Few nations have embraced euthanasia as enthusiastically and as broadly as Belgium. Not only have they legalized it for those suffering from terminal illness, but also for children and those who suffer depression and other mental illnesses. Now, however, Belgian prosecutors have charged three doctors with poisoning a 38-year-old woman who wanted to be euthanized for having Asperger’s syndrome — a mild form of autism.

It has taken eight years for these charges to be filed after a tenacious campaign by the victim’s family for justice:

Three doctors from East Flanders are being investigated on suspicion of having “poisoned” Tine Nys in 2010. The 38-year-old had been diagnosed with Asperger’s syndrome, a mild form of autism, two months before she was euthanized by a doctor in an apparently legal killing that she had asked for. … Belgium’s Chamber of Indictment “presumes that there are sufficient indications in this particular case” and the doctors involved have been referred to the Court of Assize in Ghent. Belgium’s euthanasia commission had previously approved the case after Nys’ death and did not publicly cite any problems with it. The doctors who granted Nys’ euthanasia will now face trial “due to poisoning,” said Francis Clarysse, a Ghent prosecutor. It is unclear when a trial might begin and the doctors could still appeal the decision. The charge of poisoning carries a maximum penalty of a lifetime sentence.

The AP reported on this case last year, which is now raising all sorts of questions about the doctor that both diagnosed and euthanized Nys. Her sister told prosecutors that the psychiatrist who had long treated Nys had rejected the idea that euthanasia was appropriate — but then came Dr. Lieve Thienpont:

Sophie Nys says that Thienpont diagnosed Tine with Asperger’s and approved her euthanasia request after two or three sessions with Thienpont. Because Asperger’s is “incurable and chronic,” it meets one of the legal requirements for euthanasia. Sophie said her sister was so intent on being euthanized she might have manipulated the test. “She knew that if she wasn’t diagnosed with autism or Asperger’s that she would not have a chance (of being euthanized),” she said. Two months after her diagnosis with Asperger’s, Nys was killed, at age 38. After Nys’ death, her sister Sophie filed a criminal complaint, alleging irregularities in her sister’s euthanasia procedure, including fumbling efforts to administer drugs and asking her family to confirm that Tine’s heart had stopped.

That wasn’t all Sophie found. Correspondence between Thienpont and Nys’ other doctors show evidence of a conspiracy to block an investigation into the circumstances of her euthanasia:

“We must try to stop these people,” Thienpont wrote in one email to her colleagues that was provided to the AP. “It is a seriously dysfunctional, wounded, traumatized family with very little empathy and respect for others,” the message read. “I am starting to better understand Tine’s suffering.”

That’s a very odd comment to commit to writing (as well as being a profound example of projection) after Nys’ death. Thienpont was supposedly sufficiently aware of Nys’ suffering to claim it was so profound as to qualify for euthanasia. Did Thienpont not bother to ask about family-of-origin issues before approving euthanasia, a basic subject for any psychological assistance? Did she not investigate whether the family might have resources to help Nys live a better life? Also, why block an investigation into their actions if euthanasia was fully supportable in Nys’ case?

Today’s report from the AP provides a hint of an answer. Thienpont accounts for a third of all mental-health-related euthanasia in Belgium, an industry unto herself:

Concerns have previously been raised in other cases about whether Thienpont, Nys’ psychiatrist, too easily approved euthanasia requests from patients with mental illnesses. Some experts estimated that Thienpont has been involved in about a third of all euthanasia cases for psychiatric reasons in Belgium. The AP previously published documents revealing a rift between Thienpont and Dr. Wim Distelmans, who heads Belgium’s euthanasia review commission. Distelmans voiced fears that Thienpont and his colleagues may have failed to meet certain legal requirements in some euthanasia cases — and wrote that he would no longer accept referred patients from Thienpont.

The prosecution of the Nys case, assuming it stays on track, might prompt investigations into other deaths Thienpont has produced. So far, the Belgian government has remained tight-lipped about marginal euthanasia cases, so it’s nearly impossible to judge whether doctors like Thienpont cross the line. A trial might force Belgium to disclose that information, especially on Thienpont, who might end up qualifying as a serial murderer before it’s all over. If it’s bad enough for Distelmans to distance the commission from Thienpont, it’s probably very bad.

If Thienpont and the other two doctors do get prosecuted for Nys’ death, it will be the first such trial since Belgium embraced euthanasia. One key question will be why Thienpont thought Asperger’s syndrome deserved a death sentence, and that question won’t be limited to just this trial. Despite the fact that millions of people around the world live and function with this mild form of autism, both Belgium and the Netherlands allow for euthanasia for those with the treatable condition. It’s yet another reminder that euthanasia has a deadly and steep slippery slope — and that some people will exploit it for their own purposes.