with arguments that extending it to children will stunt development in palliative care in Belgium, which is considered among the best in the world, or that it opens the door to misuse, including children pressured by their parents to seek euthanasia.

He also says the law would be applied in rare cases: in the Dutch experience, he says, only a handful of children have requested it.

But that’s why Ms. Brochier calls it a “useless law,” one she worries is being pushed by politicians for ideological reasons. She worries that Belgium, where the number of recorded cases of euthanasia grew by 25 percent in 2012 from the year before to over 1,400 cases, is becoming known as much for the “right to die” as it is for “Belgian waffles."

“It’s a slippery slope,” she says.