Lifting the veil: what really happens in Belgium's healthcare system with euthanasia

As a nurse in Brussels, I first worked in a cancer ward and in a care unit support. So I was very quickly confronted with the demands and the practice of euthanasia. For six years, I have seen how this law significantly undermines the links of solidarity we have for the sick. More than just highlighting dubious procedures, today we are now helping along a radical change in attitudes towards death and care of the dying.

Euthanasia legal, ethically precarious

From my arrival in Belgium in 2008, I witnessed first-hand many euthanasia deaths. All were accountably legal and registered officially in the medical records of patients. From the moment I took on the role, and despite my limited knowledge at the start, I found serious failures of ethics and moral obligations. Through my personal experience in care services practising euthanasia in Belgium, I wish to show that it is possible in a hospital room, just like in a television programme, to manipulate opinions and consciences, to transform euthanasia into an ideology of dying with dignity'.

• Monsieur R. never asked for euthanasia: he was released out of 'compassion'

This was the view of an oncologist just after the euthanasia of Mr R. Some days before, the doctor informed his wife that her husband was in the terminal phase of lung cancer. The doctor added that the patient 'will suffer enormously, even though he was showing no signs of pain or distress at the moment'.

The wife asked the specialist not to say a word to her husband 'so he doesn't suffer further' and at the same moment seeks euthanasia to spare him the 'horror of the end of life'. Mr R died by euthanasia without ever knowing of his illness and without deciding or even once expressing the wish to have recourse to euthanasia.

Following this euthanasia death, I asked for explanations from my superiors in the multi-disciplinary team meeting. In a chorus, the psychologist, the head of service, the nurse director and the cancer specialists explained to me how this death was 'gentle, peaceful and painless' 'a dignified end of life' ('a fitting end') in summary. In a patronising tone, they reminded me that 'in respect of caring, we must be compassionate' that 'the prognosis of Mr R was imminent death' and that 'he would certainly have suffered terribly'. The aplomb of their speeches, the logic, appearing implacable and reasonable, reduced the care team to silence.

• Monsieur L. 'benefited' from emergency euthanasia for the relief of terrible suffering not sufficiently relieved

Monsieur L. suffered from an osteosarcoma of the right femur. Hospitalised, he asked for euthanasia should his health deteriorate. One day, in a crisis of overwhelming pain, his wife, desperate, calls for help from the medical staff: she believes it is imperative to respond to her husband's request for euthanasia. The nurses, panicked, call the emergency oncologist. They propose to increase the dose of morphine and set up a provisional protocol for sedation to relieve his symptoms and distress. But the oncologist refused. Amid all the anguish and agitation, the physician directs the care team to prepare a lethal injection which he immediately administered to Mr. L. A year later, his wife returned to the service accusing the care team of having 'murdered her husband'.

Oncologists are reluctant to use morphine treatments. Even today, despite frequent and well-controlled use of morphine, some doctors are still afraid. Many patients in terrible suffering are not getting adequate pain-relief. In this context, we can see imagine how despair can be the source of a request for euthanasia. On the other hand, the undue haste with which this euthanasia was carried out resulted in a deeply shocking and inhumane brutal death, for the wife as well as for the care team. However, the patient is deemed to have met the criteria of law, repeated request, unbearable suffering, incurable disease, etc.

• Madame G 'released' from prolonged agony

Palliative sedation was administered to Mrs. G. She was in a coma for five days. Her family, deeply upset, were watching for the slightest sign of end of life. The healthcare team, continually pressurised, was tested by the incessant agitation. It was then that the doctor clearly weary of the prolonged dying, decided to 'shorten days to save her from the long decline'. Nobody condemned this act which, in the minds of the family and care team, demonstrated the altruism and humanity of the doctor. A brutal act however that drastically solved the 'problem of dying '.

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