Belgian lawmakers are considering a bill to expand the current law on euthanasia to terminally ill children. Although a controversial issue, most Belgians support the measure.

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Death is not a taboo for Christine Serneels, a pensioner in the Belgian capital of Brussels, and it’s an issue she’s about to discuss with her doctor.

Eight years ago, Serneels’ mother opted for euthanasia after she was diagnosed with an incurable disease making her blind.

Today, Serneels has decided to sign a consent form stating that in the case of an incurable illness, she would like to be euthanised.

At the office of Dr. Yves De Locht, Serneels signs a series of consent forms stating, among other things, that should she fall unconscious, doctors have the right to end her life.

"I think it is very important to fill out this form,” explains Serneels. “For me, it’s a kind of insurance, just like a fire insurance – and I want to take it before the fire, not after.”

For his part, Dr. De Locht explains that he is “committed to accompanying the patient to the very end”. As he explains the paperwork to Serneels, the doctor notes that, “it will happen how she wants, when she wants and where she wants."

"Thank you,” replies Serneels, looking visibly reassured by her decision.

In 2002, Belgium passed a law allowing voluntary euthanasia for adults suffering from an incurable disease that causes unbearable suffering. Now, a number of Belgian lawmakers want to go a step further and legalise euthanasia for minors – but only for exceptional cases.

"The first safeguard is to check the child's ability to judge – we have not introduced an age limit,” explains Senator Philippe Mahoux of Belgium’s Socialist Party. “The second is that euthanasia should only be carried out when the patient is expected to die within a short time frame. The third is that there must be parental consent from the parents or guardians.”

On November 27, a Belgian Senate committee voted 13-4 to allow minors to seek euthanasia under exceptional circumstances. On Thursday, a full Senate session is expected to vote on the bill before it moves to the House of Representatives. Lawmakers are keen to get it through before parliamentary elections in May 2014. Adoption of the law would make Belgium the second country in the world – after the Netherlands - to legalise euthanasia for minors.

Although it is a controversial topic, there has not been much of a debate in Belgium. Opponents of the bill voiced their views on blogs and televised debates, but not on the streets of Belgium.

Among Belgium’s political parties, only the Christian Democrats (both French and Flemish), and the Flemish extreme right voted against the law - meaning the bill will likely pass and come into law next Spring - just before the elections.

“Is it worth passing a law that only legislates for a very small number of exceptional situations? Do we really need to burden the child, a few hours or a few days before their death, with a psychological burden of this magnitude? I don't think so,” says Christian Democrat Senator Francis Delpérée.

A debate within the medical profession

Within the medical profession, many oppose the law. Some call it unnecessary, even dangerous.

“Even when a child is going through a great deal of physical suffering at a terminal stage, we can often relieve this suffering with means that already exist. What concerns me the most is that in the current proposed legislation, there is not even an age limit,” says Timothy Devos, a haematologist and medical professor.

Since the bill does not have any age limits, cases must be examined individually.

According to Dr. Dominique Biarent, head of paediatrics at the Queen Fabiola Hospital in Brussels, children with terminal illnesses mature faster. Along with some colleagues, Dr. Biarent has publicly expressed her support for the new measure.

“Any doctor working with sick children – seriously ill children – is obliged to answer questions and you cannot just say, ‘oh yes, your child will suffer, what a shame that they will be like this until the end,’” she explains.

A majority of Belgians – including medical professionals – appear to back the new measure. A recent poll found 75% of Belgians favour the move while 13% have no opinion. Only 12% were against the issue.

‘He knew what was happening’

Marijke Bachely is among the majority of Belgians who support the bill. In 2004, her son, Benjamin, died of liver cancer at the age of seven.

Bachely believes euthanasia must also be an option for children.

"For me, that would be the last proof of love that I could show to my child, preventing him from suffering, helping to take away the pain, so that they don't have to suffer, so that it stops," she explains.

Bachely firmly endorses Dr. Biaret’s view that children suffering from terminal illnesses mature quickly.

After his long battle with cancer, Benjamin had a heightened sense of awareness, she explains. In his final days, as Benjamin realised the end was near, her seven-year-old boy opted for a cremation rather than a burial.

"The doctors said he would lose his ability to breathe, and that if we wanted, we could go down to the ICU for intubation,” she recounts. “Benjamin said no, he did not want to. He was only seven-and-a-half years old when he died, but believe me, he knew what was happening," says Bachely, sorting through photographs of her little boy.



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