In 2007, at a bioethics forum at the University of Tasmania, I made what I thought was a fairly common sense statement: if the Port Arthur mass murderer, Martin Bryant, wants euthanasia, the state should not stand in his way.

For both political and justice reasons, Bryant is unlikely to ever be released from Risdon prison. His punishment for killing 35 people that awful day at Port Arthur is 35 life sentences.

As Chief Justice William Cox told Bryant in true penal colony style, “you are sentenced to imprisonment for the term of your natural life … let him stand down”. It was not long after the verdict that the media began reporting Bryant’s all too regular attempts to kill himself.

Earlier this month Belgium approved a high-profile prisoner, 55-year old Frank Van Den Bleeken, for voluntary euthanasia. In the 1980s, he was found guilty of rape and murder and was imprisoned for life.

Van Den Bleeken’s case first came before Belgian’s federal euthanasia commission three years ago, when his request for voluntary euthanasia was rejected. Since that time his legal team has been pursuing this goal, and have now succeeded. Van Den Bleeken is due to be admitted to a Brussels’ hospital, where doctors will likely administer a legal, voluntary lethal injection.

Under the Belgian model, physical or psychological suffering that is incurable or constant can be the grounds for voluntary euthanasia. What is there not to agree with? The Belgians’ progressive approach shifts the debate from the semantics of “terminal illness”, a definition that is notorious within medicine, to a focus upon a person’s quality of life, as experienced by them.

Martin Bryant began attempting suicide not long after he was sentenced. This is perhaps not surprising given his first eight months of incarceration were spent in solitary with no natural light. His attempts were increasingly desperate acts by a suffering man.

Imprisonment for life, with no hope of parole, is torture. I thought then and now that a modern civilised Australia should not be involved in torture, no matter the crimes of the prisoner. This is why Bryant, and others like him, should be allowed help to die. Human rights lawyer and prison reform advocate Greg Barns agreed with me back in then. Few others do even now.

A long time visitor to Belgium, I am well aware that the Belgians see things differently to the rest of us. Normally, when holding my workshops, I have a standard spiel about who should and should not attend: are you old enough, do you have a history of psychiatric illness and so on. The Brussels’ audience’s attitude is different from Australians; they wonder about the fuss.

They almost seem to suggest that it is their right to hear what I have to say. They are intolerant of any attempt to monitor their attendance. This is perhaps why the Belgian outlook should be welcomed. The Belgian state has a history of making hard decisions and their pragmatic approach is refreshing.

This brings me to Nigel Brayley. In February this year, the 45-year old Perth man was among a 250 strong audience at my annual West Australian workshop. Like the vast majority who came along, he was not terminally ill. And like so many before him, Nigel told me that it “made sense to prepare for the future. ‘You never know what’s round the corner”.

The problem was that Nigel knew exactly what was around the corner. He knew that he was being investigated for the mysterious disappearance of not one but two wives/partners. He knew, too, that the major crime squad of the WA Police was closing in. Why else did he blame them for his death in his lengthy suicide note?

Nigel’s subsequent suicide in May led the medical board to suspend my medical registration. With the content of the allegations which will form the basis of my appeal to the NT medical tribunal in Darwin in November yet to be defined, it is difficult to know the exact nature of my crime(s).

What I do know is that Nigel Brayley was an eloquent and lucid determined man in his mid-life years. He expressed a surety about how he saw the world and his place in it. When he intimated to me at later political meeting that he was planning on ending his life sooner than expected, and I retaliated by suggesting that he seek further medical advice, he told me ever so politely to mind my own business. When he emailed me the same a few months later I knew better than to interfere.

To the reader of Nigel’s many written missives, it was not hard to tell that this was a man who left little to chance. His suicide and his instructions pertaining to its aftermath, were detailed to the nth degree. When one considers Nigel’s express concern that his new wife’s finances not be decimated, presumably realising that defending multiple murder charges costs a lot of dosh, Nigel’s early suicide makes more sense; pre-emptive action against a possible life sentence.

Here I would suggest that the main difference between Nigel Brayley and lifers around the world is that Nigel’s suffering began long before his looming possible incarceration. A life imprisoned is a life wasted.

John Stuart Mill knew this when he argued in favour of capital punishment. Life imprisonment, he said, was like living in a tomb. While I fervently disagree with Mill in regard to state-sanctioned killing, if that killing is self-determined then I support it – with legislated safeguards, of course.

The rational suicide of current and potential life prisoners deserves serious consideration by the state. Australia should have the courage to follow Belgium’s lead and legislate, not just for the terminally ill, but for suffering inmates also.

• In Australia, the crisis support service Lifeline is on 13 11 14. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In the UK, the Samaritans can be contacted on 08457 90 90 90. Hotlines in other countries can be found here.

• This article was amended on September 30 to remove references to the manner of Martin Bryant’s suicide attempts, the link to Nigel Brayley’s suicide note and his method of suicide. Contact details for crisis support services were added.