Euthanasia in Belgium: trends in reported cases between 2003 and 2013

Area of Science:

• Medical Ethics
• Public Health Policy
• End-of-Life Care Research

Background:

• The Belgian Act on Euthanasia, enacted in 2002, legalized physician-assisted termination of life upon explicit patient request.
• This legislation established a framework for the practice and reporting of euthanasia in Belgium.

Purpose of the Study:

• To analyze trends in officially reported euthanasia cases in Belgium.
• To describe sociodemographic and clinical profiles of patients undergoing euthanasia.
• To examine decision-making and performance characteristics associated with euthanasia cases.

Main Methods:

• Analysis of a database of 8752 reported euthanasia cases from January 1, 2003, to December 31, 2013.
• Utilized data collected by the Federal Control and Evaluation Committee on Euthanasia.
• Employed chi-squared (χ2) technique to analyze trends in patient, decision-making, and performance characteristics, comparing Dutch and French reporting trends.

Main Results:

• A significant year-over-year increase in reported euthanasia cases, from 0.2% of all deaths in 2003 to 1.7% in 2013.
• Notable increases in euthanasia rates among patients aged 80+, those in nursing homes, with non-cancer diseases, and those not expected to die soon.
• Palliative care team consultations for euthanasia requests rose significantly, particularly in Dutch-reported cases.

Conclusions:

• The number of reported euthanasia cases in Belgium has consistently increased since legalization.
• While cancer patients and those under 80 remain the majority, observed increases in non-terminally ill and older patients underscore the importance of detailed monitoring.
• Continued surveillance is crucial for understanding evolving euthanasia practices in Belgium.