Euthanasia Is Being Granted To The Mentally Ill In Belgium, Including Minors, Which Raises Ethical Concerns Among Critics

The opinions expressed in this article are those of the author, and do not necessarily represent the views of Evie Magazine.

I, like many others, believe this should be a right. However, very few places worldwide allow euthanasia or assisted dying under any circumstances, which means many have to suffer unnecessarily from conditions that cannot be cured. 

One such place that does grant the legal right to die by lethal injection is Belgium. However, the liberal laws on the right to die are provoking heated debate after the country has euthanized people not just suffering from terminal or debilitating physical health conditions, but also physically healthy people who are suffering from mental illness. Belgium is one of only two countries in the world that permit euthanasia for mental suffering. 

The Legal Suicide for Mental Suffering in Belgium

One such case that caught my eye was the news of 23-year-old Shanti De Corte, who was recently euthanized for the mental suffering she experienced after witnessing an ISIS terrorist attack at the Brussels Airport in 2016. De Corte was physically unscathed, but witnessed a traumatic terrorist attack that killed 32 people, some of whom were her classmates, and injured more than 300 others. This all happened when she was walking through the departures hall of the airport. Just 17 years old at the time, many would count De Corte lucky to be among the survivors, but De Corte, who had previously dealt with bouts of depression, according to her school psychologist, was in a fragile state for six years following the terrorist attack. This school psychologist referred her to a psychiatric hospital, where she received psychological treatment. However, after a reported sexual assault, she attempted suicide in 2018. After dealing with panic attacks, depression, and PTSD for years following the terrorist attack, she attempted suicide again in 2020. 

Some people deal with considerable mental suffering but still find their life meaningful and worthwhile. 

This second failed attempt led her to reach out to an organization that promotes death in dignity, requesting to be euthanized for unbearable psychiatric suffering. After being evaluated and approved by two psychiatrists, De Corte was granted death by lethal injection with her supportive parents by her side. De Corte posted on social media in her final moments to say, "I was laughing and crying. Until the last day. I loved and was allowed to feel what true love is. Now I will go away in peace. Know that I miss you already." However, this case has come under fire by critics who insist that other treatment options for mental illness should have been explored before permitting De Corte to end her life. De Corte had previously posted about needing to take 11 antidepressants a day just to function, saying, "With all the medications I take, I feel like a ghost that can't feel anything anymore. Maybe there were other solutions than medications."

Other Cases of Euthanasia for Mental Suffering in Belgium

This isn’t an isolated incident, either. The Economist ran a documentary in 2015, taking viewers on a journey with 24-year-old Emilie Yerby, as she goes through the necessary steps to get approved for euthanasia because she’s tired of living with lifelong depression. Unlike De Corte, Yerby did not experience any psychological trauma and came from what she described as a happy family. However, her entire life, she felt a sense of emptiness and pointlessness to existence. 

The documentary shows the process she had to go through to be approved for such a procedure. Doctors reassure her that she can back out at any time, including up to the moment that the needle is in her arm. Yerby, who had remained steadfast in her decision to die through the entire film, gets cold feet on the day of injection and backs out. She said that for some reason, life felt bearable for her for the past two weeks leading up to her planned death, and she wasn’t sure if it was due to the serenity that death presented or if it was because something had changed in her. Curious to find out if her condition could improve, she canceled the lethal injection. However, she went through with it two years later. The documentary shows her discussing her death with her friends, who are already grieving her loss, and her mother, who reluctantly supports her decision because her daughter insists that she will kill herself if she isn’t granted the right to euthanasia. 

The documentary explains how people go through a rigorous process to get approved for legal suicide. For one, if you want to be euthanized, you need to meet with dozens of medical professionals and you need three doctors to sign off on the decision to be euthanized, one of which needs to be a psychiatrist. You are allowed to back out of the decision to die at any moment, including right up to the moment of injection. People who are approved are also generally lifetime sufferers of mental illness instead of someone experiencing a temporary moment of distress.

Belgium is the only country in the world with no age minimum for euthansia. 

Other cases reveal more ethical gray areas when it comes to euthanasia. The European Court of Human Rights (ECHR) ruled that a woman who was euthanized for depression had her right to life violated by the federal euthanasia commission. Godelieve de Troyer was a 64 year old woman who requested to be euthanized due to depression, and this decision was granted without her family’s knowledge. Her son only learned of his mother’s death the day after her euthanization, when the hospital called him to collect her belongings. He made a complaint with the ECHR that she was not properly examined because her psychiatrist of more than 20 years originally denied her euthanization request and she was in good physical health. To make things even dicier, the woman who was euthanized had made a donation of €2,500 to the same end-of-life organization that arranged for her lethal injection.

