Europe’s morality crisis: Euthanizing the mentally ill

Once prohibited — indeed, unthinkable — the euthanasia of people with mental illnesses or cognitive disorders, including dementia, is now a common occurrence in Belgium and the Netherlands.
This profoundly troubling fact of modern European life is confirmed by the latest biennial report from Belgium’s Federal Commission on the Control and Evaluation of Euthanasia, presented to Parliament on Oct. 7.
Belgium legalized euthanasia in 2002 for patients suffering “unbearably” from any “untreatable” medical condition, terminal or non-terminal, including psychiatric ones.
In the 2014-2015 period, the report says, 124 of the 3,950 euthanasia cases in Belgium involved persons diagnosed with a “mental and behavioral disorder,” four more than in the previous two years. Tiny Belgium’s population is 11.4 million; 124 euthanasias over two years there is the equivalent of about 3,500 in the United States. Recent newspaper articles and documentaries focused on cases in which psychiatrists euthanized or offered to euthanize people with mental illnesses, some still in their 20s or 30s, under dubious circumstances.
In December, 65 Belgian mental-health professionals, ethicists and physicians published a call to ban euthanasia of the mentally ill.
Seemingly stung by these criticisms, the commission spends two of its report’s pages defending the system, explaining that all is well and that no one is being euthanized except in strict accordance with the law.

In particular, the regulatory panel — chaired by Wim Distelmans, a leading proponent of euthanasia who conducts the procedure himself — defends the one-month waiting period required between the time a mentally ill or otherwise cognitively impaired person puts his or her signature on a written request for death, and the time it may be carried out.
Objections that this is too little time are “unfounded,” the report asserts, because “the formation of the true will of the patient is a long process that takes several months, sometimes years,” then culminates in the written request. In any case, the waiting time is often longer in practice.
Of course, this ignores the essential objection, which is that, by definition, the mentally ill may be less capable of forming a “true will,” or, at least, that their intentions are intrinsically more difficult for a doctor — or anyone — to establish with the necessary certainty upon which to base a life-or-death decision.

As the Belgian opponents of the practice put it in their open letter: “We see that some who were first declared incurable, eventually abandon euthanasia because new prospects showed up. In a paradoxical way, this proves that the disease can not be called incurable.”
Obviously. But the commission report breezily responds, “illness, especially if it is psychic, should not be an obstacle to making a decision on the basis of rational reasoning,” subject to a careful physician’s approval.

This, regarding a Belgian medical system that over the past two years administered lethal injections upon the request of five non-terminally ill people with schizophrenia, five with autism, eight with bipolar disorder and 29 with dementia — an increasingly common condition in the aging Western world — as well as 39 with depression, according to the report.
Increasingly questioned at home, Belgian psychiatrists’ participation in the euthanasia of the mentally ill has also caught the attention of their international colleagues, many of whom remain committed to the physician’s primary role as a healer — and fear the corrupting potential of any deviation from that, even in the name of “patient autonomy.”

One can easily see how a depressed person can make a request not on the basis of many years of will formation, but in a purely suicidal gesture which is a manifestation of the disease.

My opinions on this subject are not popular. I believe a person suffering mental health issues should be allowed the dignity of choice, just as a person in constant unbearable physical pain or deterioration should. I don't think a single depressive episode should qualify, nor do I feel the person should be allowed to make the decision while clinically depressed....but people should have rights.

It is sad to think people might be dying against their will or during a depressive and likely treatable ailment. It's sad to think of all the people suffering horribly also. It's all very sad.

That mandatory one-month waiting period between request for euthanasia and termination must be a blast.

Lol.....you make me laugh a lot !

I find this fascinating as a social scientist, and am neutral in how I feel about it mostly.

However, if I was getting dementia, I think I would choose euthanasia for myself if it were an option. For such deterioration of the mind is pure horror and suffering, from what I've been told by those who've taken care of such people. I know when I thought I was becoming schizophrenic, I decided I didn't want to live anymore at the time. Thank God, however, my boyfriend intervened and got me help before I carried through. I think choosing death is such a final decision, I'm not sure one month is really adequate. Nonetheless, is it really moral to deny someone death if they are suffering, knowing prolonged life for them will be utter hell? That's an age old moral debate that I don't have an answer for. And there may never be a final decision on it.

Over all, I feel saddened that people lose hope and come to this final conclusion. Most people are a light in the world, regardless of disorders and medical predicaments. We're all valuable by default.

Wow. I live in Europe and I wasn't aware of this. I can understand how people might choose euthanasia if their disease had gotten to a point where they couldn't cope. I've attempted suicide twice because of that reason. This most recent time was a huge wake up call and led to getting my illnesses diagnosed. I do think the one month waiting period is too short a time. I'm not sure that's really enough time for people to weigh the gravity of this type of decision. But much like abortion I don't think I'm at liberty to decide what is right for other people. Everyone should have the right to decide what's best for them.

Yes the one month is another big debate....is it too long or too short

This is in Canada too.

NOTE: This is about people who intiate the process THEMSELVES. This is NOT euthanasia but rather state sponsored SUICIDE. There is such a difficult process to go through - even harder when the individual's suffering is not physical in nature - that it rarely happens. I think the number is 2 in Canada who successfuly got approval.

I doubt this happens much in other jurisdictions either.

Oh wow approved to do so....so do they get to decide how or they have choices to select?

I support euthanasia for medical reasons, but I'm really in-between about it for psychiatric reasons.

I do understand how there are cases where mental illness might as well be a terminal, physical illness, due to severeity and untreatability. What disturbs me though, is the possibility for anyone in the midst of an episode to make a request when recovery is completely possible.

I agree with that if the person is in the middle of an episode and can make a recovery to be stable....