Six things about the right to die

Demands for laws to allow euthanasia are growing. -- ST ILLUSTRATION
Demands for laws to allow euthanasia are growing. -- ST ILLUSTRATION

Belgium's decision to grant a serial rapist's request to be allowed to die has reignited a debate on euthanasia.

The 50-year-old prisoner Frank Van Der Bleeken was convicted in the 1980s for rape and murder. And his lawyer told Belgian television that his client had not been able to get over his sexual urges and had for years requested that the state help him end his life.

Belgium's Federal Euthanasia Commission declined his request in 2011 but granted it this time. Van Der Bleeken will be transferred from his prison to a hospital over the next few days where he will be euthanised.

Belgium was the second country in the world to legalise euthanasia, after the Netherlands. But the debate on the controversial issue is taking place elsewhere as well.

Here's a closer look at right-to-die laws in Belgium, the Netherlands and elsewhere.

Euthanasia laws in Belgium & the Netherlands

Belgium legalised euthanasia in May 2002, becoming the second country in the world to do so after the Netherlands. Strict conditions were imposed for mercy killing which, among others, require that patients must be capable, conscious and have presented a "voluntary, considered and repeated" request to die.

In April 2002, the Netherlands became the first country to legalise euthanasia and assisted suicide. Among the conditions it imposed: The patient must be suffering unbearable pain, their illness must be incurable, and the demand must be made in "full consciousness" by the patient.

Impact of the laws

The number of euthanasia cases in Belgium has gradually risen each year since the law was first introduced. A record number of 1,807 cases were logged in 2013.

There were 1,432 cases in 2012, 708 in 2008 and 235 in 2003. Just over half of the cases last year were aged 70 or over, and 80 per cent of the applications were made by Dutch speakers. In February, Belgium became the first country to allow euthanasia for terminally ill children at any age, a move which drew criticism from religious groups both at home and abroad.

The number of Dutch people killed by medical euthanasia has more than doubled in the 10 years since legislation was changed to permit it, rising 13 per cent in 2012 to 4,188.

Not without controversy

Most of the cases are uncontroversial, concerning older, terminally ill people. But there have been some controversial ones as well in Belgium.

In January 2013, Belgian media reported the deaths of Marc and Eddy Verbessem - 45-year-old identical twins who were deaf and asked to die after finding out that they would go blind as a result of a genetic disorder. Another high-profile case involved a 44-year-old transsexual woman whose botched sex-change operation left her with physical deformities that she felt made her look like a "monster".

One reason why there has been a steep rise in the number of Dutch cases is the introduction of mobile euthanasia units which consist of teams of specially trained doctors and nurses visiting the homes of people whose own doctors have refused to carry out patients' requests to end their lives.

Data shows that around 80 per cent of people who request euthanasia die at home and are killed by doctors on the grounds that they are suffering unbearable pain and are making an informed choice. The opinion of a second doctor is also required. Most patients opting for euthanasia suffer from cancer, nervous system disorders or cardiovascular disease.

Laws on euthanasia elsewhere

In Europe, there are four countries at the moment which have legalised either euthanasia or assisted suicide or both. The Netherlands and Luxembourg allow euthanasia and assisted suicide; Belgium allows euthanasia only and Switzerland only assisted suicide.

Euthanasia is the act of deliberately ending a person's life to relieve suffering, while assisted suicide is the act of deliberately assisting or encouraging another person to kill himself or herself.

There is pressure to change the law in other countries. There is a Bill in England, one in Scotland, one in France and one in Germany. In the US, doctors are allowed to prescribe lethal doses of medicine to terminally ill patients in five US states. Euthanasia, however, is illegal.

Haven for assisted suicide

Switzerland has long had a permissive law on assisted suicide, and a study has found an increase in the number of people from other countries travelling to Switzerland to end their lives under the auspices of right-to-die organisations.

The study, published in The Journal of Medical Ethics, looked at assisted suicides in Zurich, where Dignitas, the most prominent right-to-die organisation, is based.

The researchers found that 611 people from 31 countries had committed assisted suicide from 2008 to 2012. Since 2009, the number of those arriving from other countries for help with suicide has increased steadily, to 172 in 2012. Nearly half of all cases involved people with neurological disorders, like Parkinson's disease and multiple sclerosis, diagnoses that are generally not terminal. Nearly 60 per cent of the 611 were women. People committing assisted suicide came largely from Germany, Britain and France.

The situation in Singapore

In Singapore, euthanasia in all forms is illegal, no matter the ethical or pragmatic arguments for it.

But more Singaporeans are taking active steps to get their end-of-life papers in order.

More than 2,500 people applied for the Lasting Power of Attorney (LPA) from April last year to March this year against 655 in the same timeframe three years ago.

An LPA is a legal document that allows one's next of kin to make key decisions on their behalf should they lose the mental ability to do so.

Source: AFP, BBC, Reuters, Guardian, Telegraph, New York Times, The Straits Times

Helplines in Singapore

Samaritans of Singapore: 1800-221-4444
Singapore Association for Mental Health: 1800-283-7019
Institute of Mental Health's Mobile Crisis Service: 6389-2222
Care Corner Counselling Centre (Mandarin): 1800-353-5800


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