In 2016, a 17 year old was euthanized in Belgium because it’s the only country in the world that has no age minimum as long as they meet the criteria. 

Additionally, there have been cases of botched euthanizations, such as the case of Tine Nys, which resulted in three doctors going to trial for murder after poisoning a woman with autism because she wanted to die after a failed relationship. While her request for euthanasia was originally denied by a doctor, a second doctor falsified documentation to give her the lethal injection. Nys, who had recently been diagnosed with autism, had not yet received any treatment for it. The doctor who performed the lethal injection had not completed his end-of-life training and did not administer it properly, leading to the infusion bag which contained the lethal drugs to fall on Nys’ face. At another point, Nys’ sisters claim that the doctor asked the patient’s father to hold the needle in her arm because he forgot to bring plasters. After the injection, he asked the family if they wanted to listen to Nys’ heartbeat through a stethoscope to ensure that it was no longer beating. This is the sort of careless attitude toward life that is raising concerns in the country. The decision to end someone’s life should not be taken so lightly or unseriously.

Criticism of Liberal Belgium Euthanasia Laws

After Shanti De Corte was legally euthanized earlier this year, neurologist Paul Deltenre drew sharp criticisms of the decision and asked that prosecutors investigate this case. Deltenre argued that De Corte had been prematurely euthanized and that other methods of treatment to improve her mental state had not been explored. While an investigation was launched, it was ultimately closed after finding that no laws had been broken and De Corte was legally killed in a manner that followed regulations. To meet criteria in Belgium, you need to be in a medically futile condition of constant and incurable physical or mental suffering that cannot be alleviated. The patient must also be awake and in an alert mental state that enables them to consent to the procedure. 

To end their lives instead of providing treatment feels contrary to the oath that medical professionals make.

However, there are concerns that the country’s liberal laws have led to a slippery slope. When euthanasia was first introduced to the country in 2002, it was not foreseen that this many people would choose to take their life, let alone for mental reasons. 2008 was the first year that euthanasia became legal to end psychological suffering. At the time, only 4 people had been euthanized to end mental suffering. Now, out of the 2,000 people that are euthanized per year in Belgium, about 40 of them are to end psychological suffering. In 2014, the country also expanded euthanasia to minors of any age. Currently, minors cannot end their life for psychological suffering, but that may change over the next few years. 

Closing Thoughts

People can generally be split into two camps in the psychological euthanasia debate – the libertarian side that argues that people who consent to end their own life should have the freedom to do so, and those who believe in the preservation of life for the wellbeing of those who have the potential to get better. Because both sides have valid arguments, it’s important that, when crafting public policy on euthanasia going forward, we take both camps into consideration. I’m horrified to see 23 year olds being killed for a very common mental health issue such as depression, which generally improves with lifestyle changes and mental health treatment. However, I grant there are likely situations in which someone is experiencing such severe psychological suffering that they would take their own life anyway. 

The reason we have assisted dying is to give people dignity in death – to prevent people from taking their own life in brutal and upsetting ways that end their life in distress and leave their families in ruin. At the same time, there have been cases in Belgium where it sounds like people have been approved for euthanasia prematurely. Some people, like Emilie, have second thoughts, because they begin to feel better. The unsettling reality is that some people who have taken their lives through euthanasia could have the potential to overcome their mental health struggles. To end their lives instead of providing them with treatment feels contrary to the oath that medical professionals take when they earn their license. Sure, we accept ending the life of a comatose person who doesn't show signs of brain activity anymore or a cancer patient who is terminally ill, but these are people that we know with incredible certainty will not go into remission. Because mental illness is not visible on a scan, there is greater uncertainty. 

Some people deal with a lifelong battle against depression and still find their life meaningful and worthwhile, even if they have dealt with considerable mental suffering. Assisted dying serves its purpose, but it needs to be heavily regulated to prevent premature death in youthful patients who have not exhausted all mental health treatment options. Such patients may be suffering from an undetected personality disorder, an autism spectrum disorder, or just be trapped in the tunnel vision that depression lures you into. I empathize with the psychological suffering of the patients who have taken their own lives, but they also leave a lot of grievers in their wake, who need to weather on without their loved one. 

At what point does assisted suicide become too much? When half the population is ending their life because they feel sad? According to the World Health Organization, 280 million people have depression. Imagine if all of us who dealt with mental health issues turned to euthanasia as the solution. While I wouldn’t discount that there are some people whose condition will never improve, this isn’t the case for most people. What I’ve deduced from looking into the people who have taken their lives – medications didn’t help them. Maybe what they were really lacking was a deeper sense of meaning in their lives, because if nothing matters, then what’s the point?

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